La. Admin. Code tit. 37 § XIII-1101

Current through Register Vol. 50, No. 9, September 20, 2024

Section XIII-1101 - Definitions

A. When used in this regulation, the following words or terms shall have the following meaning.

Administrator- an individual, partnership, or corporation engaged by a group self-insurance fund to carry out the policies of the trustees of the fund and to provide day-to-day management of the fund.

Aggregate Losses- the amount of all claims, including reserves for loss development and losses incurred but not reported, which exceeds the loss fund.

Contingent Liability- the amount that a group self-insurance fund may be obligated to pay in excess of a given fund year's normal premium collected or on hand.

Department- the Louisiana Department of Insurance.

Fiscal Agent- an individual, partnership, or corporation engaged by a group self-insurance fund to carry out the fiscal policies of the fund, invest and disburse assets, and oversee the financial matters of the fund. An administrator may be a fiscal agent.

Gross Premium- premium determined by multiplying the payroll (segregated into the proper workers' compensation job classifications) by the manual premium rates approved by the commissioner.

Group Self-Insurance Fund or Fund- employers who enter into agreements to pool their workers compensation liabilities in accordance with Louisiana Revised Statutes 23:1195.

Incurred but not Reported Reserves- a reserve established which estimates the incurred loss of claims whose existence is unknown by the fund or claims which have been reported but not recorded on the books of the fund.

Insolvency- the condition existing when the fund's liabilities before member distribution payable or dividend payable are greater than the fund's assets determined in accordance with generally accepted accounting principles as delineated in the fund's financial statement audited by an independent certified public accountant. For the purposes of determining insolvency, assets will not include intangible property, such as patents, trade names, or goodwill.

Loss Development- the change in incurred loss from one point in time to another.

Loss Development Reserve- any amount needed in a given fund year, in addition to current loss reserves, to fund future loss development.

Loss Fund- the retention under the terms of an aggregate excess contract, or if no aggregate excess is purchased, the amount remaining from normal premium in each fund year after all necessary expenses are paid.

Normal Premium- standard premium less allowed discount.

Qualified Actuary-a person who:

a. meets the basic education, experience and continuing education requirements of the Specific Qualification Standard for Statements of Actuarial Opinion, NAIC Property and Casualty Annual Statement, as set forth in the Qualification Standards for Actuaries Issuing Statements of Actuarial Opinion in the United States (U.S. Qualifications Standards), promulgated by the American Academy of Actuaries (Academy) and as adopted in Chapter 161 of this Part;

b. has obtained and maintains an Accepted Actuarial Designation; and

c. is a member of a professional actuarial association that requires adherence to the same Code of Professional Conduct promulgated by the Academy, requires adherence to the U.S. Qualification Standards, and participates in the Actuarial Board for Counseling and Discipline when its members are practicing in the U.S.

Standard Premium- gross premium adjusted by experience modifiers.

Surplus- assets of a fund in excess of loss reserves, actual and contingent liabilities and loss development reserves in all fund years.

La. Admin. Code tit. 37, § XIII-1101

Promulgated by the Department of Insurance, Office of the Commissioner, LR 18:1403 (December 1992), Amended LR 4752 (1/1/2021), Amended LR 49267 (2/1/2023).

AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1200.1.