(1) All records supporting the submitted Form DFS-F2-SI-17 (Unit Statistical Report), effective 08/09, as previously incorporated by reference in Fl. Admin. Code R. 69L-5.205, or its electronic equivalent shall be open for inspection and audit by the Department or its Authorized Representative, during regular business hours. Copies of this form are available at the Division of Workers’ Compensation, Bureau of Monitoring and Audit, Self-Insurance Section, 1579 Summit Lake Drive, Tallahassee, FL 32317. Self-insurers are required to maintain loss records that reflect a true and accurate division by the classification codes, status type, and injury codes contained in the NCCI Workers’ Compensation Statistical Plan Manual and the NCCI Basic Manual for Workers’ Compensation and Employers Liability Insurance so the proper classification code, status type, and injury code for each accident may be determined. The Workers’ Compensation Statistical Plan Manual, 2008 Edition, including updates through April 1, 2009 is hereby incorporated by reference. A copy of the Manual may be obtained from the National Council on Compensation Insurance, Inc., Customer Service Center, 901 Peninsula Corporate Circle, Boca Raton, FL 33487, telephone 1(800)622-4123. A copy of the manual is also available for viewing at the Division of Workers’ Compensation, Bureau of Monitoring and Audit, Self-Insurance Section, 1579 Summit Lake Drive, Tallahassee, FL 32317. The NCCI Basic Manual for Workers’ Compensation and Employers Liability Insurance, 2001 Edition, including updates through June 1, 2009, is previously incorporated by reference into Fl. Admin. Code R. 69L-5.201
To ensure their availability for audit purposes, the records shall be retained for five (5) years from the last date the claims data was used for calculation of the experience modification. The location of these records shall be provided to the Department upon submission of the application for self-insurance and updated within fifteen (15) days of any relocation.

Need help with an employment contract?
Have it reviewed by a lawyer, get answers to your questions and move forward with confidence.
Connect with a lawyer now

    (2) At the conclusion of the audit conducted by the Department or its Authorized Representative, a preliminary report shall be prepared and sent to the self-insurer. The preliminary report shall identify any payroll, loss, or classification deficiencies. The self-insurer shall have thirty (30) days from the date of receipt to review and respond to the Department’s preliminary report. The Department shall review the response and issue a final report.
Rulemaking Authority 440.38(1), (2), (3), 440.385(6), 440.525(2), 440.591 FS. Law Implemented 440.38(1), (2), (3), 440.385(1), (3), (6), 440.525 FS. History-New 3-9-10.