Florida Administrative Code

Any Service Agent shall be approved by the Office prior to use by the Fund. The Service Agent shall provide proof that it meets the following conditions before approval may be granted: (1) The owner(s) of the Service Agent, including members of a copartnership, the officers of a …

(1) Application for the purpose of establishing a self-insurance trust fund shall be made to the Office at Tallahassee. Such application shall contain all information necessary for the Office's consideration. At the Office's request, further information or verification as may be …

The Trustees of the Fund shall be responsible for all operations of the Fund and shall assure the financial stability of the operations of the Fund by taking all necessary precautions to safeguard the assets of the Fund, including: (1) Providing for adequate methods of funding to…

(1) In the event of a deficit in any fund year, such deficit shall be made up, either from unencumbered surplus from a fund year or years other than the current fund year; or, upon approval by the Office, by assessment of the membership, if necessary and consistent with sound act…

(1) The Trustees shall have the accounts and records of the Fund audited annually or at any time as may be required by the Office, such audit to be made by Certified Public Accountants or by authorized representatives of the Office, with the Office reserving the right to prescrib…

Specific excess and aggregate excess insurance may be required as a condition of approval or continuing operation of the Fund. The Fund shall not voluntarily reduce its specific excess or aggregate excess insurance without the prior approval of the Office. The Fund shall notify t…

(1) The Trustees of the Fund shall oversee and approve the voluntary termination or voluntary merger of the Fund in accordance with Section 627.357(7)(i), F.S. The Service Agent shall cooperate and provide the necessary assistance required to effectuate such termination or merger…

As a condition of the Office's approval of the Fund, the documents filed pursuant to Rule 69O-187.004, F.A.C., shall contain all of the following provisions, but may also contain other provisions not inconsistent with these rules or with the required provisions. (1) The bylaws of…

Rule 69O-187, F.A.C., as amended on May 10, 1989, shall allow any Fund established prior to this date an exemption from Rules 69O-187.003 and 69O-187.010, F.A.C. At such time as any of the Fund documents filed pursuant to the application process are amended, the amended document(…

Failure to comply with any of the foregoing rules or with any order of the Office within the time prescribed shall be considered good cause for revocation, suspension, or refusal of the self-insurance privilege as previously indicated. Rulemaking Authority 627.357(6), 624.308(1) …

Rulemaking Authority 624.308(1) FS. Law Implemented 624.307(1), 624.462, 624.472 FS. History-New 3-28-89, Formerly 4-78.001, 4-188.001, Repealed 4-27-26.

Rulemaking Authority 624.308(1) FS. Law Implemented 624.307(1), 624.462, 624.472 FS. History-New 3-28-89, Formerly 4-78.002, 4-188.002, Repealed 4-27-26.

(1) This rule applies to all commercial property and casualty insurance which is written by a commercial self-insurance fund, as defined in Section 624.460-.488, F.S., in accordance with a rating plan. It is intended to establish guidelines and procedures for determining whether …

Rulemaking Authority 624.308 FS. Law Implemented 624.307(1), 624.470, 624.474, 624.488 FS. History-New 12-17-90, Formerly 4-78.020, 4-188.020, Repealed 4-27-26.

As used herein and for purposes of Forms OIR-EX and OIR-IA, the following definitions shall apply. For purposes of reporting on a calendar-accident year basis, references to "policy year" in the rules in this part shall mean "calendar-accident year" as the context may require. (1…

(1) On or before March 31 of each year or a later date if approved by the Office Department for good cause, each commercial self insurance fund shall complete for the preceding policy years, excluding closed policy years, evaluated as of the preceding December 31, and submit to t…

(1) Each commercial self-insurance fund shall submit electronically to http://www.floir.com/iportal. For the purpose of complying with rule Chapter 69O-137, F.A.C., a commercial self-insurance fund shall be considered an authorized insurer, except that the fund's annual statement…

(1) After four (4) completed policy years, the commercial self-insurance fund trustees shall, within sixty (60) days of filing Forms OIR-EX and OIR-IA with the Office, make up any deficiencies identified in each policy year on Form OIR-EX, line 13., or shall levy an assessment up…

(1) Assessments shall be made only against members having a policy during a policy year reporting a deficiency on Form OIR-EX, line 13. The assessment for each policy year shall be prorated among all policyholders for that policy year as follows: X/Y x A = B X = Assessment needed…

If after reviewing any form filed pursuant to this part, the Office preliminarily determines that the numbers contained thereon are inaccurate or that justification for the numbers is necessary, it shall issue a notice to the fund requesting that a corrected form be filed or that…

(1) Once a policy year is closed, any excess funds must be: (a) Distributed as dividends to members subject to the approval of the Office; or (b) Transferred to any open fund year or years. Such transfer must be formally approved by the trustees. (2) Such action must be effective…

(1) Nothing in this part shall preclude a fund's trustees from levying an assessment to its members under the terms of their policies or shall be used as the basis for a member not to pay such an assessment. (2) Failure of the trustees to make up deficiencies or assess the member…

(1)(a) Each employer applying to a carrier in the voluntary market for workers' compensation coverage required by Section 440.38, F.S., shall use Form ACORD 130 FL (rev. 2019/07), "Florida Workers Compensation Application," which is hereby adopted and incorporated by reference. T…

F.S., authorize the filing of premium deviations which automatically expire after a period of one year unless refiled and reapproved. Any such premium deviation filing shall include the following information: (1) Proposed effective date of deviation. (2) Proposed deviation percen…

(1) The Office shall use one or more designated workers' compensation and employers' liability insurance statistical agents as designated by the Office through the contract solicitation process. (2) Each insurer and self-insurance fund as defined in Section 624.461, F.S., shall u…

If a workers' compensation insurer wishes to file for a large deductible, such filing shall be governed by the following guidelines: (1) Eligibility: Minimum standard premium of $500,000; Minimum deductible of $100,000. (2) Insurer must be clearly obligated to pay first dollar of…

Rulemaking Authority 624.308(1), 627.215 FS. Law Implemented 624.307(1), 624.424(1)(c), 627.215 FS. History-New 6-14-84, Amended 7-1-85, Formerly 4-59.061, Amended 6-1-88, Formerly 4-59.0061, Amended 12-20-00, Formerly 4-189.007, Amended 3-29-05, Repealed 7-30-17.

(1) An insurer, in order to avoid policy and advertising misrepresentation as set forth in Section 626.9541(1), F.S., shall not include an estimated amount of dividend which may be received, in the calculation of premium on proposals for workers' compensation insurance in the Sta…

A worker' compensation insurer is required to give thirty days notice of cancellation except when cancellation is for the following reasons: (1) The policy has been rewritten by the same company, with the same effective date; or (2) Prior to the effective date of the policy, the …

The filing of workers' compensation excess insurance rates may take the form of rating guidelines and parameters in lieu of specific rates. Rulemaking Authority 624.308(1) FS. Law Implemented 624.307(1), 627.091 FS. History-New 6-4-92, Formerly 4-189.013.

(1) Purpose: To administer the requirements of Section 624.4315, F.S. (2) Definitions: (a) "Insurer Group" means two or more affiliated insurers that are under common ownership and/or management. (b) "Underwriting" is defined as the insurer selection of policyholders through haza…

(1) Purpose: To establish the procedures to be utilized by insurers in the filing of workers' compensation classifications, rules, rates, rating plans, deviations and forms pursuant to Sections 627.091, 627.211 and 627.410, F.S. (2) Any insurer authorized to transact workers' com…

(1) Licensing procedures pursuant to Section 120.60, F.S., and in accordance with the model rules of procedure shall apply to this application. (2) All applications for a self-insurers fund shall be made in writing on OIR Form BSI-2. (3) All applications shall be accompanied by: …

(1) The application will be evaluated and a determination will be made of: (a) Whether the fund application, individual member applications and indemnity agreement are properly completed and that all required information is supplied. (b) Whether the combined financial condition o…

(1) The self-insurance privilege of a self-insurers fund is granted continuously until revoked. (2) A review of all self-insurers fund programs will be made annually. As a result of such reviews, changes in the prior requirements to self-insure or the imposition of additional req…

(1) Each fund shall file with the Office quarterly financial statements on OIR Form BSI-28 or the 1992 National Association of Insurance Commissioners (NAIC) Quarterly Statement, Fire and Casualty Companies Association Edition in its entirety. (2) Each fund shall file with the Of…

(1) Designation of Independent Certified Public Accountant. (a) Each fund required by subsection 69O-190.059(4), F.A.C., to file an annual audited financial statement shall, by the end of the fiscal year subject to audit, notify the Office in writing of the name and address of th…

(1) Pursuant to Section 624.4621, F.S., each self-insurers fund shall deposit with the Office acceptable securities or post a surety bond issued by a corporate surety authorized to do business in the State of Florida or make provisions as otherwise provided in these rules. (2) Th…

(1) When used in this rule, the following words or terms shall have the meaning as described herein: (a) Loss fund - the retention under the terms of an aggregate excess contract, or if no aggregate excess is purchased, the amount remaining from normal premium in each fund year a…

(1) Reports as to payroll records, coverage, accident experience and compensation payment and such periodic reports as are required to be filed with the Office shall be made as follows: (a) Summary loss data shall be filed with the Office on each fund member within 60 days after …

(1) All bonds or securities issued by the State of Florida or the United States Government which are posted as security deposits shall be reviewed annually by the Office to determine market value. In the event market value is less than the deposit requirement, the Office may requ…

(1) The board of trustees shall have complete authority over and shall retain ultimate control of the assets of the fund and shall be responsible for all operations of the fund. (2) The trustees shall have the authority to approve applications for membership in the fund. The trus…

(1) Any surplus monies for a fund year in excess of the amount necessary to fulfill all obligations under the Law for that fund year may be declared refundable to members by the trustees at any time. The amount of such declaration shall be a liability of the fund at the time of t…

(1) The trustees shall not allow a premium discount to any member for the period beginning on September 1, 1990 and ending on December 31, 1991. Beginning on January 1, 1992, if a self-insurer's fund allows premium discounts to its members, the trustees shall allow a premium disc…

(1) All members of a self-insurers fund shall have common interest. Different businesses which are owned or controlled by the same interests shall be eligible for membership in a self-insurers fund provided one of them is eligible. (2) Unless the context clearly indicates to the …

(1) Each self-insurers fund member shall enter into an indemnity agreement jointly and severally binding the self-insurers fund and each member thereof to comply with the provisions of the Florida Workers' Compensation Law and rules of the Office. Employers in the public sector w…

(1) Employers participating in a self-insurers fund under the provisions of Section 624.4621, F.S., shall be subject to the Experience Rating Plan and the payroll classification and premium determination system established by the National Council on Compensation Insurance (NCCI).…