3 Colo. Code Regs. § 702-5-1-11-4
Current through Register Vol. 48, No. 1, January 10, 2025
Section 3 CCR 702-5-1-11-4 - DefinitionsA. "Anniversary date" means, for the purpose of this regulation, the annual anniversary of the date of issue of a policy as shown in the policy declaration.B. "Certified workers' compensation risk management program" means, for the purpose of this regulation, a program which meets the minimum standards outlined in Colorado Insurance Regulation 5-3-1 and is certified with a Cost Containment Certificate by the Colorado Cost Containment Board.C. "Designated medical provider" means, for the purpose of this regulation, any physician, hospital, clinic or physician of a preferred provider organization network who meets all of the qualifications of a designated medical provider outlined in Regulation 5-3-1, which defines minimum risk management standards for cost containment certification.D. "Experience rating plan" means, for the purpose of this regulation, any rating plan or system wherein a manual rate for insurance is adjusted or modified based on the past loss experience of the insured.E. "Improved workers' compensation loss experience for experience or schedule rated insured business entities" means, for the purpose of this regulation, lower frequency and severity of losses for the last policy period as compared with frequency and severity of losses within the immediate prior policy period. If loss experience is not available for the complete last policy year, losses must be compared for equal periods of time (eight months vs. eight months, ten months vs. ten months, etc.). Whether the risk management program certification credit applies and whether the business entity's loss experience has improved shall be determined by the insurer prior to granting the cost containment credit. The Colorado Cost Containment Board reviews the business entity's loss record for the purpose of certification of the risk management program only.F. "Initial certification date" means, for the purpose of this regulation, the date the risk management program of a business entity is initially certified by the Colorado Cost Containment Board. A risk management program that meets the risk management standards of Colorado Insurance Regulation 5-3-1 shall be initially certified one year after the implementation of the program by the business entity.G. "Initial effective date of the premium dividend resulting from the implementation of a risk management program" means, for the purpose of this regulation, the annual anniversary date of a workers' compensation policy immediately after the risk management program has been certified by the Colorado Cost Containment Board. If the annual anniversary date is within sixty (60) days of the date a risk has been certified, a grace period for the application of a premium dividend is allowed. However, a grace period, when allowed, must be applied consistently.H. "Manual rate" means, for the purpose of this regulation, a rate designed to apply on a generic basis to similar risks within the same class, filed by an insurer or rating/advisory organization with the Division of Insurance and made part of the rating manual used by an insurer or rating/advisory organization.I. "Payroll" means, for the purpose of this regulation, the remuneration paid or payable by the business entity for services of employees. Remuneration is money or substitutes for money including commissions, bonuses, extra pay for overtime, pay for vacations, holidays and sickness, statutory insurance or pension plans, payments for piece work, allowances for tools, the rental value of an apartment, and the value of lodging and meals.J. "Premium Differential" means, for the purpose of this regulation, an adjustment to the workers' compensation premium when the insured business entity has selected a designated medical provider. K. "Premium dividend resulting from the implementation of a risk management program" means, for the purpose of this regulation, the credits allowed for business entities which implement a risk management program and comply with the standards established by Colorado Insurance Regulation 5-3-1 and the business entity's loss experience under the risk management program indicates that such premium dividend is warranted.L. "Premium dividend resulting from rehiring previously injured employees" means, for the purpose of this regulation, the credit arrived at for employers who rehire previously injured employees who sustained permanent partial disabilities.M. "Rate modification plan" (commonly called Schedule Rating Plan or Individual Risk Premium Modification Plan) means, for the purpose of this regulation, a rating plan or procedure which provides a listing of various risk characteristics or conditions and a range of modification factors which may be applied for these characteristics or conditions to the manual rate of a particular insurance risk. The effect of the modification factor is to increase (debit) or decrease (credit) the manual rate. Rate modification plans exclude merit rating plans and retrospective rating plans. N. "Rehired employee with permanent partial disabilities" means, for the purpose of this regulation, an employee who sustained permanent partial disabilities and is reemployed by the same employer, not a successor, at the pre-injury wages including any wage increases to which such employee would have been entitled had the employee not been injured. O. "Renewal date of premium dividend" means, for the purpose of this regulation, each annual anniversary date of a workers' compensation insurance policy after the initial effective date of the premium dividend.38 CR 17, September 10, 2015, effective 10/1/201538 CR 18, September 25, 2015, effective 10/15/201539 CR 01, January 10, 2016, effective 2/1/201639 CR 05, March 10, 2016, effective 4/1/201641 CR 01, January 10, 2018, effective 2/14/201840 CR 21, November 10, 2017, effective 4/1/201841 CR 19, October 10, 2018, effective 11/1/201842 CR 18, September 25, 2019, effective 1/1/202042 CR 23, December 10, 2019, effective 1/1/202044 CR 13, July 10, 2021, effective 6/3/202144 CR 08, April 25, 2021, effective 8/1/202145 CR 03, February 10, 2022, effective 3/2/202245 CR 22, November 25, 2022, effective 12/15/202246 CR 11, June 10, 2023, effective 4/27/2023