reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 110.00 - Procedures Concerning Rate Filings And The Conduct Of Hearings For Workers' Compensation Insurance › Section 110.11 - Appeals

Current through Register 1525, July 5, 2024
(1)
Appeal of Decisions to the
			 Commissioner
. Any person aggrieved by a final decision in a
			 Proceeding conducted by a Presiding Officer designated by the Commissioner,
			 which the Commissioner has not affirmed, may appeal the decision to the
			 Commissioner, pursuant to M.G.L. c. 26, § 7.
(2)
Review by the
			 Commissioner
. Upon the docketing of an appeal under M.G.L. c. 26,
			 § 7, the Commissioner shall set a date by which the aggrieved person must
			 file a brief which states the grounds for the appeal and the relief requested.
			 A person who fails to timely file a brief thereby waives its right to appeal.
			 The Commissioner shall notify all parties of the appeal, and of the filing date
			 for the appeal brief. If the Commissioner determines, upon review of the brief
			 and the record, that the appeal is without substantial merit, he or she may
			 issue a decision on it. Otherwise, the Commissioner shall set a filing date for
			 briefs b y p a r ties to the Proceeding and shall issue a decision after that d
			 ate. The Commissioner may modify, affirm or reverse the Presiding Officer's
			 decision, in whole or in part.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 111.00 - WORKERS' COMPENSATION INSURANCE REQUIREMENTS APPLICABLE TO EMPLOYEE LEASING COMPANIES AND THEIR CLIENT COMPANIES › Section 111.01 - Purpose and Scope

Current through Register 1525, July 5, 2024
The purpose of
				211 CMR 111.00 is to ensure
				that any entity which is defined as an employee leasing company as provided in
				211 CMR 111.02,
				properly obtains workers' compensation insurance coverage for itself and all of
				its employees leased to another entity, and that premium paid for the coverage
				for such leased employees is commensurate with the exposure and anticipated
				claim experience.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 111.00 - WORKERS' COMPENSATION INSURANCE REQUIREMENTS APPLICABLE TO EMPLOYEE LEASING COMPANIES AND THEIR CLIENT COMPANIES › Section 111.02 - Definitions

Current through Register 1525, July 5, 2024
As used in
				211 CMR 111.00, the
				following words will have the meanings indicated:
Client Company
. A person, association,
				partnership, corporation or other entity located or having operations in
				Massachusetts that utilizes workers provided by a lessor through an employee
				leasing arrangement.
Commissioner
. The Commissioner of
				Insurance appointed pursuant to M.G.L. c. 6, § 26, or his or her
				designee.
Employee Leasing Arrangement
. An
				arrangement whereby one business entity provides workers to another business
				entity under a contract, whether or not in writing, that retains for the lessor
				a substantial portion of personnel management functions, such as payroll,
				direction and control of workers, and the right to hire and fire those workers
				provided by such lessor; provided, however, that the leasing arrangement is
				long term and not an arrangement to provide the lessee temporary help services
				during seasonal or unusual conditions such as temporary skill shortages or
				temporary special assignments and projects. Any such arrangement to provide
				workers on a long-term basis shall be construed to be pursuant to a contract
				and subject to the provisions of
				211 CMR 111.00.
Employee Leasing Company or Leasing
				Company
. A sole proprietorship, partnership, corporation or other
				form of business entity whose business consists largely of providing workers to
				one or more client companies by means of employee leasing
				arrangements.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 111.00 - WORKERS' COMPENSATION INSURANCE REQUIREMENTS APPLICABLE TO EMPLOYEE LEASING COMPANIES AND THEIR CLIENT COMPANIES › Section 111.03 - Responsibility for Purchase and Maintenance of Separate Policies

Current through Register 1525, July 5, 2024
It shall be the responsibility of the employee leasing company
				to purchase and maintain a separate policy providing standard workers'
				compensation and employers' liability insurance for each client company. The
				experience of all of the employees leased to a client company shall be combined
				with the experience of the employees of the client company for purposes of
				calculating an experience modification. The experience modification so
				calculated shall be applied to the client company's policy and all policies
				maintained for it by a leasing company or leasing companies. Each policy
				written to cover leased employees shall be issued to the employee leasing
				company as the named insured. The client company shall be identified thereon by
				the attachment of an appropriate endorsement indicating that the policy
				provides coverage for leased employees in accordance with Massachusetts law.
				The endorsement shall, at a minimum, provide for the following:
(1) Coverage under the policy shall be
			 limited to the named insured's employees leased to the client
			 company;
(2) The experience of the
			 employees leased to the particular client company shall be separately
			 maintained; and
(3) Cancellation of
			 the policy shall not affect the rights and obligations of the named insured as
			 an employee leasing company with respect to any other workers' compensation and
			 employers' liability policy issued to the named insured.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 111.00 - WORKERS' COMPENSATION INSURANCE REQUIREMENTS APPLICABLE TO EMPLOYEE LEASING COMPANIES AND THEIR CLIENT COMPANIES › Section 111.04 - Obligations of Employee Leasing Company to Insurer

Current through Register 1525, July 5, 2024
(1) The insurer or any rating organization
			 licensed under M.G.L. c. 152, § 52C may take all reasonable steps to
			 ascertain exposure under each policy issued to the employee leasing company and
			 collect the appropriate premium by requiring:
(a) A complete description of employee
			 leasing company operations;
(b)
			 Periodic reporting of client company payroll, classifications, experience
			 rating modification factors, and jurisdictions with exposure. This reporting
			 may be supplemented by a requirement to submit Internal Revenue Service Form
			 941 or its equivalent on a quarterly basis and such other payroll reporting
			 forms as may be required by federal and state regulatory authority;
(c) Physical inspection of client company
			 premises pursuant to M.G.L. c. 152, § 64; and
(d) Audit of employee leasing company
			 operations.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 111.00 - WORKERS' COMPENSATION INSURANCE REQUIREMENTS APPLICABLE TO EMPLOYEE LEASING COMPANIES AND THEIR CLIENT COMPANIES › Section 111.05 - Obligations of Client Company

Current through Register 1525, July 5, 2024
(1) Nothing in
			 211 CMR 111.00 shall have
			 any effect on the statutory obligation of a client company to secure workers'
			 compensation coverage for employees not provided, supplied or maintained by an
			 employee leasing company pursuant to an employee leasing arrangement.
(2) A client company shall not be eligible
			 for coverage pursuant to a workers' compensation policy issued to the employee
			 leasing company if the client company owes its current or prior insurer any
			 premium for workers' compensation insurance.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 111.00 - WORKERS' COMPENSATION INSURANCE REQUIREMENTS APPLICABLE TO EMPLOYEE LEASING COMPANIES AND THEIR CLIENT COMPANIES › Section 111.06 - Policy Cancellation or Nonrenewal

Current through Register 1525, July 5, 2024
(1)
			 Any violation of
			 211
			 CMR 111.03 or
			 111.04
			 shall be considered fraud or material misrepresentation pursuant to M.G.L. c.
			 152, § 55A, M.G.L. c. 398, § 84 and grounds for cancellation or
			 nonrenewal, provided that the employee leasing company has been provided 30
			 days to cure the violation.
(2)
			 With respect to any workers' compensation insurance policy issued or renewed
			 pursuant to
			 211
			 CMR 111.03, for which notice has been
			 received that such policy will be canceled or nonrenewed, the leasing company
			 shall notify by certified mail, within ten days of the receipt of such notice,
			 any client company for which there is an employee leasing
			 arrangement.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 111.00 - WORKERS' COMPENSATION INSURANCE REQUIREMENTS APPLICABLE TO EMPLOYEE LEASING COMPANIES AND THEIR CLIENT COMPANIES › Section 111.07 - Insurer Audit

Current through Register 1525, July 5, 2024
Insurers shall audit policies issued or renewed pursuant to
				211
				CMR 111.03 within 90 days of the policy
				effective date and may conduct interim audits thereafter. The purpose of the
				audit will be to determine whether all classifications, experience modification
				factors and estimated payroll utilized with respect to the development of the
				premium charged to the employee leasing company are
				appropriate.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 115.00 - Requirements applicable to workers' compensation insurance deductible plans › Section 115.01 - Purpose and Scope

Current through Register 1525, July 5, 2024
The purpose of
				211 CMR 115.00 is to
				regulate the conditions under which Insurers offer workers' compensation
				insurance deductible plans in the Commonwealth.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 115.00 - Requirements applicable to workers' compensation insurance deductible plans › Section 115.04 - Requirements Applicable to Small and Medium-sized Deductible Plans

Current through Register 1525, July 5, 2024
(1) Insurers and the Pool must offer all
			 Insureds deductible plans, as optional endorsements to each workers'
			 compensation policy issued, providing for per-claim deductibles of $500,
			 $1,000, $2,000, and $2,500, as well as an alternative aggregate deductible plan
			 providing for a per-claim deductible of $2,500 combined with a $10,000
			 aggregate deductible or an aggregate deductible equal to 5% of the basis for
			 determining the aggregate deductible limit, whichever is greater.
(2) Insurers and the Pool may offer Optional
			 Deductible Plans involving per-claim deductibles of $5,000.
(3) The Rating Bureau shall file with the
			 Division at least once every two years, or at any other time requested by the
			 Commissioner, the premium credits associated with Small and Medium-sized
			 Deductible Plans. Such filings shall be subject to approval by the
			 Commissioner.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 115.00 - Requirements applicable to workers' compensation insurance deductible plans › Section 115.05 - Requirements Applicable to Large Deductible Plans

Current through Register 1525, July 5, 2024
(1) Large Deductible Plans may be offered
			 only to Insureds whose Massachusetts workers' compensation full coverage
			 standard premium plus ARAP would otherwise exceed $375,000. Insureds with
			 either:
(a) at least $50,000 of annual
			 non-Massachusetts workers' compensation premium; or
(b) at least $10,000 of annual
			 non-Massachusetts workers' compensation premium and payroll in at least two
			 states other than Massachusetts, only need $100,000 or more in countrywide
			 workers' compensation premium to be eligible to be written on Large Deductible
			 Plans. Premium determinations for eligibility to offer Large Deductible Plans
			 shall not include self-insurance "premium".
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 115.00 - Requirements applicable to workers' compensation insurance deductible plans › Section 115.06 - Penalties

Current through Register 1525, July 5, 2024
(1) Failure to comply with
			 211 CMR 115.00 may result in
			 the withdrawal of the Division's approval of an Insurer's workers' compensation
			 deductible plan or plans.
(2) The
			 Rating Bureau shall monitor its member companies' compliance with
			 211 CMR 115.00, by
			 providing, every September, a report to the Division listing large deductible
			 policies for the prior five years whose unit statistical reports indicate that
			 no aggregate deductible was applicable or whose indicated aggregate deductible
			 exceeds $10,000,000.
(3) The
			 Division may refer information related to any Large Deductible Plan written in
			 violation of
			 211 CMR 115.00 to the
			 Massachusetts Department of Revenue, along with an estimate of the policy
			 premium absent any deductible credit, for appropriate action.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 115.00 - Requirements applicable to workers' compensation insurance deductible plans › Section 115.07 - Severability

Current through Register 1525, July 5, 2024
If any section or portion of a section of
				211 CMR 115.00 or the
				applicability thereof to any person, entity or circumstance is held invalid by
				a court, the remainder of
				211 CMR 115.00 or the
				applicability of such provision to other persons, entities or circumstances,
				shall not be affected thereby.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.02 - Purpose and Scope

Current through Register 1525, July 5, 2024
211 CMR 121.00 shall govern
				the conduct of Hearings concerning Rate Filings made pursuant to M.G.L. c.
				176K.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.03 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Filing
. The provisions in
			 211 CMR 121.00 apply when a
			 Hearing is required by statute, M.G.L. c. 176K, § 7(g), or by the
			 Commissioner, M.G.L. c. 176K, § 7(d). The provisions in
			 211 CMR 121.00 apply
			 independently of any other filings that are prescribed by the Commissioner in a
			 different form or manner.
(a)
Papers
.
1.
Filing of Papers for a Hearing
. All Papers must be
			 filed at the Division's principal office during its usual business hours, 8:45
			 A.M. to 5:00 P.M. daily, except Saturdays, Sundays and legal holidays. Papers
			 must be sent to the attention of the Docket Clerk, Legal Division. Except for a
			 Rate Filing or Amended Rate Filing, the requirements for which are addressed in
			 211 CMR
			 121.05 and
			 121.06,
			 and a Responsive Filing, the requirements for which are addressed in
			 211 CMR
			 121.09, an original and one copy of Papers
			 must be filed, unless more copies are specified in
			 211 CMR 121.00 or by the
			 Presiding Officer. At least one copy must be submitted in an unbound format.
			 The Presiding Officer may permit electronic filing in his or her
			 discretion.
2.
Pagination of a Rate Filing That Is the Subject of a
			 Hearing
. The pages of a Rate Filing must be numbered sequentially
			 from the first through the last page, using Arabic numerals at the bottom right
			 of each page. Any internal numbers applied to separate parts or sections of a
			 Rate Filing must be located elsewhere on the page. The Presiding Officer may
			 reject a Rate Filing that does not comply with the mandatory numbering
			 requirement.
3.
Service
			 of Papers on Parties
. A Party or Participant shall serve,
			 concurrently with filing with the Division, a copy of Papers on all Parties by
			 hand delivery, or by electronic transmission promptly followed by delivery by
			 first-class mail, postage pre-paid, unless otherwise permitted by the Presiding
			 Officer or agreed to by the Parties.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.04 - Pre-filing Notice for Rate Filings under M.G.L. c. 176K, Section 7(g)

Current through Register 1525, July 5, 2024
A Filer must notify the Division in writing of its intent to
				submit a Rate Filing under M.G.L. c. 176K, § 7(g), not less than 30 days
				before submitting the Rate Filing. A Filer shall provide a copy of the
				pre-filing notice to the State Rating Bureau, all Statutory Intervenors, and
				all other Intervenors permitted to appear in the Filer's last Proceeding for
				that insurance product. The notice must identify all products for which the
				Filer will submit a proposed Rate Filing and the date on which the Filer
				expects to submit the Rate Filing to the Division. The notice also must inform
				all Intervenors permitted to appear in the Filer's last Proceeding, other than
				the State Rating Bureau and Statutory Intervenors, that they should advise the
				Filer if they do not want to receive a copy of the Rate Filing. If a Filer
				fails to provide a pre-filing notice, the Rate Filing shall be deemed to be
				filed 30 days after it is submitted to the Division.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.05 - Rate Filings under M.G.L. c. 176K, Section 7(g)

Current through Register 1525, July 5, 2024
(1)
Purpose
. Rate
			 Filings under M.G.L. c. 176K, § 7(g), must furnish sufficient evidence to
			 substantiate the Filer's compliance with the requirements of M.G.L. c. 176K,
			 including, but not limited to, compliance with the anticipated minimum loss
			 ratio standards of M.G.L. c. 176K, § 7(e). The Rate Filing constitutes the
			 Filer's direct case in support of its Rate Request.
(2)
Contents
. The
			 Rate Filing must consist of sequentially numbered pages and contain:
(a) a title stating the nature of the
			 Proceeding and the complete name and address of the Filer submitting the
			 Filing;
(b) the name, address and
			 other contact information of counsel or other authorized representative, as
			 prescribed in
			 211 CMR
			 121.03(6);
(c) an executive summary describing, in
			 narrative form, each element of the Rate Filing and the reasons for the
			 proposed Rate Filing;
(d) sworn
			 written testimony in support of each element of the Rate Filing;
(e) for every witness whose testimony is part
			 of the Rate Filing, the following information:
1. name and business address,
2. the specific part of the Rate Filing that
			 is the subject matter of the witness's testimony, and
3. the witness's qualifications to testify on
			 that subject matter;
(f)
			 all information, including data, statistics, schedules and exhibits that the
			 Filer intends to present for consideration at the Hearing and all information
			 upon which the proposed Rate Filing are based;
(g) all information required to be included
			 by
			 211
			 CMR 71.12(10):
Rate
			 Filings
;
(h) an actuarial
			 opinion and a legal opinion that the Filer is in compliance with the provisions
			 of M.G.L. c. 176K;
(i) the
			 proposed effective date for the rate changes in the Rate Filing, which is at
			 least 90 days after the filing date of the Rate Filing; and
(j) other information as prescribed from time
			 to time by the Commissioner or the Presiding Officer.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.06 - Rate Filings under M.G.L. c. 176K, Section 7(d)

Current through Register 1525, July 5, 2024
In a Proceeding under M.G.L. c. 176K, § 7(d), the Rate
				Filing submitted to the Division in the form and manner prescribed by the
				Commissioner for all rate and form filings shall constitute the Filer's direct
				evidence, but the Filer shall submit to the Docket Clerk five additional copies
				of the Rate Filing, unless the Presiding Officer directs otherwise. The
				Presiding Officer may permit or order the Filer to supplement its Rate Filing
				with additional material in advance of the commencement of the Proceeding. The
				Filer shall submit to the Docket Clerk five copies of any supplemental
				information, unless the Presiding Officer directs otherwise.
The Filer shall serve two copies of its Rate Filing and any
				supplemental information on the State Rating Bureau, and one copy on each
				Statutory Intervenor and any Intervenor permitted to appear in the Filer's last
				rate Hearing for that insurance product, unless such person has advised the
				Filer that a copy is not wanted. The Filer shall serve a copy of its Rate
				Filing and any supplemental information on a person permitted to intervene
				within two business days after issuance of an order allowing the person to
				intervene. By agreement of the Parties concerned, copies may be served on a
				Party electronically.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.07 - Hearing Notice

Current through Register 1525, July 5, 2024
The Filer shall arrange to publish a Hearing notice issued by
				the Commissioner. For Proceedings pursuant to M.G.L. c. 176K, § 7(g), the
				Filer shall arrange to publish the Hearing notice at least 21 days before the
				scheduled date of a Hearing in newspapers of general circulation in Boston,
				Brockton, Fall River, Pittsfield, Springfield, Worcester, New Bedford, and
				Lowell. For Proceedings pursuant to M.G.L. c. 176K, § 7(d), the Filer
				shall arrange to publish the Hearing notice at least 21 days before the
				scheduled date of a Hearing in newspapers of general circulation in Boston,
				Springfield, and Worcester. For all Proceedings, concurrently with publication,
				the Filer shall give notice of the Hearing to the State Rating Bureau and to
				all Statutory Intervenors. The Filer shall file proof of publication with the
				Division within 14 days after publication.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.08 - Intervention and Participation

Current through Register 1525, July 5, 2024
(1)
State Rating Bureau
. The State Rating Bureau need not
			 file and serve a notice of appearance on the Filer or Statutory
			 Intervenors.
(2)
Statutory Intervenors
. No later than four days after
			 publication of the Hearing notice under
			 211 CMR 121.07, a
			 Statutory Intervenor intending to take part in the Proceeding shall file and
			 serve a notice of appearance on the Filer, the State Rating Bureau, and any
			 other Statutory Intervenors.
(3)
Intervenors and Participants
. No later than ten days
			 after publication of the Hearing notice under
			 211 CMR 121.07, a
			 person who wishes to appear and take part in the Proceeding, other than the
			 State Rating Bureau, Statutory Intervenors, or the Filer, shall file, and serve
			 upon the Filer, the State Rating Bureau and all Statutory Intervenors a
			 petition for leave to intervene or to participate. The petition must state the
			 petitioner's name and address; the name, address and other contact information
			 of counsel or other designated authorized representative, as prescribed in
			 211 CMR
			 121.03(6); the statutory or
			 other authority for the petition; how the Rate Request substantially and
			 specifically affects the petitioner; the petitioner's contentions; the relief
			 petitioner seeks; and a description of the scope of the petitioner's proposed
			 intervention or participation. The petition shall describe the nature of the
			 evidence, if any, the petitioner seeks to present; state the reasons why the
			 petitioner's interests would not be represented adequately by the Filer, the
			 State Rating Bureau, Statutory Intervenors or Intervenors already taking part
			 and explain how the petitioner will avoid introduction of repetitive testimony
			 and not unduly delay the Hearing.
(4)
Responses to
			 Petitions
. A Party opposing a petition to intervene or participate
			 shall file a written objection, setting forth the grounds for its opposition,
			 no later than five days after service of the petition.
(5)
Action on
			 Petition
. The Presiding Officer may schedule a conference to
			 address the petition to intervene or participate. The Presiding Officer shall
			 determine whether the petitioner will be allowed to participate as an
			 Intervenor or as a Participant, and the extent of its participation in the
			 Proceeding. In the Presiding Officer's discretion, participation may be limited
			 to submitting written or oral argument at the close of the Hearing. The
			 Presiding Officer may order two or more petitioners to consolidate their
			 appearances or presentations if consolidation will facilitate and expedite the
			 Proceeding.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.09 - Responsive Filings

Current through Register 1525, July 5, 2024
(1)
Purpose
. A Responsive Filing shall state the grounds
			 upon which a Party supports or contests the Rate Filing. Direct testimony and
			 the documents or other exhibits in the Responsive Filing constitute the direct
			 case of that Party.
(2)
Timing
. A Party, other than the State Rating Bureau,
			 shall file a Responsive Filing no later than ten days after the transcript of
			 the cross-examination of the Filer's witnesses is filed. The State Rating
			 Bureau may file a Responsive Filing no later than two days after the other
			 Responsive Filings are due.
(3)
Contents
. A Responsive Filing must consist of
			 sequentially numbered pages, must use any format prescribed by the Presiding
			 Officer and, subject to limits on intervention set pursuant to
			 211 CMR
			 121.08, must contain:
(a) a title stating the nature of the
			 Proceeding, and the complete name and address of the Party submitting the
			 Responsive Filing;
(b) the name and
			 address of counsel, or other representative, if the Party is represented, as
			 prescribed in
			 211 CMR
			 121.03(6);
(c) a statement of the issues the Party is
			 presenting for consideration;
(d) a
			 statement of the specific components of the Rate Filing that the Party is
			 addressing;
(e) a statement of the
			 legal grounds on which the Party relies to support or oppose the Rate Filing as
			 a whole, or any part of the Rate Filing;
(f) any alternative rate adjustment that the
			 Party recommends;
(g) sworn written
			 testimony of all witnesses that includes all information and commentary
			 submitted in support of any recommendations;
(h) for every witness whose testimony is part
			 of the Responsive Filing, the following information:
1. name and business address;
2. the specific part of the Responsive Filing
			 that is the subject matter of the witness's testimony; and
3. the witness's qualifications to testify on
			 that subject matter;
(i)
			 all information, including data, statistics, schedules, and exhibits, submitted
			 in support of recommendations;
(j)
			 other information as prescribed from time to time by the Presiding
			 Officer.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.10 - Hearing Procedures

Current through Register 1525, July 5, 2024
(1)
Timing and Order of Presentation of the Hearing
. The
			 Hearing will begin within 30 days after the filing of the Rate Filing with the
			 Division. The Hearing generally will be conducted in the following order, and
			 in accordance with the orders issued by the Presiding Officer: Public Comment
			 Hearing, Technical Conference, pre-hearing conferences, examination on the Rate
			 Filing, and examination on Responsive Filings. The Presiding Officer may alter
			 the order of presentation on his or her own initiative, or on request by a
			 Party.
(2)
Motions to
			 Dismiss or Strike
. Motions to dismiss or strike must be filed in
			 accordance with the following schedule:
(a)
			 no later than 14 days after the date the Hearing notice is published, a Party
			 may move to dismiss the Rate Filing on the ground that it contains insufficient
			 evidence to substantiate the proposed Rate Filing, or otherwise fails to comply
			 with the filing requirements established in
			 211 CMR 121.00 or
			 211
			 CMR 71.12(10):
Rate
			 Filings
;
(b) no later than
			 seven days after the filing of a Responsive Filing, the Filer may move to
			 strike it on the ground that it contains insufficient evidence to substantiate
			 that Party's contest of the Rate Filing;
(c) the Presiding Officer may, in his or her
			 discretion, permit a Party to amend its Rate Filing or Responsive Filing in
			 order to address the issues raised by motions to dismiss or strike;
(d) the filing of a motion to dismiss or
			 strike will not affect the time periods provided in
			 211 CMR 121.00 unless
			 otherwise ordered by the Presiding Officer.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.11 - Discovery

Current through Register 1525, July 5, 2024
(1)
Information
			 Requests
.
(a) Subject to any
			 limits on intervention imposed pursuant to
			 211 CMR
			 121.08, a Party may serve upon another Party
			 that has submitted a Rate Filing or Responsive Filing, within ten days of the
			 filing of that Party's Filing, written Information Requests to produce or make
			 available documents or tangible things, not privileged, and not previously
			 supplied, that are in the custody or control of the Party upon whom the request
			 is served. An Information Request must set forth, with reasonable
			 particularity, the items to be provided. The Presiding Officer, in his or her
			 discretion, may permit Information Requests to be served on a Party after the
			 start of the examination of that Party's witnesses and before the conclusion of
			 the Hearing. Discovery must be conducted expeditiously and, except for good
			 cause, will not be grounds to delay the Hearing.
(b) All Information Requests must be filed
			 and served on all Parties. A Party requesting documents from the Division or
			 the State Rating Bureau shall pay the Division the fee per page for copies as
			 determined from time to time by the Executive Office for Administration and
			 Finance, unless the Presiding Officer, in his or her discretion, waives the
			 fee.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.12 - Conduct of Proceedings

Current through Register 1525, July 5, 2024
(1)
Presiding Officer
. The Presiding Officer conducts the
			 Proceeding and makes all decisions on the admission or exclusion of evidence
			 and other procedural matters that arise in the course of the Hearing. The
			 Presiding Officer may issue orders he or she finds proper, expedient or
			 necessary to enforce and administer the provisions of
			 211 CMR 121.00, M.G.L. c.
			 176K and M.G.L. c. 30A. The Presiding Officer may administer oaths and
			 affirmations, schedule Hearings and order the consolidation of related
			 Proceedings. The Presiding Officer may impose sanctions on a Party that does
			 not comply with an order issued in a Proceeding. Such sanctions can include
			 entering orders or decisions on one or more issues, limiting the introduction
			 of evidence, limiting a Party's participation in the Proceeding, and addressing
			 other matters he or she deems appropriate. The Presiding Officer may shorten or
			 terminate a phase of the Proceeding for a Party's failure, without good cause,
			 to comply with the prescribed schedule or to proceed expeditiously.
(2)
Ex Parte
Communications
.
(a) Within the time frame set forth in 211
			 CMR 121.12(2)(b), until the rendering of a final decision, no person who is not
			 employed by the Division shall communicate
ex parte
with the
			 Commissioner, the Presiding Officer, or any Division employee involved in the
			 decision process for the Proceeding in question, with respect to the merits of
			 the Proceeding. A request for a report concerning the status of a Proceeding or
			 an inquiry as to the Division's practice or procedure shall not be considered
			 an
ex parte
communication.
(b) The prohibitions of 211 CMR 121.12(2)
			 apply from the time a person knows or reasonably should know that a Proceeding
			 will be initiated. Otherwise, for Proceedings pursuant to M.G.L. c. 176K,
			 § 7(g), the prohibitions apply from the time the Filer submits a
			 pre-filing notice in accordance with
			 211
			 CMR 121.04; for Proceedings under M.G.L. c.
			 176K, § 7(d), the prohibitions apply from the time the Commissioner issues
			 the Hearing notice. In all cases, the prohibitions apply as long as a
			 Proceeding is open.
(c) If the
			 Presiding Officer determines that a Party has violated 211 CMR 121.12(2), the
			 Presiding Officer may exclude that Party from the Hearing or decide against
			 that Party with prejudice. If the Presiding Officer determines that a person
			 not a Party has violated 211 CMR 121.12(2), the Presiding Officer may exclude
			 that person from the Hearing.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.13 - Briefs

Current through Register 1525, July 5, 2024
(1)
Briefs
. Parties,
			 and any Participant who has been permitted to do so, may file briefs within a
			 period set by the Presiding Officer. Each Party and permitted Participant shall
			 file five copies of its brief and serve one copy on each Party and on each
			 Participant who has been allowed to file a brief, unless the Presiding Officer
			 directs otherwise. Briefs also shall be filed on computer disk or by other
			 electronic means in a format determined by the Presiding Officer. The Presiding
			 Officer may set a page limit for briefs. Each brief must include:
(a) a concise statement of the
			 case;
(b) the arguments of the
			 Party or Participant with specific identification of all the evidence relied
			 upon to support its positions, with references to where this supporting
			 evidence appears in the record;
(c)
			 a statement of the specific relief requested on every contested issue;
			 and
(d) any other information
			 required by the Presiding Officer.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.14 - Decision

Current through Register 1525, July 5, 2024
(1) The Presiding Officer's decision shall be
			 in writing or stated on the record no more than 30 days following the
			 conclusion of the Proceeding as prescribed by
			 211 CMR
			 121.10(8). The Presiding
			 Officer shall notify all Parties of the decision, of their right to appeal it,
			 and of the time within which to appeal.
(2) Filed rates that are approved may be
			 effective no earlier than 30 days after approval. For a filed rate that is
			 disapproved, the Presiding Officer may indicate an alternative rate or
			 component, if any, that he or she would find to be reasonable. The Filer may
			 then make a Revised Rate Filing that incorporates the rate or rate components
			 that the Presiding Officer indicated would be reasonable.
(3) The submission and approval of a revised
			 Rate Filing will not affect the Filer's right to appeal the disapproval of any
			 elements of its Rate Filing.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.15 - Revised Rate Filing

Current through Register 1525, July 5, 2024
(1)
Contents
. Within the time period specified in the
			 Presiding Officer's decision, a Filer may file a Revised Rate Filing in the
			 docket opened for the Rate Filing. The Revised Rate Filing must contain all
			 information and meet all other requirements set forth in the Presiding
			 Officer's decision, and must comply with the format, filing and service
			 requirements of
			 211 CMR
			 121.05, but otherwise need not comply with
			 211 CMR
			 121.05.
(2)
Hearing on Revised Rate
			 Filings
. The Presiding Officer may hold a Hearing on a Revised
			 Rate Filing, and shall hold a Hearing on a Revised Rate Filing if a Party
			 requests one within five days of the filing of the Revised Rate Filing. At such
			 a Hearing, the Presiding Officer may hear argument and receive evidence
			 regarding compliance with the decision on the Rate Filing. The Presiding
			 Officer shall approve a Revised Rate Filing if it meets the requirements for
			 approval set forth in the decision on the Rate Filing. The Presiding Officer
			 may permit a Filer further to revise a Revised Rate Filing to meet the
			 requirements for approval set forth in the decision on the Rate
			 Filing.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.16 - Appeals

Current through Register 1525, July 5, 2024
A person aggrieved by a Presiding Officer's decision that is
				not affirmed by the Commissioner may appeal that decision to the Commissioner
				in accordance with M.G.L. c. 26, § 7.
A person aggrieved by a decision of the Commissioner, including
				a Commissioner's simultaneous affirmation of a Presiding Officer's decision,
				may, within 20 days from the filing of the decision, file a petition in the
				Supreme Judicial Court for Suffolk County for review of the
				decision.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.17 - Suspension or Modification of the Requirements of Filing or Prior Approval of Rates

Current through Register 1525, July 5, 2024
The Commissioner may, by written order pursuant to M.G.L. c.
				176K, § 7(k), suspend or modify the requirements of filing or prior
				approval of rates.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 121.00 - Procedures Concerning Rate Filings Made Pursuant To M.g.l. C. 176k, And The Conduct Of Hearings On Such Filings › Section 121.18 - Severability

Current through Register 1525, July 5, 2024
If any section or portion of a section of
				211 CMR 121.00 or the
				applicability thereof to any person, entity, or circumstance is held to be
				invalid by a court of competent jurisdiction, the remainder of
				211 CMR 121.00 or the
				applicability of such provision to other persons, entities or circumstances,
				shall not be affected thereby.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 123.00 - Direct Payment Of Motor Vehicle Collision And Comprehensive Coverage Claims And Referral Repair Shop Programs › Section 123.01 - Authority

Current through Register 1525, July 5, 2024
211 CMR 123.00 is issued
				under the authority of M.G.L. c. 90, M.G.L. c. 175, and M.G.L. c.
				176D.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 123.00 - Direct Payment Of Motor Vehicle Collision And Comprehensive Coverage Claims And Referral Repair Shop Programs › Section 123.02 - Purpose and Scope

Current through Register 1525, July 5, 2024
The purpose of
				211 CMR 123.00 is to
				establish a procedure for approval of direct payment and referral repair shop
				plans by motor vehicle insurers for collision, limited collision and
				comprehensive insurance claims, and to establish the minimum requirements for
				such plans.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 123.00 - Direct Payment Of Motor Vehicle Collision And Comprehensive Coverage Claims And Referral Repair Shop Programs › Section 123.03 - Definitions

Current through Register 1525, July 5, 2024
As used in
				211 CMR 123.00, the
				following words will have the meanings indicated:
Claimant
means any person making a
				claim for motor vehicle damage or loss for first party damages.
Collision coverage
means that optional
				coverage defined in M.G.L. c. 90, § 34O(1) offered as part of a motor
				vehicle liability policy or bond.
Commissioner
means the Commissioner of
				Insurance appointed under the provisions of M.G.L. c. 26, § 6, or his or
				her designee.
Comprehensive coverage
means that
				optional coverage defined in M.G.L. c. 175, § 113O as fire and theft
				coverage or comprehensive coverage, so-called, offered as part of a motor
				vehicle liability policy or bond.
Insurer
means any insurance company
				authorized to write motor vehicle insurance in the Commonwealth.
Limited collision coverage
means that
				optional coverage defined in M.G.L. c. 90, § 34O(2) offered as part of a
				motor vehicle policy or bond.
Motor vehicle insurance
means motor
				vehicle liability policies or bonds as defined in M.G.L. c. 90, §§
				34A, 34O, and in M.G.L. c. 175.
Plan
means a detailed proposal or
				filing describing a formal direct payment and referral program based on a
				written plan.
Rating organization
means an insurance
				rating organization licensed under M.G.L. c. 175A.
Repair shop
means a motor vehicle
				repair shop as defined in M.G.L. c. 100A, § 1, but not including glass
				specialty shops and shops which primarily sell tires or audio
				equipment.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 123.00 - Direct Payment Of Motor Vehicle Collision And Comprehensive Coverage Claims And Referral Repair Shop Programs › Section 123.05 - Direct Payment Plans: Required Provisions

Current through Register 1525, July 5, 2024
No plan shall be approved unless it contains each of the
				following provisions:
(1)
Payment to the claimant
: The insurer shall offer to
			 pay every claimant for the loss of or damage to the insured motor vehicle under
			 collision coverage, limited collision coverage or comprehensive coverage the
			 full amount, less any applicable deductible, of the cost of repair of the
			 damage as described in an appraisal made by a licensed automobile damage
			 appraiser employed or designated by the insurer, subject to the terms and
			 conditions of the applicable insurance policy. In the case of property damage
			 liability claims, the insurer may make such offer to the person to whom such
			 liability payments are owed.
Unless such direct payment is refused by the claimant, the
				insurer shall make such payment at the time of, or within five business days
				after, the preparation of said appraisal. In no event shall payment be made
				prior to provision of a copy of the appraisal to the claimant. Nothing in 108
				CMR 123.05 be construed to affect the right of any insurer to delay payment for
				a period of time reasonably necessary to investigate any claim before
				authorizing repair work or making payment on such claim.
If the claimant refuses such direct payment, the insurer shall
				comply with applicable laws and regulations relating to such payments without
				regard to the plan.
(2)
Form of Payment
: The payments described in 211 CMR
			 123.05(1) shall be in cash or a negotiable instrument payable to the claimant,
			 and the lienholder, if applicable.
(3)
Repair
			 certification
: Each claimant shall receive, with the appraisal and
			 direct payment check, a repair certification form, the form for which shall be
			 included as part of the filed plan. The repair certification form shall at a
			 minimum contain the following:
(a) An
			 explanation of the claimant's rights and obligations with respect
			 thereto.
(b) Certification that the
			 repair work has been completed.
(c)
			 Identification of the repair shop or individual who performed the repair
			 work.
(d) An agreement that the
			 claimant will permit the insurer to reinspect the repaired vehicle within a
			 reasonable period of time after the return of the repair certification form.
The claimant shall return the repair certification form to the
				insurer upon completion of the repairs. If the claimant elects not to repair
				the vehicle or if the repair certification form is not returned to the insurer,
				the actual cash value of the insured vehicle will be reduced by the amount of
				the claim payment plus any applicable deductible, unless and until such time as
				the insurer or any successor insurer receives a repair certification
				form.