(a) All policies issued to employers for workers’ compensation insurance shall disclose clearly to employers as separate figures the portion of the premium charged for:

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(1) Medical care, services, and supplies;
(2) Wage loss benefits including temporary total, temporary partial, and permanent total disability benefits and their related benefits;
(3) Indemnity benefits for permanent partial disability; and
(4) Death benefits.

In addition, a disclosure statement shall indicate to the employer the portion of the premium attributable to loss control and administrative costs, attorney’s fees of the insurer, the cost of employer requested medical examinations, and private investigation costs.

(b) When a policy is issued to employers for workers’ compensation insurance, it shall be accompanied by a statement disclosing the percentages of premiums expended during the previous year by the insurer for claims paid in the categories specified in subsection (a), including loss control and administrative costs, attorney’s fees of the insurer, the cost of employer requested medical examinations, and private investigation costs.
(c) The information provided to employers by insurers pursuant to this section shall be provided on an annual basis to the director of labor and industrial relations and to the commissioner.
(d) Any insurer found in violation of this section shall pay a fine of $5,000 per violation to the insured, plus attorney’s fees and costs to the insured for enforcing this section.

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