reglab/statecodes huggingface dataset:
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 308 - Employer Compliance, Enforcement, Record And Report Requirements And Stop-work Orders › Section 308.3 - Record requirements for employers

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Employers must maintain at all times the
				  records required by this rule and must produce the records when requested by
				  the chair pursuant to Workers' Compensation Law, section 141-a.
(b) Identity, organizational, and
				  occupational records. Every employer shall maintain documents reflecting its:
(1) Federal employer identification number
				  (FEIN) or a record of the social security number (SSN) if the employer does not
				  have a FEIN;
(2) business name,
				  including but not limited to certificate of assumed business name;
(3) business form, such as corporation,
				  limited liability company, or partnership;
(4) articles of incorporation or
				  organization, including any amendments to such articles, occupational licenses,
				  trade licenses or certifications; and
(5) a current list of the officers, partners
				  or principals of the business.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 308 - Employer Compliance, Enforcement, Record And Report Requirements And Stop-work Orders › Section 308.4 - Periodic reports as condition of release from a stop-work order

Current through Register Vol. 46, No. 28, July 10, 2024
The chair, or his or her designee, may require an employer
					 to file periodic reports that demonstrate the employer's continued compliance
					 with the Workers' Compensation Law for a probationary period that shall not
					 exceed two years as a condition of release from a stop-work order issued
					 pursuant to Workers' Compensation Law, section 141-a(4). Whether the employer
					 must file such periodic reports shall be determined by the chair, or his or her
					 designee, at the time the chair, or his or her designee is considering whether
					 or not to release the stop-work order. If the chair, or his or her designee,
					 determines that periodic reports must be filed, such reports shall state the
					 number of workers employed by the employer during that period, the employer's
					 total payroll during the period and such other information as the chair or his
					 or her designee deems relevant. The chair, or his or her designee, will specify
					 the format and the timing for filing the periodic reports but in no case shall
					 it be more than quarterly.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 309 - Independent Livery Driver Benefit Fund › Section 309.2 - Independent livery base

Current through Register Vol. 46, No. 28, July 10, 2024
(a) A
				  livery base may join the fund only if it is designated by the board as an
				  independent livery base.
(b) A
				  livery base will only be designated as an independent livery base if:
(1) the livery base submits to the board an
				  affirmation sworn to under penalty of perjury by an officer or director on a
				  board prescribed form attesting that it meets the criteria to be an independent
				  livery base set forth in subdivision (c) of this section;
(2) the livery base agrees to provide the
				  board and fund with written notice of any inaccuracies in the information in
				  the affirmation within five business days of discovery or knowledge of the
				  inaccuracies;
(3) the livery base
				  agrees to provide the board and fund with written notice of any changes in the
				  information in the affirmation within 10 business days of such changes;
				  and
(4) the board designates the
				  livery base as an independent livery base after receipt and review of the
				  affirmation required by paragraph (1) of this subdivision.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 309 - Independent Livery Driver Benefit Fund › Section 309.4 - Annual contributions to the Fund

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Annual contributions to the Fund by
				  independent livery bases calculated using the number of liveries affiliated
				  with each livery base pursuant to section 160-ccc  of the Executive Law shall
				  include independent livery drivers as defined in subdivision (a) of section
				  309.3 
				  of this Title. Such calculation may be done at the discretion of the Fund using
				  a per ride surcharge.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 310 - Reporting Of Injuries By Employers › Section 310.1 - Penalties for refusal or neglect of an employer to file a report of injury

Current through Register Vol. 46, No. 28, July 10, 2024
Upon notification to the Secretary of the Board that an
					 employer has refused or neglected to file a report as required by Workers'
					 Compensation Law section 110, an administrative hearing to consider imposition
					 of a penalty of not more than $2,500 shall be held before an employee of the
					 board designated by the chair to conduct such hearing.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 311 - Funeral Expenses Fee Schedule › Section 311.1 - Funeral expenses fee schedule

Current through Register Vol. 46, No. 28, July 10, 2024
Reimbursement for funeral expenses or memorial services
					 under the Workers' Compensation Law, including but not limited to the following
					 items: grave sites; headstone; organist; priest, minister, rabbi or other
					 officiant; removal from hospital; casket; vault; chapel rental; embalming;
					 preparation fees; hearse; cemetery fees including plot; death certificates;
					 newspaper ad; and cremation costs, shall not exceed $ 12,5 00 in the counties
					 of Bronx, Kings, Nassau, New York, Queens, Richmond, Rockland, Suffolk, and
					 Westchester. In the remaining counties, reimbursement for such funeral expenses
					 shall not exceed $ 10,5 00. This fee schedule shall be applicable to deaths
					 occurring on or after June 8, 2016s.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 312 - CONCILIATION PROCESSING › Section 312.1 - Statement of purpose

Current through Register Vol. 46, No. 28, July 10, 2024
To address claims in a more expeditious and informal
					 manner, and to provide a mechanism for such claims to be processed without
					 undue controversy.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 312 - CONCILIATION PROCESSING › Section 312.2 - Referral to conciliation processing

Current through Register Vol. 46, No. 28, July 10, 2024
Within 30 days of carrier's response to notice of indexing,
					 all cases where the expected duration of benefits is 52 weeks or less shall be
					 referred for conciliation processing, except if a case is suitable for motion
					 calendar or administrative determination processing. If a case is initially
					 controverted, the case will be processed for a pre-hearing conference under
					 subdivision 2-a of section 25  of the Workers' Compensation
					 Law.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 312 - CONCILIATION PROCESSING › Section 312.3 - Conciliation processing

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The
				  conciliator shall completely review each case folder and, where necessary,
				  contact the various parties for additional information, documents, reports and
				  fee requests, if any.
(b) Based on
				  the evidence in file and on information obtained from the parties, if any, the
				  conciliator shall, whenever possible, prepare a proposed conciliation decision.
				  Where disputes on any issues exist, the conciliator shall attempt to reconcile
				  them through a meeting with the parties. The presumptions contained in section 21  of the Workers' Compensation Law shall be applied whenever appropriate. The
				  proposed conciliation decision shall be served upon all parties. Within 30 days
				  thereafter, any party in interest may submit to the board its written comments
				  regarding the proposed conciliation decision or request a meeting of all the
				  parties, and shall simultaneously serve copies of such comments or requests on
				  all other parties in interest. A meeting, if requested, shall be scheduled in
				  accordance with section
				  312.4  of
				  this Part.
(c) The proposed
				  conciliation decision shall contain an appropriate fee for the claimant's
				  attorney or licensed representative, if any.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 312 - CONCILIATION PROCESSING › Section 312.4 - Conciliation meetings

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
				  Meetings of all necessary parties will be arranged by the conciliator, when
				  necessary, or within 30 days after receipt of a request for a conciliation
				  meeting.
(b) No later than five
				  days before the conciliation meeting, any party may review the workers'
				  compensation case folder at the office where the conciliation meeting will be
				  held, and may make photocopies (at its own expense) of any documents and
				  reports.
(c) If the claimant is not
				  represented at the conciliation meeting, the conciliator shall advise the
				  claimant of their right to have representation present, their right to
				  reasonable adjournment to procure representation, and their right to withdraw
				  from any agreement in accordance with paragraph (g) of subdivision 2-b of
				  section 25  of the Workers' Compensation Law.
(d) After advising the unrepresented claimant
				  at the conciliation meeting in accordance with paragraph (e) of subdivision 2-b
				  of section 25  of the Workers' Compensation Law, the conciliator shall request
				  the claimant's written consent to participate in the conciliation process on a
				  form prescribed by the chair. If the claimant declines conciliation processing,
				  the conciliator shall transfer the case to a pre-hearing conference commencing
				  the regular hearing calendar process.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 312 - CONCILIATION PROCESSING › Section 312.6 - Suspension or modification of rules

Current through Register Vol. 46, No. 28, July 10, 2024
The chair may, in his or her discretion, suspend or modify
					 the application of any of the rules in this Part.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 313 - Administrative Determination Processing › Section 313.1 - Statement of purpose

Current through Register Vol. 46, No. 28, July 10, 2024
To provide a fair, timely, and efficient mechanism for
					 processing uncontroverted claims involving minor injuries, uncontested issues
					 within a claim, and certain penalties.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 313 - Administrative Determination Processing › Section 313.2 - Issues subject to administrative determination processing

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Any uncontroverted claims involving minor
				  injuries, uncontested issues within a claim, and certain penalties which
				  require a formal decision of the board may be considered for administrative
				  determination processing, provided the issue is not in dispute based upon the
				  evidence in the possession of the board and where the appearance of the parties
				  will not, in the judgment of the board, add to the ability of the board to make
				  a proper decision.
(b) Controverted
				  cases shall be referred for a pre-hearing conference in accordance with
				  subdivision 2-a of section 25  of the Workers' Compensation Law and section
				  300.33  of
				  this Title.
(c) Cases where the
				  expected duration of benefits is 52 weeks or less shall be referred for
				  conciliation processing in accordance with subdivision 2-b of section 25  of the
				  Workers' Compensation Law and Part 312 of this Title.
(d) Cases in which there has been, or may be,
				  an illegal employment of a minor pursuant to section 14-a  of the Workers'
				  Compensation Law shall be referred for hearing processing.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 313 - Administrative Determination Processing › Section 313.3 - Procedure for administrative determination processing

Current through Register Vol. 46, No. 28, July 10, 2024
(a) All claims for compensation submitted
				  shall be reviewed to determine whether any such claim is suitable for
				  administrative determination processing, in accordance with the provisions of
				  this Part. The board may request the claimant, employer, and/or its carrier to
				  provide such additional information as the board may deem necessary.
(b) If the board determines that a case is
				  suitable for administrative determination processing, a proposed decision shall
				  be prepared and transmitted to the claimant, employer or its carrier, and any
				  other party in interest. The proposed decision shall be dated the date it is
				  transmitted. The parties shall also be informed of the date that the proposed
				  decision becomes final, which shall be at least 30 days after the date it was
				  transmitted by the board.
(c) Any
				  party in interest may object to the proposed decision within 30 days of the
				  date the proposed decision is transmitted by the board. Any objection must
				  state the reason for the objection and identify the issues to be resolved. If
				  an objection is received by the board within such 30-day period, the proposed
				  decision will not be made final and the case will be scheduled for conciliation
				  processing or a hearing before a Workers' Compensation Law Judge, or may be
				  modified, as may be appropriate.
(d) All proposed decisions shall be reviewed
				  and, if appropriate, approved by a Worker's Compensation Law Judge within 30
				  days of the date of the proposed decision. If the decision is not approved, the
				  Workers' Compensation Law Judge shall refer the matter for a hearing,
				  conciliation processing, or may modify the proposed decision, as may be
				  appropriate. If the decision is approved by the Workers' Compensation Law Judge
				  and becomes final, an application for review of such decision may be made in
				  accordance with section 23  of the Workers' Compensation Law and section
				  300.13 
				  of this Title.
(e) The proposed
				  decision may contain an appropriate fee for the claimant's attorney or licensed
				  representative.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 314 - Alternative Dispute Resolution Of Claims › Section 314.1 - Applicability of board rules and regulations

Current through Register Vol. 46, No. 28, July 10, 2024
All provisions of the Workers' Compensation Law as well as
					 the rules and regulations of the Workers' Compensation Board with respect to
					 the rights, duties and obligations of employers, employees, unions, health care
					 providers and insurance carriers are expressly made applicable to this pilot
					 program, except to the extent that such rules and regulations are inconsistent
					 with section 25 (2-c)  of the Workers' Compensation Law or rules and regulations
					 promulgated by the board pursuant to section 25(2-c).
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 314 - Alternative Dispute Resolution Of Claims › Section 314.2 - Review process for collective bargaining agreements

Current through Register Vol. 46, No. 28, July 10, 2024
(a) When an employer and union enter into a
				  collective bargaining agreement that establishes an alternative dispute
				  resolution system for claims arising under the Workers' Compensation Law as
				  authorized by section 25(2-c), the parties shall submit the following to the
				  office of the chair at least 30 days prior to the proposed commencement date of
				  such alternative system:
(1) a copy of the
				  collective bargaining agreement;
(2) a statement of the approximate number of
				  employees to be covered thereby;
(3) an affirmation that the business activity
				  covered by the collective bargaining agreement is classified under one or more
				  of sections 220, 240 and
				  241  of the Labor Law;
(4) evidence that the particular union is a
				  recognized or certified exclusive bargaining representative of the covered
				  employees;
(5) the name, address,
				  and telephone number of a contact person of the employer and the union.
Within 30 days after receiving the proposed agreement, the
					 chair or the chair's designee shall review the agreement for compliance with
					 section 25(2-c) and these rules and shall notify the parties either that the
					 agreement is not in compliance and recommend appropriate action to bring the
					 agreement into compliance or that the agreement is in compliance.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 314 - Alternative Dispute Resolution Of Claims › Section 314.3 - Alternative dispute resolution process

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Claims not resolved in any prior
				  procedural stages provided in the agreement may be referred to arbitration
				  which shall be conducted pursuant to the rules established by the agreement and
				  in which the parties shall have the right to be represented by legal counsel. A
				  written record of the arbitration proceeding shall be kept. No offers or
				  recommendations made during prior procedural stages shall be admissible in the
				  arbitration proceeding.
(b) All
				  settlements and decisions resulting from proceedings authorized by section
				  25(2-c) shall be filed with the Workers' Compensation Board and shall be final
				  and binding upon the parties. Any appeal must be made within 30 days after
				  notice of the filing of an arbitrator's award or decision. All such appeals
				  shall be made to the appellate division of the supreme court, third department
				  as designated in section 23 (2)  of the Workers' Compensation Law. There shall be
				  no intermediate review by the Workers' Compensation Board.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 314 - Alternative Dispute Resolution Of Claims › Section 314.4 - Utilization of managed care organizations or authorized provider listing

Current through Register Vol. 46, No. 28, July 10, 2024
As expressed in section 25(2-c)(c)(ii), the parties to a
					 collective bargaining agreement may designate a managed care organization or a
					 list of authorized providers for exclusive medical treatment of covered
					 employees. For purposes of section 25(2-c), authorized providers are those
					 medical professionals who have been certified by the chair in accordance with
					 section 13-b and who have been agreed upon by the employer and the union.
					 Review by the chair of collective bargaining agreements which designate managed
					 care organizations or authorized provider listings for the treatment of covered
					 employees shall be conducted in the manner set forth in section
					 314.2(a),
					 (b) and (c)  of this Part.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 314 - Alternative Dispute Resolution Of Claims › Section 314.5 - Utilization of authorized provider listing for provision of medical opinions and testimony

Current through Register Vol. 46, No. 28, July 10, 2024
Authorized providers under section 25(2-c)(c)(iii) are
					 those agreed upon by the employer and the union as the exclusive source of all
					 medical opinions and testimony. Review by the chair of collective bargaining
					 agreements which provide for the utilization of authorized provider listings
					 for medical opinions and testimony shall be conducted in the manner set forth
					 in section
					 314.2(a),
					 (b) and (c)  of this Part.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 314 - Alternative Dispute Resolution Of Claims › Section 314.6 - Collective bargaining provisions related to supplemental benefits, light duty, modified job, return to work programs, vocational rehabilitation or retraining and worker injury and illness prevention program

Current through Register Vol. 46, No. 28, July 10, 2024
Review by the chair of collective bargaining agreements
					 which provide for supplemental benefits, light duty, modified job, return to
					 work programs, vocational rehabilitation or retraining and worker injury and
					 illness prevention programs as authorized by section 25(2-c)(c)(iv), (v), (vi)
					 and (vii) shall be conducted in the manner set forth in section
					 314.2(a),
					 (b) and (c)  of this Part.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 314 - Alternative Dispute Resolution Of Claims › Section 314.7 - Reporting requirements

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Within
				  30 days of the final disposition or settlement of a workers' compensation claim
				  under the alternative dispute resolution system, the employer shall be
				  responsible for filing a completed ADR-2 form with the Workers' Compensation
				  Board.
(b) At least annually and as
				  otherwise required by the chair, each employer shall submit a report to the
				  chair containing the following information:
(1) the number of employees within the
				  alternative dispute resolution program;
(2) the number of claims filed;
(3) the total amount of lost wage benefits
				  paid within the program;
(4) the
				  total amount of medical expenditures paid within the program;
(5) the number of decisions rendered,
				  settlements made and appeals taken.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 315 - Regulations › Section 315.1 - Application

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Every employer
				  desiring to become a self insurer shall make application in form prescribed by
				  the chairman. This application shall contain:
(1) a payroll report filed by classification
				  code, for the five preceding annual fiscal periods;
(2) a report in a format determined by the
				  chairman indicating compensation and medical losses (payments plus reserves),
				  for a period up to 10 years prior to the date of application;
(3) the most recent, certified, independently
				  audited financial statement of the employer, and copy of form 10K, if any,
				  filed by the employer with the Securities and Exchange Commission. A subsidiary
				  company may submit the consolidated financial statement of the parent company
				  in lieu of its own individual financial statement. In such event, however, the
				  parent company must guarantee the liability of the subsidiary company under the
				  Workers' Compensation Law, by filing with the chairman, an Agreement of
				  Assumption and Guarantee in form approved by the chairman;
(4) a description of the safety organization
				  maintained by the employer for the prevention of accidents; and
(5) a description of the business operations
				  performed or to be performed by the employer.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 315 - Regulations › Section 315.2 - Agreement

Current through Register Vol. 46, No. 28, July 10, 2024
The employer shall execute and file with the chairman an
					 agreement, in prescribed form:
(a) to
				  pay to injured employees and to the dependents of deceased employees, from time
				  to time, all compensation as required by the provisions of the Workers'
				  Compensation Law;
(b) to deposit
				  with the chair securities, and/or cash, and/or a surety bond, and/or
				  irrevocable letters of credit, in form approved by the chair, in amounts or
				  penal sum as hereinafter provided;
(c) to pay annually such share of the expense
				  of administration and other expense or assessment as provided by the Workers'
				  Compensation Law;
(d) to permit the
				  chairman's authorized representatives access to the premises of the employer
				  for the purpose of examining operations and records pertaining to the
				  employer's financial condition and status as a self-insurer under the Workers'
				  Compensation Law;
(e) that the
				  chair may sell any part of the securities deposited, draw on the letters of
				  credit or require the surety to pay forthwith to the chair all or any part of
				  the penal sum of the bond, and from the proceeds of the securities, from such
				  penal sum, from the amount drawn, or from the employer's deposit of cash pay
				  any compensation obligations, expense, or assessments imposed by law when such
				  employer may neglect or refuse to pay such obligations, expense, or assessments
				  or within 30 days prior to the expiration date of any letters of credit when
				  the employer shall have failed to renew or replace such letters or have
				  substituted cash, securities or a surety bond; and
(f) if the chairman shall so require, to pay
				  any awards commuted under section 27  of the Workers' Compensation Law into the
				  aggregate trust fund.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 315 - Regulations › Section 315.4 - Periodic reports

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Reports
				  shall be filed with the chairman, by each self-insurer as follows:
(1) the most recent certified, independently
				  audited financial statement and copy of form 10K, if any, filed by the employer
				  with the Securities and Exchange Commission, to be filed not later than three
				  months after the close of the self-insurer's fiscal year. A subsidiary company
				  may submit the consolidated financial statement of the parent company in lieu
				  of its own individual financial statement. In such event, however, the parent
				  company must guarantee the liability of the subsidiary company under the
				  Workers' Compensation Law by filing with the chairman, an Agreement of
				  Assumption and Guarantee in form approved by the chairman;
(2) a payroll report filed by classification
				  code, for the 12-month period ending March 31st of each year;
(3) a statement of all outstanding death and
				  disability claims as of September 30th of each year, segregated by State fiscal
				  year (April 1st through March 31st) of accident occurrence;
(4) a statement of compensation and medical
				  losses incurred by the self-insurer for the 12-month period ending September
				  30th, analyzed by State fiscal year of accident occurrence; and
(5) additional or more frequent reports or
				  statements as may be requested by the chairman.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 315 - Regulations › Section 315.5 - Withdrawal of securities or cash; nonrenewal of letters of credit: termination of surety bond

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Withdrawal
				  of securities or cash; nonrenewal of letters of credit.
(1) A self-insurer who has discontinued
				  business in this State or who has arranged for the payment of its compensation
				  claims by one of the other methods provided by law may apply to the chair for
				  the return of the securities or cash deposited or permission not to renew the
				  letters of credit. Such self-insurer shall file a sworn statement of:
(i) all outstanding liabilities for
				  compensation;
(ii) all pending
				  claims for compensation; and
(iii)
				  all accidents that have occurred during the period of two years prior to the
				  date of application.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 316 - Rules › Section 316.1 - The minimum exposure deposit required

Current through Register Vol. 46, No. 28, July 10, 2024
The self-insurer shall deposit securities, and/or cash,
					 with the chair, Workers' Compensation Board, and/or file an acceptable surety
					 bond and/or irrevocable letters of credit, in an aggregate amount and/or penal
					 sum determined by the chair, but not less than the lesser of either:
(a) the product of the statutory maximum
				  weekly compensation rate for total disability multiplied by 52, multiplied by
				  30; or
(b) one and one-half times
				  the self-insurer's retention as specified on the certification of excess
				  reinsurance contracts filed with the chair, but in no event less than
				  $200,000.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 316 - Rules › Section 316.2 - Security for catastrophic losses

Current through Register Vol. 46, No. 28, July 10, 2024
(a) In addition to the deposit of securities
				  and/or cash and/or the filing of a surety bond and/or irrevocable letters of
				  credit required by the chair, the applicant shall provide security against
				  catastrophic loss arising out of one accident, by filing with the chair the
				  carrier's certification of an excess, reinsurance contract issued to the
				  self-insurer in form, content and amounts acceptable to the chair; such
				  contract must be issued by an insurance carrier authorized by the
				  Superintendent of Insurance to write said excess contract in New York State,
				  and must contain specific coverage for workers' compensation.
(b) The requirement of subdivision (a) of
				  this section may be waived under special circumstances, at the discretion of
				  the chair.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 316 - Rules › Section 316.3 - Increase or reduction in the amount of deposit

Current through Register Vol. 46, No. 28, July 10, 2024
The chair may require the deposit of additional securities
					 and/or cash, an increase in the penal sum of the surety bond and/or an increase
					 in the aggregate amount of the letters of credit, or, on application of the
					 self-insurer, return a part of the securities or cash on deposit, permit a
					 reduction in the penal sum of the surety bond and/or a reduction in the
					 aggregate amount of the letters of credit, in such amounts as he or she may
					 deem necessary or determine to be advisable to secure the self-insurer's
					 liability under the Workers' Compensation Law.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 317 - Group Self-insurance › Section 317.1 - Statement of purpose

Current through Register Vol. 46, No. 28, July 10, 2024
To establish application procedures, qualifications and
					 responsibilities for any group of employers which desires to become, or which
					 has been approved to operate as, a group self-insurer.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 317 - Group Self-insurance › Section 317.2 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
For purposes of these rules:
(a) American institution, shall mean an
				  institution created or existing under the laws of the United States of America
				  or of any State, district or territory thereof.
(b) Board of trustees, shall mean that body,
				  identified in the trust agreement, which is responsible for all operations of
				  the group self-insurer and which shall take all necessary action to protect the
				  assets of the group self-insurer.
(c) Claims shall mean, for purposes of
				  financial reporting and determining trust liabilities, the present value of all
				  workers' compensation claims, including those incurred but not reported, and
				  the expenses associated therewith which the group is obliged to settle and
				  adjust. Such claims must be determined on an actuarial basis and may be
				  discounted at a reasonable rate. The board may reject discount rates considered
				  to be unreasonable. Claims may be variously referred to as claim reserves, loss
				  reserves or reserves for loss and loss adjustment expenses in group
				  self-insurers' financial statements and actuarial reports.
(d) Claims administrator or third party
				  administrator shall mean an individual or entity licensed by the Workers'
				  Compensation Board pursuant to subdivision (3-b) or (3-d) of section 50  of the
				  Workers' Compensation Law which is responsible for the administration and
				  defense of workers' compensation claims of members of an authorized group
				  self-insurer.
(e) Contribution
				  shall mean the annual charge to individual members of a group self-insurer to
				  cover its workers' compensation liabilities and assessments.
(f) Excess insurance shall mean insurance,
				  purchased from an insurance company authorized by the superintendent of
				  insurance, which reduces the exposure of the group self-insurer:
(1) for workers' compensation claims;
				  and
(2) for employers' liability.
Such excess insurance may be specific, aggregate or other
					 insurance, singly or in combination, in amounts and form acceptable to the
					 chair.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 317 - Group Self-insurance › Section 317.3 - Qualification to operate as a group self-insurer

Current through Register Vol. 46, No. 28, July 10, 2024
To qualify as a group self-insurer and to maintain
					 authorization to operate as a group self-insurer, the following requirements
					 must be satisfied.
(a) The group must
				  include two or more employers that perform related activities in a given
				  industry and that have been in business for a period of time which is
				  acceptable to the chair. With the exception of groups consisting of municipal
				  corporations, a group self-insurer must demonstrate the related nature of the
				  group members' business activities, to the satisfaction of the chair, by one or
				  more of the following methods:
(1) all group
				  members must be classified within the same or a related standard industrial
				  classification code (SIC code) division structure as published in the United
				  States Department of Commerce's Standard Industrial Classification Code Manual,
				  or must share a predominant payroll classification;
(2) all group members must be members in good
				  standing in an industry-specific trade association, which shall not have been
				  established for the primary purpose of obtaining group self-insurance status
				  and shall have been in existence for at least five years prior to applying for
				  such status; or
(3) through the
				  furnishing of such other information as may be required by the chair in order
				  to demonstrate the related nature of the participating employers' business
				  activities.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 317 - Group Self-insurance › Section 317.5 - Security

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Group
				  self-insurers shall deposit with the chair securities, cash, surety bonds
				  and/or irrevocable letters of credits, in an aggregate amount as determined by
				  the chair, but not less than:
(1) the
				  combined annual payroll of the group members multiplied by the current manual
				  rates promulgated by the New York compensation insurance rating board;
				  or
(2) one and one-half times the
				  group self-insurers' retention as specified on the certificate of excess
				  insurance filed with the chair which limits the liability of a group on a
				  specific, per occurrence basis with respect to claims; but
(3) in no event shall such security amount be
				  less than the product of the statutory maximum weekly compensation rate for
				  total disability multiplied by 52, multiplied by 30.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 317 - Group Self-insurance › Section 317.6 - Capitalization

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Group
				  self-insurers shall file evidence of capitalization in an amount approved by
				  the chair as described herein. Groups shall prepare annual financial statements
				  in accordance with generally accepted accounting principles (GAAP). However,
				  only assets and liabilities as defined in section
				  317.2  of
				  this Part will be considered when determining the group's financial
				  condition.
(b) Group self-insurers
				  are required to establish and maintain trust assets, as such term is defined in
				  section
				  317.2(n) 
				  of this Part, in an amount which exceeds trust liabilities, as such term is
				  defined in section
				  317.2(o) 
				  of this Part. Group self-insurers who fail to comply with this capitalization
				  standard shall be deemed under-funded and shall immediately provide the chair
				  with an acceptable plan of action as may be appropriate in order to make up the
				  deficiency in a time prescribed by the chair. Such under-funded groups may also
				  be subject to any or all of the provisions set forth in section
				  317.9 
				  of this Part.
(c) Upon
				  authorization to operate as a group self-insurer, the group shall deposit into
				  the trust an amount equal to a minimum of 40 percent of the initial security
				  deposit held by the chair. Consistent with section
				  317.5(d) 
				  of this Part, the security held by the chair shall not be considered a trust
				  asset and shall not be used to satisfy the financial obligations of a solvent
				  trust. By the end of the first full reporting year, the group shall have
				  deposited amounts sufficient to bring the trust assets to an amount which
				  exceeds trust liabilities. These amounts shall be paid to the trust on a
				  monthly, quarterly, or annual basis as required by the bylaws of the
				  group.
(d) The provisions of this
				  Subpart shall not apply to groups consisting exclusively of municipal
				  corporations.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 317 - Group Self-insurance › Section 317.7 - Contribution rates

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The
				  contribution rates utilized by a group self-insurer shall not be inadequate,
				  unfairly discriminatory, destructive of competition or detrimental to the
				  solvency of the group.
(b) If the
				  chair has reasonable cause to believe that a group's contribution rates do not
				  conform to the requirements of subdivision (a) of this section, then he or she
				  may require the submission of a report identifying the contributions paid by
				  each of the group members for the preceding year, the projected contributions
				  for each group member for the current fiscal year, and the manner in which such
				  contributions were calculated.
(c)
				  Such report shall be closely reviewed by the chair for purposes of determining
				  the adequacy of contributions as well as the consistency and rationality of the
				  contribution calculations. In addition to other factors, the chair may consider
				  generally accepted actuarial standards as well as the New York Compensation
				  Insurance Rating Board's manual rate premium standards in conducting its review
				  of this report.
(d) If, after such
				  review, the group's contribution rates are deemed to be inadequate, unfairly
				  discriminatory, destructive of competition or detrimental to the solvency of
				  the group, the chair may mandate the group's adherence to the New York
				  Compensation Insurance Rating Board's rates and rate making procedures. Groups
				  directed to adhere to the New York Compensation Insurance Rating Board's rates
				  may apply to the chair for discounts to such rates based upon past and
				  prospective losses, investment income, and other relevant factors.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 317 - Group Self-insurance › Section 317.9 - Terms and procedures applicable to under-funded group self-insurers

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Group
				  self-insurers are required to maintain at all times sufficient trust assets
				  within the trust fund to exceed claims and all other liabilities.
(b) Group self-insurers whose assets do not
				  exceed liabilities are deemed to be under-funded and may be subject at any time
				  to any or all of the following provisions, at the discretion of the chair:
(1) the chair may call for meeting with the
				  group's board of trustees and/or group administrator to discuss the financial
				  condition of the trust fund and to determine the appropriate course of action
				  to restore the trust fund's financial stability in a timely manner;
(2) the chair may require an examination of
				  the group self-insurer pursuant to section
				  317.4(a)(7)(iv) 
				  of this Part;
(3) the chair may
				  require the submission of additional financial and/or actuarial documentation
				  from the group self-insurer including, but not limited to, a report such as
				  that described in section
				  317.7(b) 
				  of this Part;
(4) the chair may
				  require a written plan from the group's board of trustees and/or group
				  administrator in order to restore the trust fund's financial stability. Such
				  written plan must be in a form and content acceptable to the chair including,
				  but not limited to, a projected plan for member contributions for the next five
				  years or such additional period of time as the chair may require;
(5) the chair may suspend the addition of any
				  new members into the group and/or suspend the payment of any earnings on
				  deposits or investments or assessments or any portion thereof until the group
				  self-insurer is deemed to be adequately funded; or
(6) the chair may require additional security
				  deposits to be held in accordance with section
				  317.5  of this
				  Part;
(7) the group self-insurer
				  may be required to immediately levy an assessment upon the group members or
				  take such other action as may be appropriate in order to make up the
				  deficiency.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 317 - Group Self-insurance › Section 317.10 - Excess insurance

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The
				  group self-insurer shall also file certificate(s) evidencing that excess
				  insurance, as defined in section
				  317.2(f) 
				  of the Part, has been obtained to reduce the exposure of the group
				  self-insurer:
(1) for workers' compensation
				  claims; and
(2) for employers'
				  liability.
Such excess insurance must be in a form approved by the
					 superintendent of insurance and must be issued by a property and casualty
					 company licensed by the superintendent of insurance to write excess insurance
					 in New York with respect to workers compensation insurance and employer's
					 liability insurance as defined in paragraph (15) of subdivision (a) of section 1113  of the Insurance Law. The retention
					 levels for the excess insurance shall be in an amount acceptable to the
					 chair.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 317 - Group Self-insurance › Section 317.11 - Blanket fidelity bond

Current through Register Vol. 46, No. 28, July 10, 2024
Every group self-insurer shall be required to file with the
					 chair evidence that it has obtained a Blanket Fidelity Bond providing coverage
					 for theft, disappearance or destruction of money, securities, or other
					 property, in an amount acceptable to the chair. Such bond shall provide
					 coverage for dishonest acts of the group administrator, or a trustee, employee
					 or agent of the group, whether identified or not, while acting alone or in
					 collusion with others, and shall name the group self-insurer as loss payee.
					 Such bond shall be maintained at all times during the existence of the group
					 self-insurer.
New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter B - Self-insurers › Part 317 - Group Self-insurance › Section 317.12 - Bylaws

Current through Register Vol. 46, No. 28, July 10, 2024
Each group self-insurer's board of trustees must also
					 establish written bylaws which provide detailed information as to the
					 operations and administration of the group self-insurer. Such bylaws shall
					 address issues including but not limited to: qualifications for group
					 membership; procedures for adding or terminating group members; rights and
					 responsibilities of group members including acknowledgments of the joint and
					 several liability assumed by each member of the group; group self-insurer's
					 name, location, fiscal year; basis for establishing member contributions;
					 underwriting considerations; meetings; safety programs, if any; disclosure of
					 group self-insurer's books, reports, etc. to members; and procedures for
					 amending bylaws.