West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-24 - Qualified Loss Management Programs › Section 85-24-3 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
As used in these rules, the following terms have the stated
				  meanings unless the context of a specific use clearly indicates another meaning
				  is intended.
3.1. "Act" means the
				workers' compensation laws of the state of West Virginia which are codified at
				W. Va. Code § 23-1 et seq.
3.2. "Client employer" means an employer who
				participates with a qualified loss management service provider in accordance
				with and under the provisions of this rule.
3.3. "Commission" means the workers'
				compensation commission created pursuant to the provisions of W. Va. Code
				§
									23-1-1.
3.4. "Credit factor" means a multiplier,
				determined in accordance with this rule, utilized to calculate premium tax
				credits.
3.5. "Director" means the
				executive director of the workers' compensation commissions who serves as the
				chief executive officer of the of the workers' compensation commission,
				provided by W. Va. Code §
									23-1-4.
3.6. "Board" means the workers "compensation
				board of managers created pursuant to the provisions of W. Va. Code §
									23-1-1a.
3.7. "Experience modification factor" means
				an actuarially determined multiplier of the premium tax base rate used to
				determine an individual employer's premium tax rate (Note: The experience
				modification factor has been historically referred to as the experience
				modification rate or EMR).
3.8.
				"Good standing" with the commission means that the employer has not defaulted
				on its obligations to make payments to the commission. Being in delinquent
				status, as provided for in W. Va. Code §
									23-2-5(b),
				is not equivalent to being in default and does not deprive the employer of good
				standing with the commission.
The term default is defined in W. Va. Code, §§
										23-2-5(d),
				  -5(e), -6, & -8. The term default also includes those situations under W.
				  Va. Code, §
										23-2-5(f)(2)-(4),
				  where an employer returns to default status upon breaching a reinstatement
				  agreement. If an employer fails to meet the requirements of those sections,
				  then it is in default and is not in good standing with the
				  commission.
3.9. "Incurred
				losses" are claims reserves consisting of compensation awards, medical
				payments, and claims expense payments.
3.10. "Injury" means compensable injuries or
				illnesses for which costs are incurred by the commission within the meaning of
				W. Va. Code, §
									23-4-1
				et seq.
3.11. "Joint labor and
				management safety committee" means a formally structured process to provide for
				and foster employee and employer involvement in safety reforms. Such structures
				include, but are not limited to, groups such as quality circles and self
				directed work teams. A tiered safety organization is permitted, if employees
				participate at each level of the organized committees.
A joint labor and management safety committee must exhibit
				  the following characteristics to be considered acceptable:
a. Safety must be a priority of the
				group;
b. The group must have the
				authority to conduct safety inspections of the work area for which they are
				responsible and to determine and recommend corrective measures to
				management;
c. The group must meet
				regularly and minutes must be kept of the meetings;
d. Each member of the committee shall have an
				equal vote;
e. Members of the
				committee shall not experience any loss of wages or other retaliation while
				attending safety committee meetings or performing duties at the direction of
				the safety committee;
f. At least
				fifty percent (50%) of the members of the tiered safety organization and of
				each committee shall be employee representatives; and
g. All members of the committee shall be trained in
				matters related to workplace safety, such training shall include attendance at
				a seminar on basic safety programs sponsored or approved by the
				commission.