reglab/statecodes huggingface dataset:
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 123 - GENERAL PROVISIONS-PART II › Subchapter G - INFORMAL CONFERENCE › Section 123.601 - Representation of corporation at informal conference

Current through Register Vol. 54, No. 28, July 13, 2024
Each party may be represented at the informal conference
					 conducted under section 402.1 of the act (77 P. S. §
											711.1), but the employer may only be
					 represented by an attorney at the informal conference if the employee is also
					 represented by an attorney. When the employee is not represented at the
					 informal conference, an employer may be represented by an agent or other
					 representative, other than an attorney, at the informal
					 conference.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 123 - GENERAL PROVISIONS-PART II › Subchapter H - USE OF OPTICALLY SCANNED DOCUMENTS › Section 123.701 - Use of optically scanned documents

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The Bureau may optically scan original
				  documents, or make other images or paper copies which accurately reproduce the
				  originals, and may dispose of originals so copied.
(b) Copies made under this section, and
				  certified by the custodian of records for the Bureau, are admissible in
				  evidence in a proceeding with the same effect as though they were an
				  original.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 123 - GENERAL PROVISIONS-PART II › Subchapter I - UNINSURED EMPLOYER GUARANTY FUND-STATEMENT OF POLICY › Section 123.801 - Uninsured Employer Guaranty Fund

Current through Register Vol. 54, No. 28, July 13, 2024
The Department of Labor and Industry (Department) adopts
					 this statement of policy so that all parties will have a clear understanding of
					 their rights and obligations under the act, as amended by Act 147 of 2006 (P.
					 L. 1362, No. 147) (Act 147). This subchapter does not constitute a rule or
					 regulation with the force and effect of law. The Department intends to
					 promulgate regulations for this purpose as soon as
					 practicable.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 123 - GENERAL PROVISIONS-PART II › Subchapter I - UNINSURED EMPLOYER GUARANTY FUND-STATEMENT OF POLICY › Section 123.802 - Notice to the Uninsured Employer Guaranty Fund

Current through Register Vol. 54, No. 28, July 13, 2024
(a) For purposes of Article XVI of the act
				  (77 P. S. §§ - ), an injured worker who seeks benefits from the
				  Uninsured Employer Guaranty Fund (Fund) shall notify the Fund of a claim within
				  45 days from the date upon which the injured worker knew that the employer was
				  uninsured.
(b) Compensation will
				  not be paid from the Fund until notice is given.
(c) Notice to the Fund shall consist of
				  completing and mailing the form designated as "Notice of Claim Against
				  Uninsured Employer" (Notice) to the Department of Labor and Industry
				  (Department) at the address listed on the form. The Department may reject any
				  incomplete Notice.
(d) The Notice
				  will be deemed filed as of the date of the Notice's deposit in the United
				  States Mail, as evidenced by a United States Postal Service postmark, properly
				  addressed, with postage or charges prepaid. If a United States Postal Service
				  Postmark is not present, the date of the Department's actual receipt of the
				  Notice is the filing date.
This section cited in 34 Pa. Code §
												123.803 (relating to prerequisites
						for filing claim petition for benefits from fund); and 34 Pa. Code §
												123.804 (relating to filing of
						claim petition for benefits from the
						fund).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 123 - GENERAL PROVISIONS-PART II › Subchapter I - UNINSURED EMPLOYER GUARANTY FUND-STATEMENT OF POLICY › Section 123.803 - Prerequisites for filing claim petition for benefits from Fund

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Upon the filing
				  of a completed "Notice of Claim Against Uninsured Employer" (Notice), the
				  Uninsured Employer Guaranty Fund (Fund) will determine whether it will commence
				  making payments.
(b) An injured
				  worker may not seek an award against the Fund unless the worker completes and
				  files the form designated as the "Claim Petition for Benefits from the
				  Uninsured Employer Guaranty Fund."
(c) A "Claim Petition for Benefits from the
				  Uninsured Employer Guaranty Fund" may not be filed until at least 21 days after
				  the injured worker filed the Notice as required in §
										123.802 (relating to notice to the
				  Uninsured Employer Guaranty Fund).
(d) A completed "Claim Petition for Benefits
				  from the Uninsured Employer Guaranty Fund" will be deemed filed upon the later
				  of either of the following:
(1) The date of
				  the petition's deposit in the United States Mail, as evidenced by a United
				  States Postal Service postmark, properly addressed, with postage or charges
				  prepaid; or, if no United States Postal Service Postmark is present, as of the
				  Department's receipt of the petition.
(2) Twenty-one days after the filing of the
				  Notice identified in § 123.802.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 123 - GENERAL PROVISIONS-PART II › Subchapter I - UNINSURED EMPLOYER GUARANTY FUND-STATEMENT OF POLICY › Section 123.804 - Filing of claim petition for benefits from the Fund

Current through Register Vol. 54, No. 28, July 13, 2024
(a) If an injured worker attempts to file a
				  "Claim Petition for Benefits from the Uninsured Employer Guaranty Fund" before
				  filing the "Notice of Claim Against Uninsured Employer" (Notice) required under
				  §
										123.802 (relating to notice to the
				  Uninsured Employer Guaranty Fund), the Department will return the petition to
				  the injured worker and instruct the worker to complete a Notice.
(b) A Claim Petition for Workers'
				  Compensation (LIBC-362) filed against an employer may not act as a claim
				  against the Uninsured Employer Guaranty Fund (Fund) or be deemed notice to the
				  Fund.
(c) An injured worker seeking
				  an award of benefits from the Fund shall file the "Claim Petition for Benefits
				  from the Uninsured Employer Guaranty Fund" with the Bureau and shall serve the
				  Fund and the alleged employer at the addresses identified on the petition. The
				  Fund is not required to answer a petition which does not conform to this
				  section.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 123 - GENERAL PROVISIONS-PART II › Subchapter I - UNINSURED EMPLOYER GUARANTY FUND-STATEMENT OF POLICY › Section 123.805 - Rights of Fund

Current through Register Vol. 54, No. 28, July 13, 2024
The Uninsured Employer Guaranty Fund (Fund) is not
					 prejudiced by an agreement, admission or stipulation concerning the
					 compensability, facts or legal conclusions relating to an injury underlying a
					 claim against the Fund unless the Fund is a party to and specifically endorses
					 the agreement, admission or stipulation.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 123 - GENERAL PROVISIONS-PART II › Subchapter J - WORKERS' COMPENSATION AUTOMATION AND INTEGRATION SYSTEM-STATEMENT OF POLICY › Section 123.901 - Workers' Compensation Automation and Integration System

Current through Register Vol. 54, No. 28, July 13, 2024
(a) This subchapter provides guidelines
				  concerning how the Department uses its electronic filing and record retention
				  system, known as the Workers' Compensation Automation and Integration System
				  (WCAIS). This subchapter expresses the present intentions of the Department
				  with respect to utilizing WCAIS for the electronic reporting, filing and
				  retention of forms. The Department intends to promulgate regulations for this
				  purpose as soon as practicable.
(b)
				  For the following forms, the form electronically generated in WCAIS using data
				  provided through an electronic data interchange transaction is the format
				  prescribed by the Bureau under §
										121.3 (relating to filing of
				  forms) for purposes of reporting, filing and service of these forms to the
				  Department. Form LIBC-495 (Notice of Compensation Payable), Form LIBC-496
				  (Notice of Compensation Denial), Form LIBC-501 (Notice of Temporary
				  Compensation Payable) and Form LIBC-502 (Notice Stopping Temporary
				  Compensation) may not be submitted to the Department in any other
				  format.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.1 - Purpose

Current through Register Vol. 54, No. 28, July 13, 2024
This subchapter is promulgated under section 435 of the act
					 (77
					 P. S. §
											991) to provide regulatory
					 guidelines for the uniform and orderly administration of self-insurance for
					 individual employers. This subchapter ensures full payment of compensation when
					 due to employees of self-insured employers and to their dependents under the
					 act and the Occupational Disease Act.
The provisions of this §
												125.1 amended under sections
						305(a) and 435(a) of the Workers' Compensation Act (77 P. S. §§
													501 and
						991(a)) and section 2205 of
						The Administrative Code of 1929 (71 P. S. §
													565).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.5 - Preliminary requirements

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An
				  applicant shall have been in business for at least 3 consecutive years prior to
				  application.
(b) An applicant shall
				  be incorporated or organized under the laws of a state of the United
				  States.
(c) Each employer
				  requesting self-insurance shall have an adequate accident and illness
				  prevention program.
The provisions of this §
												125.5 amended under sections
						305(a) and 435(a) of the Workers' Compensation Act (77 P. S. §§
													501 and
						991(a)) and section 2205 of
						The Administrative Code of 1929 (71 P. S. §
													565).
This section cited in 34 Pa. Code §
												125.6 (relating to decision on
						application).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.6 - Decision on application

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
				  application of an applicant which meets the requirements of §
										125.5 (relating to preliminary
				  requirements) will be approved if the Bureau determines that the applicant has
				  demonstrated that it possesses the financial ability to self-insure.
(1) An applicant shall demonstrate that it
				  has adequate financial capacity by showing one of the following:
(i) The retention amount of the applicant's
				  current or proposed excess insurance equals or is less than its authorized
				  retention amount.
(ii) The
				  applicant's catastrophic loss estimation is equal to or is less than its
				  maximum quick assets exposure amount.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.7 - Permit

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A permit is
				  issued for 1 year, except that the Bureau may shorten or extend the effective
				  period of a permit by not more than 6 months to facilitate the filing of timely
				  financial statements or other data and information required with the next
				  renewal application.
(b) If the
				  Bureau fails to issue an initial decision with respect to a renewal application
				  under §
										125.6 (relating to decision on
				  application) prior to the expiration of the permit for the prior year, the
				  prior permit will be automatically extended under the prior conditions as set
				  forth under §
										125.6(c)(2)
				  beyond the permit's original expiration date, until a decision on the renewal
				  application is issued by the Bureau. This automatic extension applies only in
				  cases when the renewal application has been timely filed under §
										125.3 (relating to application)
				  and the applicant has submitted or is submitting all data, information,
				  explanation, corrections and missing items, or has corrected or is correcting
				  inaccurate data, within the time period prescribed in writing by the
				  Bureau.
(c) If a renewal
				  applicant's permit for the prior year expires while the applicant is in the
				  process of satisfying conditions set forth in an initial or reconsideration
				  decision, the prior permit will be automatically extended beyond its original
				  expiration date, pending satisfaction of the conditions within the time period
				  set forth under the applicable provisions of §
										125.6.
The provisions of this §
												125.7 amended under sections
						305(a) and 435(a) of the Workers' Compensation Act (77 P. S. §§
													501 and
						991(a)) and section 2205 of
						The Administrative Code of 1929 (71 P. S. §
													565).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.8 - Reserved

Current through Register Vol. 54, No. 28, July 13, 2024
The provisions of this §
												125.8 reserved under sections
						305(a) and 435(a) of the Workers' Compensation Act (77 P. S. §§
													501 and
						991(a)) and section 2205 of
						The Administrative Code of 1929 (71 P. S. §
													565).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.9 - Security requirements

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
				  private employer shall provide security in an amount as set forth in subsection
				  (d). The security required in this section is not a substitute for the
				  applicant demonstrating its financial ability to self-insure. A self-insurer's
				  security may be adjusted annually or more frequently as determined by the
				  Bureau.
(b) The following forms of
				  security are acceptable:
(1) A surety bond on
				  a form prescribed by and available upon request from the Bureau issued by a
				  company authorized to transact surety business in this Commonwealth by the
				  Insurance Department.
(i) At the time of the
				  issuance of the bond, the surety company shall possess a current A. M. Best
				  Rating of A- or better or a Standard & Poor's insurer's financial strength
				  rating of A or better or a comparable rating by another NRSRO.
(ii) The self-insurer shall replace the bond
				  with a new bond issued by a surety company with an acceptable rating or with
				  another acceptable form of security if the surety company's highest rating
				  falls below an A. M. Best Rating of B+, a Standard & Poor's insurer's
				  financial strength rating of A- or a comparable rating by another NRSRO after
				  the bond is issued. If the bond is not replaced within 45 days of the
				  self-insurer's receipt of written notification of the rating decline from the
				  Bureau, the Bureau will have discretion to draw on the surety bond and deposit
				  the proceeds with the State Treasurer to secure the self-insurer's liability
				  and to revoke the current permit if the bond exclusively secures claims
				  currently being incurred against the self-insurer.
(iii) An active self-insurer that does not
				  post another bond or another acceptable form of security to cover claims
				  currently being incurred against the self-insurer, after the surety of a bond
				  that exclusively secures the claims provides notification of its intention to
				  terminate the bond, shall obtain workers' compensation insurance coverage
				  effective the bond's termination date. The self-insurer shall provide evidence
				  of the coverage, such as a certificate of insurance, to the Bureau no later
				  than the coverage's effective date.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.10 - Funding by public employers

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
				  self-insured public employer shall establish and maintain a dedicated asset
				  account to provide a source of funds for the payment of benefits and other
				  obligations and expenses relating to its self-insurance program. This section
				  does not apply to a runoff self-insured public employer whose average annual
				  payout of benefits on self-insurance claims over its last 3 completed fiscal
				  years, net of workers' compensation excess insurance recoveries, is less than
				  the current Statewide average weekly wage multiplied by 100.
(b) For a new self-insured public employer
				  and for an active self-insured public employer that has been self-insured for
				  less than 3 consecutive years, the required asset level of the dedicated asset
				  account established under subsection (a) is calculated as follows:
(1) An amount greater than or equal to 20% of
				  the public employer's modified manual premium calculated in accordance with
				  §
											125.202 (relating to definitions)
				  or the minimum funding amount, whichever is greater.
(2) Discounted by the percentage outlined
				  under §
											125.9(l)
				  (relating to security requirements) for the self-insurer's highest current
				  long-term credit or debt rating, if any.
(3) The dedicated asset account must equal
				  the above prescribed asset level no later than 30 days before the effective
				  date of the public employer's initial permit and may not be reduced below this
				  asset level for the first 3 years of self-insurance.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.11 - Excess insurance

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An
				  applicant whose catastrophic loss estimation is greater than its maximum quick
				  assets exposure amount shall obtain aggregate excess insurance or specific
				  excess insurance with a retention amount that is no more than its authorized
				  retention amount and a liability limit acceptable to the Bureau to provide an
				  adequate level of protection to cover the losses from a catastrophic event. The
				  Bureau will consider the financial capacity of the applicant and the amount of
				  the catastrophic loss estimation in determining the adequacy of the applicant's
				  proposed liability limit.
(b) A
				  contract or policy of excess insurance must comply with the following:
(1) For excess indemnity insurance:
(i) It must state that it is not cancelable
				  or nonrenewable unless written notice by registered or certified mail is given
				  to the other party to the policy and to the Bureau at least 45 days before
				  termination by the party desiring to cancel or not renew the policy.
(ii) It must state that it applies to any
				  losses of a self-insurer under the act or the Occupational Disease
				  Act.
(iii) It may not exclude
				  coverage for any categories of injuries or diseases compensable under the act
				  and the Occupational Disease Act.
(iv) It must be issued by an insurer that
				  possesses an A. M. Best rating of A- or better, or a Standard & Poor's
				  insurer financial strength rating of A or better, or a comparable rating by
				  another NRSRO.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.12 - Payment, handling and adjusting of claims

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A self-insurer and its claims service
				  company are responsible for the prompt payment of compensation in accordance
				  with the act, the Occupational Disease Act and this part.
(b) A self-insurer shall have ample
				  facilities and competent personnel within its organization to service its
				  program of claims handling and adjusting or shall contract with a registered
				  claims service company to provide these services.
(c) A self-insurer shall immediately notify
				  the Bureau when it changes arrangements for the handling or adjusting of its
				  claims, including the initiation, modification or termination of
				  self-administration arrangements or the initiation, termination, expiration or
				  modification of services with a registered claims services company. The
				  self-insurer shall file with the Bureau a summary of data on its claims, such
				  as cumulative payments sorted by year of loss, in a format prescribed by the
				  Bureau and provided to the self-insurer within 21 days of its receipt of
				  written notification from the Bureau of its need to do so.
The provisions of this §
												125.12 amended under sections
						305(a) and 435(a) of the Workers' Compensation Act (77 P. S. §§
													501 and
						991(a)) and section 2205 of
						The Administrative Code of 1929 (71 P. S. §
													565).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.13 - Special funds assessments

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
				  self-insurer is responsible for the payment of assessments to maintain funds
				  under the act, including:
(1) The Workmen's
				  Compensation Administration Fund.
(2) The Subsequent Injury Fund.
(3) The Workmen's Compensation Supersedeas
				  Fund.
(4) The Self-Insurance
				  Guaranty Fund.
(5) The Uninsured
				  Employers Guaranty Fund.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.14 - Change in legal status, ownership or financial condition

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A self-insurer shall submit promptly a
				  renewal application to continue its self-insurance status under this subchapter
				  in the event of a change in its or its parent's controlling interest, by sale
				  or otherwise. Failure to comply with this subsection may result in the
				  revocation of the self-insurer's permit.
(b) A self-insurer which amends its articles,
				  charter or agreement of incorporation, association, partnership or sole
				  proprietorship to change its identity or business structure shall promptly
				  notify the Bureau in writing of that action. The Bureau may request copies of
				  documents or information deemed necessary to determine whether the transaction
				  has affected the ability of the employer to self-insure.
(c) A self-insurer shall promptly notify the
				  Bureau in writing of any material adverse changes to its financial condition
				  which occur after the date of the most recent financial statements submitted
				  with its last application.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.15 - Workers' compensation liability

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Notwithstanding the terms of a guarantee
				  and assumption agreement executed under §
										125.4(b)
				  (relating to application for affiliates and subsidiaries), a self-insurer or a
				  runoff self-insurer remains liable for workers' compensation on injuries or
				  disease exposures occurring during its period of self-insurance. With
				  application to and permission from the Bureau, liability can be transferred to
				  another employer. Liability also may be transferred through a self-insurance
				  loss portfolio transfer policy.
(b)
				  A self-insurer which liquidates or dissolves shall transfer its liability to a
				  third party, subject to the approval of the Bureau, or shall obtain a
				  self-insurance loss portfolio transfer policy covering the liability.
(c) If a self-insurer sells or divests a part
				  of itself, self-insurance coverage ends for the separated parts on the date of
				  separation. The self-insurer remains liable for claims incurred against the
				  separated part occurring up to the date of separation unless the Bureau
				  approves a request to transfer the self-insurer's liability to another
				  entity.
The provisions of this §
												125.15 amended under sections
						305(a) and 435(a) of the Workers' Compensation Act (77 P. S. §§
													501 and
						991(a)) and section 2205 of
						The Administrative Code of 1929 (71 P. S. §
													565).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.16 - Reporting by runoff self-insurer

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
				  A runoff self-insurer shall file an annual report with the Bureau by a date
				  prescribed by the Bureau on a prescribed form provided by the Bureau until all
				  cases incurred during its period of self-insurance have been closed for at
				  least 2 years.
(b) The runoff
				  report must include a listing in a Bureau-prescribed electronic format provided
				  by the Bureau to the runoff self-insurer of the runoff self-insurer's
				  Pennsylvania workers' compensation claims, including all claims currently in
				  litigation, and information such as payments and reserves on each claim. The
				  listing must include:
(i) All open claims at
				  the time of submission.
(ii) All
				  claims closed on or after September 11, 2010.
(iii) Case reserves provided in the listing
				  must be established according to the instructions on forms prescribed by the
				  Bureau and provided to the runoff self-insurer.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.17 - Claims service companies

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
				  claims service company desiring to engage in the business of adjusting and
				  handling claims for an approved self-insurer shall register with the Bureau as
				  provided under section 441(c) of the act (77 P. S. §
											997(c)) and regulations
				  thereunder on a prescribed form before entering into a contract to provide
				  these services. The claims service company shall answer the questions on the
				  registration form and swear to the information provided on the form.
(b) A claims service company shall have
				  adequate facilities and employ competent staff to provide claims services in a
				  manner which fulfills a self-insurer's obligations under the act, the
				  Occupational Disease Act and this part. A claims service company which
				  repeatedly or unreasonably fails to provide claims adjusting or services
				  promptly with the result that compensation is not paid as required under the
				  act or the Occupational Disease Act may have its privilege of conducting this
				  business revoked or suspended under the procedures of section 441(c) of the
				  act.
(c) The claims service company
				  shall employ at least one person on a full-time basis who has the knowledge and
				  experience necessary to service claims properly under the act and the
				  Occupational Disease Act. A resume covering that person's background must be
				  attached to the registration form of the claims service company.
(d) A claims service company whose engagement
				  to handle or adjust the claims of a self-insurer is terminating or expiring, or
				  has terminated or expired, shall provide reasonable assistance to the
				  self-insurer and the Bureau in providing data and information on the claims
				  serviced to maintain the integrity of past data on the claims filed with the
				  Bureau, to rectify or explain discrepancies or questions on the claims data
				  raised by the Bureau, or to address other related issues identified by the
				  Bureau.
The provisions of this §
												125.17 amended under sections
						305(a) and 435(a) of the Workers' Compensation Act (77 P. S. §§
													501 and
						991(a)) and section 2205 of
						The Administrative Code of 1929 (71 P. S. §
													565).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.18 - Contact person

Current through Register Vol. 54, No. 28, July 13, 2024
A self-insurer shall provide the Bureau with the name,
					 title, address and phone number of a contact person who will be the liaison
					 with the Bureau regarding all self-insurance matters, including the processing
					 of applications, the provision of information and the payment of assessments,
					 and to whom self-insurance correspondence will be sent. The self-insurer shall
					 give written notice of a change in contact person or change in address or
					 telephone number within 10 days of this change.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.19 - Additional powers of Bureau and orders to show cause

Current through Register Vol. 54, No. 28, July 13, 2024
(a) If the Bureau has reason to question
				  whether a self-insurer continues to maintain the financial ability to
				  self-insure during the pendency of a permit, authorized under section 305(a)(3)
				  of the act (77 P. S. §
											501(a)(3)) and under section
				  305 of the Occupational Disease Act (77 P. S. §
											1405), it will issue a letter to the
				  self-insurer noting the reasons for its concerns and outlining the documents,
				  data and information upon which the Bureau's concerns are based. The following
				  also apply:
(1) The Bureau's letter is treated
				  for procedural purposes as if it were an initial decision denying a renewal
				  application under §
											125.6(d)
				  (relating to decision on application).
(2) When the Bureau determines that the
				  self-insurer no longer possesses the financial ability to self-insure, the
				  self-insurer's current permit will be revoked, unless the self-insurer timely
				  initiates the procedures outlined under § 125.6(e)-(g).
(3) The self-insurer shall obtain workers'
				  compensation insurance coverage effective no later than 30 days after its
				  receipt of a notice of revocation by the Bureau and provide evidence of the
				  coverage, such as a certificate of insurance, to the Bureau no later than the
				  coverage's effective date.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.20 - Computation of time

Current through Register Vol. 54, No. 28, July 13, 2024
Except as otherwise provided by law, in computing a period
					 of time prescribed or allowed by this chapter, the day of the act, event or
					 default after which the designated period of time begins to run may not be
					 included. The last day of the period so computed shall be included, unless it
					 is Saturday, Sunday or a legal holiday in this Commonwealth, in which event the
					 period shall run until the end of the next day which is neither a Saturday,
					 Sunday nor a holiday. A part-day holiday shall be considered as other days and
					 not as a holiday. Intermediate Saturdays, Sundays and holidays shall be
					 included in the computation.
The provisions of this §
												125.20 amended under sections
						305(a) and 435(a) of the Workers' Compensation Act (77 P. S. §§
													501 and
						991(a)) and section 2205 of
						The Administrative Code of 1929 (71 P. S. §
													565).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter A - INDIVIDUAL SELF-INSURANCE › Section 125.21 - Self-insurance loss portfolio transfer policy

Current through Register Vol. 54, No. 28, July 13, 2024
A self-insurance loss portfolio transfer policy must comply
					 with all of the following:
(1) The
				  insurance carrier must be a workers' compensation insurer.
(2) The policy must provide statutory
				  coverage limits and state that the insurer is responsible to defend, adjust and
				  handle all open, reopened and incurred but not reported claims against the
				  self-insurer for the period of time covered by the policy.
(3) The policy must be retrospective,
				  providing coverage for a consecutive period of time of
				  self-insurance.
(4) The policy must
				  be noncancelable by either the insurance carrier or the self-insurer for any
				  reason.
(5) The amount of annual
				  compensation paid by the insurance carrier on any claims assumed under the
				  policy must be included as compensation paid on the data reports filed with the
				  Insurance Department.
(6) The
				  insurance carrier must include the premium received on the policy in the amount
				  of net written workers' compensation premium it annually reports to the
				  Insurance Department or to the National Association of Insurance
				  Commissioners.
(7) The insurance
				  carrier must notify existing claimants with injuries or diseases covered by the
				  policy that it has assumed liability for the payment and handling of their
				  claims.
(8) The insurance carrier
				  must file the policy with a rating organization approved by the Insurance
				  Commissioner and identify it as a special self-insurance loss portfolio
				  transfer policy. The insurance carrier should not report statistical
				  information on claims assumed under the policy to the rating
				  organization.
(9) The insurance
				  carrier must enter an appearance with the appropriate workers' compensation
				  judge, the Workers' Compensation Appeal Board and any appellate court on each
				  pending claim in adjudication against the self-insurer for injuries or disease
				  exposures occurring during the time period covered by the policy.
The provisions of this §
												125.21 issued under sections
						305(a) and 435(a) of the Workers' Compensation Act (77 P. S. §§
													501 and
						991(a)) and section 2205 of
						The Administrative Code of 1929 (71 P. S. §
													565).
This section cited in 34 Pa. Code §
												125.2 (relating to
						definitions).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter B - GROUP SELF-INSURANCE › Section 125.131 - Purpose

Current through Register Vol. 54, No. 28, July 13, 2024
This subchapter is promulgated under sections 435 and 818
					 of the act (77 P. S. §§
											991 and
					 1036.18) to provide
					 regulatory guidelines for uniform and orderly administration of group
					 self-insurance funds under Article VIII of the act (77 P.S §§
											1036.1-1036.18). This subchapter will ensure
					 full payment of compensation due under the act and the Occupational Disease Act
					 to employes of employers that pool their liabilities through participation in a
					 group self-insurance fund.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter B - GROUP SELF-INSURANCE › Section 125.134 - Decision on application

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
				  application of an applicant which meets the requirements of the act relating to
				  matters such as the number of homogeneous employers, aggregate net worth and
				  aggregate premium will be approved if the Bureau determines that the applicant
				  has demonstrated, with reasonable certainty, that it will meet the liabilities
				  incurred by its members under the act and the Occupational Disease Act. The
				  Bureau will include the following factors in assessing the applicant's ability
				  to meet those liabilities:
(1) The adequacy of
				  member contributions.
(2) The
				  applicant's plans for the establishment of surpluses to absorb matters such as
				  unexpected losses and uncollected contributions.
(3) The applicant's plans for member
				  assessments needed to maintain actuarially appropriate loss reserves.
(4) Restrictions on the payment of dividends
				  on surplus.
(5) The overall
				  financial ability of the members to satisfy their obligations to the
				  applicant.
(6) The applicant's
				  ability to control losses through the safety and loss control program
				  proposed.
(7) The excess insurance
				  coverage obtained by the fund, if any.
(8) The validity of the actuarial assumptions
				  used to predict the likely loss levels, if any.
(9) The liquidity and safety of the fund's
				  assets.
(10) The likely stability
				  of membership in the fund.
(11) The
				  adequacy of the trust agreement, bylaws and written policies.
(12) The degree to which the total risk of
				  the fund is spread among the members.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter B - GROUP SELF-INSURANCE › Section 125.136 - Addition of members

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The addition
				  of a new member to a fund shall be approved on an application form prescribed
				  by the Bureau. The approval shall be granted by the plan committee or the board
				  of trustees or by the administrator if the board of trustees has delegated this
				  authority to the administrator.
(b)
				  The approved application form for fund membership shall be filed with the
				  Bureau no more than 15 days after the effective date of the employer's
				  membership in the fund.
(c) With
				  the approved application, the fund shall submit to the Bureau:
(1) Evidence of the prospective member's
				  execution of the trust agreement and the bylaws.
(2) A schedule of the prospective member's
				  annual contributions to the fund.
(3) The prospective member's prior year's
				  audited or reviewed financial statement if its annual contributions will make
				  up more than 10% of total annual contributions to the fund.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter B - GROUP SELF-INSURANCE › Section 125.137 - Withdrawal or expulsion of members

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
				  A fund shall notify the Bureau in writing of the withdrawal or expulsion of a
				  member no less than 15 days prior to the effective date of the withdrawal or
				  expulsion.
(b) Each member which
				  withdraws or is expelled from a fund shall provide to the Bureau a certificate
				  providing evidence of its workers' compensation coverage by the effective date
				  of its withdrawal or expulsion.
(c)
				  The fund shall provide to the Bureau any financial information requested by the
				  Bureau to determine whether the withdrawal or expulsion of a member will affect
				  the fund's continuing ability to satisfy its obligations, such as special
				  financial statements or projections.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter B - GROUP SELF-INSURANCE › Section 125.138 - Change in legal status, ownership, financial condition, name and address of member

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A member
				  shall promptly notify the fund in writing in the event of a change in its or
				  its parent's controlling interest, by sale or otherwise.
(b) A member which amends its articles,
				  charter or agreement of incorporation, association, partnership or sole
				  proprietorship to change its identity or business structure shall promptly
				  notify the fund in writing of that action.
(c) A member shall promptly notify the fund
				  in writing of any material adverse changes to its financial
				  condition.
(d) A member shall
				  promptly notify the fund in writing of any changes in its name or
				  address.
(e) The fund shall
				  promptly notify the Bureau in writing of changes reported by members under
				  subsections (a)-(d).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter B - GROUP SELF-INSURANCE › Section 125.139 - Change of administrator, fiscal agent or service companies

Current through Register Vol. 54, No. 28, July 13, 2024
A fund shall promptly notify the Bureau in writing of a
					 change in its administrator, fiscal agent or its service
					 companies.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter B - GROUP SELF-INSURANCE › Section 125.140 - Change of trust agreement, bylaws or written policies; notification of insufficient assets

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A fund shall
				  promptly file with the Bureau amendments to its trust agreement or bylaws or
				  amendments to its written policies which could materially affect the operation
				  of the fund.
(b) A fund which
				  knows, or should know, that it has insufficient assets to maintain actuarially
				  appropriate loss reserves as defined under section 801 of the act
				  (77
				  P. S. §
											1036.1) shall immediately notify
				  the Bureau in writing of this condition. With the notification, the fund shall
				  inform the Bureau of its plan to correct the deficiency.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter B - GROUP SELF-INSURANCE › Section 125.141 - Annual report

Current through Register Vol. 54, No. 28, July 13, 2024
(a) No more than
				  5 months following the end of each fund year, a fund shall file a report with
				  the Bureau as required by section 815 of the act (77 P. S. §
											1036.15). Failure to file an annual report in
				  the time prescribed may result in the revocation of the fund's
				  permit.
(b) The fund shall submit
				  with its annual report:
(1) The evaluation fee
				  in the amount of $1,000 required by section 815(c) of the act.
(2) The fund's audited financial statements
				  for its prior fund year as prepared by a certified public accountant in
				  accordance with generally accepted accounting principles.
(3) A report prepared by an independent
				  actuary projecting the value of the fund's incurred and outstanding liability
				  by fund year.
(4) The prior fiscal
				  year's audited or reviewed financial statements of each member whose annual
				  contribution to the fund makes up more than 10% of the total annual
				  contributions to the fund.
(5) A
				  schedule of the projected administrative expenses in dollar amounts and as a
				  percentage of the total member contributions for the current fund
				  year.
(6) A schedule of the annual
				  contributions which will be paid by each member and in total during the current
				  fund year and worksheets showing the calculation of each member's annual
				  contributions.
(7) A certificate
				  providing evidence of excess insurance as required by the Bureau.
(8) A schedule of member dividends paid
				  during the prior fund year and the fund year from which the dividends were
				  paid.
(9) A schedule of the
				  dividends the fund plans to return to its members during the current year. The
				  schedule shall include a recommendation from an independent actuary that the
				  dividends proposed will not impair the fund's ability to meet its obligations
				  and that the dividends will comply with the other requirements of section 809
				  of the act (77 P. S. §
												1036.9).
(10) Confirmation of the existence of the
				  fidelity bonds required under §
											125.134(d)(6)
				  (relating to decision on application).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter B - GROUP SELF-INSURANCE › Section 125.142 - Maintenance of fund permit

Current through Register Vol. 54, No. 28, July 13, 2024
Following the submission of a fund's annual report or at
					 other times determined by the Bureau, the Bureau may revise the conditions
					 previously set for the issuance of the fund's permit. The fund's permit may be
					 revoked if the revised conditions are not met in the time prescribed by the
					 Bureau, subject to the right of a hearing under §
										125.154 (relating to
					 hearings).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE › Subchapter B - GROUP SELF-INSURANCE › Section 125.143 - Restriction on the use of assets

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
				  A fund, its board of trustees, fiscal agent or administrator may not use member
				  contributions for a purpose unrelated to the satisfaction of the workers'
				  compensation obligation of the fund and expenses related to those
				  obligations.
(b) The board of
				  trustees, administrator or fiscal agent of the fund may not borrow money from
				  the fund or in the name of the fund, including the issuance of loan guarantees
				  or other forms of encumbrances.
(c)
				  A fund may not extend credit to a member for payment of contributions. This
				  subsection does not prohibit the payment of annual contributions based on an
				  installment plan as presented in the schedule submitted to the Bureau in §
										125.133(c)(6) or
				  §
										125.141(b)(6)
				  (relating to application; and annual report).