2.55.101 | ORGANIZATIONAL RULE |
This rule has been repealed.
2.55.102 | ORGANIZATIONAL RULE |
(1) Organization of the State Compensation Insurance Fund:
(a) History . The State Compensation Insurance Fund (state fund) was implemented under the provisions of 39-71-2313, MCA (1989) , on January 1, 1990. Its functions and responsibilities are set forth in Title 39, chapter 71, part 23, MCA.
(b) Departments . The state fund consists of the following departments:
(i) Underwriting department;
(ii) Benefits department;
(iii) Legal department;
(iv) Administrative and finance department; and
(v) Management information services department.
(c) Board of Directors . The board of directors, appointed by the governor, is responsible for the management and control of the state fund.
(d) President . The president, appointed by the board of directors, has general responsibility for the operations of the state fund.
(e) Executive Vice President . The executive vice president has the responsibility of assisting the president in the implementation of policy and procedures under the direction of the president.
(f) Executive Staff . The executive staff performs general administrative functions for the president and vice president of the state fund. Its activities include, but are not limited to, personnel, special projects, and support.
(2) Functions of Department .
(a) Underwriting Department . The underwriting department has the responsibility of underwriting and administering policies of workers' compensation insurance. Its activities include marketing, issuance, and cancellation of policies; safety; audits; and employer services regarding policies of insurance.
(b) Benefits Department . The benefits department has the responsibility for all aspects of administering and adjusting claims for benefits.
(c) Legal Department . � The legal department is responsible for providing legal services to the state fund.
(d) Administrative and Finance Department . The administrative and finance department has the responsibility of performing accounting and related services, providing administrative support, and assisting in compliance with state budgetary laws and procedures.
(e) Management Information Services Department . The management information services department has the responsibility for collection, analysis and dissemination of data, and responsibility for programming and hardware administration.
(3) Information or submissions . General inquiries regarding the state fund may be addressed to the executive vice president. Specific inquiries regarding the functions of each department may be addressed to the vice president who heads the particular department. The address of the State Fund is 5 South Last Chance Gulch, Helena, Montana 59601.
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2.55.201 | OPEN MEETINGS |
This rule has been repealed.
2.55.202 | POLICIES AND OBJECTIVES IN PROVIDING CITIZEN PARTICIPATION IN THE OPERATION OF THE STATE COMPENSATION INSURANCE FUND |
2.55.203 | GUIDELINES FOR DETERMINATION OF SIGNIFICANT PUBLIC INTEREST |
(a) The adoption, amendment or repeal of an administrative rule which sets forth formula and factors for adopting or changing premium rates for classifications or other administrative rulemaking pursuant to Title 2, chapter 4, MCA.
(b) Premium rate adjustments.
(c) Any final agency action as defined by 2-3-102 (3) , MCA, that is of significant interest to the public.
2.55.204 | GUIDELINES FOR STATE FUND PROGRAMS |
(2) The state fund files, other than personnel files and those files required by law or requirements of personal privacy to remain confidential, are open to public inspection during office hours. These files are located at the state fund office in Helena. Copies of specific documents are available within a reasonable time, upon a written request, for a copying charge plus employee time if applicable. A written request may be either mailed, delivered or filled out on a form provided by the state fund if the request is in person. Copies of documents will be mailed to parties upon their specific written request and upon payment of copying charges, employee time, if applicable, and mailing costs.
(3) One person appointed by the president shall be designated as contact person with the public on a proposed decision or action of significant public interest as enumerated in ARM 2.55.203. This person should be a state fund employee familiar with the proposed decision or action.
(4) General inquires regarding the state fund may be addressed to the president. Specific inquires regarding the functions of each department or for requests for information may be addressed to the vice president who heads the particular department. The address of the State Fund is�855 Front Street, Helena, Montana 59601.
(5) The listing of specific measures in this section shall not preclude additional techniques for obtaining, encouraging or assisting public participation.
2.55.205 | NOTICE AND MEANS FOR PUBLIC PARTICIPATION |
(1) One or more of the following steps, as applicable, shall be taken to assist public participation in decision making or items of significant public interest as enumerated in ARM 2.55.203:
(a) a proceeding or hearing shall be held in compliance with the provisions of the Montana Administrative Procedure Act, Title 2, chapter 4, MCA;
(b) notice shall be mailed to those persons on the list of interested persons in ARM 2.55.204 above;
(c) a news release, legal advertisement, or other method of publication shall be given to news media which shall include the proposed action, and the date, time and place of the meeting where oral data, views or arguments may be submitted, or the name and address where written data, views or arguments may be submitted concerning the proposed action.
2.55.206 | OPEN MEETINGS |
2.55.301 | METHOD FOR ASSIGNMENT OF CLASSIFICATIONS OF EMPLOYMENTS |
This rule has been repealed.
2.55.302 | CALCULATION OF EXPERIENCE RATES |
This rule has been repealed.
2.55.303 | CALCULATION OF CREDIBILITY WEIGHTED RATES |
This rule has been repealed.
2.55.304 | DETERMINATION OF AGGREGATE REVENUE REQUIREMENTS |
This rule has been repealed.
2.55.305 | PREMIUM RATESETTING |
This rule has been repealed.
2.55.309 | EXPERIENCE MODIFICATION FACTOR |
This rule has been repealed.
2.55.310 | VARIABLE PRICING WITHIN A CLASSIFICATION |
This rule has been repealed.
2.55.311 | MULTIPLE RATING TIERS |
(2) The State Fund, upon approval of the board, must establish multiple rating tiers for the following fiscal year, to be applied to all classification rates with assignment of individual policies to a tier based on factors as approved by the board. Factors utilized by the board may include but are not limited to:
(a) loss experience;
(b) premium size;
(c) the policyholder's experience modification factor;
(d) length of coverage with the State Fund;
(e) number of losses;
(f) expense;
(g) management;
(h) loss experience of a premium segment;
(i) location of the insured; and
(j) type of industry.
(3) An analysis shall be conducted upon policy renewal, or upon enrollment for new policies, and will result in placement of insureds into a rating tier for the policy period for policies with new or renewal effective dates in the fiscal year (July 1 through June 30) .
(4) Notwithstanding placement in a rating tier under (2) , a policyholder may be placed in a higher or lower rated tier based on underwriting criteria including, but not limited to:
(a) industry type;
(b) the prior insolvency of the insured or any of the insured's principals;
(c) determination that the insured is an increased or decreased risk pursuant to a State Fund evaluation;
(d) the work is primarily performed at locations other than the insured's principal job site or place of business and the insured does not have control over the job site or place of business;
(e) the insured has a history of preventable losses;
(f) an employer's history and experience with any other insurer; or
(g) new business without workers' compensation experience history.
(5) This rule is to be effective July 1, 2002.
2.55.315 | VOLUME DISCOUNT |
This rule has been repealed.
2.55.316 | MINIMUM YEARLY PREMIUM |
This rule has been repealed.
2.55.319 | CALCULATION OF MANUAL RATES |
(a) the aggregate adequacy of advisory organization loss-costs;
(b) State Fund loss adjustment expense;
(c) production and acquisition expense;
(d) investment yield on underwriting cash flow;
(e) net credits or debits attributable to underwriting programs;
(f) the desired target level of contribution to surplus; and
(g) the risk characteristics of policyholders assigned to each applicable rate tier as provided for in ARM 2.55.311. This subsection is to be effective July 1, 2002.
(2) The advisory or rating organization loss-costs used by the board shall be the latest filed or prior filed loss-costs, as determined by the board, at the time the board determines the loss-cost multiplier.
(3) Using processes, procedures, formulas, and factors certified by the consulting actuary as being consistent with generally accepted actuarial principles, State Fund staff shall conduct an analysis of the adequacy of the advisory or rating organization's filed loss-costs, by classification. State Fund staff shall present the conclusions of this analysis to the board along with recommendations, if any, to establish loss-costs for classifications which differ from the advisory or rating organization loss-costs as provided for in (2) . The determination whether to establish loss-costs for a classification which differ from the advisory or rating organization loss-costs shall consider factors such as, but not limited to:
(a) indications based on State Fund loss experience;
(b) indications based on other rating sources;
(c) the ability of the State Fund to appropriately underwrite affected policies;
(d) the amount of payroll written or potentially written by the State Fund in the affected classification;
(e) administrative convenience;
(f) volatility of rates;
(g) differences in State Fund classifications or their usage; and
(h) other relevant underwriting and actuarial judgments.
(4) For classifications in use by the State Fund which are not part of the advisory or rating organization loss-cost filing and for classifications identified in (3) , State Fund staff shall develop a loss-cost using the processes, procedures, formulas, and factors provided for in (3) and other factors consistent with generally accepted actuarial principles. Upon certification of the consulting actuary, State Fund staff shall present the results of this analysis to the board along with recommendations if any, for approval of the board. The consulting actuary shall certify that such loss-cost rates are neither excessive, inadequate, nor unfairly discriminatory. The board shall act to accept or not accept the consulting actuary's certification.
(5) NCCI classifications not in the State Fund's inventory at the time rates are adopted under this rule for the following fiscal year, may be adopted during a fiscal year in accordance with ARM 2.55.320 and attendant NCCI loss-costs and the previously approved loss-cost multiplier shall be applied for new and renewal policies during the fiscal year.
2.55.320 | METHOD FOR ASSIGNMENT OF CLASSIFICATIONS OF EMPLOYMENTS |
(1) Risks insured by the State Fund must be divided by the State Fund into classifications. An individual classification must group together risks so that each classification reflects exposures common to those employers in the classification.
(2) An employer covered by a State Fund policy must be assigned a classification according to the type of exposure to risk within the employer's business. The classification generally includes all the various types of labor of the business. If a single classification is not sufficient to describe the risk, more than one classification may be assigned to the employer.
(3) The State Fund staff shall assign its insureds to classifications contained in the classifications section of the State Compensation Insurance Fund Policy Services Underwriting Manual effective July 1, 2014, and assign new or changed classifications as approved by the board. That section of the manual is incorporated by reference. Copies of the classification section of the manual may be obtained from the Insurance Operations Support Department of the State Fund, 855 Front Street, P.O. Box 4759, Helena, Montana 59604-4759.
2.55.321 | CALCULATION OF EXPERIENCE RATES |
This rule has been repealed.
2.55.322 | CALCULATION OF CREDIBILITY WEIGHTED RATE |
This rule has been repealed.
2.55.323 | OVERALL RATE LEVEL |
(a) the value of claims, as determined by actuarial analysis, expected to be incurred as a direct result of covered accidents during the following fiscal year of the State Fund;
(b) operational and administrative expenses, claims adjustment expense related to covered claims, and other expenses required to operate the State Fund for the fiscal year; and
(c) an amount sufficient to maintain appropriate contingency reserves and policyholder surplus.
(2) In determining the projected revenue requirements for the following State Fund fiscal year, the State Fund actuary shall consider:
(a) the present financial condition of the State Fund;
(b) trends in the number and cost of accidents;
(c) investment yield on underwriting cash flow;
(d) recent court decisions that may affect the liability of the State Fund;
(e) legislative changes in the statutory benefit scheme;
(f) factors relating to maintenance of the policy base of the State Fund;
(g) the anticipated changes in covered payroll during the year for which the premium rates will be in effect; and
(h) other factors considered relevant in recommending an accurate projection of an overall rate level adjustment.
2.55.324 | PREMIUM RATESETTING - HORSE RACING AND BOARD INTERIM MODIFICATION OF RATES |
(2) The board, in lieu of a fee based policy for horse racing activities, may utilize classifications and establish loss-costs under ARM 2.55.319 for horse racing activities if a fee based policy is determined to be inappropriate.
(3) The State Fund may, with concurrence of the State Fund board of directors, adopt and implement changes to previously adopted rates. These changes may be based on, but are not limited to, statutory or other legal changes in benefits or costs, or revisions in actuarial indications. These rate changes shall be effective on a date and in such manner as determined by the board of directors, and shall apply to each policy for the remainder of the policy year to which the previously adopted rates apply, and for new and renewal policies.
2.55.325 | VARIABLE PRICING WITHIN A CLASSIFICATION |
This rule has been repealed.
2.55.326 | MINIMUM LOSS BASED PREMIUM |
(2) The minimum loss based premium may be derived by establishing a minimum yearly payroll. The minimum loss based premium shall be determined by multiplying the minimum yearly payroll by the rate of the governing classification of the policy. The board may adopt an amount that the minimum loss based premium may not be below, and may adopt an amount that the minimum loss based premium may not exceed.
(3) Minimum loss based premium may be established as a flat dollar amount.
2.55.327 | CONSTRUCTION INDUSTRY PREMIUM CREDIT PROGRAM |
This rule has been repealed.
2.55.327A | CONSTRUCTION INDUSTRY PREMIUM CREDIT PROGRAM |
(1) The State Fund shall each fiscal year offer a program which provides a premium credit to insureds in the construction industry who pay their workers wages equal to or in excess of 1.168 times the state's average weekly wage.
(2) To become eligible for the program, the insured must meet all of the following criteria:
(a) maintain accurate individual employee records of the total hours worked and payroll by class code and make those records available for verification and audit;
(i) If a payroll audit period includes all or a portion of a policy year to which a construction credit applies, the survey period will also be audited to determine the proper credit for the payroll audit period even though the survey period may be more than three years prior.
(ii) If the verification or audit reveals hourly records are not available, the insured is disqualified from the program.
(iii) If the insured fails to make the records available within a reasonable period of time after contact, the insured is disqualified from the program.
(iv) If the application of the insured was originally disapproved based on criteria (2)(c) or (2)(d) but otherwise qualified and a subsequent verification or audit results in adjustments which determine the insured actually met those criteria, a credit will be applied retroactively.
(b) apply for the premium credit program and submit the completed and signed application form to State Fund no later than seven calendar days after the stated due date on the application form;
(c) have paid an average hourly wage equal to or in excess of 1.168 times the state's average weekly wage as published by the Department of Labor and Industry for each fiscal year; and
(d) have at least 50% of the manual premium during the survey period attributable to one or more of the eligible construction class codes.
(3) The following class codes are the construction codes eligible for the construction industry premium credit program:
2799 |
5057 |
5213 |
5443 |
5491 |
5645 |
6217 |
6400 |
3365 |
5059 |
5215 |
5445 |
5506 |
5703 |
6229 |
7538 |
3719 |
5069 |
5221 |
5462 |
5507 |
5705 |
6233 |
7605 |
3724 |
5102 |
5222 |
5472 |
5508 |
6003 |
6251 |
7855 |
3726 |
5146 |
5223 |
5473 |
5511 |
6005 |
6252 |
8227 |
5020 |
5160 |
5348 |
5474 |
5535 |
6017 |
6306 |
9521 |
5022 |
5183 |
5402 |
5478 |
5537 |
6018 |
6319 |
9534 |
5037 |
5188 |
5403 |
5479 |
5551 |
6045 |
6325 |
9552 |
5040 |
5190 |
5437 |
5480 |
5610 |
6204 |
6365 |
|
(4) The following credit percentages, are to be applied to the manual premium of the insured's construction class codes during the survey period to determine the premium credit factor for policies with effective dates between:
(a) July 1, 2000 and June 30, 2001 inclusive:
Average Hourly Wage Credit Percentage
$ 12.40 or less 0%
12.41 - 13.43 2%
13.44 - 14.46 3%
14.47 - 15.49 4%
15.50 - 16.52 5%
16.53 - 17.55 6%
17.56 - 18.58 8%
18.59 - 19.61 10%
19.62 - 20.64 12%
20.65 - 21.67 14%
21.68 - 22.70 16%
22.71 - 23.73 18%
23.74 - 24.76 20%
24.77 and above 22%
(b) July 1, 2001 and June 30, 2002 inclusive:
Average Hourly Wage Credit Percentage
$ 12.80 or less 0%
12.81 - 13.86 2%
13.87 - 14.93 3%
14.94 - 15.99 4%
16.00 - 17.05 5%
17.06 - 18.12 6%
18.13 - 19.18 8%
19.19 - 20.24 10%
20.25 - 21.31 12%
21.32 - 22.37 14%
22.38 - 23.43 16%
23.44 - 24.50 18%
24.51 - 25.56 20%
25.57 and above 22%
(c) The credit percentages for policies with effective dates between each July 1 and June 30, beginning July 1, 2002, will be those filed with the Commissioner of Insurance by the designated advisory organization as provided for both the State Fund and Compensation Plan Number Two under 39-71-2211 , MCA, or as approved by the board.
(5) Procedures and processes for the premium credit program are:
(a) The State Fund will provide an application form to insureds who are assigned one or more of the construction codes listed in (3) ;
(b) The insured must sign the application, report total payroll and hours worked by class code (both construction and nonconstruction) for the survey period and return the form by the stated due date. Following are the only allowed exceptions to reporting total payroll and/or actual hours worked:
(i) The premium portion of overtime wages must be excluded.
(ii) In the absence of specific hourly records for salaried employees, the insured must report total payroll and an assumed 40 hours per week.
(iii) In the absence of specific hourly records for covered corporate officers, or managers of a limited liability company, the insured must report total payroll, subject to the officer minimum and maximum payroll reporting requirements in effect for the survey period, and an assumed 40 hours per week.
(iv) If specific hourly records are maintained for covered corporate officers, or managers of a limited liability company the insured must report those hours and total payroll, subject to the officer minimum and maximum payroll reporting requirements in effect for the survey period.
(v) Covered owners must report an assumed 40 hours per week and payroll (wages) equal to their elected coverage level in effect for the survey period.
(c) The State Fund will determine whether the insured meets the criteria, approve or disapprove the application and notify the insured of approval or disapproval;
(i) If approved, the notice will include the premium credit factor.
(ii) If disapproved the notice will specify the reason(s) for disapproval.
(d) The State Fund will calculate the premium credit factor of each insured based on the information reported for the survey period. The State Fund reserves the right to verify or audit the records of the insured before and/or after the premium credit factor is calculated to verify the information submitted and to adjust the premium credit factor accordingly if necessary;
(e) The premium credit factor will be calculated as follows using the information for the survey period provided by the insured or as adjusted by verification or audit:
(i) The average hourly wage will be calculated for each of the construction and nonconstruction class codes by dividing payroll by the number of hours worked.
(ii) The manual premium will be calculated for each construction and nonconstruction class code by multiplying the payroll, divided by 100, times the manual class code rate in effect for the insured during the survey period.
(iii) The manual premium for each construction class code will be multiplied by the appropriate credit percentage to determine the construction credit dollar amount and these amounts will be totaled for the survey period.
(iv) The total of the construction credit dollar amounts will be divided by total manual premium and the result will be subtracted from 1.0000 to arrive at the premium credit factor.
(6) The following definitions apply to the construction industry premium credit program:
(a) "Policy year" means the period beginning on the effective date of the policy and ending on the expiration date of the policy.
(b) "Premium credit factor" means the factor as calculated in (5)(e). This factor will be applied to the insured's total standard premium for that policy year.
(c) "Survey period" means the third calendar quarter, July 1 through September 30, preceding the program year to which the premium credit factor will apply. Program year as used in this rule means July 1 through June 30. If the insured did not engage in operations for the complete usual survey period (July 1 through September 30), then the last complete quarter prior to the policy effective date shall be used or if there was no complete quarter of operations prior to the policy effective date, the first complete quarter after the policy effective date shall be used.
2.55.328 | EMPLOYERS' LIABILITY - LIMITS AND RATES |
(2) In establishing rates the board shall, in consultation with the actuary, consider employers' liability basic limits coverage in establishing the overall rate level adjustment. Limits of liability above the basic limit, and related rates, may be established by the board in consultation with the actuary.
2.55.401 | EXPERIENCE MODIFICATION FACTOR |
(2) The state fund shall use the methods used by the workers' compensation advisory or rating organization to identify a qualified insured and determine the insured's experience modification factor in order to reward an insured with a good safety record and penalize an insured with a poor safety record.
2.55.402 | MEDICAL DEDUCTIBLE |
(2) To qualify for the plan for the next policy year, an employer must:
(a) file an endorsement form, provided by the state fund prior to the beginning of the next policy year;
(b) have estimated annual premium for the next policy year which equals or exceeds the chosen deductible amount; and
(c) demonstrate the ability to promptly pay the deductible amounts by not having a poor premium payment history with the state fund.
(3) The state fund is responsible for initial payment of medical benefits; then bills the employer for reimbursement up to the chosen deductible amount. The state fund may cancel the employer's policy for failure to reimburse the state fund for expended medical deductible amounts.
2.55.403 | VOLUME DISCOUNT |
(2) The state fund may provide a group volume discount to a group as provided by 39-71-433 , MCA.
2.55.404 | SCHEDULED RATING - HIGH LOSS MODIFIER |
This rule has been repealed.
2.55.405 | SCHEDULED RATING - LOSS CONTROL NONCOMPLIANCE MODIFIER |
This rule has been repealed.
2.55.406 | SCHEDULED RATING - UNIQUE RISK CHARACTERISTICS MODIFIER |
(2) All scheduled rating debit and credit modifiers shall be based on evidence contained in the file of the state fund at the time the scheduled rating modifier is applied. The effective date of any scheduled rating modifier shall not be any date prior to the receipt in the state fund's office of the evidence supporting the debit or credit.
(3) The derivation of the scheduled rating modifier must be made available to the insured upon request.
(4) To the degree that the insured can correct the reason for any scheduled rating debit modifier to the satisfaction of the state fund, the modifier may be removed at the beginning of the next quarterly period.
(5) If the insured fails to maintain the basis for which a scheduled rating credit modifier was applied, the modifier may be removed by the state fund at the beginning of the next quarterly period.
(6) An insured subject to the modifier may be assigned a quarterly report basis.
2.55.407 | OPTIONAL DEDUCTIBLE PLANS |
(2) The board shall establish deductible plans for each fiscal year. The board shall determine the factors, multipliers, ratios or other formula components for the plan.
(3) Except as provided in (4) , to qualify for a plan an employer must meet the following conditions:
(a) be selected by the state fund pursuant to criteria established by the board, and be provided a written proposal for state fund optional deductible plan;
(b) the employer shall have an annual estimated earned premium that equals or exceeds the deductible level chosen or such annual estimated earned premium as established by the board;
(c) file an endorsement form provided by the state fund; and
(d) the endorsement is approved by the state fund for the plan chosen by the employer.
(4) The employer may be disqualified or terminated at any time from participation in a plan because of a poor payment history with the state fund; as a result of a credit investigation, or review of relevant financial information which demonstrates the employer is not sufficiently financially stable to be responsible for the payment of the reasonably anticipated deductible amounts. As a condition of approval or continuation in a plan, the state fund may require security including, but not limited to, surety bond, cash deposit or guarantee sufficient to meet the reasonably anticipated obligations of the employer for the policy year.
(5) The plan shall provide for penalty for early termination of the plan by an employer.
2.55.408 | RETROSPECTIVE RATING PLANS |
(1) The State Fund may offer an employer, or a group, a retrospective rating plan for coverage under the Workers' Compensation Act.
(2) The board shall establish employer retrospective rating plans for each fiscal year utilizing the methods and formulas published by the National Council on Compensation Insurance Retrospective Rating Manual, 2009 edition. The board shall determine the factors, multipliers, ratios, or other formula components for the plan. The board may establish a group retrospective rating plan utilizing the methods, formulas, factors, multipliers, ratios, or other formula components as determined by the board.
(3) To qualify for participation in a plan the employer or group shall:
(a) be selected by the State Fund pursuant to criteria established by the board, and be provided a written proposal for a State Fund retrospective rating plan;
(b) execute an agreement with the State Fund; and
(c) have an annual estimated employer or group earned premium that equals or exceeds an amount determined by the board.
(4) The employer, group, or group member may be disqualified from participation in a plan because of a poor payment history with the State Fund, as a result of a credit investigation or review of relevant financial information which demonstrates the employer, group, or group member is not sufficiently financially stable to be responsible for the payment of any retrospective rating adjustment. As a condition of approval the State Fund may require security including, but not limited to, surety bond, cash deposit or guarantee sufficient to meet the reasonably anticipated obligations of the employer for the policy year.
(5) The plan shall provide for penalty for early termination of the plan by an employer. The plan may provide for penalty for early termination of the plan by a group.
2.55.409 | EXPENSE CONSTANT |
(2) The expense constant is included in the total minimum premium charged if the expense constant plus premium is less than the total minimum premium established by the board for the fiscal year.
(3) The expense constant includes, but is not limited to, expense components for issuing, maintaining and servicing policies, which are common to all policies regardless of premium size.
(4) The state fund may cancel the employer's policy for failure to pay an expense constant.
2.55.501 | DEFINITIONS |
(1) "Dividend factors" means the percentage multiplied times premium to arrive at the dividend amount payable to an eligible policyholder.
(2) "Fiscal year" or "dividend year" means the period of time between July 1 and the succeeding June 30.
(3) "Incurred losses" means:
(a) losses as reflected on the first report of the unit statistical reports including any corrections to the first report as provided to the National Council on Compensation Insurance (NCCI) for the dividend year; or
(b) incurred losses for the dividend year on a date, or on various dates based on policy period such that eligible policyholder losses are captured at equivalent maturities, as selected by the State Fund board of directors.
(4) "Individual loss sensitive dividend" means dividends authorized pursuant to 39-71-2323 , MCA, declared by the board as an amount not to exceed the approved dividend amount, and distributed based upon a table of dividend factors.
(5) "Insurance charge" means an actuarially determined loss component associated with the probability of exceeding an expected range of loss.
(6) "Loss ratios" means incurred losses divided by premium for the dividend year.
(7) "Premium" means payroll times the manual rate for each classification code, times premium modifiers, minus volume discount for the dividend year and any premium adjustment pursuant to a rating plan. The premium utilized for dividend calculation purposes shall be the premium on a date selected by the State Fund board of directors and the premium utilized is not subject to change thereafter.
(8) "Table of dividend factors" means a dividend distribution table created for each dividend year pursuant to ARM 2.55.502.
2.55.502 | INDIVIDUAL LOSS SENSITIVE DIVIDEND DISTRIBUTION PLAN |
(1) Upon declaration of a dividend by the State Fund board of directors (board) as of the end of any fiscal year, but in no event prior to July 1, 1998, the following factors and procedures shall be utilized to determine the entitlement of a State Fund policyholder to an individual loss sensitive dividend. The dividend shall be declared as an amount not to exceed the approved dividend amount, to aid distribution of the declared dividend among policyholders through the table of dividend factors.
(2) Distribution of dividends to individual policyholders shall be based on a table of dividend factors as approved by the board, subject to the certification by the State Fund independent consulting actuary pursuant to (4). The table of dividend factors shall be constructed with one axis based on increments of policyholder premium size in the dividend year and the other axis based on increments of policyholder loss ratios from the dividend year.
(3) Dividend factors shall be based on an actuarial determination of policyholders' proportionate contribution to the operating results of the State Fund during the dividend year. The proportionate contribution of the policyholder shall be determined by taking into consideration factors such as, but not limited to, the following: incurred losses, loss development, credibility of incurred loss ratios, provision for excess losses, loss adjustment expenses, other expenses including differences in expense levels by premium segment, rate adequacy by premium segment, actuarially determined insurance charges, and future investment income on premiums paid.
(4) The independent actuary shall certify that the approved table of dividend factors, to include the increments of policyholder premium size and loss ratios, is consistent with (3) and generally accepted actuarial principles.
(5) To be eligible for a dividend a policyholder must have six continuous months of coverage with the State Fund in the policy period that is new or renewed within the dividend year.
(6) Individual retrospectively rated and optional deductible policies shall not be eligible for a dividend declared by the board under this rule. This section applies to policies with policy effective dates after December 31, 2006.
(7) The board may set a minimum amount below which a dividend shall not be payable to an individual policyholder.
(8) A dividend will be issued as a warrant to a policyholder, unless (8)(a) through (8)(c) exist. The dividend will be applied to the account, unless an exception is made by the board of directors for a warrant to be issued, if the following situations exist:
(a) a current policy has a past-due premium or other debt pending;
(b) a canceled policy with an existing obligation owed the State Fund, including a past-due premium or an outstanding payroll report; or
(c) a current policy when the dividend amount is above the minimum amount established pursuant to (7) but below an amount as established by the board.
(9) If a dispute under the policy arising from the dividend year exists and remains unresolved at the time the dividend is declared, the dividend amount will be withheld and not applied to the account or a warrant issued until such time as outstanding issues with the State Fund are resolved.