Section 166.5 - [Effective 7/1/2024] Inspections of Adequacy of Accident Prevention Facilities and Services(a) Inspections. The division may conduct inspections to determine the adequacy of an insurance company's accident prevention services.(1) Affiliated companies of an insurer may be inspected together if the same facilities, programs, and personnel are used by each of the companies.(2) At least 90 days before an inspection, the division must notify the insurance company in writing of the inspection. The notice must specify the location and date of the inspection.(3) The division may conduct unannounced on-site visits to determine compliance with the Labor Code and division rules in accordance with the procedures governing on-site visits in Chapter 180 of this title (relating to Monitoring and Enforcement) regardless of the provisions of this section.(b) Site of inspection. The inspection of the insurance company's accident prevention services must take place as determined by the division:(1) at the insurance company's office in Texas;(c) Pre-inspection exchange of information.(1) At least 60 days before the date set for inspection, in the format and manner specified by the division, the insurance company must provide to the division a list of policyholders.(A) For the period of time determined by the division, the list must be organized by: (iii) effective date or expiration date of the policy;(v) number of fatalities;(vi) principal Texas location;(vii) indication of whether the insurance company has contracted with the policyholder for accident prevention services; and(viii) indication of whether that policyholder has requested accident prevention services.(B) The list must also: (i) be taken from the insurance company's most current records;(ii) be separated by affiliated companies;(iii) be arranged in descending order by premium; and(iv) include all policies.(2) Within 10 days of receipt of the policyholder list, the division must select the specific policyholder files to be evaluated and notify the insurance company of those selected files.(3) For each policy selected by the division, the insurance company must prepare an accident prevention services worksheet in the format and manner prescribed by the division. The worksheet must include the:(D) principal Texas office address or principal corporate office address if there is no principal Texas office address;(E) policyholder contact person's name, phone number, and email address;(F) insurance company name;(G) effective date of the policy; and(H) name of person completing the form and date completed.(4) At least 10 days before the date of the inspection, the insurance company must file the completed worksheets with the division.(d) Information to be made available at or before the inspection. The insurance company must make available for the time frame specified by the division: (1) the loss control files corresponding to the requested worksheets;(2) a sample policy declaratory page as evidence that each policyholder has been provided the notice required by § 166.2(b)(1) of this title;(3) a copy of all documentation of accident prevention services provided in accordance with this title;(4) samples of policyholder training materials, audiovisual aids, and training programs; and(5) other information requested by the division necessary to complete the inspection. Information requested may include, but is not limited to:(F) industrial health and hygiene services;(G) return-to-work coordination services information; and(H) the name, location, status (whether employee or contractor), and qualifications of each person that provided accident prevention services in the loss control files being reviewed during the inspection.(e) Insurance company policyholder visits and contacts. The division may conduct scheduled visits of the jobsite of an insurance company's policyholder and make other off-site contacts with a policyholder to obtain information about the insurance company's accident prevention facilities and use of services.(f) Written report of inspection. (1) The division must prepare a written report of the inspection and must provide a copy to the insurance company's executive management and to the Texas Department of Insurance, Loss Control Regulation Division.(2) The inspection report must contain the division's determination of adequacy in accordance with Labor Code § 411.061 and § 166.2 of this title, and include specific findings and required corrective actions. The inspection report will indicate whether the division has issued a final determination of adequacy, a final determination of inadequacy, or an initial determination of inadequacy with regard to an insurance company's accident prevention services.(3) The division will provide written notification to the insurance company of specific deficiencies and recommendations for corrective action if it assigns an initial determination of inadequacy. Not later than the 60th day after the date of the initial inspection report, the insurance company must provide written documentation evidencing its compliance with the division's recommendations contained in the initial inspection report. The written documentation must detail the corrective actions taken to address each specific finding. If the insurance company believes that it will take more than 60 days to implement the recommendations listed in the initial inspection report, it must request an extension from the division. After the end of the correction period, a final determination of adequacy or inadequacy will be assigned. The division must provide the insurance company with notification of this final determination.(g) Reinspection. (1) After an inspection and a final determination of inadequacy of an insurance company's accident prevention services, the division will reinspect the accident prevention services of the insurance company not earlier than the 180th day or later than the 270th day after the date the accident prevention services were determined by the division to be inadequate.(2) Information required under this section to be provided at the time of initial inspection is required to again be provided at the time of reinspection in accordance with the time frames established within this section.(h) This section is effective July 1, 2024.28 Tex. Admin. Code § 166.5
The provisions of this §166.5 adopted to be effective September 1, 1995, 20 TexReg 5248; amended to be effective October 1, 2013, 38 TexReg 2000; Amended by Texas Register, Volume 49, Number 16, April 19, 2024, TexReg 2547, eff. 7/1/2024