Rules and Regulations of the State of Georgia
 

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  • 1. In the address bar, type about:config and press Enter.
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<xmp>.</xmp> <form name="form1" method="post" action="120-2-38?urlRedirected=yes&amp;data=admin&amp;lookingfor=120-2-38" id="form1"> <input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" value="/wEPDwUKLTY5ODkwOTM2Nw8WAh4Ec3BhbQILFgJmD2QWAgIFDw8WAh4EVGV4dAUFNSArIDZkZGSeh1keZIEYNgEydR57rh6kTGEz/w==" /> <input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="EEBB6393" /> <input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION" value="/wEWCALEpPmEDALniKOhBALV5cpNAoa5iIEFAoznisYGAsrv5u0MAsrv4u0MAsrv3u0MYpPHt/zME8Jc+ZQF/d6Lbs8zvFk=" /> <div class='popup'> <div class='cnt223'> <div style="margin-bottom:6px;"> <img alt="Rules and Regulations of the State of Georgia" src="/images/new.gif"/> </div> <div class="header"> Terms and Conditions of Agreement for Access to Rules and Regulations of the State of Georgia Website </div> <div class="scroll"> <p>(Note: certain features of this site have been disabled for the general public to prevent digital piracy. If you are an entitled government entity pursuant the Georgia Administrative Procedures Act, <a target="_new" href="http://links.casemakerlegal.com/states/GA/books/Code_of_Georgia/browse?ci=25id=gasos&amp;codesec=50-13-7&amp;title=50&amp;#50-13-7(d)">O.C.G.A.§ 50-13-7(d)</a> contact the State of Georgia's Administrative Procedures Division at 678-364-3785 to enable these features for your location.)</p> <p>To access this website, you must agree to the following: </p> <p> These terms of use are a contract between you and/or your employer (if any), and Lawriter, LLC. </p> <p> You agree that you will not copy, print, or download anything from this website for any commercial use. </p> <p> You agree not to use any web crawler, scraper, or other robot or automated program or device to obtain data from the website.</p> <p> You agree that you will not sell, will not license, and will not otherwise make available in exchange for anything of value, anything that you download, print, or copy from this site.</p> <p> You agree that you will not copy, print, or download any portion of the regulations posted on this site exceeding a single chapter of regulations for sale, license, or other transfer to a third party, except that you may quote a reasonable portion of the regulations in the course of rendering professional advice.</p> <p> If you violate this agreement, or if you access or use this website in violation of this agreement, you agree that Lawriter will suffer damages of at least $20,000. </p> <p> THIS WEBSITE AND ITS CONTENT ARE PROVIDED "AS IS." 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If you are an entitled government entity pursuant the Georgia Administrative Procedures Act, <a target="_new" href="http://links.casemakerlegal.com/states/GA/books/Code_of_Georgia/browse?ci=25id=gasos&amp;codesec=50-13-7&amp;title=50&amp;#50-13-7(d)">O.C.G.A.§ 50-13-7(d)</a> contact the State of Georgia's Administrative Procedures Division at 678-364-3785 to enable these features for your location.)</p> <p>To access this website, you must agree to the following: </p> <p> These terms of use are a contract between you and/or your employer (if any), and Lawriter, LLC. </p> <p> You agree not to use any web crawler, scraper, or other robot or automated program or device to obtain data from the website. </p> <p> You agree that you will not sell or license anything that you download, print, or copy from this website.</p> <p> THIS WEBSITE AND ITS CONTENT ARE PROVIDED "AS IS." 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Section <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=34-9-133&amp;title=34#" target="_newtab">34-9-133</a>.</P> <h2><a href="/GAC/120-2-38-.02" name="120-2-38-.02" title="120-2-38-.02">Rule 120-2-38-.02 Purpose</a></h2> <P>The purpose of this Regulation is:</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.02(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> to approve a workers' Compensation insurance plan which will provide a method for the apportionment on a pro rata basis, among all Insurers writing insurance providing workers' compensation benefits, of any rejected workers' compensation application, including vendors who provide logging services to a named insured or covering an association of such vendors;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.02(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> to establish separate categories of risk rejected for: insufficient prior workers' compensation experience, factors other than workers' compensation loss experience, and poor workers' compensation experience;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.02(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> to provide for operating procedures to implement the Plan; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.02(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> to authorize an Administrator to administer the workers compensation insurance plan approved in this Regulation.</td> </tr> </table> <h2><a href="/GAC/120-2-38-.03" name="120-2-38-.03" title="120-2-38-.03">Rule 120-2-38-.03 Applicability and Effective Date</a></h2> <P>Upon its effective date, this Regulation shall apply to all Insurers authorized to write insurance providing workers' compensation benefits in the State of Georgia, except those statutorily exempted in Titles 33 or 34 of the Official Code of Georgia Annotated.</P> <h2><a href="/GAC/120-2-38-.04" name="120-2-38-.04" title="120-2-38-.04">Rule 120-2-38-.04 Definitions</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Administrator" means the Plan Administrator for the State of Georgia.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Commissioner" means the Commissioner of Insurance of the State of Georgia.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Carrier" or "Insurer" means any insurance Company authorized to write workers' compensation benefits in the State of Georgia.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Assigned Carrier" means a carrier to whom a workers' compensation insurance application made under the provisions of this Regulation has been assigned.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Servicing Carrier" means a carrier, other than a Direct Assignment Carrier, which is charged with issuing and servicing the workers' compensation insurance policy for Risks assigned under the provisions of this Regulation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Direct Carrier" or Direct Assignment Carrier" means a carrier, other than a Servicing Carrier, that has elected and been authorized to receive, through direct assignment, without participation in the Pool, workers' compensation insurance policies assigned under the provisions of this Regulation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Pool" means the National Workers' Compensation Reinsurance Pool.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Licensed Producer" means a person properly licensed to negotiate or sell workers' compensation insurance in the State of Georgia.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(9)">(9)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Plan" means the Georgia Workers' Compensation Assigned Risk Insurance Plan.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(10)">(10)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Rejections" or "Declinations" means written refusals from four Insurers duly authorized to write workers' compensation insurance in State of Georgia, or where the Licensed Producer for the Applicant confirms, in writing, to the four Insurers a refusal to insure the applicant.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(11)">(11)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Risk" means an insured to which the Plan applies.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(12)">(12)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Group 1" means Risks which have insufficient prior workers' compensation experience to be experience rated.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(13)">(13)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Group 2" means Risks which are not Group 1 or Group 3 Risks.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(14)">(14)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Group 3" mens Risks which have an experience rating modification greater than 1.0.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.04(15)">(15)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Involuntary Rates" means Plan rates.</td> </tr> </table> <h2><a href="/GAC/120-2-38-.05" name="120-2-38-.05" title="120-2-38-.05">Rule 120-2-38-.05 Approved by Insurance Commissioner</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.05(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Plan which is set forth in this Regulation is approved as the method used in the State of Georgia to apportion on a pro rata basis any workers' compensation Risk which has been rejected.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.05(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Commissioner shall be the final authority in all matters relating to the interpretation and enforcement of this Chapter, except insofar as his orders may be reversed or modified by the courts.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.05(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If within thirty (30) days of a request or order the Administrator fails to submit an acceptable plan or if at any time fails to submit necessary or suitable amendments thereto, the Commissioner shall promulgate such plan consistent with the Regulation.</td> </tr> </table> <h2><a href="/GAC/120-2-38-.06" name="120-2-38-.06" title="120-2-38-.06">Rule 120-2-38-.06 Administration of Plan</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.06(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrator of the Plan shall be appointed by the Commissioner of Insurance of the State of Georgia and shall be removable at the discretion of the Commissioner.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.06(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrator shall file, in such form as is acceptable to the Commissioner, operating rules, procedures and guidelines for the operation of the Plan. The Commissioner shall approve such reasonable operating rules, procedures and guidelines as are necessary or advisable to effectuate the provisions of this Regulation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.06(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The operating rules, procedures or guidelines for the operation of the Plan may include a provision for one or more Carriers to assume the duties of issuing and servicing workers' compensation insurance policies written in accordance with this Plan. Such provision, however, shall not relieve any Carrier of its obligations under this Plan nor affect any allotment of assignments made hereunder.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.06(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrator shall file with the Commissioner for prior approval all administrative fees it intends to collect for administering and servicing Plan business. This shall be submitted by October 1st for the upcoming year. For purposes of this subsection, administrative fees are defined as any revenue collected by the Administrator involving Plan business including, but not limited to, company assessments, service fees, interest, inspection reports fees, experience rating worksheets fees, survey fees, agency based fees, computer service fees, and amounts collected from the sale of reports, filings or publications using Georgia Workers' Compensation Assigned Risk data. <P>On or before April 1 of each year, the Administrator shall submit a report to the Commissioner for the prior calendar year detailing all administrative fees actually collected.</P> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.06(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrator shall establish eligibility criteria and written performance standards for Assigned Carriers, subject to the Commissioner's approval. The Commissioner may designate the Administrator to conduct a Servicing Carrier bid process or other method of selecting Servicing Carriers and establishing the Servicing Carrier allowance at his discretion. Any contract issued between the Administrator and the Servicing Carrier shall not contain any language that could circumvent or limit the Commissioner's authority in terminating Servicing Carriers for cause.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.06(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any Carrier interested in becoming a Direct Assignment Carrier shall submit an application annually to the Commissioner for approval. The Commissioner may establish eligibility criteria for Carriers applying to qualify for Direct Assignment status. Direct Assignment Carrier will be required to adhere to the same performance standards and rules established by the Plan. Any Direct Assignment Carrier not complying with Plan performance standards or rules may be terminated by the Commissioner with thirty (30) days notice. The Administrator, at least every three years, or more often if warranted, shall perform a performance audit to ensure compliance with the above conditions.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.06(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrator shall submit to the Commissioner on a quarterly basis or annual basis depending on the nature of the report, true and correct copies of any performance audits conducted by or on behalf of the Administrator on Assigned Carriers.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.06(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrator shall file, on a quarterly basis, a list of all assignments made. Such list shall include the Carrier's name and indicate whether servicing or direct, the name and address of the assigned Risk, original effective date of coverage, expiration date, experience modification factor, governing class, state premium and the Risk identification number.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.06(9)">(9)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any and all information collected by the Administrator, including but not limited to policyholder information, workers' compensation insurance data, statistical data, and information resulting from the use of such data, in manual and automated form, shall be provided to the Commissioner upon request in a format prescribed by the Commissioner and shall be and remain the property of the State of Georgia.</td> </tr> </table> <h2><a href="/GAC/120-2-38-.07" name="120-2-38-.07" title="120-2-38-.07">Rule 120-2-38-.07 Participation in Plan</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.07(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Every Carrier authorized to write insurance providing workers' compensation benefits in the State of Georgia, which has not been statutorily exempted in Titles 33 or 34 of the Official Code of Georgia Annotated, shall fully participate in the Plan and comply with all rules, procedures and guidelines of the Administrator as a condition of the Carrier's authority to transact insurance in the State of Georgia. This shall include any employers' liability insurance written in connection with worker's compensation benefits.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.07(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All assignments under this plan are to be made on an intrastate basis. Distribution of assignments among the Carriers in the State of Georgia shall be made in proportion to each Carrier's share of the total net direct workers' compensation and employers' liability premium in such state, so far as practicable.</td> </tr> </table> <h2><a href="/GAC/120-2-38-.08" name="120-2-38-.08" title="120-2-38-.08">Rule 120-2-38-.08 Rates, Rating Plans, Rating Systems, Underwriting Rules and Policy Forms for Plan</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The rates, rating plans, rating systems, underwriting rules and policy forms used in connection with the Plan shall be the rates, rating plans, rating systems, underwriting rules and policy forms filed by the Administrator and approved by the Commissioner.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrator shall maintain necessary ratemaking data in order to permit the actuarial determination of rates and rating plans appropriate for the business insured through the Plan, shall monitor both rate adequacy and Plan results, and shall notify the Commissioner if excessive losses are indicated to enable the Commissioner to take corrective action.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The intended purpose of this section is to provide rates in the Plan that are adequate, not excessive and not unfairly discriminatory and which will allow the Plan to operate as a self-funded mechanism.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> For Plan policies with effective dates on or after January 1, 1996, the Commissioner shall approve and implement a plan which establishes rates adequate to eliminate any Plan operating deficit by January 1, 1999. In this Plan, the Commissioner shall also consider expense saving items which may improve the operating results of the Plan.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any Plan operating deficit generated from Plan policy years prior to January 1, 1996 shall not be passed along to current or future Plan policy holder. Any such deficit shall be fulfilled pursuant to the plan of operation in effect at that time.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrator shall include necessary ratemaking data in each rate filing with the Commissioner to sufficiently support such filing. This shall include information concerning loss development and trend, expenses, and investment income. The Administrator shall also, upon request, provide any other information needed to assist the Commissioner in his review of each rate filing.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The following system of credits shall be granted by the Administrator against assessment or participation of Insurers in the Plan for the voluntary writing of a Risk whose immediate prior Insusrer for a period of at least one year was the Plan. The system of credits shall apply for a period of time specified in the Administrator's filing and approved by the Commissioner: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(7)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> For policies with an annual premium of $7,500 or less, a credit of four times the amount of such annual premium;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(7)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> For policies with an annual premium of at least $7,501, but not exceeding $15,000, a credit of three times the amount of such annual premium;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(7)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> For policies with an annual premium of at least $15,001, but not exceeding $25,000, a credit of two times the amount of such annual premium;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(7)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> For policies with an annual premium of at least $25,001, but not exceeding $200,000, a credit of one and one-half times the amount of such annual premium; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(7)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> For policies with an annual premium of $200,001 or greater, a credit of the amount of such annual premium.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.08(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Commissioner shall annually submit a report to the General Assembly. To assist the Commissioner in this responsibility, the Administrator shall provide, by September 1 of each year, estimated Plan operating surpluses or deficits, Plan premium and size distributions, results of the three tier rating program, effect of the Servicing Carrier remedial program, results of Servicing Carrier incentives and disincentives, and any other information that the Commissioner deems necessary to evaluate the Plan.</td> </tr> </table> <h2><a href="/GAC/120-2-38-.09" name="120-2-38-.09" title="120-2-38-.09">Rule 120-2-38-.09 Georgia Workers' Compensation Assigned Risk Insurance Plan</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An employer, including a vendor who provides logging services to a named entity or an association of such entities, or a self-insurer who is in good faith entitled to insurance as defined in subparagraph (1)(b) below, required under workers' compensation laws, state and federal, and who has been unable to secure such insurance (and has four Rejections and/or Declinations as defined in <a title="120-2-38-.04" href="120-2-38-.04">120-2-38-.04</a> ) may make an application to the Plan. <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An application for insurance shall be made with the Administrator by the employer or his representative, in a format provided by the Administrator and approved by the Commissioner. Within seventy-five (75) days preceding the date of application, the applicant must have applied for workers' compensation insurance and been rejected as defined in <a title="120-2-38-.04" href="120-2-38-.04">120-2-38-.04</a>. The employer or its representative shall maintain on record for this policy period the Insurer name, contact person, address, phone number and date of contact and make such information available to the Administrator or Assigned Carrier upon request.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Good Faith will be presumed in the absence of evidence to the contrary. An employer is not in good faith entitled to insurance if any of the following circumstances exist at the time of application or thereafter, or other evidence exists that such employer is not in good faith entitled to insurance: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(1)(b)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> At the time of application, a self-insured employer is aware of pending bankruptcy proceedings, insolvency, cessation of operations or conditions that would probably result in occupational disease or cumulative injury claims from exposures incurred while the employer was self-insured.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(1)(b)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> The employer, while insurance is in force, knowingly refuses to meet reasonable health, safety, or loss control requirements; does not allow reasonable access to the Insurer for audit or inspection under the policy; or does not comply with any other policy obligations.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(1)(b)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> The employer has an outstanding workers' compensation insurance premium obligation to an Assigned Carrier that is not subject to a bona fide dispute.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(1)(b)4.">4.</a></td> <td valign="top" style="text-align:left" class="leftalign"> The employer, its representative, or the Licensed Producer knowingly fails to comply with Plan rules or procedures; or knowingly makes a material misrepresentation on the application by omission or otherwise.</td> </tr> </table> </td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Upon receipt of the completed application, the Administrator shall assign the Risk to an Assigned Carrier, furnishing such Assigned Carrier with the application and any classification and rating data which may be available.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Coverage may be bound under the Plan consistent with the Plan rules in accordance with the following procedures: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(3)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> At least annually, the Commissioner shall evaluate procedures for binding coverage, as described hereunder, to determine if each of the methods of binding described herein is viable;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(3)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Issues to be considered shall include the comparative usage among the methods, the cost of maintaining any one method, and the effect of discontinuance of a method on employers;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(3)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If the Commissioner deems any one method not to continue to be viable, the Commissioner shall have the authority to delete any such method as an authorized method of binding coverage. <P>Except as indicated on the binder/verification page, all assignments under this Plan are to be made on an intrastate basis. However, any employer desiring insurance for operations in states other than those covered by its Assigned Carrier may request its Assigned Carrier to furnish insurance in the additional states, subject to the rules of the Plan, including the operating rules and procedures.</P> </td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A requested effective date may be secured consistent with Plan rules in accordance with the following procedures: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(4)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The employer or its representative shall forward an application to be Administrator using one of the submission methods established by the Administrator. The employer or its representative may request an effective date not later than seventy-five (75) days from the date of application; however, such requested effective date shall be the later of the following options: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(4)(a)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> 12:01 a.m. on the date following receipt by the Administrator of a complete and eligible application,</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(4)(a)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> the date of expiration of existing coverage, or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(4)(a)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> a date the employer requested. <P>If the Licensed Producer forwards via U.S. mail a signed application to the Administrator with a check payable to the Administrator for the estimated annual or initial deposit premium, coverage will be bound at 12:01 a.m. on the day following the postmark time and date on the envelope in which the application is mailed, including the estimated annual or deposit premium, or the expiration of existing coverage. If U.S. mail is used and/or there is no postmark, or if the application does not contain the required information as described in the Plan rules, provisions for securing a requested effective date as stated above and rules for binding coverage as stated in paragraph (5) below shall apply. The Administrator shall apply all rules in securing an effective date of coverage equally, no matter what method of submission the employer or its representative chooses.</P> </td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(4)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Subject to the review by the Assigned Carrier, employers who were formerly self-insured shall secure a requested effective date no later than 12:01 a.m. ninety (90) days following receipt by the Administrator of a complete and eligible application.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(4)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Upon receipt of the application, the Administrator shall review said application for eligibility and completeness. The Administrator may request additional information at his/her discretion to establish eligibility. The employer and/or its representative shall provide such information/documentation, or provide an acceptable explanation for failure to provide the requested items within the time frame established by the Administrator. Incomplete applications received by the Administrator may, at the discretion of the employer or its representative, be retained by the Administrator pending receipt of further information. Failure to comply in a timely manner with a request from the Administrator may result in the rejection of the application.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(4)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> After the application has been reviewed and eligibility has been determined, the Administrator shall calculate the total and deposit premium and inform the employer, its representative, or the Licensed Producer of the applicable premium, using the submission options identified by the Administrator.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Coverage may be bound under the Plan consistent with Plan rules in accordance with the following procedures: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(5)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Licensed Producer or employer must submit the total required deposit premium to the Administrator using one of the submission methods established by the Administrator. The required deposit premium must be received within the time frame established by the Administrator in order for coverage to be bound on the requested effective date.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(5)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The effective date on the binder will be the secured effective date as secured under paragraph (4) above, only if all of the following occur: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(5)(b)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> the Administrator is in receipt of a complete signed application within the established time frame,</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(5)(b)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> the applicant is deemed eligible, and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(5)(b)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> the total deposit premium has been received by the Administrator within an established time frame.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(5)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Coverage will not be bound by the Administrator without a complete signed application and receipt of the appropriate deposit premium. The binder/verification page shall be sent to the appropriate parties as required and shall remain in effect until canceled or a policy has been issued. In accordance with Plan procedures, coverage shall not exist if a binder was not issued.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If, after the issuance of a policy, the Assigned Carrier determines that an employer is not entitled to insurance, has failed to comply with reasonable health, safety, and loss control requirements, or has violated any of the terms and conditions under which the insurance was issued, and after providing opportunity for cure, the Assigned Carrier shall initiate cancellation and inform the Administrator and appropriate state organization of the reason for such cancellation. Any insured employer so cancelled must reestablish eligibility or must demonstrate entitlement to the Administrator before any further assignment can be made under this Plan.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All Risks to which this Plan applies shall be written utilizing the classifications, forms, rates and rating plans, and data filed by the Administrator and approved by the Commissioner.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any Risk or Carrier may appeal to the Georgia Workers Compensation Appeals Board if it does not agree with the established classification, rates, rules, rating data, or rating plans. The decision of the Board may be appealed to the Commissioner.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(9)">(9)</a></td> <td valign="top" style="text-align:left" class="leftalign"> At least forty-five (45) days prior to the expiration date of insurance, the Assigned Carrier shall send a renewal proposal to the insured, Licensed Producer and the Administrator. The renewal proposal shall include the dollar amount of any premium increase in excess of 15% which results from a change in rates in compliance with O.C.G.A. <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-24-47&amp;title=33#" target="_newtab">33-24-47</a>. Upon receipt of the required premium, the policy shall be issued in the normal manner and a copy of such poliy and all endorsement properly stamped "Georgia Workers' Compensation Assigned Risk Insurance Plan", furnished to the Administrator. The Carrier shall be credited with the premium for such renewal insurance.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(10)">(10)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any Assigned Carrier terminating, either by non-renewal or by cancellation, a Risk assigned to it shall notify the Risk and the Administrator in accordance with the provisions of O.C.G.A. <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-24-47&amp;title=33#" target="_newtab">33-24-47</a>.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(11)">(11)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If any Risk is dissatisfied with its Assigned Carrier, the Risk may request reassignment upon expiration date.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(12)">(12)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any Carrier who wishes to insure a Risk as direct business may do so at any time provided that the Assigned Carrier shall not directly or indirectly request, encourage, or solict employers it insures under the Plan to utilize the services of any specific insurance agent, agency, broker or Insurer for purposes of providing voluntary workers' compensation insurance or other lines of insurance to such employer. If the Risk is taken out of the Plan, it shall be canceled on a pro-rata basis. The replacement Carrier shall receive the take-out credits provided for in this regulation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(13)">(13)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The commission paid to a Licensed Producer shall be based on the following percentages of the total premium charged and collected: eight (8%) percent for the first $1,000 in premium, five (5%) percent for the next $4,000, three (3%) percent for the next $95,000 and two (2%) percent for that portion of the premium over $100,000. However, if the employer designates a representative other than a Licensed Producer, the representative shall be deemed the Licensed Producer of record for all policy matters other than for payment of producer fee. <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(13)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The employer may designate a Licensed Producer, and with respect to any renewal of the assigned insurance, may change the designated Licensed Producer by notice to the Assigned Carrier.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(14)">(14)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Assigned Carrier shall complete a final audit and bill for any additional premium or refund excess premiums paid during the policy year within 90 (ninety) calendar days of policy expiration or cancellation. <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(14)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign">120-2-38.09(1) shall not apply when the Carrier can demonstrate to the satisfaction of the Commissioner that attempts were made in good faith to secure the relevant information from the Risk. In order for the Commissioner to allow an extension of the audit period, the Assigned Carrier must demonstrate to the Commissioner that the insured is not cooperative or that an extension is the result of a mutual agreement between the Carrier and the insured. <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(14)(a)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> An Assigned Carrier may request an extension of the audit period by making application to the Commissioner. In order for the Commissioner to consider a request for extension, the application must be received by the Commissioner within 95 calendar days of the expiration or cancellation of the policy. The application must contain documentation of all attempts made by the Assigned Carrier to secure the relevant information. The application must also contain evidence that the employer has not been cooperative.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(14)(a)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Receipt of an application for an audit extension by the Commissioner within 95 days will preserve the Assigned Carrier's right to any additional premium due as the result of the final audit, if the application is not subsequently disapproved by the Commissioner.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(14)(a)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> No application is required if an extension of the audit period is the result of a mutual agreement between the Carrier and the insured. The Carrier shall properly document their records with evidence that the extension was mutually agreed upon.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(14)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Neither the Assigned Carrier nor the Administrator shall demand an additional premium resulting from an audit if the audit was not conducted in accordance with this regulation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(14)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrator shall submit procedures including a standard application for audit extensions or a plan of operation to ensure compliance, and provide procedures to apportion write-offs for audits not conducted in accordance with this Regulation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(14)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Failure of the Assigned Carrier to conduct the audit within ninety (90) days or within an extended period approved by the Commissioner shall not relieve the Carrier from the duty to refund an excess premium.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(14)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrator shall file a policy or endorsement(s) which conforms with subparagraph (14) above.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(15)">(15)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Proper classification of Risk and proper allocation of payroll shall be the duty of the Administrator or the Assigned Carrier.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(16)">(16)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrator or the Assigned Carrier shall categorize Risks written in accordance with this regulation. <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(16)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Manual rates for Groups 1, 2 &amp; 3 shall be determined by applying a deviation factor for each group to Involuntary Rates.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(16)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All Risks written with an effective date prior to the effective date of this regulation shall be properly categorized upon the first renewal following the effective date of this regulation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(16)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Administrator shall file the deviation factors and applicable rules mandated by this regulation upon its effective date.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)">(17)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Assigned Carrier shall verify with the Risk the data to be submitted to the Administrator who shall determine the experience modification factor. Verification of such data shall be accomplished in accordance with this regulation: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Assigned Carrier shall provide the Risk with a copy of the statistical data being submitted to the Administrator. The statistical data shall be presented in a legible and understandable format. Technical terms shall be avoided wherever possible. It shall be permissible for the Insurer to provide the unit statistical report, by whatever name called, in lieu of an independently created form, provided the unit statistical report is accompanied by a legible and understandable explanation of the format of the unit statistical report.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The disclosure statement contained in Form GID-63 attached hereto and incorporated herein, or one substantially the same, shall be attached to the statistical data provided to the Risk. <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(b)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> The disclosure shall provide a statement in bold face type, to be signed by an authorized representative of the Risk, that the statistical data has been reviewed and is accurate, and a representative of the Assigned Carrier has explained to the Risk's representative that the statistical data may affect the Risk's premium for the Plan.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(b)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> The disclosure shall indicate that the statistical data will be deemed accurate if the disclosure is not returned to the address provided by the Assigned Carrier within 30 days from the date mailed. <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(b)2.(i)">(i)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Assigned Carrier shall deliver the statistical data and disclosure in person or by depositing the information in the United States mail to be dispatched by at least first-class mail to the last address of record of the Risk, and receiving the receipt provided by the United States Postal Service or such other evidence of mailing as prescribed or accepted by the United States Postal Service.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(b)2.(ii)">(ii)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Statistical data that is deemed to be accurate will not in any way affect the right of the Risk to appeal to the Georgia Workers' Compensation Appeals Board.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(b)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> The disclosure shall also provide a statement for an authorized representative of the Risk to dispute the accuracy of the data. The statement shall direct the Risk to clearly identify any discrepancies. The disputed data shall be furnished to the Assigned Carrier by the return date indicated on the disclosure statement. <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(b)3.(i)">(i)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If the Assigned Carrier confirms the accuracy of the information provided by the Risk, the designated Carrier shall correct their records and proceed to furnish the amended data to the Administrator.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(b)3.(ii)">(ii)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If the Assigned Carrier does not agree with the data provided by the Risk, the designated carrier shall submit the Carrier's date to the Administrator, <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(b)3.(ii)(I)">(I)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Assigned Carrier shall notify the Risk within 60 days of the original mail date that the experience modification factor will be promulgated from the information provided by the Assigned Carrier.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(b)3.(ii)(II)">(II)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Risk shall be instructed, in detail, of its right to appeal to the Georgia Workers' Compensation Appeals Board.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(b)3.(ii)(III)">(III)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Failure to respond to the Risk in the time prescribed shall be deemed an acknowledgement that the insured's records are accurate, and amendments are to be made before reporting the statistical data to the Assigned Carrier.</td> </tr> </table> </td> </tr> </table> </td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(17)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Verification of data shall not be mandatory for insureds who are not eligible for experience rating; however, the data and explanation shall be furnished to insureds upon request.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(18)">(18)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Assigned Carriers shall provide the same type or level of services to Plan policyholders that it would to its voluntary business.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-38-.09(19)">(19)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Assigned Carriers shall provide cooperation to Plan policyholders wanting to implement safety programs. No Plan policyholders shall be denied a safety program or loss control program if so requested; provided, however, the Assigned Carrier shall only be obligated to provide such services that are reasonably commensurate with the exposures, hazards, loss experience and size of the policyholder's operations.</td> </tr> </table> <h2><a href="/GAC/120-2-38-.10" name="120-2-38-.10" title="120-2-38-.10">Rule 120-2-38-.10 Penalties</a></h2> <P>Any Carrier or Administrator failing to comply with the requirements of this Regulation shall be subject to such penalties as prescribed in O.C.G.A. Chapters 33-2 and 33-3.</P> <h2><a href="/GAC/120-2-38-.11" name="120-2-38-.11" title="120-2-38-.11">Rule 120-2-38-.11 Severability</a></h2> <P>If any provision of this Regulation or the application thereof to any person or circumstance is held invalid by a court of competent jurisdiction, the remainder of the regulation or the applicability of such provision to other persons or circumstances shall not be affected thereby.</P> </div> </div> </HTML> </div> <div id="toc" class="sidebar noprint"> <ul id="toc-children" class="children"><li><a href="/GAC/120-2-38-.01" name="120-2-38-.01" title="120-2-38-.01">Rule 120-2-38-.01 Authority</a></li><li><a href="/GAC/120-2-38-.02" name="120-2-38-.02" title="120-2-38-.02">Rule 120-2-38-.02 Purpose</a></li><li><a href="/GAC/120-2-38-.03" name="120-2-38-.03" title="120-2-38-.03">Rule 120-2-38-.03 Applicability and Effective Date</a></li><li><a href="/GAC/120-2-38-.04" name="120-2-38-.04" title="120-2-38-.04">Rule 120-2-38-.04 Definitions</a></li><li><a href="/GAC/120-2-38-.05" name="120-2-38-.05" title="120-2-38-.05">Rule 120-2-38-.05 Approved by Insurance Commissioner</a></li><li><a href="/GAC/120-2-38-.06" name="120-2-38-.06" title="120-2-38-.06">Rule 120-2-38-.06 Administration of Plan</a></li><li><a href="/GAC/120-2-38-.07" name="120-2-38-.07" title="120-2-38-.07">Rule 120-2-38-.07 Participation in Plan</a></li><li><a href="/GAC/120-2-38-.08" name="120-2-38-.08" title="120-2-38-.08">Rule 120-2-38-.08 Rates, Rating Plans, Rating Systems, Underwriting Rules and Policy Forms for Plan</a></li><li><a href="/GAC/120-2-38-.09" name="120-2-38-.09" title="120-2-38-.09">Rule 120-2-38-.09 Georgia Workers' Compensation Assigned Risk Insurance Plan</a></li><li><a href="/GAC/120-2-38-.10" name="120-2-38-.10" title="120-2-38-.10">Rule 120-2-38-.10 Penalties</a></li><li><a href="/GAC/120-2-38-.11" name="120-2-38-.11" title="120-2-38-.11">Rule 120-2-38-.11 Severability</a></li></ul> </div> </div> <!--content ends here--> <div id="footer" class="noprint"><span class="footer">Copyright &copy; 2019 Lawriter LLC - All rights reserved.</span>| <a href="mailto:support@casemakerlegal.com?subject=Rules and Regulations of the State of Georgia">Email Us</a> | 844-838-0769 | <a href="http://livechat.casemakerlegal.com/client.php?locale=en" target="_blank" onclick="if(navigator.userAgent.toLowerCase().indexOf('opera') != -1 && window.event.preventDefault)window.event.preventDefault();this.newWindow = window.open('http://livechat.casemakerlegal.com/client.php?locale=en&url='+escape(document.location.href)+'&referrer='+escape(document.referrer), 'webim','toolbar=0,scrollbars=0,location=0,status=1,menubar=0,width=640,height=480,resizable=1');this.newWindow.focus();this.newWindow.opener=window;return false;">Live Chat</a> </div> </div> </body> </html>