Indemnity Violations.
(a) Late payments of compensation. In order
to ensure insurer compliance under Chapter 440, F.S., the
Department shall
monitor, examine, and investigate the performance of insurers. The
Department
shall assess penalties for late payments of compensation that are below a
minimum 95 percent timely payment performance standard. The insurer shall pay
to the Workers' Compensation Administration Trust Fund a penalty of:
1. Fifty dollars per number of installments
of compensation below the 95 percent timely payment performance standard and
equal to or greater than a 90 percent timely payment performance
standard.
2. One hundred dollars
per number of installments of compensation below a 90 percent timely payment
performance standard.
(b) Late filing of forms.
1. Employers shall be fined for each Form
DFS-F2-DWC-1 (First Report of Injury or Illness), effective 03/2009, as
incorporated in Rule
69L-3.025, F.A.C., which is
not filed timely with the insurer or claims-handling entity as follows:
Number of Days Late |
Penalty for Untimely
Filing |
1-7 calendar days late |
$100 per form |
8-14 calendar days late |
$200 per form |
15-21 calendar days late |
$300 per form |
22-28 calendar days late |
$400 per form |
Over 28 calendar days late |
$500 per form
|
2.
The
Division, through CPS, will calculate the penalties in order starting with
the form with the greatest number of days late first. Insurers shall be fined
for each Form DFS-F2-DWC-1 (First Report of Injury or Illness), effective
03/2009, as incorporated in Rule
69L-3.025, F.A.C., or an
electronic equivalent as required in Rule
69L-56.301,
F.A.C., form which is not timely filed with the
Department. Penalties shall be
calculated for all the Form DFS-F2-DWC-1 or an electronic equivalent as
required in Rule
69L-56.301,
F.A.C., that have been received by the
Department in a specific CPS batch month
as follows:
Number of Days Late |
Penalty for Untimely
Filing |
1-7 calendar days late |
$100 per form |
8-14 calendar days late |
$200 per form |
15-21 calendar days late |
$300 per form |
22-28 calendar days late |
$400 per form |
Over 28 calendar days late |
$500 per form
|
3.
After the insurer has accepted all penalties and submitted the batch to the
Division for a specific month and the total amount of untimely filing penalties
for that month exceeds $10,000 as calculated under subparagraphs (1)(b)1. and
2. herein, the penalty for each untimely filing not included in the calculation
of the penalty up to $10,000, shall be recalculated and assessed a penalty of
$25.00 per untimely filing for that specific month.
4. Insurers that incur untimely filing
penalties issued through CPS in excess of $10,000 for three or more specific
months in a calendar year shall, in addition to penalties assessed, conduct
quarterly self audits of their Form DFS-F2-DWC-1 filings to the Department
documenting compliance by the insurer with the reporting requirements for Form
DFS-F2-DWC-1, and submit the results of those audits to the Department
documenting compliance with the reporting requirements for Form DFS-F2-DWC-1
for a one year period.
5. Any
insurer that has been assessed penalties in excess of $10,000 for a calendar
month since January 1, 2008, until the effective date of this rule chapter, for
untimely filing of Form DFS-F2-DWC-1, will have their penalty amount
recalculated pursuant to subparagraph (1)(b)3. herein. If the insurer has
already paid penalties to the Department for the untimely filing of Form
DFS-F2-DWC-1, the Department shall refund the difference between the penalties
paid and those recalculated under subparagraph (1)(b)3. herein, to the insurer,
unless the insurer owes any outstanding, unpaid penalties to the Department.
The outstanding, unpaid penalties must be paid in full prior to any refund
being issued by the Department.
6.
If the electronic equivalent of the First Report of Injury or Illness as
required in Rule
69L-56.301,
F.A.C., is assigned an Application Acknowledgement Code of Transaction Accepted
(TA) within 30 days after the Claim Administrator, as defined in Rule
69L-56.002, F.A.C.,
is first approved and required by the
Division to send electronic First Reports
of Injury or Illness to the
Division pursuant to paragraph
69L-56.300(1)(d),
F.A.C., the insurer, as defined in Section 440.02(38), F.S., shall not be
assessed a filing penalty pursuant to subparagraph 69L-24.006(1)(b) 2., F.A.C.,
based on the filing requirements established in rule subsections
69L-56.301(1)
and (2), F.A.C. After the completion of the
30 day period referenced above, all electronic First Reports of Injury or
Illness must be assigned an Application Acknowledgement Code of Transaction
Accepted (TA) by the
Division within the required filing timeframes established
in subsections
69L-56.301(1)
and (2), F.A.C., to be considered timely
filed.