Or. Admin. Code § 436-085-0030 - Premium Assessment; Manner and Intervals for Payments; Experience Rating Modification Factors: Self-Insured Employers and Self-Insured Employer Groups
(1) As used in
this rule, the term "self-insured employers" includes self-insured employer
groups.
(2) Self-insured employers
must report and pay premium assessments using a completed Form 900, "Payroll
and Assessment Quarterly Report - Retrospective rating plan," or Form 937,
"Payroll and Assessment Quarterly Report - Normal plan." The report must be
certified to be true and accurate by an authorized representative of the
self-insured employer.
(3) For
premium assessment purposes, the premium of all self-insured employers will be
calculated using rates developed by the director. The rates for each fiscal
year will be developed by applying a multiplier determined by the director to
the manual rates published by the National Council on Compensation Insurance
effective and published by April 1 of the previous fiscal year.
(a) The multiplier will be no greater than
the average of all loss cost multipliers filed with the Division of Financial
Regulation effective and filed by April 1 of the previous fiscal year, weighted
by market share.
(b) For the
purpose of determining the multiplier, the director may consider factors
including, but not limited to, the net difference between the maximum
multiplier possible under subsection (a) of this section and the modifier used
in the preceding fiscal year.
(4) Self-insured employers may choose to have
their premium calculated using either:
(a)
The normal method of calculation, which is manual premium modified by
experience rating and premium discount; or
(b) A one-year retrospective rating plan
developed by the Division of Financial Regulation and approved by the director.
However, any employer becoming self-insured after July 1 may not choose a
retrospective rating plan for that fiscal year.
(5) On or before May 31 of each year, the
director will issue a bulletin notifying all self-insured employers of the
premium rates and retrospective rating plans to be used in the fiscal year
beginning July 1.
(6) On or before
July 1 of each year, a self-insured employer may change its current method of
premium calculation by submitting written notification of its choice to the
director. Once chosen, the method may not be changed for that fiscal year and
remains in effect until the self-insured employer chooses to change the
method.
(7) A self-insured employer
must use the normal method of premium calculation unless it has notified the
director that it chooses to use a one-year retrospective rating plan.
(8) A self-insured employer must report and
pay premium assessment based on the self-insured employer's premium and the
premium assessment rate in effect under OAR 440-045 no later than:
(a) October 31, for the quarter ending
September 30;
(b) January 31, for
the quarter ending December 31;
(c)
April 30, for the quarter ending March 31; and
(d) July 31, for the quarter ending June
30.
(9) Premium
assessment for a self-insured employer that has chosen to have its premium
calculated using a retrospective rating plan must be based on 80 percent of the
self-insured employer's assessable premium until adjusted by retrospective
rating.
(10) All premium
adjustments resulting from retrospective rating plans or payroll audits must be
made using the premium assessment rate or rates in effect for the period being
adjusted.
(11) When retrospective
rating adjustments are made to periods where more than one assessment rate
applied, the adjusted premium will be prorated in direct proportion to the
self-insured employer's assessable premium for each period. Total premium
assessment due for the entire period will be adjusted on the same
basis.
(12) The director will
determine an experience rating modification factor for each self-insured
employer.
(a) The director will calculate
experience rating modification factors using the method provided by the
National Council on Compensation Insurance in the Experience Rating
Plan Manual - 2003 Edition, except that the director will use only
Oregon claims and payroll exposure, and will assign a policy period of July 1
through the following June 30. A copy of the Experience Rating Plan
Manual - 2003 Edition is available for review during regular business
hours at the Workers' Compensation Division, 350 Winter St. NE, Salem OR
97301.
(b) The self-insured
employer's authorized claims processing location(s) must provide the director
with the loss information necessary to calculate the experience rating
modification factor.
(c) If
sufficient Oregon experience is not available to calculate an experience rating
modification factor based on Oregon experience only, the director will assign
the self-insured employer an experience rating modification factor of
1.00.
(d) If payroll information
submitted by a self-insured employer is determined to be incorrect, the
director may order, or the self-insured employer may request, a revision of
experience rating modification factors using that data. Only payroll
information reported in the last three calendar years may be corrected. The
director will recalculate all experience rating modification factors previously
calculated using the incorrect payroll information.
(e) When the director orders an adjustment to
the experience rating modification factor for a particular policy period, the
adjustment will be applied retroactively to the beginning of the period. Any
resulting increase in the assessment is payable on demand. Any resulting
decrease may be applied against the next quarterly assessment
payment.
(13) The
director may waive a self-insured employer's reporting requirement on the
self-insured employer's request after confirming that the self-insured employer
has had no Oregon payroll for four consecutive quarters. The waiver will remain
in effect until the self-insured employer has Oregon payroll.
Notes
Statutory/Other Authority: ORS 656.612 & 656.726
Statutes/Other Implemented: ORS 656.612 & 656.614
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