16 Va. Admin. Code § 30-80-70

Current through Register Vol. 41, No. 6, November 4, 2024

Section 16VAC30-80-70 - Reporting requirements

A. The following regular reports must be submitted annually to the commission.

1. Within 60 days after the request, the self-insurer must provide a report of payroll to the commission, broken down by NCCI payroll classifications.

2. Within 60 days after the request, the self-insurer must provide a completed annual questionnaire on operations and claims experience.

3. Private self-insurers, but not public self-insurers, must also provide with the annual questionnaire:

a. Audited financial figures for the latest year of operations, and

b. A list of subcontractors who are, or may be, covered by the certificate of self-insurance.

B. The following information must be reported to the commission 30 days before the change occurs:

1. Any substantial change in corporate structure and status that affects overall management, financial soundness, or corporate names and designations.

2. Any substantial change in Virginia operations to include:

a. The addition of any subsidiary,

b. The addition of, or change to, any different kind of operation, or

c. An increase in the number of employees of more than 20% from the figure provided in the most recent annual questionnaire (or from the information in the self-insurer's original application if no annual questionnaire has yet been submitted).

3. Any decision to cease operating as a self-insurer.

C. Any proposed change in claims management or third party administration must be sent to the commission at least 60 days prior to the proposed change.

D. The requirements listed below apply to excess coverage. All reports, notices, and requests for approval of changes in, or notices of cancellation of, excess coverage shall be provided by certified mail, addressed to "Self-Insurance Program," Virginia Workers' Compensation Commission, 333 East Franklin Street, Richmond VA 23219.

1. All excess coverage policies must contain a clause requiring 60 days advance notice of cancellation.

2. All excess coverage policies must contain a clause to the effect that the policy is automatically renewable except upon 60 days advance notice of nonrenewal.

3. Prompt notification is required for any change in carrier, any decrease or moderate increase in retention level, or any increase or moderate decrease in indemnity limits.

4. Thirty days prior notice, subject to commission approval, is required for any change in excess coverage that involves more than a 25% decrease in indemnity limits or more than a 25% increase in retention levels.

E. Self-insurers must also respond to individual requests for information from the commission. Such requests may include, but are not limited to, the following:

1. Quarterly financial reports.

2. Clarification of information provided in regular reports.

3. Information on particular accidents and claims.

4. Copies of insurance policies and endorsements.

5. Copies of claims management and loss control reports and statistics.

F. The commission reserves the right to conduct independent audits of a self-insurer's financial records, claims management practices, and safety and loss control programs. Such audits may be conducted by commission staff or by their authorized agents.

16 Va. Admin. Code § 30-80-70

Derived from VR405-20-01 §7, eff. January 13, 1993; Amended, Virginia Register Volume 38, Issue 07, eff. 11/22/2021.

Statutory Authority

§§ 65.2-201 and 65.2-801 of the Code of Virginia.