§2392. Definitions
As used in this chapter, unless the context otherwise indicates, the following terms
have the following meanings. [1995, c. 289, §11 (NEW).]
1. Association.
"Association" means the Maine Insurance Guaranty Association.
[
1995, c. 289, §11 (NEW)
.]
2. Board.
"Board" means the governing board of the Maine Workers' Compensation Residual Market
Pool.
[
1995, c. 289, §11 (NEW)
.]
3. Chapter 250.
"Chapter 250" means Bureau of Insurance Rules, Chapter 250, "Requirements for Eligibility
to Self-Insurer Workers' Compensation Benefits," as amended and as in existence prior
to the effective date of this chapter.
[
1995, c. 289, §11 (NEW)
.]
4. Chapter 440.
"Chapter 440" means Bureau of Insurance Rules, Chapter 440, "Plan of Operation for
the Workers' Compensation Residual Market Mechanism," as amended, as in existence
prior to the effective date of this chapter and as modified in this chapter.
[
1995, c. 289, §11 (NEW)
.]
5. Delinquent insurer.
"Delinquent insurer" means an insurer that has not timely paid in full that insurer's
allocated share pursuant to section 2393, subsection 1, paragraph A, subparagraphs
(1) or (2) or section 2393, subsection 1, paragraph B, subparagraphs (1) to (5), except
as provided in section 2393, subsection 1, paragraph A, subparagraph (3), division
(d) and section 2393, subsection 1, paragraph B, subparagraph (6), division (d).
[
1995, c. 289, §11 (NEW)
.]
6. Employer.
"Employer" means any employer in the State that, at any time relevant under this
chapter, is required under the Workers' Compensation Act to secure workers' compensation
benefits for its employees.
[
1995, c. 289, §11 (NEW)
.]
7. Expense constant.
"Expense constant" means a premium charge approved by the superintendent that applies
to every policy, in addition to other premium charges, covering expenses such as those
for issuing, recording and auditing that are common to all workers' compensation policies
regardless of premium size.
[
1995, c. 289, §11 (NEW)
.]
8. Fresh start period.
"Fresh start period" means the period from January 1, 1988 to December 31, 1992.
[
1995, c. 289, §11 (NEW)
.]
9. Initial surcharge period.
"Initial surcharge period" means the period from July 1, 1995 to June 30, 2003.
[
1995, c. 289, §11 (NEW)
.]
10. Insured employer.
"Insured employer" means an employer in the State that, on or after July 1, 1995,
secures or continues to secure workers' compensation benefits under the Workers' Compensation
Act for its employees through the purchase of an insurance policy.
[
1995, c. 289, §11 (NEW)
.]
11. Insurer.
"Insurer" means every insurer or group of affiliated insurers authorized to provide
workers' compensation insurance in the State at any time during the fresh start period.
For purposes of this chapter, a group of affiliated companies under common ownership,
management or control is treated as one entity.
[
1995, c. 289, §11 (NEW)
.]
12. Large deductible policy.
"Large deductible policy" means a workers' compensation policy written with a per
occurrence deductible in excess of $5,000 or a medical deductible in excess of $500.
[
1995, c. 289, §11 (NEW)
.]
13. Major insurer.
"Major insurer" means any insurer that was designated by the superintendent as a
servicing carrier in the workers' compensation residual market in the State as of
October 1, 1986.
[
1995, c. 289, §11 (NEW)
.]
14. Minor insurer.
"Minor insurer" means any insurer other than a major insurer.
[
1995, c. 289, §11 (NEW)
.]
15. Net direct written premium.
"Net direct written premium" means the Maine direct gross premiums charged less
all return premiums, except dividends and savings refunded under participating policies,
returned to policyholders for all Workers' Compensation and Occupational Disease Insurance
written in this State. Excess workers' compensation insurance is not considered "net
direct written premium."
[
1995, c. 289, §11 (NEW)
.]
16. Net present value.
"Net present value" is the sum of future payments, discounted to a specified valuation
date at the discount rate provided.
[
1995, c. 289, §11 (NEW)
.]
17. Plan year.
"Plan year" means, for an employer, the period beginning on the self-insured employer's
plan approval or renewal date and ending the day before the next plan renewal or anniversary
date. The plan renewal date for a member of a group self-insurer is the group's plan
renewal date; the plan approval date for a new member joining an established group
is the effective date of group membership. The plan year may be less than 12 months
as a result of changes in plan accounting periods, midyear entry into a group self-insurance
plan or termination of self-insurance authorization.
[
1995, c. 289, §11 (NEW)
.]
18. Policy year.
"Policy year" means the following:
A. With respect to a particular calendar year, all policies issued or renewed in that
calendar year and all subsequent events occurring in later years relating to those
policies, including premium adjustments, audit results and claims experience under
those policies; and [1995, c. 289, §11 (NEW).]
B. With respect to a particular employer, the 12-month period beginning upon the date
of issuance or renewal of a policy and ending the day before the next renewal date
and all subsequent events occurring in later years relating to those policies, including
premium adjustments, audit results and claims experience under that policy. [1995, c. 289, §11 (NEW).]
[
1995, c. 289, §11 (NEW)
.]
19. Pool.
"Pool" means the Maine Workers' Compensation Residual Market Pool described in and
governed by chapter 440.
[
1995, c. 289, §11 (NEW)
.]
20. Residual market.
"Residual market" means the instrument to provide coverage to employers not able
to obtain coverage in the voluntary market.
[
1995, c. 289, §11 (NEW)
.]
21. Self-insured employer.
"Self-insured employer" means an employer that, on or after July 1, 1995, secures
or continues to secure workers' compensation through a self-insured program under
the Workers' Compensation Act as approved by the superintendent pursuant to the provisions
of Title 39-A, section 403, subsection 3.
[
1995, c. 289, §11 (NEW)
.]
22. Self-insured group or groups.
"Self-insured group or groups" means a self-insured group approved by the superintendent
pursuant to chapter 250, section 3.
[
1995, c. 289, §11 (NEW)
.]
22-A. Succession transaction.
"Succession transaction" means an asset sale, merger, consolidation, reorganization
or restructuring that creates a successor self-insured employer.
[
1995, c. 619, §1 (NEW);
1995, c. 619, §8 (AFF)
.]
22-B. Successor self-insured employer.
"Successor self-insured employer" means any self-insured employer that is a successor
entity to another employer or employers doing business in this State. A successor
self-insured employer includes any entity that purchases all or a portion of the assets
of an employer or the surviving entity in any other merger, consolidation, reorganization
or restructuring.
[
1995, c. 619, §1 (NEW);
1995, c. 619, §8 (AFF)
.]
23. Superintendent.
"Superintendent" means the Superintendent of Insurance.
[
1995, c. 289, §11 (NEW)
.]
24. Surchargeable premium.
"Surchargeable premium" means:
A. For insured employers, the manual workers' compensation premium applicable to the
insured employer, as adjusted by any applicable experience modification factor, premium
discount, expense constant and any other debits or credits to a lawfully received
premium. In calculating the surchargeable premium for retrospectively rated policies
and large deductible policies, "surchargeable premium" means the discounted workers'
compensation standard premium, which is the manual premium that would apply to the
insured employer absent the retrospectively rated or large deductible nature of the
policy, as adjusted by any applicable experience modification factor, premium discount
and expense constant. For retrospectively rated and large deductible policies, the
insurer shall calculate a discounted standard premium amount utilizing estimated payrolls
at policy inception, subject to the final determination upon audit, applying the insurer's
manual rates, the insured's experience modification factor, any premium discount,
expense constant and other debits or credits to a lawfully received premium. When
calculating the discounted standard premium for policies with large deductibles, the
maximum credit for the deductible option may not be greater than the amount approved
by the superintendent in the most recent advisory loss cost filing for a $5,000 indemnity
deductible. [1995, c. 289, §11 (NEW).]
B. For self-insured employers, the manual workers' compensation premium adjusted by
the experience modification factor applicable to the self-insured employer, and any
applicable premium discount and expense constant. For purposes of this definition,
"manual premium" means the workers' compensation premium that would have been applicable
to the individual self-insured employer if calculated using the advisory loss costs
in effect at the time the surcharge is due multiplied by 1.2, applying the rating
rules, excluding any premium discount, and experience rating procedure approved by
the superintendent for the designated workers' compensation advisory organization
pursuant to section 2382-B, to the exposure and experience of the individual self-insured
employer. For a self-insured employer who is a member of a self-insurance group,
"surchargeable premium" means the actual amount of workers' compensation premium that
is paid to the self-insurance group including experience modification, premium discount
and expense constant in accordance with the requirements of chapter 250, but excluding
any surplus distributions credited against or applied to reduce premiums. [1995, c. 289, §11 (NEW).]
[
1995, c. 289, §11 (NEW)
.]
25. Timely pay; timely paid; timely payment.
"Timely pay," "timely paid" or "timely payment" means payment by the party responsible
for the payments on or before the due date specified in this chapter.
[
1995, c. 289, §11 (NEW)
.]
26. Voluntary market.
"Voluntary market" means the workers' compensation insurance market in which insurance
companies voluntarily offer coverage to applicants who meet the insurers' underwriting
standards or guidelines.
[
1995, c. 289, §11 (NEW)
.]
27. Workers' Compensation Act.
"Workers' Compensation Act" means and refers to the Maine Workers' Compensation
Act of 1992, as amended.
[
1995, c. 289, §11 (NEW)
.]
28. Worker's compensation residual market mechanism.
"Worker's compensation residual market mechanism" or "residual market mechanism"
means the workers' compensation residual market mechanism described in and governed
by Chapter 440.
[
1995, c. 289, §11 (NEW)
.]
SECTION HISTORY
1995, c. 289, §11 (NEW).
1995, c. 619, §1 (AMD).
1995, c. 619, §8 (AFF).
