Cal. Code Regs. Tit. 8, § 10104 - Annual Report of Inventory
(a)
Each claims administrator shall maintain, and shall file with the
Administrative Director, an Annual Report of Inventory for each of its
adjusting locations. The report shall be filed annually by April 1. It shall
include the name, address, and telephone number of the adjusting location and
the name and title of the person responsible for audit coordination. Claims
administrators shall report, as of the preceding January 1, the numbers of
indemnity, denied, and medical-only claims reported to each of its adjusting
locations during the preceding calendar year for insurers and private
self-insured employers, or public self-insured employers. If the administrator
adjusts for more than one entity at that location, the report shall give the
total numbers of claims at that location and shall also identify the numbers of
claims for each self-insured employer or insurer liable for the payment of
compensation. Indemnity claims shall be differentiated on the Annual Report of
Inventory from medical-only claims or any other claim where no indemnity
payment(s) has been made.
(b) If a
claims administrator relocates, opens a new adjusting location, closes an
adjusting location, changes contact persons, changes the e-mail address,
changes from third-party administered to self-administered or from
self-administered to third-party administered, or changes from self-insured to
insured, the claims administrator shall advise the Administrative Director by
mailing written notice to the manager of the Audit Unit within 45 calendar days
of the event.
(c) Adjusting
locations that have no indemnity, denied, or medical-only claims reported
during the preceding calendar year must file with the Administrative Director a
statement indicating whether the location is actively adjusting workers'
compensation claims. The statement, which shall be filed annually by April 1,
shall contain the name, address, and telephone number of the adjusting location
and the name and title of the person responsible for audit
coordination.
(d)
(1) A claims administrator's obligation to
submit an Annual Report of Inventory under subdivision (a) of this section is
waived upon a determination by the Administrative Director that the claims
administrator is in compliance with the electronic data reporting requirements
of the Workers' Compensation Information System, as set forth in California
Code of Regulations, title 8, section
9702.
(2) Each claims administrator whose
obligation to submit an Annual Report of Inventory is satisfied under
subdivision (d)(1) of this section shall maintain and file with the
Administrative Director an Annual Report of Adjusting Locations. This report
shall be filed annually by April 1 of each calendar year and shall report, as
of the preceding December 31, each of the claims administrator's adjusting
locations. The report shall include the name, street and mailing address,
physical zip code, e-mail address, fax number, and telephone number for each
adjusting location and the name, title, e-mail address, fax number and
telephone number of the person responsible for audit coordination.
(3) The claims administrator shall notify the
Administrative Director, by mailing written notice to the manager of the Audit
Unit, of any change in the information provided in the Annual Report of
Adjusting Locations. A reportable change shall include the relocation of the
claims administrator or the opening or closing of an adjusting location. The
notification shall be made within 45 calendar days after the effective date of
the change.
(4) The waiver granted
to a claims administrator under subdivision (d)(1) of this section shall be
rescinded if the total number of claims reported by the claims administrator to
the Audit Unit in a claim log submitted pursuant to California Code of
Regulations, title 8, section
10107.1(a) is not
within one percent of the total number of claims electronically reported by the
claims administrator to the Workers' Compensation Information System for the
same period of time as covered in the submitted claim log.
Notes
2. Amendment filed 12-30-2002; operative 1-1-2003 pursuant to Government Code section 11343.4 (Register 2003, No. 1).
3. Amendment filed 10-6-2003; operative 12-1-2003 (Register 2003, No. 41).
4. Amendment of section and NOTE filed 4-20-2009; operative 5-20-2009 (Register 2009, No. 17).
Note: Authority cited: Sections 59, 129.5, 133 and 5307.3, Labor Code. Reference: Sections 129, 129.5 and 138.6, Labor Code.
2. Amendment filed 12-30-2002; operative 1-1-2003 pursuant to Government Code section 11343.4 (Register 2003, No. 1).
3. Amendment filed 10-6-2003; operative 12-1-2003 (Register 2003, No. 41).
4. Amendment of section and Note filed 4-20-2009; operative 5-20-2009 (Register 2009, No. 17).
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