806 KAR 46:050. Liability self-insurance group rate, underwriting and evidence of coverage filings

Link to law: http://www.lrc.ky.gov/kar/806/046/050.htm
Published: 2015

      806 KAR 46:050. Liability self-insurance group rate, underwriting

and evidence of coverage filings.

 

      RELATES TO: KRS 304.1-050, 304.13-011,

304.13-051, 304.14-120, 304.48-020(7), 304.48-180

      STATUTORY AUTHORITY: KRS 304.48-180,

304.48-230

      NECESSITY, FUNCTION, AND CONFORMITY: KRS

304.48-230 authorizes the commissioner to promulgate reasonable administrative

regulations not inconsistent with KRS 304 Subtitle 48 that the commissioner

deems necessary for the proper administration of the subtitle. KRS 304.48-180

authorizes the commissioner to promulgate administrative regulations to

establish requirements for liability self-insurance groups to follow when

filing rates, underwriting guidelines, evidence of coverage, and any changes. This

administrative regulation establishes the procedures for liability

self-insurance groups to submit these filings.

 

      Section 1. Definitions. (1) "Commissioner"

is defined by KRS 304.1-050(1).

      (2) "Liability self-insurance group"

is defined by KRS 304.48-020(7).

      (3) "Rates and underwriting

guidelines" means any rating manuals and underwriting rules for all

coverage types including any manual or plan of rates, loss costs, risk

classifications, rating schedule, minimum premium, policy fees, premium payment

plans, rating rules, supplementary rating information or any other similar information

needed to determine the applicable coverage rate or premium for a member.

      (4) "Supplementary rating

information" is defined by KRS 304.13-011(2).

 

      Section 2. General Filing Requirements. (1)

All filings shall be accompanied by a completed and signed Form LSIG F-1A

P&C, Face Sheet and Verification Form for Liability Self-Insurance Groups.

      (2) All paper filings shall include one

(1) full document set on 8 1/2 in. x 11 in. white paper with two (2) cover

letters and a self-addressed stamped envelope.

      (3) A filing may include any number of

documents, filed together on a particular date. Rates and underwriting

guidelines shall be filed separately from evidence of coverage forms.

      (4)(a) A liability self-insurance group

may submit a filing in an electronic format established by the National

Association of Insurance Commissioners.

      (b) An electronic filing shall be in lieu

of a paper filing.

      (5) The period of time in which the

commissioner may affirmatively approve or disapprove the filing, as set forth

in KRS 304.13-051, shall not begin until a complete filing and the filing fee

in accordance with KRS 304.48-180, is received.

 

      Section 3. Rate and Rule Filings. (1) The

rates and underwriting guidelines shall be filed not later than fifteen (15)

days after the date of first use of the rates and underwriting guidelines,

pursuant to KRS 304.13-051(1).

      (2) A liability self-insurance group

shall comply with the requirements of KRS 304.13-051(5).

      (3) Form LSIG: S-1 P & C, Filing Synopsis

for Rates and or Rules, shall be filed with all rate and underwriting guideline

filings. Separate forms shall be filed for each type of coverage.

      (4)(a) Form LSIG: LC-1 P & C, Calculation

of Loss Cost Multiplier, shall be filed with all rate filings referencing loss

costs formulated by any advisory organization. Separate forms shall be filed

for each type of coverage.

      (b) Form LSIG LC-2 P & C, Expense

Constant Supplement, shall be filed with all rate filings referencing loss

costs formulated by an advisory organization in which an expense constant is

used. Separate forms shall be filed for each type of coverage.

      (5)(a) All rate or underwriting guideline

filings utilizing an experience modification plan shall include the experience

rating plan by type of coverage with the formula used for calculating the experience

modification factor for that coverage. Each experience modification factor

applied shall be made available to the member upon request.

      (b) All rate or underwriting guideline

filings containing schedule rating plans shall identify the characteristics of

the risk not reflected in an experience modification factor.

      (c) Any application of the schedule

rating plan shall be based on evidence contained in the liability self-insurance

group’s file when it is applied. The schedule rating plan debit or credit

factor applied shall be made available to the member upon request.

      (d) If the reason for application of any

schedule debit is corrected by the member to the satisfaction of the liability

self-insurance group, the debit may be removed when evidence of the correction

is received by the group.

 

      Section 4. Coverage Form Filings. (1) Form

LSIG: S-2 P & C, Filing Synopsis for Forms, and Form LSIG: F-2 P & C, Forms

Index, shall be filed with all evidence of coverage form filings.

      (2) An evidence of coverage form shall

not be used until it has been approved by the commissioner. If the rates

pertaining to an evidence of coverage form are required to be filed with or

approved by the commissioner pursuant to KRS 304.13-051, the coverage form

shall not be used until the appropriate rates have been filed or approved as

required.

      (3) A filing which amends, replaces, or

supplements an evidence of coverage form previously filed and approved shall include

an explanation setting forth all changes contained in the newly filed coverage

form, the effect, if any, the changes have upon the hazards purported to be

assumed by the policy, and an explanation as to the effect on the rates applicable

thereto.

      (4) A change of signature of the

executing officer on an evidence of coverage form shall not, because of this

change alone, require a new filing.

 

      Section 5. Advisory Organization Filings.

(1) A liability self-insurance group that is a member, subscriber, or service

purchaser of an advisory organization, statistical agent or forms provider may

adopt coverage forms, rating plans, rating rules, rating schedules, other

supplementary rating information, underwriting rules or guidelines, or statistical

plans of that advisory organization or statistical agent by doing so in

accordance with the procedures established in this administrative regulation

and shall clearly identify each filing of the advisory organization or

statistical agent it is adopting.

      (2) If a liability self-insurance group

chooses to adopt only a specific filing of an advisory organization,

statistical agent, or form provider it shall do so in accordance with the

procedures established in this administrative regulation, and shall clearly

identify which filing of the advisory organization or statistical agent it is

adopting. Loss cost filings shall be specifically adopted.

      (3)(a) If a liability self-insurance

group chooses to adopt all of the current and future evidence of coverage

forms, rating plans, rating rules, rating schedules, other supplementary rating

information, underwriting rules or guidelines and statistical plans, excluding

loss costs, of an advisory organization, statistical agent, or forms provider,

it may file written notice with the commissioner that it is adopting by blanket

reference all of the current and future coverage forms, rating plans, rating

rules, rating schedules, other supplementary rating information, underwriting

rules or guidelines and statistical plans, excluding loss costs, as filed by

the advisory organization, statistical agent, or forms provider. Loss cost

filings shall not be adopted on this blanket reference basis.

      (b) If a liability self-insurance group previously

notified the commissioner of its adoption of all current and future filings,

excluding loss cost filings, by the advisory organization, statistical agent,

or forms provider and chooses to not adopt certain evidence of coverage forms, rating

plans, rating rules, rating schedules, other supplementary rating information,

underwriting rules or guidelines, or statistical plans, the group shall file notice

of the nonadoption with the commissioner and shall pay the appropriate filing

fee in accordance with KRS 304.48-180.

      1. If a liability self-insurance group

previously notified the commissioner of its adoption of all current and future

filings, excluding loss cost filings, by the advisory organization, statistical

agent, or forms provider and chooses to delay the effective date of its adoption,

it shall submit a letter to the commissioner requesting the revised date upon

which it will adopt the filing.

      2. The delayed adoption date shall be

within six (6) months of the original effective date.

      3. If additional time is needed, a second

letter shall be submitted to the commissioner, requesting a revised delayed

adoption date.

      4. All revised delayed adoption dates

shall be within one (1) year of the original effective date as filed by the

advisory organization, statistical agent or forms provider.

      5. If a liability self-insurance group

fails to adopt the advisory organization, statistical agent, or forms provider

filing within one (1) year of the original effective date as filed by the

advisory organization, statistical agent or forms provider, the insurer shall

submit a filing to the commissioner indicating it is nonadopting.

 

      Section 6. Incorporation by Reference. (1)

The following material is incorporated by reference:

      (a) Form LSIG: F-1A P & C, "Face

Sheet and Verification Form for Liability Self Insurance Groups", 7/2010;

      (b) Form LSIG: F-2 P & C, "Forms

Index", 7/2010;

      (c) Form LSIG: S-1 P & C,

"Filing Synopsis for Rates and or Rules", 7/2010;

      (d) Form LSIG: S-2 P & C,

"Filing Synopsis Form", 7/2010;

      (e) Form LSIG: LC-1 P & C, "Calculation

of Loss Cost Multiplier", 7/2010;

      (f) Form LSIG: LC-2 P & C,

"Expense Constant Supplement", 7/2010; and

      (g) Form LSIG: EMA P & C, "E-mod

Affidavit", 7/2010.

      (2) This material may be inspected,

copied, or obtained, subject to applicable copyright law, from the Department

of Insurance, 215 West Main Street, Frankfort, Kentucky 40601, Monday through

Friday, 8 a.m. to 4:30 p.m. Forms may also be obtained on the Department of

Insurance Internet Web site, http://insurance.ky.gov. (37 Ky.R. 976;

eff. 11-05-2010.)
Read Entire Law on www.lrc.ky.gov