reglab/statecodes huggingface dataset:
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter IV - Financial Condition Of Insurer and Reports to Superintendent › Subchapter F - Public Retirement Systems › Part 136 - Public Retirement Systems › Subpart 136-2 - Standards For The New York State And Local Employees' Retirement System, The New York State And Local Police And Fire Retirement System And The New York State Common Retirement Fund › Section 136-2.7 - Implementation

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Failure to
					 implement provisions of applicable law or regulation shall be regarded as a
					 breach of fiduciary responsibility.
(b) The Comptroller, any officer or employee
					 of OSC, or any other person or entity having a fiduciary responsibility to the
					 fund, who willfully violates or knowingly participates in a violation of any
					 fiduciary standard promulgated pursuant to section 314  of the Insurance Law or other applicable
					 law or regulation, shall be guilty of a breach of fiduciary
					 responsibility.
(c) In the event
					 the superintendent determines that there is reasonable cause to believe that
					 the breach has occurred, the superintendent shall, after providing notice to
					 the Comptroller or his or her designee, and to the subject officer or employee
					 of OSC or such other person or entity having a fiduciary responsibility to the
					 fund, transmit a notice of reasonable cause to: the Temporary President of the
					 Senate and the Speaker of the Assembly, if the notice relates to the
					 Comptroller; or to the Comptroller, if the notice relates to an officer or
					 employee of OSC or to any other person or entity having a fiduciary
					 responsibility to the fund.
(d) In
					 any case where the superintendent determines that there is reasonable cause to
					 believe that a breach by the Comptroller, an officer or employee of OSC, or any
					 other person or entity having a fiduciary responsibility to the fund, has
					 resulted in a depletion of the fund, the superintendent, after providing notice
					 to the Comptroller or the Comptroller's designee, may transmit a copy of his or
					 her determination to the Attorney General or any other appropriate civil or
					 criminal law enforcement authorities for any appropriate further
					 action.
(e) In any case where the
					 superintendent's transmittal results in an adjudication that the fund has been
					 depleted by reason of any breach, the adjudication will be published on the OSC
					 public website.
(f) This Subpart
					 shall take effect upon publication in the State Register, and will apply to all
					 contracts related to the management of the fund entered into or renewed by the
					 Comptroller subsequent to that date.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter A - Automobile Statistical Plan › Part 140 - Private Passenger Automobile And Commercial Automobile Statistical Plans › Section 140.1 - Purpose and applicability

Current through Register Vol. 46, No. 28, July 10, 2024
The purpose of this Part is to establish procedures for
					 statistical plans for the reporting of private passenger automobile and
					 commercial automobile statistical experience in order that this experience may
					 be available to the New York Insurance Department or to officially designated
					 statistical agents of the department. This Part is applicable to insurers that
					 write direct private passenger automobile and commercial automobile insurance
					 business in the State of New York and to officially designated statistical
					 agents of the department.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter A - Automobile Statistical Plan › Part 140 - Private Passenger Automobile And Commercial Automobile Statistical Plans › Section 140.2 - General requirements

Current through Register Vol. 46, No. 28, July 10, 2024
All private passenger automobile and commercial automobile
					 insurance statistical plans subject to this Part must be filed and approved by
					 the Superintendent of Insurance prior to implementation.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter A - Automobile Statistical Plan › Part 140 - Private Passenger Automobile And Commercial Automobile Statistical Plans › Section 140.3 - Calls for statistical experience

Current through Register Vol. 46, No. 28, July 10, 2024
Annual calls for detailed classification and territorial
					 experience for the private passenger automobile and commercial automobile
					 liability, no-fault, uninsured/underinsured motorist, medical payments and
					 physical damage coverages will be distributed to the insurers. Such calls for
					 experience will require reports of experience to be made to the department or
					 its officially designated statistical agent in accordance with the time frames
					 specified in the call.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter A - Automobile Statistical Plan › Part 140 - Private Passenger Automobile And Commercial Automobile Statistical Plans › Section 140.4 - Reinsurance

Current through Register Vol. 46, No. 28, July 10, 2024
Calls for experience will relate to experience for direct
					 business only. Therefore, the reports of experience shall not include premiums
					 received from or losses paid to other carriers on account of reinsurance
					 assumed by the reporting carrier nor shall any deductions be made by the
					 reporting carrier for premiums ceded to or for losses recovered from other
					 carriers on account of reinsurance ceded.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter A - Automobile Statistical Plan › Part 145 - Implementation Of Private Passenger Automobile Insurance Statistical Data Monitoring System › Section 145.0 - Preamble

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The purpose of
				  this Part is to assure the accuracy and reliability of private passenger
				  automobile statistical data reported to the Insurance Department by its
				  licensed statistical agents. The statistical data provide part of the general
				  support for insurers' rate and classification filings and supply important
				  information with respect to the character and composition of the market. In
				  addition, in most companies, the raw data utilized in a company's statistical
				  reporting system are essentially the same data as those utilized in its
				  ratemaking system. The accuracy and reliability of these data are of
				  fundamental importance to the Insurance Department.
(b) The procedures required to accomplish the
				  goal of accuracy and reliability are specified in a set of manuals entitled the
				  Statistical Data Monitoring System (SDMS). The SDMS comprises six elements:
(1) Systems Descriptions and Procedural
				  Control Checklists.
(2) Statistical
				  Sampling Procedures (Detail Data Verification).
(3) Reasonability Test Procedures (Summary
				  Data Verification).
(4)
				  Reconciliation of Statistical Data to Financial Statement.
(5) Annual Self-Review and Certification by
				  the insurer or statistical agent.
(6) Periodic Review by the Insurance
				  Department.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter A - Automobile Statistical Plan › Part 145 - Implementation Of Private Passenger Automobile Insurance Statistical Data Monitoring System › Section 145.1 - Applicability

Current through Register Vol. 46, No. 28, July 10, 2024
This Part shall be applicable to:
(a) all insurers writing private passenger
				  automobile insurance in this State; and
(b) all statistical agents reporting private
				  passenger automobile statistics to the Insurance Department.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter A - Automobile Statistical Plan › Part 145 - Implementation Of Private Passenger Automobile Insurance Statistical Data Monitoring System › Section 145.2 - Implementation

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Each insurer
				  and statistical agent shall monitor private passenger automobile statistical
				  data in accordance with the provisions of the SDMS as required by the Insurance
				  Department. However, the superintendent may waive or modify any SDMS
				  requirement(s) for an individual insurer or statistical agent where the
				  implementation of the requirement(s) would be impractical or unreasonable
				  because of the small volume of private passenger automobile insurance premiums
				  written by the insurer or in such other instances where the superintendent
				  deems that such implementation would place an unreasonable burden on the
				  insurer or statistical agent.
(b)
				  The superintendent shall provide a copy of the SDMS manuals to each insurer and
				  statistical agent.
(c) The
				  superintendent shall maintain copies of the SDMS for public perusal at the
				  offices of the Insurance Department in New York City and in Albany and at other
				  locations within this State.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-1 - Rate Filings Prior Approval › Section 151-1.0 - Preamble

Current through Register Vol. 46, No. 28, July 10, 2024
Prior to the September 1, 1984 recodification of the
						Insurance Law, section 184(7) provided that no workers' compensation rate could
						be made effective by any rating organization or insurer until such rate had
						been approved by the superintendent. Following recodification, however, section
						2305(b) provides that workers' compensation rates cannot become effective
						unless either:
(a) the filing has been
					 approved; or
(b) 15 days, which the
					 superintendent may extend to 30 days, elapse without disapproval.
Section 2305(e), nonetheless, provides that the
						superintendent may, by regulation, require specific approval before workers'
						compensation rates can take effect.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-1 - Rate Filings Prior Approval › Section 151-1.1 - Forms, classifications and territories

Current through Register Vol. 46, No. 28, July 10, 2024
Every workers' compensation filing that has a rate impact
						and relates to new or revised forms, classifications or territories must be
						accompanied by a rate filing.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-1 - Rate Filings Prior Approval › Section 151-1.2 - Specific approval

Current through Register Vol. 46, No. 28, July 10, 2024
No workers' compensation rate filing shall be made
						effective by any rate service organization or insurer until an appropriate
						workers' compensation rate has been specifically approved by the
						superintendent.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-1 - Rate Filings Prior Approval › Section 151-1.3 - Supporting memorandum

Current through Register Vol. 46, No. 28, July 10, 2024
Each workers' compensation rate filing with a rate impact
						shall be supported by a memorandum that contains a comparison between any
						existing filing and the proposed revision describing and justifying all
						changes.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-2 - Industry Standard Rate For Aggregate Trust Fund › Section 151-2.1 - Preamble

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Section 27  of
					 the Workers' Compensation Law requires the present value of certain awards of
					 compensation to be deposited into the Aggregate Trust Fund on either a
					 mandatory basis or by the discretion of the Workers' Compensation Board. The
					 present value is discounted by a percentage rate specified by section 27. On
					 March 13, 2007, legislation establishing comprehensive reform to New York's
					 Workers' Compensation Law was signed into law, becoming chapter 6 of the Laws
					 of 2007. Chapter 6 amended section 27 to replace the six percent discount rate
					 previously applicable to ATF deposits, as well as various other interest rates
					 associated with ATF deposits, with an "industry standard rate" to be determined
					 by the Superintendent of Insurance by regulation. Section 27, as amended,
					 applies the industry standard rate to accidents occurring on or after January
					 1, 2001.
(b) After discussions with
					 the New York State Insurance Fund (NYSIF) (which administers the ATF),
					 insurers, the Workers' Compensation Board, and other interested parties, the
					 superintendent has determined the industry standard rate. Among the factors
					 that were considered by the superintendent in making this determination were
					 the following:
(1) the rate of return on
					 invested assets experienced by the NYSIF in recent years;
(2) the investment performance of domestic
					 property/casualty insurers;
(3) the
					 rates of return on low risk investments of comparable duration to that of the
					 ATF liabilities; and
(4) the
					 discount rate used in calculating the minimum individual case reserves for
					 policies of workers' compensation insurance, pursuant to section 4117 (d)  of the Insurance
					 Law and section 86  of the Workers' Compensation Law.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-2 - Industry Standard Rate For Aggregate Trust Fund › Section 151-2.2 - Industry standard rate

Current through Register Vol. 46, No. 28, July 10, 2024
The industry standard rate shall be five percent per
						year.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-2 - Industry Standard Rate For Aggregate Trust Fund › Section 151-2.3 - Effective date

Current through Register Vol. 46, No. 28, July 10, 2024
This Subpart shall apply to all new deposits made into
						the ATF on or after July 1, 2007, for accidents occurring on or after January
						1, 2001, as mandated by chapter 6 of the Laws of 2007.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-3 - Workplace Safety And Loss Prevention Incentive Program › Section 151-3.1 - Preamble

Current through Register Vol. 46, No. 28, July 10, 2024
(a) In March 2007,
					 the Legislature enacted chapter 6 of the Laws of 2007, which reformed New
					 York's workers' compensation system. Chapter 6 amended Workers Compensation
					 Law, section 134(6), to state that employers insured through the State
					 Insurance Fund (except those who are current policy holders in a recognized
					 safety group) or any other insurer that issues policies of workers'
					 compensation insurance, shall be eligible for a credit in workers' compensation
					 insurance premiums if the employer implements any of the following:
(1) a safety incentive program that conforms
					 to regulations promulgated by the Commissioner of Labor;
(2) a drug and alcohol prevention program
					 that conforms to regulations issued by the Commissioner of Labor, in
					 consultation with the office of alcoholism and substance abuse services;
					 or
(3) a return to work program
					 that conforms to regulations issued by the Commissioner of Labor.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-3 - Workplace Safety And Loss Prevention Incentive Program › Section 151-3.2 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
In this Part:
(a) Credit means credit in workers'
					 compensation insurance premium provided to an insured employer that implements
					 an approved WSLPIP.
(b) Industrial
					 Code Rule 60 means the rule promulgated by the Commissioner of Labor as 12
					 NYCRR 60.
(c) Workplace Safety and
					 Loss Prevention Incentive Program or WSLPIP means, pursuant to 12 NYCRR 60, a
					 qualifying:
(1) safety incentive
					 program;
(2) drug and alcohol
					 prevention program; or
(3) return
					 to work program.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-3 - Workplace Safety And Loss Prevention Incentive Program › Section 151-3.3 - Employer safety incentive program credits

Current through Register Vol. 46, No. 28, July 10, 2024
For each policy of workers' compensation insurance issued
						or renewed in the State, an insurer shall provide credit to an insured employer
						that implements and maintains a safety incentive program, which meets the
						requirements of Industrial Code Rule 60. The credit shall be:
(a) four percent in the first full year in
					 which the insured is entitled to a credit; and
(b) two percent in each consecutive full year
					 thereafter.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-3 - Workplace Safety And Loss Prevention Incentive Program › Section 151-3.4 - Employer drug and alcohol prevention program credits

Current through Register Vol. 46, No. 28, July 10, 2024
For each policy of workers' compensation insurance issued
						or renewed in the State, an insurer shall provide credit to an insured employer
						that implements and maintains a drug and alcohol prevention program, which
						meets the requirements of Industrial Code Rule 60. The credit shall be two
						percent in the every full year for which the insured is entitled to a
						credit.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-3 - Workplace Safety And Loss Prevention Incentive Program › Section 151-3.5 - Employer return to work program credits

Current through Register Vol. 46, No. 28, July 10, 2024
For each policy of workers' compensation insurance issued
						or renewed in the State, an insurer shall provide credit to an insured employer
						that implements and maintains a return to work program, which meets the
						requirements of Industrial Code Rule 60:
(a) four percent in the first full year for
					 which the insured is entitled to a credit; and
(b) two percent in each consecutive full year
					 thereafter.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-3 - Workplace Safety And Loss Prevention Incentive Program › Section 151-3.6 - Deviation from premium credit amount

Current through Register Vol. 46, No. 28, July 10, 2024
An insurer, upon written application to the
						superintendent, may deviate from the credit, provided that the superintendent
						approves the deviation in accordance with, and pursuant to, the standards set
						forth in Insurance Law, article 23.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-3 - Workplace Safety And Loss Prevention Incentive Program › Section 151-3.7 - Credit for employers with more than one wslpip

Current through Register Vol. 46, No. 28, July 10, 2024
For each insured with more than one WSLPIP, an insurer
						shall add all credits to which the insured is entitled for a total combined
						credit amount.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-3 - Workplace Safety And Loss Prevention Incentive Program › Section 151-3.8 - Amount of credit for a wslpip when not implemented for consecutive years

Current through Register Vol. 46, No. 28, July 10, 2024
(a) An insured that
					 ceases to maintain a previously approved WSLPIP for less than four years shall,
					 upon application pursuant to 12 NYCRR 60-1.6, be eligible for a credit in an
					 amount equal to the amount that the insured would have been entitled to as if
					 the insured had continuously maintained the WSLPIP.
(b) An insured that ceases to maintain a
					 previously approved WSLPIP for four or more years shall, upon application
					 pursuant to 12 NYCRR 60-1.6, be eligible for a credit in an amount equal to the
					 amount that the insured would have been entitled to as if the insured were a
					 new entrant into the WSLPIP.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-3 - Workplace Safety And Loss Prevention Incentive Program › Section 151-3.9 - Provision of initial approval certificate and annual credit recertification

Current through Register Vol. 46, No. 28, July 10, 2024
(a) An insurer
					 shall require an insured that receives a credit pursuant to Industrial Code
					 Rule 60 and this Part to provide the insurer with the certificate of approval
					 issued pursuant to section
					 60-1.6(e) 
					 of Industrial Code Rule 60.
(b) An
					 insurer shall require an insured that receives a credit pursuant to Industrial
					 Code Rule 60 and this Part to recertify the credit by annually submitting to
					 the insurer the verification submitted to the Department of Labor pursuant to
					 12 NYCRR 60-1.8.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-3 - Workplace Safety And Loss Prevention Incentive Program › Section 151-3.10 - Reporting requirements

Current through Register Vol. 46, No. 28, July 10, 2024
An insurer providing a credit pursuant to this Part shall
						report annually to the superintendent and the Commissioner of Labor, in a form
						prescribed by the superintendent, the total number of employers insured during
						the prior year that received a premium credit for each WSLPIP program, and the
						total amount of the credit provided by the insurer.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-4 - Reserves For Special Disability Fund Claims › Section 151-4.2 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
Waiver agreement, in this Subpart, means any agreement
						entered into between an insurer, self-insured employer, or the State Insurance
						Fund and the New York State Workers' Compensation Board pursuant to Workers'
						Compensation Law section 32(i)(2) and (3).
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-4 - Reserves For Special Disability Fund Claims › Section 151-4.3 - Reserve amounts

Current through Register Vol. 46, No. 28, July 10, 2024
Any insurer, self-insured employer, or the State
						Insurance Fund that enters into a waiver agreement shall establish reserves for
						those claims in accordance with Insurance Law sections 1303 and
						4117(d).
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-5 - Independent Livery Driver Benefit Fund › Section 151-5.0 - Purpose

Current through Register Vol. 46, No. 28, July 10, 2024
The purpose of this Subpart is to authorize workers'
						compensation and employers' liability insurers to provide coverage as afforded
						under Executive Law, article 6-G.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-5 - Independent Livery Driver Benefit Fund › Section 151-5.1 - Authorization of workers' compensation insurers' to write insurance pursuant to executive law, article 6-g

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
					 Pursuant to Insurance Law, section
					 3451, insurance companies authorized to
					 write workers' compensation insurance and employers' liability insurance, as
					 defined in Insurance Law, section
					 1113(a)(15), are hereby
					 authorized to write policies of insurance affording coverage in accordance with
					 Executive Law, article 6-G.
(b) No
					 policy or certificate thereunder providing for coverage pursuant to Executive
					 Law, article 6-G shall be issued or issued for delivery in this State unless
					 the forms have been filed with, and approved by, the superintendent in
					 accordance with Insurance Law, article 23.
(c) No policy or certificate thereunder
					 providing for coverage pursuant to Executive Law, article 6-G shall be issued
					 or issued for delivery in this State unless the rates have been filed with the
					 superintendent for prior approval in accordance with article 23 of the
					 Insurance Law and Subpart 151-1 of this Part.
(d) Every policy and certificate thereunder
					 providing for coverage pursuant to Executive Law, article 6-G issued or issued
					 for delivery in this State shall provide coverage in accordance with the
					 provisions of Executive Law, article 6-G.
(e) The policy shall be issued on a group
					 basis to the Independent Livery Driver Benefit Fund and shall provide coverage
					 to livery drivers dispatched by independent livery bases that are members of
					 the Independent Livery Driver Benefit Fund established pursuant to Executive
					 Law, article 6-G.
(f) A certificate
					 issued under the group master policy shall be provided to each member
					 independent livery base and contain all material terms and conditions of
					 coverage with respect to a livery driver, unless the group master policy is
					 incorporated by reference, and in which event, a copy of the master policy
					 shall accompany the certificate or shall be promptly provided to a member
					 independent livery base upon request.
(g) An insurer issuing or renewing the group
					 policy shall maintain separate statistics tracking group loss and expense
					 experience for the group program. The statistics shall be maintained in
					 conformance with Part 243 (Regulation 152) of this Title.
(h) Coverage disputes between insurers
					 pursuant to Executive Law, article 6- G shall be subject to mandatory
					 arbitration of controversies between insurers, pursuant to the provisions of
					 section 5105  of the Insurance Law and section
					 65-4.11 
					 of this Title (Regulation 68-D).
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-6 - Workers' Compensation Insurance Assessments › Section 151-6.0 - Preamble

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Workers'
					 Compensation Law, sections 15(8)(h)(4), 25-A(3), and 151(2)(b) require the
					 Workers' Compensation Board to assess insurers, and the State Insurance Fund
					 for the special disability fund, the fund for reopened cases, and the
					 operations of the board, respectively. First the assessments are allocated to
					 insurers, self-insurers, group self-insurers, and SIF based upon the total
					 compensation payments made by all such entities. In the case of an insurer,
					 once the assessment amount is determined, each pays the percentage of the
					 allocation based on the total premiums it wrote during the preceding calendar
					 year.
(b) Prior to January 1, 2010,
					 each insurer paid a percentage of the allocation based on the total direct
					 written premiums it wrote in the preceding calendar year. However, part QQ of
					 chapter 56 of the Laws of 2009 (part QQ) amended Workers' Compensation Law,
					 sections 15(8)(h)(4), and 151(2)(b) to change the basis upon which the board
					 collects the portion of the allocation from each insurer. Thus, effective
					 January 1, 2010, each insurer pays a percentage of the allocation based on the
					 total standard premium it wrote during the preceding calendar year. Part QQ
					 requires the Superintendent of Insurance (the superintendent) to define
					 "standard premium," for the purposes of the assessments, and to set rules, in
					 consultation with the board, and NYCIRB for collecting the assessment from
					 insureds.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-6 - Workers' Compensation Insurance Assessments › Section 151-6.1 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
As used in this Part:
(a) Board means the New York Workers'
					 Compensation Board.
(b) Insurer
					 means an insurer authorized to write workers' compensation insurance in this
					 State, except for the SIF.
(c)
					 NYCIRB means the New York Workers Compensation Rating Board.
(d) SIF means the State Insurance
					 Fund.
(e) Standard premium means:
(1) The premium determined on the basis of
					 the insurer's approved rates; as modified by:
(i) any experience modification or merit
					 rating factor;
(ii) any applicable
					 territory differential premium;
(iii) the minimum premium;
(iv) any Construction Classification Premium
					 Adjustment Program credits;
(v) any
					 credit from return to work and/or drug and alcohol prevention
					 programs;
(vi) any surcharge or
					 credit from a workplace safety program;
(vii) any credit from independently-filed
					 insurer specialty programs (for example, alternative dispute resolution,
					 drug-free workplace, managed care or preferred provider organization
					 programs);
(viii) any charge for
					 the waiver of subrogation;
(ix) any
					 charge for foreign voluntary coverage; and
(x) the additional charge for terrorism, and
					 the charge for natural disasters and catastrophic industrial
					 accidents.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-6 - Workers' Compensation Insurance Assessments › Section 151-6.2 - Collection of assessments

Current through Register Vol. 46, No. 28, July 10, 2024
Any assessment required by Workers' Compensation Law,
						sections 15(8)(h)(4), 25-A(3) and 151(2)(b) that are collected by an insurer or
						SIF from policyholders shall be collected through a surcharge based on standard
						premium in a percentage to be determined by the superintendent in consultation
						with NYCIRB and the board.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-7 - Workers'Compensation Safe Patient Handling Program › Section 151-7.0 - Preamble

Current through Register Vol. 46, No. 28, July 10, 2024
In March 2014, Governor Andrew M. Cuomo signed into law
						Part A of Chapter 60 of the Laws of 2014, which amended the Public Health Law
						and Insurance Law with regard to safe patient handling programs. Specifically,
						Part A of Chapter 60 added a new Title 1-A to Public Heal th Law Article 29-D.
						Section 2997-i of Title 1-A required the commissioner of health to establish a
						safe patient handling workgroup tasked with submitting a report to the
						commissioner of health by July 1, 2015. Section 2997-j of Title 1-A also
						required the commissioner of health to disseminate best practices, safe patient
						handling polices, and other resources and tools to all health care facilities
						covered by Title 1-A on or before January 1, 2016. Section 2997-k of Title 1-A
						required each health care facility to establish a safe patient handing
						committee by January 1, 2016, and requires a health care facility to establish
						a safe patient handling program o n or before January 1, 2017. In addition,
						Part A of Chapter 60 added a new Insurance Law section
						2304(j) to require the
						department to make rules establishing requirements for health care facilities
						to obtain a reduced workers' compensation insurance rate for safe patient
						handling programs implemented pursuant to Public Health Law section 2997-(k)(2)
						on or before July 1, 2016, which the department did on an emergency basis.
						Insurance Law section
						2304(j) further requires
						the department to complete an evaluation of the results of the reduced rate,
						including changes in claim frequency and costs, and to report to the
						appropriate commit tees of the legislature on or before December 1, 2018 and
						again on or before December 1, 2020.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-7 - Workers'Compensation Safe Patient Handling Program › Section 151-7.1 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
In this Subpart, health care facility shall have the
						meaning set forth in Public Health Law section 2997-(h)(1).
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-7 - Workers'Compensation Safe Patient Handling Program › Section 151-7.2 - Safe patient handling program credits

Current through Register Vol. 46, No. 28, July 10, 2024
(a) For each workers'compensation insurance
					 policy issued or renewed in this State on or after October 1, 2017, an insurer
					 shall provide a credit to a health care facility that implements and maintains
					 a safe patient handling program that meets the requirements of Public Health
					 Law section 2997-(k)(2). The amount of the credit and the manner in which it is
					 applied shall be in accordance with the approved manual filed by the rate
					 service organization of which the insurer is a member.
(b) An insurer shall verify or obtain
					 verification from a health care facility that the health care facility has
					 implemented and maintains a safe patient handling program that meets the
					 requirements of Public Health Law section 2997-(k)(2) before providing a
					 credit.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 151 - Workers' Compensation Insurance › Subpart 151-7 - Workers'Compensation Safe Patient Handling Program › Section 151-7.3 - Reporting requirements

Current through Register Vol. 46, No. 28, July 10, 2024
By June 1 of each year, starting in 2018, every workers'
						compensation rate service organization shall submit a report to the
						superintendent regarding policies receiving a credit pursuant to this Part,
						including policy year payrolls, indemnity losses, indemnity claim counts, and
						medical losses by classification, and such other information as the
						superintendent may require. Every workers'compensation rate service
						organization shall report the information, including adjustments, consistent
						with the comparable classification relativity review.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 152 - Physicians And Surgeons Professional Insurance Merit Rating Plan › Section 152.2 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
As used in this Part:
(a) The term claim shall mean written notice
				  or demand upon the insured, including suit, filed by a claimant or other person
				  acting on behalf of the claimant, and received by the insurer, that alleges
				  injuries or damages sustained from an incident. A single incident may result in
				  no more than one chargeable loss for each physician.
(b) The term chargeable loss shall mean: for
				  claims closed prior to July 1, 1981, the sum of all indemnity payments on any
				  one closed claim must be at least $15,000 for claims closed or outstanding on
				  or after July 1, 1981, the sum of all indemnity payments on any one closed or
				  outstanding claim must be at least $30,000.
(c) The term physician, when used in
				  connection with the Excess Medical Malpractice Risk Management Program, shall
				  mean a physician, surgeon or dentist participating in the Excess Medical
				  Malpractice Insurance Program.
(d)
				  The term Excess Medical Malpractice Program means the program established by
				  section 19 of chapter 294 of the Laws of 1985, as extended by section 18 of
				  chapter 266 of the Laws of 1986, as amended.
(e) The term insurer includes the plan
				  established pursuant to Part 430 (Regulation 170) of this Title.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 152 - Physicians And Surgeons Professional Insurance Merit Rating Plan › Section 152.3 - Department of Financial Services merit rating plan model

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
Evaluation period to be
				  used.
Chargeable losses paid in the 10-year review period and
					 disciplinary actions imposed in the five-year period prior to the latest policy
					 effective date shall be included for evaluation purposes. If, for any claim,
					 the length of time between the occurrence and settlement dates is more than 10
					 years, then such claim can no longer be, or become, a chargeable loss even
					 though settlement occurs in the 10-year review period. Physicians licensed to
					 practice for less than 10 years shall be rated only on their years of practice.
					 In issuing new and renewal policies for the period beginning July 1, 1986,
					 insurers shall use the full 10-year experience period (or less, for physicians
					 licensed less than 10 years). Upon request, physicians, insurers and managers
					 of insurance programs shall furnish to current insurers claims and disciplinary
					 information necessary to calculate an accurate surcharge. Existing insurers
					 shall request and obtain this information.
(b)
Surcharges for disciplinary
				  actions.
The following surcharges shall apply where there has
					 been:
(1) Licensing board disciplinary
				  proceedings within the past five years:
(i)
				  License revoked in any state: surcharge 100 percent.
(ii) License suspended in any state:
				  surcharge 75 percent.
(iii)
				  Probation invoked in any state: surcharge 50 percent.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 152 - Physicians And Surgeons Professional Insurance Merit Rating Plan › Section 152.4 - Alternative plans

Current through Register Vol. 46, No. 28, July 10, 2024
A plan may be submitted for the superintendent's approval
					 which varies in one or more aspects from the rules established in this Part.
					 Any merit rating plan must consider the criteria established in section 2343 (d)  of the Insurance
					 Law. The plan must be intended to be revenue-neutral and must:
(a) reflect an individual physician's or
				  surgeon's experience with respect to incidents or occurrences of alleged
				  medical malpractice;
(b) be
				  reasonable and not unfairly discriminatory, inequitable, violative of public
				  policy or otherwise contrary to the best interests of the people of this
				  State;
(c) consider the following
				  hazards:
(1) hazards of the
				  insured;
(2) geographical
				  area;
(3) specialties of practice;
				  and
(4) loss and expense
				  experience, trends in frequency, and severity of losses; and
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 152 - Physicians And Surgeons Professional Insurance Merit Rating Plan › Section 152.5 - Amount and application of risk management premium credits

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Insurers may
				  file, for approval by the superintendent, a premium credit of up to five
				  percent for insured physicians who successfully complete a qualified risk
				  management program.
(b)
(1) The premium credit shall be effective
				  with the next anniversary date of the policy following completion of the basic
				  course of the risk management program. However, if an insured completes the
				  risk management course within 60 days after the policy anniversary date, the
				  credit may be applied retroactively to that anniversary date.
(2) Where a policy is paid for on other than
				  an annual basis insurers may provide for the risk management premium credit to
				  become effective on the premium due date next following completion of the basic
				  course.
(3) Premium credits after
				  the second year following the insured's first receiving the premium credit may
				  only be applied if the insured successfully completes the follow-up course as
				  provided in section
				  152.6(e) 
				  of this Part.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 152 - Physicians And Surgeons Professional Insurance Merit Rating Plan › Section 152.6 - Standards for qualified risk management program

Current through Register Vol. 46, No. 28, July 10, 2024
In order to qualify for the credit, a risk management
					 program must meet the following minimum standards:
(a) The program must be administered by the
				  insurer or, after the insurer has investigated the entity's qualifications, by
				  an entity designated by the insurer to administer the program on its
				  behalf.
(b) The program must
				  contain at least two components:
(1) a basic
				  risk management course; and
(2) a
				  follow-up course to be taken once every two years after first receiving the
				  risk management premium credit.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 152 - Physicians And Surgeons Professional Insurance Merit Rating Plan › Section 152.7 - Implementation

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Insurers may
				  continue to use merit rating plans which have been approved by the
				  superintendent. The offsets that must be applied to the base rates in order to
				  insure that these plans are revenue neutral should be incorporated in all
				  subsequent rate filings. These offsets shall be periodically reviewed by all
				  insurers.
(b) An insurer wishing to
				  modify its approved merit rating plan shall submit the modified plan to the
				  superintendent for approval. An insurer entering the physicians and surgeons
				  professional liability market in New York may utilize the merit rating plan
				  model set forth in this Part or may submit an alternative merit rating plan. A
				  submission shall include a detailed explanation of how the proposed merit
				  rating plan complies with section
				  152.4  of this
				  Part.
(c) Any insurer that intends
				  to offer the premium credit provided for in section
				  152.5 
				  of this Part must submit its proposed risk management program to the
				  superintendent and obtain approval prior to the granting of any such
				  credit.
(d) The risk management
				  program must specify:
(1) the amount of the
				  credit;
(2) the length of the basic
				  and follow-up courses;
(3) the
				  specific basic and follow-up courses;
(4) the qualifications required for
				  developers of the internet-based program and instructors in each subject
				  area;
(5) the methodology for
				  monitoring attendance during the lecture course format and for assuring that
				  the eligible insured is the person who has taken and completed the
				  internet-based course;
(6) a
				  description of the required project;
(7) the methodology for verifying
				  satisfactory completion of all components of the program prior to the granting,
				  or continuation, of any premium credit;
(8) the identity of the entity, if any,
				  designated by the insurer to administer the risk management program on its
				  behalf, the qualifications of that entity, and the steps the insurer will take
				  to monitor the program;
(9) the
				  methodology for informing insureds of the availability of the risk management
				  credit and the dates, locations, and, if applicable, the internet address, of
				  each risk management program offered by the insurer;
(10) the amount of tuition and other fees, if
				  any, to be charged insureds participating in the program; and
(11) for internet-based program format, a
				  description of the type of interaction required of the insured, and the basis
				  for the insurer's determination that the component is equivalent to the time
				  and content of the lecture component.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter V - Rates And Rating Organizations › Subchapter B - Commercial And Industrial Risks › Part 152 - Physicians And Surgeons Professional Insurance Merit Rating Plan › Section 152.8 - Standards for risk management programs conducted for qualification in the excess medical malpractice insurance program

Current through Register Vol. 46, No. 28, July 10, 2024
In order to be eligible for participation in the Medical
					 Malpractice Excess Insurance Program (or remain eligible if currently
					 participating in that program), a physician must successfully complete an
					 Excess Medical Malpractice Risk Management Program that meets the following
					 requirements:
(a) The program must
				  consist of at least two components:
(1) an
				  excess medical malpractice risk management basic course; and
(2) an excess medical malpractice risk
				  management follow-up course to be taken once every two years
				  thereafter.