Florida Administrative Code

(1) Current Self-Insurers and Former Self-Insurers, other than Governmental Entities, that have a current Investment Grade Credit Rating shall maintain a minimum Security Deposit of $100,000. (2) Current Self-Insurers, other than Governmental Entities, that do not have a current …

(1) Current Self-Insurers, other than Governmental Entities, shall maintain a Specific Excess Insurance Policy. Such policy shall have a workers' compensation limit of not less than $50,000,000. (a) The self-insured retention of Specific Excess Insurance Policies shall be as foll…

(1) In order for self-insurers to receive up to a five percent (5%) credit on the computation of premiums used in the determination of the assessments for the Workers' Compensation Administration Trust Fund, the Special Disability Trust Fund and the Florida Self-Insurers Guaranty…

(1) In order for self-insurers to receive up to a two percent (2%) credit on the computation of premiums used in the determination of the assessments for the Workers' Compensation Administration Trust Fund, the Special Disability Trust Fund and the Florida Self-Insurers Guaranty …

(1) Failure to comply with any of the rules herein or with any order of the Department or court of competent jurisdiction within the time prescribed shall be considered good cause for revocation of the self-insurance authorization, within the meaning of Section 440.38(3), F.S. No…

(1) The state and its boards, bureaus, departments, and agencies and all of its political subdivisions which employ labor, and the state universities that are electing to self-insure pursuant to Section 440.38(6), F.S., shall submit to the Division for review at least ninety (90)…

A Governmental Entity who ceases self-insurance shall notify the Division of such withdrawal and shall continue to file all reports required by this rule with the Division upon withdrawal and thereafter until such time as the employer has satisfied the Division that there is no r…

An entity applying for a self-insurance authorization pursuant to Section 440.38(1)(b), F.S., shall meet the following requirements and shall submit a completed application package at least ninety (90) days prior to the desired effective date of the self-insurance authorization: …

(1) An application for self-insurance shall be made on Form DFS-F2-SI-1 (Application for Self-Insurance), effective 08/09, as incorporated by reference. An application may be obtained at: Florida Self-Insurers Guaranty Association, Inc. 1427 E. Piedmont Dr., 2nd Floor Tallahassee…

An Alien Corporation applying for self-insurance must submit the following documentation in duplicate at the time of application in addition to the application requirements outlined in Rule 69L-5.225, F.A.C.: (1) An opinion from an attorney, with a minimum of three years experien…

(1) A FSIGA Member who obtains replacement coverage and desires to terminate its self-insurance authorization shall advise the Association in writing within thirty (30) days of the desired termination date and shall provide proof of replacement coverage in the form of a certifica…

(1) Application to become a Qualified Servicing Entity shall be made on Form DFS-F2-SI-22 (Qualified Servicing Entity Application), effective 08/09, incorporated by reference. Entities may apply to become a Qualified Servicing Entity in any or all of the following: claims-adjusti…

(1) Each Qualified Servicing Entity shall file Form DFS-F2-SI-19 (Certification of Servicing for Self-Insurers), effective 08/09, as previously incorporated by reference in Rule 69L-5.216, F.A.C., within thirty (30) days of entering into a contract for servicing. (a) For Governme…

The following forms are incorporated herein by reference and adopted for use in filing Proof of Coverage (POC) and Claims (non-medical) Electronic Data Interchange (EDI) transactions to the Division. All of the forms may be obtained from the Division of Workers' Compensation at i…

Unless otherwise defined in this section, definitions of data elements and terms used in this rule are defined in the Data Dictionary located in Section 6 of the "IAIABC Implementation Guide for Claims: First, Subsequent, Header, Trailer & Acknowledgement Detail Records, Release …

(1) Effective March 1, 2002, every insurer authorized to insure employers in the State of Florida, except for individual self-insurers approved under Section 440.38, F.S., shall file policy information electronically to the Division rather than by filing on paper forms previously…

(1) In order to send Proof of Coverage data electronically to the Division, the insurer or third party vendor shall complete the testing requirements set forth in Section 1 of the Florida Division of Workers' Compensation Proof of Coverage Electronic Data Interchange (EDI) Implem…

(1) Except for cancellation for nonpayment of premium or failure to pay deductible, or cancellation or non-renewal at the request of the insured, an insurer shall not cancel or non-renew any workers' compensation insurance policy, contract of insurance, or renewal until at least …

For any workers' compensation insurance policy, contract of insurance or renewal written for an employee leasing company or clients of an employee leasing company, with a policy effective date on or after October 1, 2009, the insurer shall electronically file any workers' compens…

Pursuant to Section 440.593(1), F.S., the Division may establish different deadlines for filing required reports electronically than are otherwise required when reporting information by other means. Accordingly, notwithstanding the deadlines for filing policy information by other…

(1)(a) On or before the implementation schedules set out in paragraphs (3)(a) and (b) of this section, every insurer shall file claims information for all "Lost Time/Indemnity," "Medical Only to Lost Time," and "Denied" cases via electronic data interchange (EDI) pursuant to para…

On or before the compliance date established in the insurer's Primary Implementation Schedule set forth in paragraph 69L-56.300(3)(a), F.A.C., the insurer shall file the electronic form equivalent for claims information otherwise reported on Form DFS-F2-DWC-1 adopted in Rules 69L…

(FROI/SROI MTC 04, SROI MTC PD as found in the IAIABC Implementation Guide for Claims: First, Subsequent, Header, Trailer & Acknowledgement Detail Records, Release 3, January 1, 2009 Edition). On or before the compliance date established in the insurer's Primary Implementation Sc…

(SROI MTC SA, FN as found in the IAIABC Implementation Guide for Claims: First, Subsequent, Header, Trailer & Acknowledgement Detail Records, Release 3, January 1, 2009 Edition). On or before the compliance date established in the insurer's Primary Implementation Schedule set for…

(FROI/SROI MTC 02, FROI MTC AQ, AU, SROI IP, PY, EP as found in the IAIABC Implementation Guide for Claims: First, Subsequent, Header, Trailer & Acknowledgement Detail Records, Release 3, January 1, 2009 Edition). (1) Electronic Notice of Action or Change (MTC 02). On or before t…

(SROI MTC 02, CA, CB, AB, S1-S8, P7, RB, ER as found in the IAIABC Implementation Guide for Claims: First, Subsequent, Header, Trailer & Acknowledgement Detail Records, Release 3, January 1, 2009 Edition.) (1) Electronic Notice of Action or Change (SROI MTC 02). On or before the …

(FROI MTC 01 as found in the IAIABC Implementation Guide for Claims: First, Subsequent, Header, Trailer and Acknowledgement Detail Records, Release 3, January 1, 2009 Edition.) (1) The claim administrator shall send FROI MTC 01 (Cancel) immediately upon the claim administrator's …

(1) Insurers shall send Claims EDI Filings required in Rules 69L-56.301, 69L-56.3012, 69L-56.3013, 69L-56.304, 69L-56.3045, 69L-56.307 and 69L-56.330, F.A.C., to the Division using only the following transmission methods: (a) Advantis Value Added Network (VAN); or (b) Secure Sock…

(1) Prior to sending an initial test transmission, the claim administrator shall file the EDI Trading Partner forms required in subsection 69L-56.300(2), F.A.C. If a form is incomplete and does not contain responses to all of the required fields in accordance with the form instru…

Rulemaking Authority 440.591, 440.593 FS. Law Implemented 440.593 FS. History-New 5-29-05, Amended 1-7-07, Repealed 5-17-09.

(1) An employer shall record all industrial injuries and diseases as follows: (a) For a first aid case that is not required to be reported to the claim administrator, the employer shall maintain a record of the following information regarding the injury or illness: 1. The employe…

(1) A claim administrator shall record all industrial injuries and diseases as follows: (a) Upon receipt of a Form DFS-F2-DWC-1, as adopted in Rule 69L-3.025, F.A.C., the claim administrator shall legibly date stamp the form in the "Received by Claims-handling Entity" box. Upon n…

(1) If the claim administrator denies entitlement to any benefit, or subsequently rescinds that denial, it shall send a copy of Form DFS-F2-DWC-12, as adopted in Rule 69L-3.025, F.A.C., to the employee, employer and any additional party requesting payment or authorization. The Fo…

(1) The claim administrator shall send Form DFS-F2-DWC-13, as adopted in Rule 69L-3.025, F.A.C., to the Division for the following cases: (a) Lost time cases as defined in subsection 69L-3.002(19), F.A.C., which include lost time cases in which no indemnity benefits have been pai…

Forms DFS-F2-DWC-1, DFS-F2-DWC-4, DFS-F2-DWC-12 and DFS-F2-DWC-13, as incorporated in Rule 69L-3.025, F.A.C., shall be reported to the Division using Electronic Data Interchange (EDI). Requirements for EDI reporting are located in Rules 69L-56.301, 69L-56.304, 69L-56.3045, 69L-56…

The claim administrator shall send Form DFS-F2-DWC-4, as adopted in Rule 69L-3.025, F.A.C., to the Division as specified in this section for any industrial accident or injury filed for lost time cases as defined in subsection 69L-56.4011(2), F.A.C., within 14 days of the claim ad…

If an insurer contracts with a claim administrator or third party vendor to electronically send transactions to the Division on the insurer's behalf, or uses a claim administrator or third party vendor's software product for electronically sending transactions to the Division, th…

(1)(a) Upon issuance of an insurance policy or certificate of membership in a self-insurance fund or a renewal certificate thereof, the insurer or self-insurance servicing agent shall electronically send the compensation notice to the employer or furnish the employer with a suffi…

Rulemaking Authority 440.05(9), 440.591 FS. Law Implemented 440.05 FS. History-New 11-20-79, Amended 4-15-81, 1-2-86, Formerly 38F-6.09, Amended 5-28-91, 2-15-94, 2-2-00, 3-5-02, Formerly 38F-6.009, 4L-6.009, Amended 2-19-07, 1-7-08, 12-31-08, Repealed 9-4-13.

(1) Only corporate officers of non-dissolved or active corporations who meet the conditions for the issuance of valid Form DFS-F4-DWC-252, https://www.flrules.org/Gateway/reference.asp?No=Ref-15433 Certificate of Election to be Exempt from Florida Workers' Compensation Law, revis…

(1) Employers must at all times maintain the records required by this rule and must produce the records when requested by the division pursuant to Section 440.107, F.S. (2) Identity, organizational, and occupational records. Every employer shall maintain the notice that assigns t…

(1) An employer who fails to secure compensation as required by Sections 440.10(1) and 440.38(1), F.S., for each employee classified by the employer as an independent contractor but who does not meet the criteria of an independent contractor specified in Section 440.02, F.S., sha…

(1) Every employer who is required to provide workers' compensation coverage for employees engaged in work in this state shall obtain a Florida policy or endorsement for such employees that utilizes Florida class codes, rates, rules and manuals that are in compliance with and app…

(1) The Division adopts the classification codes and descriptions that are specified in the Florida Contracting Classification Premium Adjustment Program, and published in the Florida exception pages of the National Council on Compensation Insurance, Inc. (NCCI), Basic Manual (20…

Rulemaking Authority 440.185(10), 440.591 FS. Law Implemented 440.125, 440.185(11) FS. History-New 3-27-03, Formerly 4L-6.022, Repealed 2-15-16.

Under Section 440.05(14), F.S., an officer of a corporation who elects to be exempt from Chapter 440, F.S., may not recover benefits or compensation under Chapter 440, F.S., and a carrier may not consider any officer of a corporation who holds a valid certificate of election to b…

(1) The requirements for issuance of a Form DFS-F4-1602 http://www.flrules.org/Gateway/reference.asp?No=Ref-15437, Agreed Order of Conditional Release from Stop-Work Order, revised 01/23, and incorporated by reference herein, as provided for in Section 440.107, F.S., are as follo…

Rulemaking Authority 440.107(7)(a), 440,591 FS. Law Implemented 440.107 FS. History-New 9-15-10, Repealed 11-26-14.

(1) For purposes of calculating penalties to be assessed against employers pursuant to Section 440.107, F.S., the Division shall use Form DFS-F4-1595, https://www.flrules.org/Gateway/reference.asp?No=Ref-15434, Penalty Calculation Worksheet, revised 01/23, which is hereby incorpo…

(1) In the event an employer fails to provide business records sufficient for the Department to determine the employer's payroll for the time period requested in the business records request for the calculation of the penalty pursuant to Section 440.107(7)(e), F.S., the Departmen…