Section 287.955

Title XVIII LABOR AND INDUSTRIAL RELATIONS

Chapter 287

Effective - 01 Jan 2014, 2 histories, see footnote   (history) 

  287.955.  Insurers to adhere to uniform classification system, plan — director to designate advisory organization, purpose, duties — risk premium modification plan, requirements. — 1.  Every workers' compensation insurer shall adhere to a uniform classification system and uniform experience rating plan filed with the director by the advisory organization designated by the director and subject to his disapproval.

  2.  An insurer may develop subclassifications of the uniform classification system upon which a rate may be made, except that such subclassifications shall be filed with the director thirty days prior to their use.  The director shall disapprove subclassifications if the insurer fails to demonstrate that the data thereby produced can be reported consistent with the uniform statistical plan and classification system.

  3.  The director shall designate an advisory organization to assist him in gathering, compiling and reporting relevant statistical information.  Every workers' compensation insurer shall record and report its workers' compensation experience to the designated advisory organization as set forth in the uniform statistical plan approved by the director.

  4.  The designated advisory organization shall develop and file manual rules, subject to the approval of the director, reasonably related to the recording and reporting of data pursuant to the uniform statistical plan, uniform experience rating plan, and the uniform classification system.

  5.  Every workers' compensation insurer shall adhere to the approved manual rules and experience rating plan in writing and reporting its business.  No insurer shall agree with any other insurer or with the advisory organization to adhere to manual rules which are not reasonably related to the recording and reporting of data pursuant to the uniform classification system of the uniform statistical plan.

  6.  (1)  A workers' compensation insurer may develop an individual risk premium modification rating plan which prospectively modifies premium based upon individual risk characteristics which are predictive of future loss.  Such rating plan shall be filed thirty days prior to use and may be subject to disapproval by the director.

  (2)  The rating plan shall establish objective standards for measuring variations in individual risks for hazards or expense or both.  The rating plan shall be actuarially justified and shall not result in premiums which are excessive, inadequate, or unfairly discriminatory.  The rating plan shall not utilize factors which are duplicative of factors otherwise utilized in the development of rates or premiums, including the uniform classification system and the uniform experience rating plan.  The premium modification factors utilized under the rating plan shall be applied on a statewide basis, with no premium modifications based solely upon the geographic location of the employer.

  (3)  Within thirty days of a request, the insurer shall clearly disclose to the employer the individual risk characteristics which result in premium modifications.  However, this disclosure shall not in any way require the release to the insured employer of any trade secret or proprietary information or data used to derive the premium modification and that meets the definitions of, and is protected by, the provisions of chapter 417.

  (4)  (a)  Premium modifications under this subsection may be determined by an underwriter assessing the individual risk characteristics and applying premium credits and debits as specified under a schedule rating plan.  Alternatively, an insurer may utilize software or a computer risk modeling system designed to identify and assess individual risk characteristics and which systematically and uniformly applies premium modifications to similarly situated employers.

  (b)  Premium modifications resulting from a schedule rating plan, with an underwriter determining individual risk characteristics, shall be limited to plus or minus twenty-five percent.  An additional ten percent credit may be given for a reduction in the insurer's expenses.

  (c)  Premium modifications resulting from a risk modeling system shall be limited to plus or minus fifty percent.  Premium modifications resulting from a risk modeling system shall be reported separately under the uniform statistical plan from premium modifications resulting from a schedule rating plan.

  (d)  Premium credits or reductions shall not be removed or reduced unless there is a change in the insurer, the insurer amends or withdraws the rating plan, or unless there is a corresponding change in the insured employer's operations or risk characteristics underlying the credit or reduction.

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(L. 1993 S.B. 251 § 27, A.L. 2013 S.B. 1)

Effective 1-01-14