Current through Register Vol. XLI, No. 50, December 13, 2024
Section 85-8-11 - Ratemaking11.1. Beginning on the fiscal year commencing the first day of July 2008, all private carriers shall determine their base rates from the actuarially determined loss costs filed by and approved for the designated rating organization. All private carriers shall additionally adhere to the rating rules filed by and approved for the designated rating organization unless the private carrier makes an approved filing permitting deviation from the same.11.2. The base rates charged by the private carriers may also include; (1) a reasonable provision for expenses related to the administration costs of the private carrier, including underwriting expenses, such as commissions to agents and brokers, other policy acquisition or servicing expenses, premium taxes, assessments, surcharges and fees, catastrophe reinsurance expenses, expenses associated with rating organizations, loss adjustment expenses not included in the loss costs, such as claims defense expenses, claim administration expenses, and other related expenses;(2) a reasonable profit and contingency provision to contribute to the private carrier's surplus; and(3) all other ratemaking components consistent with industry practices. All such provisions shall be subject to the provisions of W. Va. Code § 33-20-4. Any filing made to establish or amend a loss cost multiplier or multipliers which accounts for expenses is effective until such time as the private carrier makes another filing to adjust the same.11.3. Private carriers may offer premium credits and debits through schedule rating plans which are consistent with industry practices. The ultimate premium net said credits and debits may not violate W. Va. Code § 23-2C-18(c). All rating plans shall be subject to the filing requirements of chapter thirty-three of the West Virginia Code that are applicable to other commercial insurance lines. Any credit or debit applied to the insured shall reasonably reflect; (1) appropriate judgment of the private carrier as to the risk and/or exposure characteristics of the insured;(2) the private carrier's interpretation of any statistical data;(3) the insured's adoption or refusal to adopt relevant loss limiting practices; and(4) other relevant considerations.11.4. Deductible plans. Deductible workers' compensation plans are permitted subject to the approval of the Insurance Commissioner, including the underwriting standards used for issuing such plans. Under a deductible plan, an insured employer that fails to make a required deductible payment shall be deemed to be in default of the policy premium and subject to cancellation for its failure to timely remit adequate premium, but the default shall not affect the payment of all benefits in otherwise compensable claims made under a policy inclusive of a deductible plan. Under all deductible plans, the private carrier remains responsible for the payment of claims benefits and administration and defense of claims.11.5. In addition to the premium charges determined, private carriers shall charge (1) all Deficit Reduction Fund surcharges as provided for in chapter twenty-three of the West Virginia Code and W. Va. Code St. R. § 85-6-1et seq.; (2) all regulatory surcharges required to fund the Insurance Commissioner's regulation of the workers' compensation industry as provided for in chapter twenty-three of the West Virginia Code and W. Va. Code St. R. § 85-6-1et seq.; and (3) all assessments made by the Insurance Commissioner for the funding of the Uninsured Employers' Fund or the Private Carrier Guaranty Fund as defined in W. Va. Code § 23-2C-1et seq. All collected surcharges shall be remitted as directed by the Insurance Commissioner.