Florida Regulations 69O-189.006: Guidelines for Large Deductible Workers’ Compensation Filings
Current as of: 2024 | Check for updates
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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 loss just like any other workers’ compensation policy without a deductible.
(3) Reimbursement of deductible by insured does not affect insurer obligation to pay losses.
(4) Insurer must continue all filing requirements with Department of Financial Services in compliance with chapter 440, F.S., for all losses including those below the deductible limits.
(5) Insurer must file unit statistical reports with the NCCI which show all losses including those below the deductible limit.
(6) Unit statistical reports are to be completed and filed with the NCCI so that an experience modification factor can be calculated for the insured.
(7) Data must be maintained to allow for reporting on financial calls of Standard Premium at NCCI Level together with all losses including those below the deductible limit.
(8) Insurers must comply with NCCI Aggregate Financial Calls, Detail Claim Information Calls, Unit Statistical Reporting, and other required calls.
(9) Insurer must have an established program to evaluate financial ability of insured to pay losses within the deductible. Insurers are required to use various financial mechanisms to insure that funds are available from the insured to pay deductible portion of losses.
Rulemaking Authority Florida Statutes § 624.308(1). Law Implemented 624.307(1), 627.091(1) FS. History-New 6-4-92, Formerly 4-189.006.
Terms Used In Florida Regulations 69O-189.006
- Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
(2) Insurer must be clearly obligated to pay first dollar of loss just like any other workers’ compensation policy without a deductible.
(3) Reimbursement of deductible by insured does not affect insurer obligation to pay losses.
(4) Insurer must continue all filing requirements with Department of Financial Services in compliance with chapter 440, F.S., for all losses including those below the deductible limits.
(5) Insurer must file unit statistical reports with the NCCI which show all losses including those below the deductible limit.
(6) Unit statistical reports are to be completed and filed with the NCCI so that an experience modification factor can be calculated for the insured.
(7) Data must be maintained to allow for reporting on financial calls of Standard Premium at NCCI Level together with all losses including those below the deductible limit.
(8) Insurers must comply with NCCI Aggregate Financial Calls, Detail Claim Information Calls, Unit Statistical Reporting, and other required calls.
(9) Insurer must have an established program to evaluate financial ability of insured to pay losses within the deductible. Insurers are required to use various financial mechanisms to insure that funds are available from the insured to pay deductible portion of losses.
Rulemaking Authority Florida Statutes § 624.308(1). Law Implemented 624.307(1), 627.091(1) FS. History-New 6-4-92, Formerly 4-189.006.