reglab/statecodes huggingface dataset:
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15400 - Claim File

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Every
					 self-insurer or its administrative agency shall keep a claim file of each
					 indemnity and medical-only work-injury occurring on or after January 1, 1990,
					 in accordance with Title 8, Section
					 10101 and Section
					 10101.1.
(b) For work injuries occurring prior to
					 January 1, 1990, every self insurer shall keep a claim file including those
					 claims which were denied. Said claim file shall contain, but not be limited to,
					 a copy of:
(1) Employers Report of
					 Occupational Injury or Illness, Form No. 5020;
(2) Every report made to the Administrative
					 Director of the Division of Industrial Accidents; including but not limited to
					 the letter of denial to the employee;
(3) Doctor's First Report of Occupational
					 Injury or Illness, Form No. 5021;
(4) Every subsequent relevant medical
					 report;
(5) All applicable orders
					 of the Workers' Compensation Appeals Board and reports relating
					 thereto;
(6) A record of payment of
					 compensation benefits as compensation is defined in Section
					 3207 of the
					 Labor Code, together with a record of the periods covered by disability
					 payments, including a copy of DIA Form 500, Notice of Termination of
					 Benefits;
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15400.1 - Claim Log

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) After
					 January 1, 1993, every self-insurer or its administrative agency shall
					 maintain:
(1) a manually prepared log of all
					 work injury claims for each self-insurer at each adjusting location in
					 accordance with Title 8, Section
					 10103 and
					 10103.1; or
(2) a computerized log of claims for each
					 self-insurer at each adjusting location in accordance with Title 8, Section
					 10103 and
					 10103.1.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15400.2 - Maintenance of Records

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 All claim files shall be kept and maintained for a period of five years from
					 the date of injury or from the date on which the last provision of compensation
					 benefits occurred as defined in Labor Code Section
					 3207, whichever
					 is later. Claim files with awards for future benefits shall not be destroyed,
					 but two years after the date of the last provision of workers' compensation
					 benefits as defined in Labor Code Section
					 3207, they may
					 be converted to an inactive or closed status by the administrator, but only if
					 there is no reasonable expectation that future benefits will be claimed or
					 provided.
(b) Inactive and closed
					 claim files may be microfilmed or electronically stored for storage. However,
					 if the file is not microfilmed or electronically stored the original paper
					 files shall be maintained for at least two years after the claim has been
					 closed or become inactive. Such microfilmed or electronically stored files must
					 be readily reproducible into legible paper form if requested by the Manager for
					 an audit.
(c) All claim files and
					 the claim logs shall be kept and maintained in California unless the Manager
					 has given written approval to a self insurer or former self insurer to
					 administer its workers' compensation self-insurance plan from a location
					 outside of California.
(d) All
					 claim files and claim logs, together with records of all compensation benefit
					 payments, shall be readily available for inspection by the Manager or his
					 representative.
1.
						Amendment filed 2-19-92; operative 3-20-92 (Register 92, No. 13).
2.
						Amendment of subsection (a) filed 2-9-2006; operative 3-11-2006 (Register 2006,
						No. 6).
3. Amendment of subsection (b) filed 9-19-2011; operative
						10-19-2011 (Register 2011, No. 38).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  59,
						  129,
						  3700,
						  3702.1 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15400.3 - Maintenance of Records. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Repealer filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  55 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15401 - Self-Insurance Plan Administration. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Repealer filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  55 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15401.1 - Competence. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New
						section filed 6-1-72; effective thirtieth day thereafter (Register 72, No.
						23).
2. Amendment filed 11-19-75; effective thirtieth day thereafter
						(Register 75, No. 47).
3. Repealer filed 2-19-92; operative 3-20-92
						(Register 92, No. 13).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  55 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15401.2 - Competency at Adjusting Location. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New
						section filed 11-19-75; effective thirtieth day thereafter (Register 75, No.
						47).
2. Repealer filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  59 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15402 - Notice of Change of Administrator and Location of Records

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Each self-insurer or administrative
					 agency shall annually report on the Self Insurer's Annual Report form to the
					 Manager the name, title, and office address of the person or persons appointed
					 to administer the employer's self-insurance plan and of the location or
					 locations of records required to be kept and maintained pursuant to Section
					 15400 of these
					 regulations.
(b) The new
					 administrator shall report any changes of the administrative agency
					 administering the employer's self-insurance plan or any change of location or
					 locations of records in writing to the Manager no later than the date of such
					 change.
NOTE: Reporting required by subsection (b) may be done by
						submitting a "Report of Changes" on the appropriate Division of Workers'
						Compensation AE Form 101 or AE Form 102 (see Plate L-1 and L-2 of the
						Appendix.)
1.
						Amendment filed 6-1-72; effective thirtieth day thereafter (Register 72, No.
						23).
2. Amendment filed 11-19-75; effective thirtieth day thereafter
						(Register 75, No. 47).
3. Amendment filed 2-19-92; operative 3-20-92
						(Register 92, No. 13).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  59,
						  129,
						  3700,
						  3702.1 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15402.1 - Self Insurer's Interim Report

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A self-insurer and its administrative
					 agency shall jointly submit to the Manager a self-insurer's annual report,
					 covering any interim period between regularly scheduled reporting periods
					 whenever any of the following changes occur in the administration of the
					 employer's self insurance plan:
(1) A change
					 from an agency-administered plan to another agency-administered plan, (i.e.
					 from one third party administrator to another third party
					 administrator);
(2) A change from
					 an agency-administered plan to a self-administered plan;
(3) A change from a self-administered plan to
					 an agency-administered plan; or
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15402.2 - Report of Transfer of Records

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) After July 1, 1992, at the time of a
					 change of administration of a self insurance plan, as set forth in Section
					 15402.1(a) of
					 these regulations, the former administrative agency or previously self
					 administering self insurer shall submit to the Manager and to the new
					 administrative agency a written report containing the following:
(1) A list of all open and closed claims for
					 the self insurer in the possession of the former administrative agency as of
					 the date of the transfer; and
(2) A
					 written description of the physical location of all claim files, the required
					 claim logs, and any computer data files of the self insurer's plan. Physical
					 location shall include claim files sent to storage and where stored; files sent
					 to the self insurer; and files sent to the new
					 administrator.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15402.3 - Notice of Change of Membership in a Joint Powers Authority or in a Private Group Self Insurer

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 The joint powers authority shall notify the Manager when a Public entity with
					 an affiliate certificate to self insure changes its membership from the
					 existing joint powers authority to
(1) another
					 joint powers authority;
(2) a
					 carrier insured plan or;
(3) an
					 independent self insured plan.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15402.4 - Transfer of Claim Files and Computerized Claim File Data Information

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Upon change of
					 an administrative agency, all open claims shall be transferred immediately to
					 the new administrative agency, unless otherwise provided by agreement between
					 the self insurer, former administrator and new administrator.
(b) All closed claim files in the possession
					 of the former administrator shall be transferred to the new administrator
					 within 30 days, unless otherwise provided by agreement between the self
					 insurer, former administrator and new administrator.
(c) All computerized claim file data showing
					 all historical claim information, including payments and reserve data as of the
					 date of the transfer of the open claim files shall be provided by the former
					 administrator on the date that all open claim files are transferred, unless
					 otherwise provided for by written agreement between the self insurer, former
					 administrator and the new administrator. In the event that an agreement
					 precludes the transfer of electronic claim contents of claims being transferred
					 to the new administrator, the former administrator will provide hard copies of
					 any required contents to the new administrator at its own expense. The closing
					 date of the transactions on the computerized data shall coincide with the date
					 of the physical transfer of the claim files to the new administrator. In the
					 event that computerized data pertaining to the specific administration is
					 changed by the former administrator after the physical claims have been
					 transferred and the data provided to the new administrator, the former
					 administrator shall provide reported computerized information to the new
					 administrator within 14 days of any such changes.
1. New
						section filed 2-19-92; operative 3-20-92 (Register 92, No. 13).
2.
						Amendment of subsection (c) filed 2-9-2006; operative 3-11-2006 (Register 2006,
						No. 6).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  59,
						  129,
						  3700,
						  3702.1 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15403 - Audits

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Pursuant to
					 Labor Code Sections
					 129 and
					 3702.6, the
					 Manager may order an audit of any self insurer or individual claim file at such
					 reasonable times as is deemed necessary. Such audits shall include, but not be
					 limited to, an audit of the files and records required by Section
					 15400 of these regulations. Such
					 files and records shall be made readily available by the self insured employer
					 or its administrative agency.
(b)
					 In the event of an audit, the Manager may require that claims administered at
					 the home of a telecommuting adjuster be presented for audit at a California
					 office location of the administrator, or at a California location of the self
					 insured employer.
1.
						Amendment filed 6-1-72; effective thirtieth day thereafter (Register 72, No.
						23).
2. Amendment filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
3. Amendment designating first paragraph as subsection (a) and
						new subsection (b) filed 2-9-2006; operative 3-11-2006 (Register 2006, No.
						6).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  59,
						  129,
						  3700,
						  3702 and
						  3702.6, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15403.1 - Notice of Special Audit

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
When in the discretion of the Manager, a special audit as
						defined in Section
						15201 of these regulations is
						necessary, the Manager shall notify the self-insurer of the requirement in
						writing fourteen (14) calendar days prior to the special audit and give the
						reasons therefor.
1. New
						section filed 6-1-72; effective thirtieth day thereafter (Register 72, No.
						23).
2. Repealer and new section filed 11-19-75; effective thirtieth
						day thereafter (Register 75, No. 47).
3. Amendment filed 2-19-92;
						operative 3-20-92 (Register 92, No. 13).
Note: Authority cited: Sections
						  54,
						  55,
						  59 and
						  3702.10, Labor
						  Code. Reference: Sections
						  59,
						  129,
						  3700,
						  3700(b),
						  3701,
						  3702,
						  3702.5,
						  3702.6,
						  3702.10,
						  3703,
						  3704 and
						  3705, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15403.2 - Financial Information. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New
						section filed 11-19-75; effective thirtieth day thereafter (Register 75, No.
						47).
2. Amendment filed 11-21-78; effective thirtieth day thereafter
						(Register 78, No. 47).
3. Repealer filed 2-19-92; operative 3-20-92
						(Register 92, No. 13).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10 Labor Code. Reference:
						  Sections
						  59,
						  129,
						  3700,
						  3701 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15404 - Expense of Out-of-State Audit

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The audit of any self insurer, pursuant to Section
						15403 of these regulations, at
						locations outside of the State of California, shall be at the expense of the
						self-insurer. The Manager shall bill the self insurer for the expense incurred
						in making such out-of-state audit.
1.
						Amendment filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  59,
						  129,
						  3702.6 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15404.1 - Expense of Revoked Certificate Audit

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
A self-insurer whose certificate to self insure has been
						revoked shall pay expenses incurred by the Director or his representative in
						conducting an audit pursuant to Section
						15425 of these regulations. The
						Manager shall bill the self insurer for expenses incurred.
1. New
						section filed 6-1-72; effective thirtieth day thereafter (Register 72, No.
						23).
2. Amendment filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10 Labor Code. Reference:
						  Sections
						  59,
						  129,
						  3702.6 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15404.2 - Expense of Special Audit

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
A self-insurer shall pay the expenses incurred whenever a
						special audit as defined in Section
						15201, of these regulations, is
						ordered by the Manager pursuant to Sections
						15403,
						15404 and
						15404.1 of these
						regulations.
The Manager shall bill the self insurer for expenses
						incurred.
1. New
						section filed 11-19-75; effective thirtieth day thereafter (Register 75, No.
						47).
2. Amendment filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
3. Change without regulatory effect amending section filed
						10-18-95 pursuant to section
						100, title 1, California Code of
						Regulations (Register 95, No. 42).
Note: Authority cited: Sections
						  54,
						  55 and
						  59, Labor Code.
						  Reference: Sections
						  59,
						  129,
						  3700,
						  3700(b),
						  3701,
						  3702,
						  3702.5,
						  3702.6,
						  3703,
						  3704 and
						  3705,
						  3702.6 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15405 - Confidentiality

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Financial
					 information submitted to the Director or Chief to establish the solvency and
					 worth of any self-insurer, applicant to be self-insured, third party
					 administrator, or of a guarantor of a self-insurer or applicant to be
					 self-insured shall be considered confidential in accordance with California
					 Government Code Sections
					 6254 and
					 6255, and
					 California Labor Code Section
					 3701.8(b)(5).
					 Except as otherwise provided by law, such information shall not be disclosed to
					 any other entity or person without an order from an appropriate court or
					 administrative subpoena from an agency of the State, with the following
					 exceptions:
(1) The Chief shall disclose any
					 financial information to the Self-Insurers' Security Fund on any private
					 self-insurer whose liabilities have been turned over to the Fund pursuant to
					 Labor Code Section
					 3701.5, or that
					 has filed bankruptcy, failed to pay its liabilities, or failed to post an
					 increase in deposit due that would potentially put the Fund at risk for the
					 self-insurer's liabilities.
(2)
					 Pursuant to Labor Code Section
					 3701.8(b)(5)
					 and Section
					 15220.1(d) of
					 these regulations, the Chief may provide to the Self-Insurers' Security Fund
					 any financial information for any self-insurer needed to determine and set
					 deposit assessments for self-insured employers.
(3) Notwithstanding this section, the Board
					 of Trustees of any private group self-insurer currently or previously
					 self-insured pursuant to Labor Code Section
					 3700(b)
					 and sections
					 15470 through
					 15500 of these regulations shall
					 upon written request provide a copy of the group's most recent certified,
					 independently audited financial statement to any affiliate employer of the
					 group. The Chief also may provide to the Self-Insurers' Security Fund financial
					 information, including actuarial reports, of any group self-insurer, so that
					 the Security Fund may determine the financial risk and stability of the
					 group.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 9 - Recordkeeping and Audits › Section 15406 - Confidentiality. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New
						section filed 11-21-78; effective thirtieth day thereafter (Register 78, No.
						47).
2. Repealer filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
Note: Authority cited: Sections
						  54,
						  55, and
						  3702, Labor
						  Code. Reference: Sections
						  159,
						  3700,
						  3702.5 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 10 - Revocation of a Certificate to Self-Insure or Certificate to Administer and Continuing Jurisdiction › Section 15420 - Compliance with Statutes and Regulatory Requirements

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Self-insured employers and their administrative agencies
						shall comply with applicable regulations governing the administration of
						self-insurance pursuant to Labor Code Sections
						129, and
						3700-3709.5, which
						are adopted in accordance with the provisions of the California Administrative
						Procedure Act (Government Code, Title 2, Division 3, Part 1, Chapters 3.5
						[commencing with Section
						11340]). Failure to comply with
						these statutes governing administration of self insurance or with these
						regulations may be good cause for revocation of a Certificate to Self Insure or
						Certificate to Administer or other action by the Director.
1.
						Repealer of Article 10 (§§
												15420-15423) and new Article 10
						(§§
												15420-15427) filed 6-1-72;
						effective thirtieth day thereafter (Register 72, No. 23). For prior history,
						see Register 69, No. 49.
2. Amendment of article heading, section
						heading and section and new NOTE filed 11-24-93; operative 12-24-93 (Register
						93, No. 48).
3. Amendment of article heading filed 12-14-2016;
						operative 1-1-2017 pursuant to Government Code section
						11343.4(b)(3)
						(Register 2016, No. 51).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  54,
						  55,
						  59,
						  129,
						  3700,
						  3701,
						  3701.5,
						  3702,
						  3702.3,
						  3702.5,
						  3702.6,
						  3702.10,
						  3703,
						  3705,
						  3740-
						  3745, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 10 - Revocation of a Certificate to Self-Insure or Certificate to Administer and Continuing Jurisdiction › Section 15421 - Safety Violations. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Repealer filed 11-24-93; operative 12-24-93 (Register 93, No.
						48).
Note: Authority cited: Sections
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 10 - Revocation of a Certificate to Self-Insure or Certificate to Administer and Continuing Jurisdiction › Section 15422 - Voluntary Revocation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Any self-insurer or administrative agency may voluntarily
						request that its Certificate to Self-Insure or Certificate to Administer be
						revoked at any time by informing the Chief in writing. The Director shall
						revoke the Certificate to Self-Insure or Certificate to Administer after the
						self-insurer or administrative agency has shown to the satisfaction of the
						Director that the self-insurer or administrative agency has established a
						program to discharge all liabilities and all responsibilities incurred by the
						self-insurer or administrator during the period the Certificate to Self-Insure
						or Certificate to Administer was in force.
1.
						Amendment of section and new NOTE filed 11-24-93; operative 12-24-93 (Register
						93, No. 48).
2. Amendment filed 12-14-2016; operative 1-1-2017
						pursuant to Government Code section
						11343.4(b)(3)
						(Register 2016, No. 51).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  54,
						  55,
						  59,
						  129,
						  3700,
						  3701,
						  3701.5,
						  3702,
						  3702.3,
						  3702.5. 3702.6, 3703, 3705,
						  3740-3745, Labor Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 10 - Revocation of a Certificate to Self-Insure or Certificate to Administer and Continuing Jurisdiction › Section 15423 - Revocation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Revocation for Cause. Proceedings to revoke a Certificate
						to Self Insure or Certificate to Administer for good cause as defined in Labor
						Code Section
						3702 and in
						these regulations shall be after Notice of Intent and opportunity for a hearing
						in accordance with Article 11 of these regulations. The Notice of Intention to
						Revoke a Certificate to Self Insure or Certificate to Administer shall include
						a clear description of cause for revocation.
1.
						Repealer and new section filed 11-21-78; effective thirtieth day thereafter
						(Register 78, No. 47).
2. Amendment of section heading and section
						and NOTE filed 11-24-93; operative 12-24-93 (Register 93, No.
						48).
Note: Authority cited: Sections
						  54,
						  55,
						  59,
						  129,
						  3700,
						  3700(b),
						  3701,
						  3701.5,
						  3702,
						  3702.5,
						  3702.6,
						  3703,
						  3705,
						  3740-
						  3745, Labor
						  Code. Reference: Sections
						  129,
						  3700,
						  3700(b),
						  3701,
						  3702,
						  3702.5,
						  3702.6,
						  3703 and
						  3705, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 10 - Revocation of a Certificate to Self-Insure or Certificate to Administer and Continuing Jurisdiction › Section 15424 - Revoked Certificate Report

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The Director shall require a former self-insurer whose
						certificate to self insure has been revoked to continue to submit
						self-insurer's annual reports pursuant to Section
						15251 of these regulations, setting
						forth the status of all open work-injury claims until all claims are
						resolved.
1.
						Amendment of section and new NOTE filed 11-24-93; operative 12-24-93 (Register
						93, No. 48).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  54,
						  55,
						  59,
						  129,
						  3700,
						  3701,
						  3701.5,
						  3702,
						  3702.3,
						  3702.6,
						  3702.10,
						  3703,
						  3705,
						  3740-
						  3745, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 10 - Revocation of a Certificate to Self-Insure or Certificate to Administer and Continuing Jurisdiction › Section 15425 - Revoked Certificate Audit

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Pursuant to Sections
						15403 and
						15427 of these regulations, the
						Manager shall continue to audit the work-injury cases of any former
						self-insurer whose certificate to self insure has been
						revoked.
1.
						Amendment of section and new NOTE filed 11-24-93; operative 12-24-93 (Register
						93, No. 48).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  54,
						  55,
						  59,
						  129,
						  3700,
						  3701,
						  3701.5,
						  3702,
						  3702.3,
						  3702.6,
						  3702.10,
						  3703,
						  3705,
						  3740-
						  3745, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 10 - Revocation of a Certificate to Self-Insure or Certificate to Administer and Continuing Jurisdiction › Section 15426 - Release of Security Deposit

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Upon any revocation of a private
					 employer's certificate to self-insure, a new deposit level shall be determined
					 by the Chief to be sufficient to secure all actual and potential liabilities.
					 The former self-insurer shall continue to be responsible to increase the
					 deposit at the written request of the Chief as required in Section
					 15210 of these
					 regulations.
(b) Except as provided
					 in Labor Code Section
					 3702.8(c),
					 the deposit shall not be reduced below the required amount pursuant to Labor
					 Code Section
					 3701.
(c) Upon issuance of an order of default
					 pursuant to Labor Code section
					 3701.5, the
					 self-insurer, or its estate, shall forfeit all right, title and interest in its
					 security deposit and shall have no right to return of all or any portion of the
					 security deposit from the Self-Insurers' Security Fund.
1.
						Amendment of section heading and newly designated subsection (a), and new
						subsection (b) and NOTE filed 11-24-93; operative 12-24-93 (Register 93, No.
						48).
2. Amendment filed 12-14-2016; operative 1-1-2017 pursuant to
						Government Code section
						11343.4(b)(3)
						(Register 2016, No. 51).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  54,
						  55,
						  59,
						  129,
						  3700,
						  3701,
						  3701.5,
						  3702,
						  3702.3,
						  3702.6,
						  3702.10,
						  3703,
						  3705,
						  3740-
						  3745, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 10 - Revocation of a Certificate to Self-Insure or Certificate to Administer and Continuing Jurisdiction › Section 15427 - Continuing Jurisdiction

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
After revocation of a certificate to self insure, the
						Director's jurisdiction over work injuries sustained during the period of
						self-insurance shall continue until all liabilities and all responsibilities
						have been terminated in accordance with law.
1.
						Amendment of section and new NOTE filed 11-24-93; operative 12-24-93 (Register
						93, No. 48).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  54,
						  55,
						  59,
						  129,
						  3700,
						  3701,
						  3701.5,
						  3702,
						  3702.3,
						  3702.6,
						  3702.10,
						  3703,
						  3705,
						  3740-
						  3745, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 10 - Revocation of a Certificate to Self-Insure or Certificate to Administer and Continuing Jurisdiction › Section 15428 - Administration of Claims After Revocation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A private sector self insurer whose
					 certificate to self insure has been revoked shall continue to provide competent
					 administration of workers' compensation claims incurred during the period of
					 self insurance in accordance with Sections
					 15450-15463 of these regulations,
					 and the claims shall be administered from within the State of
					 California.
(b) If it is determined
					 by the Manager that the claims are not being competently administered, the
					 Manager shall arrange for the claims administration. The cost of administration
					 shall be borne by the former self insurer.
1. New
						section filed 11-24-93; operative 12-24-93 (Register 93, No.
						48).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  54,
						  55,
						  59,
						  129,
						  3700,
						  3701,
						  3701.5,
						  3702,
						  3702.3,
						  3702.6,
						  3702.10,
						  3703,
						  3705,
						  3740-
						  3745, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 11 - Hearing and Appeal Procedures › Section 15430.1 - Definitions

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
As used in article 11, the following definitions shall
						apply.
Aggrieved Party. Any person aggrieved as a result of
						failure to pass a Self Insurance Administrator examination pursuant to Labor
						Code section
						3702.1(b)
						or the revocation of a certificate to administer pursuant to Labor Code
						sections
						3702.1(a)
						or
						3702.7 and as
						prescribed in article 12 of these regulations.
Appeals Board. A California Workers' Compensation Appeals
						Board.
Certificate. See section
						15201 for definition.
Certificate to Administer. A Certificate of Consent to
						Administer issued to an administrative agency, except exempt insurance carrier,
						pursuant to section
						3702.1 of the
						Labor Code.
Custodian of a Security Deposit. The Office of the State
						Treasurer for approved securities; the Manager of Self-Insurance Plans for
						surety bonds and letters of credit; a bank or financial institution for savings
						accounts and certificates of deposit.
Employer. Any private corporation or other private
						business entity or public agency as defined in Labor Code section
						3300 that has
						or did have a Certificate of Consent to Self-Insure or any such private entity
						or public agency seeking a Certificate of Consent to Self Insure pursuant to
						Labor Code sections
						3700 and
						3701.
Letter of Credit, Maker of. Any financial institution
						providing an irrevocable letter of credit to a self-insured employer pursuant
						to Labor Code section
						3701.
SISF. Self-Insurers' Security Fund (SISF), a nonprofit
						entity created pursuant to Labor Code section
						3740 et
						seq.
Surety. Any corporation authorized to provide surety in
						the State of California and providing a surety bond to a self-insured employer
						pursuant to Labor Code section
						3701.
1. New
						section filed 12-17-90; operative 1-16-91 (Register 91, No. 6).
2.
						Amendment of definitions of "Aggrieved Party," "Appeals Board" and "Custodian
						of a Security Deposit" filed 9-19-2011; operative 10-19-2011 (Register 2011,
						No. 38).
Note: Authority cited: Sections
						  54,
						  55, and
						  3702.10, Labor
						  Code. Reference: Sections
						  3300,
						  3700,
						  3701,
						  3701.5,
						  3702.1,
						  3702.7,
						  3740-
						  3747, Labor
						  Code; Sections
						  11181-
						  11188,
						  Government Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 11 - Hearing and Appeal Procedures › Section 15431 - Delegation of Authority

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Manager of Self-Insurance Plans is
					 the authorized representative of the Director. The Manager is authorized to:
(1) Issue notice of intention to revoke a
					 certificate and to deny a request for a certificate or a certificate to
					 administer;.
(2) Receive requests
					 for a hearing by parties enumerated in section
					 15430 of these
					 regulations;
(3) Schedule
					 hearings;
(4) Perform all
					 administrative duties as required to conduct a hearing, including granting of
					 extensions of time requested in writing upon a showing of good cause;
(5) Hear and determine an appeal by any party
					 aggrieved by the result of the self-insurance administrator examination;
					 and
(6) Hear and determine an
					 appeal regarding the revocation of a certificate to administer prescribed in
					 article 12 of these regulations.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 11 - Hearing and Appeal Procedures › Section 15431.1 - Appeals and/or Requests for Hearings

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Appeals and/or requests for hearing under this article, by an employer or aggrieved party, shall be in writing and shall include the following information:
(1) Name and address of the person making the appeal or requesting the hearing (i.e. the requesting party);
(2) The specific nature of the request (for example, "This request is to review action denying revoking a certificate to administer"; or "This request is to appeal the failure to pass the self-insurance administrator's examination");
(3) A statement of the requesting party's rationale, basis, evidence, facts, reasoning, arguments, documentation, or other supporting material which establishes and supports the position of the requesting party;
(4) A statement of whether the requesting party wishes a formal hearing or a written decision only on the matter; and
(5) When a formal hearing is requested, an additional statement estimating the number of witnesses, if any, to be called by the requesting party at the hearing and the amount of time the requesting party will require to present its case at the hearing.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 11 - Hearing and Appeal Procedures › Section 15431.2 - Complaints

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Any
					 self-insured employer, administrator, the Self-Insurers' Security Fund, or
					 injured employee of a self-insured employer may file a complaint to the manager
					 in writing concerning the failure of any self-insured employer or administrator
					 to provide timely payment of benefits due or to fund the payment of such
					 benefits.
(b) The Manager shall
					 review any complaints received and may investigate the complaint, determine
					 what benefits may be due and order payment thereof, audit the claim records of
					 the self-insurer or administrator, and take action to revoke the certificate or
					 certificate to administer for cause.
(c) The Manager shall not seek to substitute
					 his/her judgement for that of the Workers' Compensation Appeals Board on any
					 adjudicated claim and may refuse to consider the complaint of any injured
					 worker's entitlement to benefit or self-insurer where the matter involved in
					 the complaint is waiting the decision of the Appeals Board.
(d) Any written complaint shall include the
					 following information:
(1) The basis of
					 jurisdiction of the Director;
(2)
					 The relief or action requested;
(3)
					 The grounds for the requested relief or action;
(4) The facts involved in the
					 complaint;
(5) A statement of
					 whether or not the specific claim or claims is being adjudicated before the
					 Workers' Compensation Appeals Board and the Appeal number of the claim before
					 the Appeals Board; and
(6) The name
					 of the parties known to the complainant against which any relief is sought or
					 who have an interest in the proceeding. The complaint shall be served on these
					 other persons who may have interest in the proceedings by the person submitting
					 the complaint.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 11 - Hearing and Appeal Procedures › Section 15432 - Hearings; Special Requirements: Failure to Appear

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Before seeking reconsideration by the
					 Director an appeal shall be first made to the Manager in matters of:
(1) A failing score on any self-insurance
					 administrator's examination; or
(2)
					 The revocation of a certificate to administer or denial of a renewal of a
					 certificate to administer.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 11 - Hearing and Appeal Procedures › Section 15433 - Hearing Officer: Appointment and Delegation of Authority

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Director may appoint a hearing
					 officer. The appointed hearing officer shall have full power, jurisdiction and
					 authority to:
(1) Hold a hearing and ascertain
					 facts for the information of the Director;
(2) Hold a pre-hearing conference and/or to a
					 certify official acts;
(3) Regulate
					 the course of the hearing;
(4) Join
					 and dismiss parties in a complaint proceeding pursuant to section
					 15431.2 of these
					 regulations;
(5) Grant a
					 withdrawal, disposition or amendment;
(6) Order a continuance or to extend the
					 submittal date of the proceeding;
(7) Approve a stipulation voluntarily entered
					 into by the parties;
(8) Administer
					 oaths and affirmations;
(9) Rule on
					 objections, privileges, defenses, and the receipt of relevant and material
					 evidence;
(10) Request a party at
					 any time to state his theory concerning any fact or issue in the
					 proceeding.
(11) Hear and determine
					 all issues of fact and law presented; and
(12) Issue interlocutory and final orders,
					 findings and decisions as may be necessary for full adjudication of the
					 matter.