N.Y.
Workers' Compensation Law Section 50
Security for payment of compensation
1.
By insuring and keeping insured the payment of such compensation in the state fund, or2.
By insuring and keeping insured the payment of such compensation with any stock corporation, mutual corporation or reciprocal insurer authorized to transact the business of workers’ compensation insurance in this state through a policy issued under the law of this state.3.
By furnishing satisfactory proof to the chair of his financial ability to pay such compensation for himself, or to pay such compensation on behalf of a group of employers in accordance with subdivision ten of this section, in which case the chair shall require the deposit with the chair of such securities as the chair may deem necessary of the kind prescribed in subdivisions one, two, three, four and five, and subparagraph (a) of paragraph three of subdivision seven of Banking Law § 235 (Investment of funds)section two hundred thirty-five of the banking law, or the deposit of cash, or the filing of irrevocable letters of credit issued by a qualified banking institution as defined by rules promulgated by the chair or the filing of a bond of a surety company authorized to transact business in this state, in an amount to be determined by the chair, or the posting and filing as aforesaid of a combination of such securities, cash, irrevocable letters of credit and surety bond in an amount to be determined by the chair, to secure his liability to pay the compensation provided in this chapter. Any such surety bond must be approved as to form by the chair. If an employer or group of employers posts and files a combination of securities, cash, irrevocable letters of credit and surety bond as aforesaid, and if it becomes necessary to use the same to pay the compensation provided in this chapter, the chair shall first use such securities or cash or irrevocable letters of credit and, when the full amount thereof has been exhausted, he shall then require the surety to pay forthwith to the chair all or any part of the penal sum of the bond for that purpose. The chair may also require an agreement on the part of the employer or group of employers to pay any awards commuted under § 27 (Depositing future payments in the aggregate trust fund)section twenty-seven of this chapter, into the special fund of the state fund, as a condition of his being allowed to remain uninsured pursuant to this section. The chair shall have the authority to deny the application of an employer or group of employers to pay such compensation for himself or to revoke his consent furnished, under this section at any time, for good cause shown. The employer or group of employers qualifying under this subdivision shall be known as a self-insurer. If for any reason the status of an employer or group of employers under this subdivision is terminated, the securities or the surety bond, or the securities, cash, or irrevocable letters of credit and surety bond, on deposit referred to herein shall remain in the custody of the chair for such time as the chair may deem proper and warranted under the circumstances. In lieu thereof, and at the discretion of the chair, the employer, his or her heirs or assigns or others carrying on or liquidating such business, may execute an assumption of workers’ compensation liability insurance policy as described herein. Separately, the chair may execute an assumption of workers’ compensation liability insurance policy as described herein on behalf of the special funds created under the provisions of subdivisions eight and nine of section fifteen and section twenty-five-a of this chapter, and notwithstanding any provision to the contrary the chair may execute an assumption of workers’ compensation liability insurance policy on behalf of the uninsured employers’ fund. An assumption of workers’ compensation liability policy referred to herein shall secure such further and future contingent liability as may directly or indirectly arise from prior injuries to workers and be incurred by reason of any change in condition of such workers warranting the board making subsequent awards for payment of additional compensation. Such policy shall be in a form approved by the superintendent of financial services and issued by the state fund or any insurance company licensed to issue this class of insurance in this state or, upon application by the chair, any other insurance company deemed by the superintendent of financial services to be an acceptable issuer. In the event that such policy is issued by an insurance company other than the state fund, then said policy shall be deemed of the kind specified in paragraph fifteen of subsection (a) of Insurance Law § 1113 (Kinds of insurance authorized)section one thousand one hundred thirteen of the insurance law and covered by the workers’ compensation security fund as created and governed by article 6-A (Workers’ Compensation Security Fund)article six-A of this chapter. It shall only be issued for a single complete premium payment in advance and in an amount deemed acceptable by the chair and the superintendent of financial services. In lieu of the applicable premium charge ordinarily required to be imposed by a carrier, said premium shall include a surcharge in an amount to be determined by the chair to:(i)
satisfy all assessment liability due and owing to the board and/or the chair under this chapter; and(ii)
satisfy all future assessment liability under this section, and which surcharge shall be adjusted from time to time to reflect any changes to the assessment of group self-insured employers, including any changes enacted by the chapter of the laws of two thousand eleven amending sections fifteen and one hundred fifty-one of this chapter. Said surcharge shall be payable to the board simultaneous to the execution of the assumption of workers’ compensation liability insurance policy. However, the payment of said surcharge does not relieve the carrier from any other liability, including liability owed to the superintendent of financial services pursuant to article 6-A (Workers’ Compensation Security Fund)article six-A of this chapter. When issued such policy shall be non-cancellable without recourse for any cause during the continuance of the liability secured and so covered. 3-a. Group self-insurance.(1)
Definitions. As used in this chapter the term “employers” shall include: (a) employers with related activity in a given industry which shall include municipal corporations as that term is defined in sections two and six-n of the general municipal law, employing persons who perform work in connection with the given industry, (b) an incorporated or unincorporated association or associations consisting exclusively of such employers provided they employ persons who perform such related work in the given industry, and (c) a combination of employers as described in subparagraph (a) hereof and an association or associations of employers as described in subparagraph (b) hereof.(2)
(a) Any group consisting exclusively of such employers may adopt a plan for self-insurance, as a group, for the payment of compensation under this chapter to their employees, except that no new groups may adopt such a plan, and no group not composed solely of public entities set forth in subparagraph (a-1) of this paragraph may insure any liabilities for any employers on and after January first, two thousand twelve, except as provided for in paragraph ten of this subdivision. Under such plan the group shall assume the liability of all the employers within the group and pay all compensation for which the said employers are liable under this chapter, except that in the case of public group self-insurers as defined in subparagraph (a-1) of this paragraph no proof of financial ability or deposit of securities or cash need be made in compliance with this subdivision. The group qualifying under this subdivision shall be known as a group self-insurer and the employers participating therein and covered thereby shall be known as members. (a-1) Any group consisting exclusively of public corporations as defined in General Construction Law § 66 (Definitions)section sixty-six of the general construction law, county self-insurance plans established under article 5 (County Self-insurance Plan)article five of this chapter, boards of cooperative educational services and consortia established by boards of cooperative educational services, and any other entity defined as a public entity under paragraph fifty-one of subsection (a) of Insurance Law § 107 (Definitions of terms of general use in this chapter)section one hundred seven of the insurance law except the state of New York, may adopt a plan for self-insurance, as a group, for the payment of compensation under this chapter to their employees. Such a group shall be known as a “public group self-insurer”. A county self-insurance plan established under article 5 (County Self-insurance Plan)article five of this chapter is not itself a public group self-insurer and is not itself subject to the requirements of this section, but may join a public group self-insurer and, if it does so, shall assume all of the obligations of its participants to the public group self-insurer. A public group self-insurer shall comply with all of the requirements of this subdivision, including any obligations imposed upon a group administrator, but is not required to secure the services of a group administrator or obtain a license authorizing it to act as a group self-insurer administrator, to furnish satisfactory proof to the chair of its financial ability to pay compensation from its revenues, their source and assurance of continuance, to pay a license fee, or to deposit securities, post a bond or provide other security, except as specifically provided in this subdivision. (b) Where such plan is adopted the group self-insurer shall furnish satisfactory proof to the chair of its financial ability to pay such compensation for the members in the industry covered by it, its revenues, their source and assurance of continuance. The chair shall require the deposit with the chair of such securities as may be deemed necessary of the kind prescribed in subdivisions one, two, three, four and five, and subparagraph (a) of paragraph three of subdivision seven of Banking Law § 235 (Investment of funds)section two hundred thirty-five of the banking law or the deposit of cash or the filing of irrevocable letters of credit issued by a qualified banking institution as defined by rules promulgated by the chair or the filing of a bond of a surety company authorized to transact business in this state, in an amount to be determined to secure its liability to pay the compensation of each employer as above provided. Such surety bond must be approved as to form by the chair. The chair shall require each group self-insurer to provide regular reports no less than annually, which shall include but not be limited to audited financial statements, actuarial opinions and payroll information containing proof that it is fully funded. Such reports shall also include a contribution year analysis detailing contributions and expenses associated with each specific contribution year. For purposes of this paragraph, proof that a group self-insurer is fully funded shall at a minimum include proof of unrestricted cash and investments permitted by regulation of the chair of at least one hundred percent of the total liabilities, including the estimate presented in the actuarial opinion submitted by the group self-insurer in accordance with this chapter. The chair by regulation, may set further financial standards for group self-insurers. Any group self-insurer that fails to show that it is fully funded shall be deemed underfunded, and must submit a plan for achieving fully funded status which may include a deficit assessment on members of such group self-insurer which shall be subject to approval or modification by the chair. The amount of such under-funding, as measured by the actuarial opinion or assumption of loss policy quotation submitted by the group, shall be considered unfunded claims as set forth in subdivision two of Public Authorities Law § 1680-Q (State university of New York dormitory facilities)section sixteen hundred eighty-q of the public authorities law as added by section 35 of Part GG of chapter 57 of the laws of 2013. (c) The chair shall evaluate, no less than once every three years, a group self-insurer’s compliance with the financial and regulatory requirements for self-insurance. The chair may engage any qualified person or organization to assist with such evaluation and any costs incurred by the chair shall be borne by the group self-insurer under examination. Failure to submit to such independent review or to pay such costs, upon demand of the chair, shall be sufficient grounds to terminate coverage of the group self-insurer. (d) The chair may require reports to be prepared by an auditor, actuary or other consultant, selected by the board or, at the chair’s discretion, by the group self-insurer from a list which shall be pre-approved by the chair to determine whether the group self-insurer meets the financial criteria for self-insurance. All actuaries so selected shall be fellows or associates of the casualty actuarial society. (e) The chair may also require that any and all agreements, contracts and other pertinent documents relating to the organization of the members in the group self-insurer shall be filed with the chair. (f) The chair shall have the authority to revoke consent furnished under this section at any time for good cause shown. (g) Prior to the requested effective date of the participating agreement, a group self-insurer shall notify the chair on a prescribed form of a new group self-insurer member and file (1) a member application and (2) a copy of the properly executed prescribed participation agreement wherein the member acknowledges their joint and several obligation for their period of membership. The board shall, on a form promulgated by the chair, provide notice of the member’s rights and responsibilities as a group self-insurer member, including the member’s assumption of joint and several liability, and require the member to return a signed copy to the chair as a condition of membership. (h) Any member terminating membership in a group self-insurer after less than four years in such group self-insurer, and any member in a group self-insurer that has defaulted, shall be precluded from obtaining prospective coverage from any group self-insurer for a period of at least three years from the effective date of termination.(3)
A member’s participation in a group self-insurer shall not relieve it of its liability for compensation prescribed by this chapter except by the payment thereof by the group self-insurer or by itself. Each member shall be responsible, jointly and severally, for all liabilities of the group self-insurer provided for by this chapter occurring during its respective period of membership, and such liability shall attach to any recipient of a conveyance of assets made in violation of subdivision (a) of Debtor & Creditor Law § 274 (Transfer or obligation voidable as to present creditor)section two hundred seventy-four of the debtor and creditor law. As between the employee and the group self-insurer, notice to or knowledge of the occurrence of the injury on the part of the member shall be deemed notice or knowledge, as the case may be, on the part of the group self-insurer; jurisdiction of the member shall, for the purpose of this chapter, be jurisdiction of the group self-insurer and such group self-insurer shall in all things be bound by and subject to the orders, findings, decisions or awards rendered against the participating member for the payment of compensation under the provisions of this chapter. The insolvency or bankruptcy of a participating member shall not relieve the group self-insurer from the payment of compensation for injuries or death sustained by an employee during the time the member was a participant in such group self-insurer. Notice of termination of a participating member shall not be effective until at least ten days after notice of such termination, on a prescribed form, has been either filed in the office of the chair or sent by certified or registered letter, return receipt requested, and also served in like manner upon the member. In the event such termination is due to a member’s failure to pay required contributions, such member’s termination shall not be rescinded more than three times. (3-a) If the chair determines that a public group self-insurer has become insolvent, the chair shall pay the compensation and benefits that would otherwise have been required to be paid by the members of the public group self-insurer from administration expenses as provided in § 151 (Assessments for annual expenses)section one hundred fifty-one of this chapter upon audit and warrant of the comptroller and upon vouchers approved by the chair, which payments shall be considered expenses of administration. For purposes of this paragraph, a public group self-insurer is insolvent when the value of the public group self-insurer’s assets is less than the total costs of the workers’ compensation liabilities that it is anticipated the public group self-insurer will be required to pay within the succeeding six months or that the compensation and benefits provided by this chapter may be unpaid by reason of the default of a public group self-insurer. Upon the insolvency of a public group self-insurer, each member shall assume responsibility for the continued administration and payment of all claims against it, provided however that the public group self-insurer shall, within thirty days, turn its assets over to the chair and the chair shall assume the administration and cost of the claims of the public group self-insurer for a period not to exceed one year. During the period of chair administration of claims, each member of the public group self-insurer shall secure the services of a licensed claims administrator and the chair shall segregate the claims obligations of the insolvent public group self-insurer by member, and, if necessary segregate an adequate claim reserve for any claims of defunct or insolvent members of the insolvent public group self-insurer. Not later than one year from the assumption of the administration of the claims of the public group self-insurer, each member of the insolvent public group self-insurer shall resume administration of its own claims and the chair shall return to each member whatever pro rata share of the public group self-insurer’s assets remain after the period of chair administration. The chair shall be reimbursed for any payment made under this paragraph by the public group self-insurer itself and, if the public group self-insurer is unable to reimburse the chair fully for payments made by the chair, then by the member of the public group self-insurer against which the claim is asserted. Further, nothing herein shall preclude the chair from directing that an underfunded public group self-insurer levy an assessment on its members as part of a plan for achieving fully funded status which may include a deficit assessment on members of such group self-insurer which shall be subject to approval or modification by the chair. No member shall be liable for any obligations of the public group self-insurer or any obligations of any member of the public group self-insurer. The chair shall require any member that has pending claims but has failed to secure the services of a licensed claims administrator to resume administration of the claims to pay to the chair any expenses the chair incurs in administering and paying those claims.(4)
Each group self-insurer, in its application for self-insurance, shall set forth the names and addresses of each of its officers, directors, trustees, third party administrator and group administrator. Notice of any change in the officers, directors, trustees, third party administrator or group administrator shall be given to the chair within ten days thereof. No officer, director, trustee, employee, third party administrator or group administrator of the group self-insurer may represent or participate directly or indirectly on behalf of an injured worker or his dependents in any workers’ compensation proceeding. All employees of members participating in group self-insurance shall be and are deemed to be included under the group self-insurance plan.(5)
(a) Each group self-insurer shall secure the services of a group administrator to be responsible for assisting the group self-insurer in complying with the provisions of this section and the rules and regulations promulgated hereunder, and for coordinating services including but not limited to claims processing, loss control, legal, accounting and actuarial services. No person, firm or corporation shall coordinate such services or otherwise carry out the tasks of a group administrator as provided in this subdivision or in the regulations issued pursuant thereto on behalf of a group self-insurer unless such person shall have obtained from the chair a license authorizing it to act as a group self-insurer administrator, which license may be revoked for good cause. The chair shall promulgate regulations setting forth any additional qualifications for such license, governing the conduct and compensation of group self-insurer administrators, and setting a license fee in an amount not less than five thousand dollars per year for such license for each group self-insurer the administrator administers. Each administrator shall post a bond in the amount of five hundred thousand dollars for each group self-insurer administered or such other amount as may be set by the chair based on the cost and availability of such bond, from which the chair may recover any recoveries or penalties against the administrator under this section. Nothing in this section shall relieve the trustees of a group self-insurer of any fiduciary obligation they hold to the other members of such group self-insurer. (b) A group administrator that knowingly and with intent to mislead makes a material misrepresentation of a material fact in soliciting members in a group self-insurer shall be guilty of a class E felony. Additionally, the chair may impose a civil penalty of up to ten thousand dollars for each such violation. (c) A group administrator, actuary or accountant that knowingly makes a material misrepresentation of a material fact concerning the financial status of any group self-insurer to the chair or board, or in its annual report to members of the group self-insurer, shall be guilty of a class E felony. The chair may impose a civil penalty of up to twenty thousand dollars for each such violation. A second and subsequent violation of this paragraph shall be a class D felony. The chair may recover in a civil action any damages resulting from such misrepresentations, including the value of any amount assessed against any entities that are not members of the defaulted self-insurer that resulted from any such misrepresentation. (d) (1) A group administrator shall provide an annual written report to all members of the group self-insurer and to the board which shall include: a. the members of the group self-insurer; b. the group administrator and trustees; c. the results of the most recent financial audit; d. the percentage of total liabilities held by the self-insurer in unrestricted cash and investments permitted by regulation as determined in accordance with subparagraph (b) of paragraph two of this subdivision; e. the number and amount of rate deviations provided to members during the prior year and whether the recipient of any such deviation was a trustee; and f. such other information as the chair may direct. The group administrator shall provide a copy of the most recent financial audit to any group self-insurer member upon written request.(2)
The chair shall make available to the public, on its website and in writing upon request: a. the identity of all group self-insurers that have provided workers’ compensation under this subdivision in the prior three years; b. the group administrator of each such group self-insurer; c. the financial condition of all group self-insurers as determined by the board in the last financial audit and the board’s regulatory definition of assets; and d. such other information as the chair may direct, but which shall not include any confidential or proprietary information. The board may direct the disclosure of any non-proprietary information regarding any group self-insurer, including whether a member is a member thereof, to any claimant upon a showing of need. (e) (1) The chair may condition the issuance or continuation of a license under this subdivision upon the presentation by a group administrator of such information as the board requests, at any time chosen by the chair or at regular intervals, including but not limited to the annual financial statements of the group administrator detailing the compensation the administrator and its substantially owned affiliated entities, as defined in § 2 (Definitions)section two of this chapter, have received or shall receive from the group self-insurer or its members, and the method by which such compensation has been or will be calculated. The chair may issue regulations governing the method of calculating compensation which a group administrator may receive, including restrictions on the process by which such compensation may be set.(2)
The chair may revoke the license of any group administrator that receives compensation in violation of such regulations, and may impose a penalty of up to two times any compensation so received. (f) (1) No officer or director of, or person holding five percent or more ownership interest in, a group administrator shall within two years of serving in such capacity or holding such ownership interest, serve in any capacity or hold any ownership interest in a workers’ compensation carrier that provides or solicits the provision of compensation under this title for any employer that is or was a member of such group self-insurer. No officer or director of, or person holding five percent or more ownership interest in a group administrator shall serve in such capacity or hold such ownership interest in a carrier that provides or solicits excess coverage for any group self-insurer administered by such administrator.(2)
The chair may impose a civil penalty of up to ten thousand dollars for each violation of this paragraph. (g) Each group self-insurer shall submit to the chair copies of any agreement or contract with an entity that serves or will serve as its group administrator, accountant, actuary or third party administrator at least thirty days prior to becoming effective, and the effectiveness of such contract shall be conditioned on the absence of an objection by the board during the thirty day period. Contracts that shall be subject to such objection shall include any contract in violation of regulation; and any contract that does not provide reasonable cancellation or renewal terms, including any contract that requires an affirmative act by the trustees of the group self-insurer to prevent automatic renewal, or that does not permit cancellation for negligence, violation of law, or other good cause.(6)
(a) Group self-insurers must file with the board, as soon as practicable but no later than sixty days prior to the start of the fund year a rating plan which is supported by an actuarial rate study prepared by an independent, qualified actuary that is a fellow or associate of the casualty actuarial society, that clearly identifies the actuary’s indicated rate assumptions therein. The rating plan must apply consistently to all members, and must provide for a common renewal date for all group self-insurer members. The rates filed can be adjusted based on an experience modification calculated for every member in accordance with the experience rating plan promulgated by the workers’ compensation rating board. Experience modification formulas must be applied identically to all members. Other rate deviations may be permissible provided a plan has been approved by the board. Such deviations shall not be in excess of ten percent of the actuary’s indicated rate unless otherwise approved by the board for a fully funded group self-insurer, and shall in no event result in amounts less than the actuary’s overall indicated rate. The chair by regulation may set further rate plan and actuarial reporting standards. (b) If the chair has cause to believe that a group self-insurer’s contribution rates including experience modifications do not conform to the requirements of this part then he or she may require the submission of a report identifying the contributions paid by each of the members for the preceding year, the projected contributions for each group self-insurer member for the current fiscal year, and the manner in which such contributions were calculated. If, after review by the chair, the group self-insurer’s contribution rates are deemed to be detrimental to its solvency, the chair may mandate that the group self-insurer modify such rates as the chair directs. The chair may impose a penalty of up to five thousand dollars for each violation of this subparagraph. A group self-insurer’s failure to adhere to the rating structure determined by the board shall constitute good cause for termination.(7)
(a) If for any reason, the status of a group self-insurer under this subdivision is terminated, including by operation of law on and after January first, two thousand twelve, the securities or cash or the surety bond on deposit referred to herein shall remain in the custody of the chair for such time as the chair may deem proper and warranted. In lieu thereof, and at the discretion of the chair, the group self-insurer, its heirs or assigns or others carrying on or liquidating such group self-insurer, including the chair on the group self-insurer’s behalf, may execute an assumption of workers’ compensation liability insurance policy securing such further and future contingent liability as may arise from prior injuries to workers and be incurred by reason of any change in the condition of such workers warranting the board making subsequent awards for payment of additional compensation. Such policy shall be in a form approved by the superintendent of financial services and issued by the state fund or any insurance company licensed to issue this class of insurance in this state. In the event that such policy is issued by an insurance company other than the state fund, then said policy shall be deemed of the kind specified in paragraph fifteen of subsection (a) of Insurance Law § 1113 (Kinds of insurance authorized)section one thousand one hundred thirteen of the insurance law and covered by the workers’ compensation security fund as created and governed by article 6-A (Workers’ Compensation Security Fund)article six-A of this chapter. It shall only be issued for a single complete premium payment in advance by the group self-insurer and in an amount deemed acceptable by the chair and the superintendent of financial services. In lieu of the applicable premium charge ordinarily required to be imposed by a carrier, said premium shall include a surcharge in an amount to be determined by the chair to:(i)
satisfy all assessment liability due and owing to the board and/or the chair under this chapter; and(ii)
satisfy all future assessment liability under this section, and which surcharge shall be adjusted from time to time to reflect any changes to the assessment of group self-insured employers, including any changes enacted by the chapter of the laws of two thousand eleven amending sections fifteen and one hundred fifty-one of this chapter. Said surcharge shall be payable to the board simultaneous to the execution of the assumption of workers’ compensation liability insurance policy. However, the payment of said surcharge does not relieve the carrier from any other liability, including liability owed to the superintendent of financial services pursuant to article 6-A (Workers’ Compensation Security Fund)article six-A of this chapter. When issued such policy shall be noncancellable without recourse for any cause during the continuance of the liability secured and so covered. (b) The chair shall levy an interim assessment on the members of a defaulted group self-insurer within one hundred twenty days of such default or of the effective date of the chapter of the laws of two thousand eight which amended this subdivision, whichever is later, and against the members of any other terminated group self-insurer when necessary, for such an amount as he or she determines to be necessary to discharge all liabilities of the group self-insurer, including the reasonable cost of liquidation such as claims administration costs, actuarial and accounting services, and the value of future assessments on members of such group self-insurer as they are known at the time of the assessment. The chair may impose subsequent and further deficit assessments, or return funds to members, to adjust the moneys collected to reflect the time of participation, and percent of group self-insurer liabilities for such time. The time limitations included in the first sentence of this subparagraph do not apply to the imposition of any subsequent and further deficit assessments that exceed the interim assessment made by the chair against members of a defaulted group insurer or members of any other terminated group self-insurer. Notwithstanding any such action by the chair, each member of the group self-insurer shall remain jointly and severally responsible for all liabilities provided by this chapter including but not limited to outstanding and estimated future liabilities and assessments. Further, separate and apart from, and in addition to a member’s joint and several liability and notwithstanding any payments made by any other members of the group self-insurer pursuant to this subparagraph, in the event that a member neglects or fails to pay an assessment levied pursuant to this subparagraph, the member shall be deemed in default in the payment of compensation. Such defaulting member is subject to the enforcement provisions of § 26 (Enforcement of payment in default)section twenty-six of this chapter for the payment of all compensation relative to awards due and owing on claims filed by the employees of such member that have neither been paid by the member or the group self-insurer. Nothing in this paragraph shall prevent the chair from offering payment plans or settling claims against members of any group self-insurer as necessary to facilitate collection. (c) Upon the assumption of the assets and liabilities of a group self-insurer by the chair or his or her designee pursuant to regulation of the chair, all records, documents and files of whatever nature, pertaining to the group self-insurer, be they in the possession of the group self-insurer or a third party, and all remaining assets of the group self-insurer, shall become the property of the chair. All custodians of such records and/or funds shall turn over to the chair or his designee all such original records upon demand.(8)
All the provisions of this chapter relating to self-insurance and the rules and regulations promulgated thereunder shall be deemed applicable to group self-insurance. The chair shall implement the provisions of this subdivision by promulgating rules and regulations but no such rules or regulations shall be necessary for any provision of this subdivision to be effective. The chair may impose a civil penalty of up to ten thousand dollars for each violation against any group self-insurer that violates any provision of this subdivision or of any regulation issued pursuant thereto for which a civil penalty is not specified.(10)
(a) A non-municipal group of employers may make application to the chair to qualify jointly as a self-insurer, provided:(1)
The members of the group secure the services of an administrator, who shall carry out the responsibilities of such an administrator as set forth in subdivision five of this section, and who shall be subject to the restrictions and penalties applicable to an administrator under this section;(2)
The members of the group, through the administrator, (a) jointly deposit sufficient securities in accordance with subdivision three of this section or in a trust governed in accordance with Part 126 of title 11 of the New York code of rules and regulations to secure the liability of the members of the group to pay for all existing claims obligations, provided such deposit shall be made by November first, two thousand eleven, (b) jointly deposit sufficient securities in accordance with subdivision three of this section or in a trust governed in accordance with Part 126 of title 11 of the New York code of rules and regulations to secure all anticipated present and future claims of the members of the group, by November first, two thousand fourteen, provided annual deposits are made in accordance with a schedule set by the chair on or before November first of each year, and provided that the deposit shall be deemed an asset of the group for the purpose of determining its funding status, and (c) by November first, two thousand eleven and thereafter, shall maintain funds sufficient for all other liabilities besides claims in a trust governed in accordance with Part 126 of title 11 of the New York code of rules and regulations, of which the board shall be the sole beneficiary, and the terms of the trust agreement, and the trustee, shall be approved by the chair in his or her sole discretion, and provided that any group self-insurer that does not hold such funds in a trust that meets the terms of this paragraph shall post them with the board;(3)
The group has been authorized by the chair to self-insure in accordance with this subdivision prior to the effective date of this paragraph;(4)
The group’s members or participant employers either (a) are parties to collective bargaining agreements with the same unions; or (b) fall within a limited number of payroll classifications, as set by the chair, after giving due consideration to the risks associated with any group of employers self-insuring. However, employers that were active prior to the effective date of this section and whose classification codes do not meet the limitations on payroll classification codes or are not parties to collective bargaining agreements with the same unions will be permitted to remain in the trust provided (a) they continue to meet the other terms and conditions of the trust; and (b) any new members shall be subject to the limitations on the number of payroll classifications; and provided further, the chair shall revoke such permission in the event the trust violates paragraph six of this subdivision relating to filing of a rating plan;(5)
The group was fully funded for three out of the previous five years and at least ninety percent funded for one other year out of the previous five years, as determined by the chair following a financial review, and the group self-insurer has sufficient funds to meet its liabilities;(6)
The group has a safety program acceptable to the chair; and(7)
The group is subject to such other limitations and requirements of this subdivision unless waived by the chair and to regulations of the chair. (b) The members of any such group shall enter into an agreement among themselves and with the group’s administrator which shall, at a minimum:(1)
Indicate that each of the members of the group is jointly and severally liable for any liabilities of the group; and(2)
Provide for the collection of additional funds from group members in the event the deposit with the board is insufficient to meet the liabilities of the group.(11)
Former group self-insurer. Any group self-insurer that has ceased to self-insure, or has ceased to self-insure any new liabilities after January first, two thousand twelve in accordance with paragraph two of this subdivision, shall remain subject to all the provisions of this subdivision and the regulations issued pursuant thereto and any assessments provided for by this section until such time as the group self-insurer no longer possesses any liabilities.(12)
Any non-municipal group of employers authorized to self-insure under paragraph ten of this section on or after January first, two thousand twelve shall be deemed a “private self-insurer” for purposes of the assessments set forth in sections fifteen and one hundred fifty-one of this chapter. 3-b. (a) Except as provided in subdivision three-d of this section, no person, firm or corporation, other than an attorney and counsellor-at-law, shall solicit the business of representing, or engage in representing self-insurers or group self-insurers, as defined in subdivisions three and three-a of this section, before the board or any officer, agent or employee of the board assigned to conduct any hearing, investigation or inquiry relative to a claim for compensation or benefits under this chapter, unless he or she shall be a citizen of the United States or a noncitizen lawfully admitted for permanent residence in the United States, or a corporation organized under the laws of the state of New York, and shall have obtained from the board a license authorizing him or her to appear in matters or proceedings before the board. Such license shall be issued by the board in accordance with the rules established by it. Any person, firm or corporation violating the aforesaid provisions shall be guilty of a misdemeanor. The chair may impose a civil penalty of up to one thousand dollars for each violation against any representative licensed in accordance with this section that violates any provision of this section or of any regulation issued pursuant thereto, in addition to any other sanctions provided for under this chapter. (b) The board, in its rules, may provide for the issuance of licenses to persons, firms or corporations, upon such proof of character and fitness as it may deem necessary, without annual license fee, and for the giving of a bond running to the people of the state of New York, conditioned upon the faithful performance of all duties required of such person, firm or corporation, and in an amount to be fixed by the board in its rules. Such bond shall be approved by the board as to form and sufficiency and shall be filed with it. (c) There shall be maintained in each office of the board a registry or list of all persons to whom licenses have been issued, as provided herein, which list shall be corrected as often as licenses are issued or revoked. Absence of record of the license issued, as herein provided, shall be prima facie evidence that a person, firm or corporation is not licensed to represent self-insurers. (d) Any such license may be revoked by the board for cause after a hearing before it. (e) No license shall be issued hereunder for a period longer than three years from the date of its issuance. The provisions of this section shall not apply to a regular employee of a self-insured employer or to the state insurance fund acting in accordance with an insuring agreement with the state as authorized pursuant to the provisions of section eighty-eight-c of this chapter. 3-c. Notwithstanding any provision in this chapter or in any general, special or local law contained, all cash and securities deposited with the chairman by an employer who is a party or a wholly owned subsidiary of a party to a plan heretofore or hereafter adopted under article seven of the public service law by the transit commission-- metropolitan division of the department of public service, and who is, or at the time of the consummation of such plan was, a self-insurer under this chapter, may be withdrawn upon, or at any time after, the consummation of such plan as hereinafter provided. All cash and securities deposited by any such employer with and held by the chairman may be withdrawn upon, or at any time after, the consummation of such plan where any city which is a party thereto and which is a self-insurer under this chapter assumes all liabilities of or claims against such employer under this chapter, as follows: (a), where such plan provides that such city shall acquire, or that such employer or his assigns shall retain, all the right and interest of such employer in the deposited cash and securities, the chairman shall surrender and deliver such cash and securities to such city or to such employer or his assigns, as the case may be, upon its demand, and (b), where such plan provides that such city and such employer, or his assigns, shall each retain some right and interest in such cash and securities, the chairman shall surrender and deliver such cash and securities to such city and to such employer or his assigns upon their joint demand as shall be specified therein. 3-d. The state insurance fund, an insurance company duly authorized or licensed to write workers’ compensation insurance in this state, a subsidiary or an affiliate of such an insurance company, or a licensed or authorized adjusting company or association may apply for a license from the board to solicit the business of representing and engage in representing self-insurers, as defined in subdivision three of this section, before the board or any officer, agent or employee of the board assigned to conduct any hearing, investigation or inquiry relative to a claim for compensation or benefits under this chapter. Any corporation formed solely for the purpose of engaging in the activities described by this subdivision shall be formed under the laws of the state of New York. The state insurance fund, an insurance company, its subsidiary or affiliate, or such adjusting company or association shall designate those employees who are to appear in matters or proceedings before the board on behalf of self-insurers. Such employees shall obtain an authorization from the board. Upon application to the board for such authorization all such employees who, on the effective date of this subdivision, have been appearing in matters or proceedings before the board on behalf of insurers for a period of at least two years shall automatically receive a temporary authorization from the board. Such temporary authorization shall remain in effect until the applicant employee has been granted or denied final authorization by the board. The board in its rules shall provide for the issuance of authorizations to such employees and other designated employees. If the board, in its rules, provides for the issuance of authorization to persons, firms or corporations under subdivision three-b of this section upon such proof of character and fitness as it may deem necessary, the same proof of character and fitness shall be required for an authorization issued under this subdivision. The state insurance fund, an insurance company duly authorized or licensed to write workers’ compensation insurance in this state, a subsidiary or an affiliate of such an insurance company, or a licensed or authorized adjusting company or association shall apply to the board for the issuance of a license upon such proof of character and fitness as the board may deem necessary. Such proof of character and fitness shall be the same as that required by the board of persons, firms or corporations under subdivision three-b of this section. If the board charges a fee for a license issued under subdivision three-b of this section, the same amount shall be charged for a license issued under this subdivision. If the board requires for the giving of a bond running to the people of the state of New York, conditioned upon the faithful performance of all duties required of such person, firm, or corporation licensed under subdivision three-b of this section, the same shall be required for a license under this subdivision. Such bond shall be approved by the board as to form and sufficiency and shall be filed with it. All license and authorization fees collected under the provisions of this subdivision shall be paid into the state treasury. Any person, insurance company, its subsidiary or affiliate, or adjusting company or association which violates the aforesaid provisions of this paragraph shall be guilty of a misdemeanor. There shall be maintained in each office of the board a registry list of all persons to whom authorizations and licenses have been issued as provided herein, which list shall be corrected as often as authorizations and licenses are issued or revoked. Absence of record of the authorization or license issued, as herein provided, shall be prima facie evidence that a person, firm or corporation is not authorized or licensed to represent self-insurers. Any such authorization or license may be revoked by the board for cause after a hearing before it. No authorization or license shall be issued hereunder for a period longer than three years from the date of its issuance. The board shall make rules pertaining to when conflicts of interest arise in individual cases which shall apply to those who are licensed or authorized to represent self-insurers under subdivision three-b of this section or under this subdivision. The provisions of article twenty-four of the insurance law, insofar as applicable, shall apply to the state insurance fund, insurance companies, their subsidiaries and affiliates or adjusting companies or associations in their activities representing self-insurers before the board. 3-e. (a) The state insurance fund and any other insurer that issues policies of workers’ compensation insurance shall offer at the option of the policyholder a deductible for benefits payable under a workers’ compensation policy with an annual premium of twelve thousand dollars or more, if in the opinion of the state insurance fund or such other insurer the policyholder meets the eligibility requirements of paragraph (b) of this subdivision. (b) A policyholder is eligible for a policy deductible for any renewal period of the policy if such policyholder has paid the entire billed premium on the policy for all policy periods within forty-five days of each billing for the past three years. A policyholder will continue to be eligible for a deductible provided that no part of any premium is more than forty-five days overdue from the date billed or reimbursement for any deductible amount is unpaid by the policyholder to such insurer. The state insurance fund or any other insurer that has issued a policy with a deductible may revoke the policyholder’s entitlement to a deductible if the policyholder fails to reimburse any deductible amounts, or pay any billed premium, within forty-five days after such reimbursement or premium payment has become due. Upon such revocation of a policyholder’s entitlement to a deductible, the policyholder shall be entitled to cancel such policy and such policyholder will forfeit eligibility for entitlement to a deductible as provided above. (c) Deductibles shall be offered by the state insurance fund or any other insurer in writing to eligible policyholders at the beginning of policy periods, in the amounts of one hundred dollars, two hundred dollars, three hundred dollars, four hundred dollars and five hundred dollars, and thereafter, in increments of five hundred dollars up to a maximum of two thousand five hundred dollars per occurrence. The eligible policyholder shall select, in writing, only one deductible amount which shall be binding on such policyholder throughout the policy period. (d) If the policyholder selects a deductible under paragraph (c) of this subdivision, workers’ compensation benefits payable under the policy shall be paid by the state insurance fund or other insurer liable under the policy to the person or provider entitled to such benefits without regard to any deductible applied to such policy. Upon payment of benefits on a claim up to or exceeding the deductible amount, the state insurance fund or other insurer shall be entitled to bill the policyholder for reimbursement up to the deductible amount. A policyholder’s failure to pay billed deductible reimbursement amounts to the state insurance fund or other insurer under this paragraph shall be treated in the same manner as non-payment of premium and render the policy cancelable in accordance with the provisions of subdivision five of § 54 (The insurance contract)section fifty-four of this article. The deductibles paid by the insured employer during any one year period of the policy of insurance shall not exceed the annual premium for such policy of insurance. (e) Premium reductions, in accordance with methodology approved by the superintendent of financial services shall be applied to any policy written with a deductible. Such premium reductions shall be determined before the application of any experience modification premium surcharge or premium discount. (f) The New York workers’ compensation rating board shall file for appropriate premium discounts subject to the approval of the superintendent of financial services. (g) The state insurance fund and any other insurer may, at its option, offer a deductible in an amount specified in paragraph (c) of this subdivision to any policyholder who is not otherwise eligible for a deductible under this subdivision. A public group self-insurer may offer a deductible in accordance with paragraph (h) of this subdivision. (h) A public group self-insurer which has been providing workers’ compensation and employers’ liability coverage for not less than five years and is operated as a self-administered not-for-profit corporation governed by a board not less than two-thirds of the members of which are representatives of members of the public group self-insurer, and all of the officers of which are representatives of members of the public group self-insurer may, upon a determination by the chair that the methodology used by the public group self-insurer in creating its deductible rating plan is supported by an actuarial analysis prepared by an independent, qualified actuary who is a member of the casualty actuarial society that clearly identifies the actuary’s rate assumptions, and subject to underwriting by the public group self-insurer, offer as part of the policy or by endorsement, deductibles optional to the member, not subject to the foregoing monetary limits, consistent with the following:(1)
claimants’ rights are properly protected, and claimants’ benefits are paid without regard to any such deductible;(2)
appropriate premium reductions reflect the type and level of any deductible approved by the chair and selected by the member;(3)
premium reductions for deductibles are determined before application of any experience modification, premium surcharge, or premium discount;(4)
recognition is given to member’s characteristics, including size, financial capabilities, nature of activities, and number of employees;(5)
if the member selects a deductible, the member is liable to the public group self-insurer for the deductible amount in regard to benefits paid for compensable claims;(6)
the public group self-insurer pays all of the deductible amount, applicable to a compensable claim, to the person or provider entitled to benefits and then seeks reimbursement from the member for the applicable deductible amount;(7)
a failure by the member to reimburse deductible amounts to the public group self-insurer is treated in the same manner as nonpayment of the member’s contribution;(8)
the public group self-insurer shall be fully-funded as defined in subparagraph (b) of paragraph two of subdivision three-a of this section and if, after offering deductible policies, the public group self-insurer ceases to be fully funded as so defined, the public group self-insurer may not permit any new member to elect the deductible option until the public group self-insurer becomes fully funded;(9)
the public group self-insurer may add no more than seven new deductible members in any one contribution year;(10)
the aggregate contributions for all new members selecting the deductible option in any one year may not exceed ten percent of the total contributions of all of the public group self-insurer’s members for the immediately prior year;(11)
if the member was self-insured prior to joining the public group self-insurer, the member’s deductible amount during the member’s first year of membership in the public group self-insurer may not exceed the amount of the member’s reinsurance retention level immediately before joining the public group self-insurer;(12)
each member which has elected the deductible option shall:(i)
maintain in a dedicated account held by the public group self-insurer an amount actuarially determined to be sufficient to pay the portion of each compensation claim that is within the deductible amount for the succeeding three months; and(ii)
maintain in its own dedicated reserve account or in its own undesignated fund balance, the actuarially-determined amount that the member will be required to pay for all of the member’s claims below the deductible amount; and(13)
the public group self-insurer shall provide to all members of the public group self-insurer an annual statement identifying the contributions provided by and the reserves attributable to the members which have elected a deductible and must provide to each member of the public group self-insurer which has elected the deductible option an annual actuarial analysis of the member’s open claims, stating the amounts the public group self-insurer anticipates that the member will be required to pay for the life of each claim.4.
a. A county, city, village, town, school district, fire district or other political subdivision of the state may secure compensation to its employees in accordance with subdivision one, two or three-a of this section, and a public corporation as defined in subdivision one of § 60 (Definitions)section sixty of this chapter may also secure such compensation in accordance with article 5 (County Self-insurance Plan)article five of this chapter. If compensation is not so secured, a county, city, village, town, school district, fire district or other political subdivision shall be deemed to have elected to secure compensation pursuant to subdivision three of this section and, in such case, no proof of financial ability or deposit of securities or cash need be made in compliance with such subdivision. All other requirements prescribed by this chapter for employers so electing shall be complied with and notice of such election shall be filed with the chair. For failure to file such notice of election, prescribed in form by the chair, within ten days after the election was made, the treasurer or other financial officer shall be liable to pay to the chair the sum of one hundred dollars as a penalty, to be transferred to the state treasury. b. The treasurer or other fiscal officer of a self-insuring county, city, village, town, school district, fire district or other political subdivision shall, upon presentation of an award of compensation forthwith begin payment of it to the person entitled thereto in accordance with this chapter. c. The governing board of a county, city, village, town, school district, fire district or other political subdivision may authorize the treasurer or other fiscal officer of such municipal corporation, district or political subdivision, as the case may be, to pay the compensation provided for in this chapter to the person entitled thereto without waiting for an award in any case in the manner provided in § 25 (Compensation, how payable)section twenty-five of this chapter. The amount of such compensation payable prior to an award pursuant to such authorization shall constitute a settled claim within the meaning of the local finance law. d. A contract of insurance issued to a county or a town in accordance with subdivision one or two of this section and in force on or after the first day of March, nineteen hundred sixty-three, in relation to fire districts and on or after the first day of January, in the year in which this paragraph as hereby amended becomes effective in relation to ambulance districts shall contain a provision reading as follows: "This contract does not provide (1) any coverage under the Workers’ Compensation Law or the Volunteer Firefighters’ Benefit Law or the Volunteer Ambulance Workers’ Benefit Law for which any fire district or ambulance district would be liable under such laws, (2) any workers’ compensation benefits for fire or ambulance district officers and employees for which any fire district or ambulance district would be liable under the Workers’ Compensation Law, or(3)
any volunteer firefighters’ or ambulance workers’ benefits for any volunteer firefighters or volunteer ambulance workers under the Volunteer Firefighters’ Benefit Law or the Volunteer Ambulance Workers’ Benefit Law". e. If for any reason the status of a county, city, village, town, school district, fire district or other political subdivision of state is terminated, at the discretion of the chair, the county, city, village, town, school district, fire district or other political subdivision of state, may execute an assumption of workers’ compensation liability insurance policy securing such further and future contingent liability as may arise from prior injuries to workers and be incurred by reason of any change in the condition of such workers warranting the board making subsequent awards for payment of additional compensation. Such policy shall be in a form approved by the superintendent of financial services and shall be issued by the state fund or any insurance company licensed to issue this class of policy in this state. In the event that such policy is issued by an insurance company other than the state fund, then said policy shall be deemed to be insurance of the kind specified in paragraph fifteen of subsection (a) of Insurance Law § 1113 (Kinds of insurance authorized)section one thousand one hundred thirteen of the insurance law and covered by the workers’ compensation security fund as created and governed by article 6-A (Workers’ Compensation Security Fund)article six-A of this chapter. It shall only be issued for a single complete premium payment in advance by the county, city, village, town, school district, fire district or other political subdivision of state and in an amount deemed acceptable by the chair and the superintendent of financial services. In lieu of the applicable premium charge ordinarily required to be imposed by a carrier, said premium shall include a surcharge in an amount to be determined by the chair to satisfy all assessment liability due and owing to the board and/or the chair under this chapter. Said surcharge shall be payable to the board simultaneous to the execution of the assumption of workers’ compensation liability insurance policy. However, the payment of said surcharge does not relieve the carrier from any other liability, including liability owed to the superintendent of financial services pursuant to article 6-A (Workers’ Compensation Security Fund)article six-A of this chapter. When issued such policy shall be non-cancellable without recourse for any cause during the continuance of the liability secured and so covered.5.
Self-insurance. “Self-insurance,” as used herein, shall be deemed to be the system of securing compensation as provided in subdivisions three, three-a and four of this section, and article 5 (County Self-insurance Plan)article five of this chapter. a. The chair shall administer all matters relating to self-insurance under this chapter. All penalties set forth in subdivisions three and three-a of this section shall be paid into the fund for uninsured employers provided for in section twenty-six-a of this chapter. b. Advisory committee for individual self-insurance.(1)
To advise the chair, there shall be an advisory committee for individual self-insurance, which shall be called the advisory committee for self-insurance and consist of the chair and ten additional members appointed by the chair. Three of such members shall be named from the manufacturing and trade group of self-insurance, three from the transportation, public utilities and construction group, and one member shall be a self-insurer selected at large by the chairman, who shall be vice-chairman of the advisory committee. The chair shall be chair of the advisory committee; the secretary of the board shall act as secretary of the advisory committee. Any member appointed to such advisory committee shall be a self-insurer or an officer of a self-insurer or a person who on account of his or her employment or affiliation can be classed as a management representative of a self-insurer. The members of the advisory committee for self-insurance in office at the time this subdivision takes effect, shall be and they are hereby continued in office as such for the remainder of the terms for which they were appointed respectively. The members of the advisory committee for self-insurance next appointed, except to fill a vacancy created otherwise than by expiration of term, shall be appointed for terms of three years, except that of the three additional members to be appointed after May first, two thousand eight, one such member shall be appointed for an initial term of one year, one such member shall be appointed for an initial term of two years, and one such member shall be appointed for an initial term of three years. No member shall be appointed to the advisory committee for individual self-insurance if he or she has been convicted of a crime under this chapter or has been subject to criminal or civil penalties under this subdivision. Vacancies shall be filled for the unexpired term by appointment by the chair. Members shall continue in office until their successors are appointed; in the event that no appointment is made within three months after a vacancy exists or after the expiration of the term of a member, the remaining members may fill the vacancy by a majority vote. If a member shall be absent from two consecutive regular meetings without adequate excuse his or her place may be declared vacant by the chair. Members of such advisory committee shall serve without pay, but shall be entitled to their reasonable and necessary traveling and other expenses incurred in connection with their duties. Regular meetings of the advisory committee shall be held twice a year, on dates to be fixed by the chair. In addition, special meetings shall be held if called by the chair or any five members of the committee. Such advisory committee shall have access to all self-insurance records except those restricted by the chair or those whose disclosure is restricted under § 110-A (Confidentiality of workers’ compensation records)section one hundred ten-a of this chapter, and shall have the power to require the presence before it of any employee of the board or any self-insurer as reasonable and related to matters within the purview of the committee. Information obtained by members of the advisory committee shall be deemed confidential unless disclosed by order of the committee. It shall be the duty of the advisory committee to advise the chair on all matters relating to self-insurance, particularly in respect to rules governing self-insurance, the deposit or withdrawal of securities, the standards for permitting employers to self-insure under this section, the appropriate amount of security or payments that self-insured employers must provide, and on such other matters as the chair shall request. The chair shall detail to such advisory committee such stenographic or other assistance as may be necessary. Minutes shall be kept of the meetings of the advisory committee and shall be provided within forty-five days of such meeting to the governor and legislature, including the chairs of the assembly and senate committees on insurance and labor. c.(1)
The chair and the department of audit and control as soon as practicable after May first, nineteen hundred sixty, and annually thereafter, as soon as practicable after April first in each succeeding year, shall ascertain the total amount of net expenses, including (a) administrative expenses, which shall include the direct costs of personal services, the cost of maintenance and operation, the cost of retirement contributions made and workers’ compensation premiums paid by the State for or on account of personnel, rentals for space occupied in state owned or state leased buildings, and (b) all direct or indirect costs incurred by the board during the preceding fiscal year in carrying out the provisions of subdivision three and three-a of this section. Such expenses shall be adjusted annually to reflect any change in circumstances, and shall be assessed against all private self-insured employers, including for this purpose active and terminated group self-insurers, active individual self-insured employers, and individual self-insured employers who have ceased to exercise the privilege of self-insurance.(2)
Such expenses shall be assessed against all self-insurers including for this purpose employers who have ceased to exercise the privilege of self-insurance. The basis of apportionment of the assessment against each self-insurer shall be a sum equal to that proportion of the amount which the indemnity payment for each self-insurer bore to the total indemnity payments for all self-insurers for the calendar year which ended within the preceding state fiscal year. All such assessments when collected shall be deposited into a fund which shall be used to reimburse the appropriations theretofore made by the state for the payment of the expenses of administering this chapter.(3)
Pure premium for assessments made prior to January first, two thousand nine against individual and group self-insurers who ceased to self-insure shall be based on payroll at the time the individual or group self-insurer has ceased to self-insure, reduced by a factor reflecting the reduction in the group or individual self-insurer’s self-insurance liabilities since ceasing to self-insure. d. The chair may from time to time request the superintendent of financial services for assistance, and the superintendent of financial services is hereby authorized to render such assistance upon request of the chair, as may be necessary to insure the financial ability of such group self-insurers to pay all liabilities provided by this chapter. e. Notwithstanding the provisions of paragraph c of this subdivision, the chair shall require that partial payments for expenses of the fiscal year beginning April first, nineteen hundred eighty-three, and for each fiscal year thereafter shall be made on March tenth of the preceding fiscal year and on June tenth, September tenth, and December tenth of each year, or on such other dates as the director of the budget may prescribe, by each self-insurer. Provided, however, that the payment due March tenth, nineteen hundred eighty-three for the fiscal year beginning April first, nineteen hundred eighty-three shall not be required to be paid until June tenth, nineteen hundred eighty-three. Each such payment shall be a sum equal to twenty-five per centum of the annual expenses assessed upon each self-insurer, as estimated by the chair. The balance of assessments for the fiscal year beginning April first, nineteen hundred seventy-three and each fiscal year thereafter, shall be paid upon determination of the actual amount due in accordance with the provisions of paragraph c of this subdivision. Any overpayment of annual assessments resulting from the requirements of this paragraph shall be refunded or at the option of the chair shall be applied as a credit against the assessment of the succeeding fiscal year. The requirements of this subdivision shall not apply to those self-insurers whose estimated annual assessment for the fiscal year is less than one hundred dollars and such self-insurers shall make a single payment of the estimated annual assessment on or before September thirtieth of the fiscal year. f. Whenever the chair shall determine that the compensation and benefits provided by this chapter may be unpaid by reason of the default of an insolvent private self-insured employer, including a private group self-insurer, the chair shall pay such compensation and benefits from administration expenses as provided in § 151 (Assessments for annual expenses)section one hundred fifty-one of this chapter upon audit and warrant of the comptroller upon vouchers approved by the chair. Such payments shall be considered expenses of administration. The chair shall be reimbursed therefor from the surety bond, cash or securities held or, if such surety bond, securities or cash is insufficient, by the employer, its receiver, liquidator, rehabilitator or trustee in bankruptcy. All moneys reimbursed to the chair or recovered by the chair in an action or proceeding to secure such reimbursement shall forthwith be applied as a credit against the expenses on which the assessment levied upon all private self-insured employers, in accordance with paragraphs c and e of this subdivision, is calculated. g. Whenever the chair shall determine that the compensation and benefits provided by this chapter may be unpaid by reason of the default of an insolvent private self-insured employer, including a private group self-insurer, the chair shall levy an assessment against all private self-insured employers, including private group self-insurers, in accordance with paragraphs c and e of this subdivision to assure prompt payment of such compensation and benefits. Whenever compensation and benefits are unpaid by reason of such default, the chair shall promptly pay such compensation and benefits from administration expenses as provided in § 151 (Assessments for annual expenses)section one hundred fifty-one of this chapter upon audit and warrant of the comptroller upon vouchers approved by the chair. Nothing in this paragraph shall preclude the chair from recovering the moneys it expends from its administrative expenses against the defaulted individual self-insurer, or the members of the defaulted group self-insurer, as otherwise permitted by this chapter.6.
Any policy of insurance purchased pursuant to the provisions of this subdivision six as in effect prior to the first day of March, nineteen hundred fifty-seven, shall be cancelled prior to, or as of, the twenty-eighth day of February, nineteen hundred fifty-seven. The cost of such insurance shall be apportioned by the clerk of the board of supervisors of the county to each such city, village, fire district, fire protection district, fire alarm district, and territory outside such municipal corporations and districts, in the proportion that the agreed population bears to the entire population of the group. Refunds, dividends and discounts in relation to such insurance shall be distributed or credited according to the same apportionment. Upon notification by the clerk of the board of supervisors, the chief fiscal officer of each such city, village or fire district shall pay to the county treasurer, from moneys available or made available, the amount apportioned to such city, village or district. Upon like notification, the supervisor of each town in which a fire protection district or fire alarm district is located in whole or in part, or in which outside territory is located, shall pay to the county treasurer the amount apportioned for such district, in whole or in part, or territory, as the case may be, using moneys raised or made available for the purposes of fire protection in such district or outside territory, or if there be no such moneys or insufficient moneys, using funds of the town available or made available, which funds shall be a charge upon such district or territory for which the town shall be reimbursed. The county treasurer shall pay the cost of such insurance with such moneys, or if any apportioned share has not been paid, the county treasurer shall advance the amount necessary from moneys of the general fund upon resolution of the board of supervisors. Any such advance shall be repaid as soon as moneys are available therefor. If any apportioned share remains unpaid, the county may recover the same by action at law. If any member of the group shall fail to pay its apportioned share within thirty days after notice that such amount has become due and payable, the chairman of the board of supervisors may terminate the participation of such member in the group by notice by mail to such member on a date specified in the notice, and a copy of such notice shall be filed by the chairman of the board of supervisors with the insurance carrier, who shall notify the chairman of the workmen’s compensation board of the termination of coverage in the same manner as provided for cancellation of policy under subdivision five of § 54 (The insurance contract)section fifty-four of this chapter. If any participating fire protection district or fire alarm district includes territory in more than one town, whether or not in more than one county, the amount of cost of insurance, refund, dividend or discount apportioned to such district shall be apportioned in the proportion that the population of the district within each such town bears to the population of the entire district. The figure used for population in such case shall be the one stated in the agreement.7.
Any policy of insurance purchased pursuant to the provisions of this subdivision seven as in effect prior to the first day of March, nineteen hundred fifty-seven, shall be cancelled prior to, or as of, the close of the twenty-eighth day of February, nineteen hundred fifty-seven. The cost of such insurance shall be a town charge and shall be levied and collected in the same manner as other town charges only in the territory of such town outside of any villages and fire districts not covered by such a policy.8.
The requirements of § 10 (Liability for compensation)section ten of this chapter regarding the provision of workers’ compensation insurance as to owners and trainers governed by the racing, pari-mutuel wagering and breeding law who are employers under § 2 (Definitions)section two of this chapter are satisfied in full by compliance with the requirements imposed upon owners and trainers by section two hundred twenty-one of the racing, pari-mutuel wagering and breeding law, provided that in the event double compensation, death benefits, or awards are payable with respect to an injured employee under § 14-A (Double compensation and death benefits when minors illegally employed)section fourteen-a of this chapter, the owner or trainer for whom the injured jockey, apprentice jockey or exercise person licensed under article two or four of the racing, pari-mutuel wagering and breeding law, and at the election of the New York Jockey Injury Compensation Fund, Inc., with the approval of the New York state gaming commission, employee of a licensed trainer or owner, is performing services as a jockey, apprentice jockey or exercise person so licensed at the time of the accident or, if approved by the New York state gaming commission, an employee of a licensed trainer or owner shall bear the sole responsibility for the amount payable pursuant to such section fourteen-a in excess of the amount otherwise payable under this chapter, unless there shall be a failure of the responsible owner or trainer to pay such award within the time provided under this chapter. In the event of such failure to pay and the board requires the fund to pay the award on behalf of such owner or trainer who has been found to have violated § 14-A (Double compensation and death benefits when minors illegally employed)section fourteen-a of this chapter, the fund shall be entitled to an award against such owner or trainer for the amount so paid which shall be collected in the same manner as an award of compensation. Coverage directly procured by any owner or trainer for the purpose of satisfying the requirements of this chapter with respect to employees of the owner or trainer shall not include coverage on any jockey, apprentice jockey or exercise person licensed under article two or four of the racing, pari-mutuel wagering and breeding law, and at the election of the New York Jockey Injury Compensation Fund, Inc., with the approval of the New York state gaming commission, any employee of a licensed trainer or owner, to the extent that such jockey, apprentice jockey, exercise person or, if approved by the New York state gaming commission, employee of a licensed trainer or owner is also covered under coverage procured by The New York Jockey Injury Compensation Fund, Inc. pursuant to the requirements of section two hundred twenty-one of the racing, pari-mutuel wagering and breeding law, and to that extent, coverage procured by the fund pursuant to the requirements of the racing, pari-mutuel wagering and breeding law shall be considered primary.9.
The requirements of sections ten and eleven of this chapter regarding the securing and provision of workers’ compensation benefits as to a central dispatch facility, as defined in article six-F of the executive law, are satisfied in full by compliance with the requirements imposed upon such central dispatch facility by such article. Insurance coverage directly procured by any central dispatch facility for the purpose of satisfying the requirements of this chapter with respect to employees of the central dispatch facility shall not include coverage of any black car operator to the extent that the black car operator is also covered under coverage secured by the New York black car operators’ injury compensation fund, inc. pursuant to the requirements of article six-F of the executive law, and to that extent, coverage secured by the fund pursuant to the requirements of article six-F of the executive law shall be considered primary.10.
An individual self-insured employer or group self-insurer who fails to file or maintain the security deposit required by the chair will be deemed to have failed to secure compensation for the amount not deposited, and shall be liable for all penalties for such failure provided for under this title.11.
If at any time an individual self-insured employer or member of a group self-insurer intentionally and materially understates or conceals payroll, or intentionally and materially misrepresents or conceals employee duties or if the employer intentionally or materially misstates payroll or claims information for the purposes of determining employer contributions as provided for under subdivisions three and three-a of this section, such employer shall be deemed to have failed to secure compensation and shall be subject to sanctions applicable under § 52 (Effect of failure to secure compensation)section fifty-two of this article in addition to any other sanctions available under law.12.
The chair, with the approval of the director of the budget, may request the issuance of bonds by the dormitory authority for one or more of the purposes authorized by Public Authorities Law § 1680-Q (State university of New York dormitory facilities)section sixteen hundred eighty-q of the public authorities law and by a self-insured bond financing agreement authorized by § 50-C (Self-insured bonds)section fifty-c of this article. The net proceeds of such bonds shall be deposited into the self-insurer offset fund or as otherwise provided by the applicable self-insured bond financing agreement.
Source:
Section 50 — Security for payment of compensation, https://www.nysenate.gov/legislation/laws/WKC/50 (updated Sep. 22, 2023; accessed Apr. 13, 2024).
