Florida Workers’ Compensation Regulation Developments: Application and Audit Procedures, Ombudsman Dispute Letter Changes
Dec 23, 2009
Certain developments concerning the following rules relating to Florida workers’ compensation law occurred today, December 23, 2009:
Florida Joint Administrative Procedures Council Prompts Changes to Workers’ Compensation: Application and Audit Procedures Proposed Rule
In response to concerns expressed by the Florida Joint Administrative Procedures Council, the following changes have made to proposed Rule 69O-189.003, “Workers’ Compensation: Application and Audit Procedures”:
1) The phrase “to the extent that such notarization complies with Parts I and II of Chapter 668, F.S.” was added at the end of the first sentence of 69O-189.003(2)(b) and at the end of the second sentence of 69O-189.003(2)(b).
2) In 69O-189.003(4)(b)2., “with reasonable grounds” was replaced with “unless such request is unnecessarily repetitive.”
3) In 69O-189.003(4)(b)4., “but not be limited to” was stricken.
4) 69O-189.003(4)(b)4.h. was added which reads “Any other employer records necessary to establish premium or assign classifications.”
5) 69O-189.003(4)(c)1.f. was rewritten as follows: “For all policies with a loss ratio of 120 percent or greater the first year the employer qualifies and thereafter, regardless of premium range, subject to the Florida Workers’ Compensation Joint Underwriters Association or its service provider’s determination whether such audit is unnecessarily repetitive;”
6) In 69O-189.003(4)(c)1.g., the phrase “on reasonable grounds” was replaced with “unless such request is unnecessarily repetitive”.
7) In 69O-189.003(4)(c)1.h., “in” was replaced with “by”; “judgment by” was replaced with “evaluation of”; and the phrase “or by questions concerning” was stricken.
8) In 69O-189.003(4)(c)3., “but not be limited to” was stricken.
9) 69O-189.003(4)(c)3.h. was added which reads “Any other records necessary to establish premium or assign classifications.”
The remainder of the proposed Rule reads as previously published. To view the text, click here.
The Florida Financial Services Commission is required by law to issue public notices regarding workers’ compensation coverage application, payroll audit and worker classification Rules. In 2008, the National Council on Compensation Insurance (“NCCI”) filed a proposal for a Rule addressing these matters with the OIR.
Based on the NCCI proposal, the proposed Rule would allow electronic signatures in the application for workers’ compensation coverage and in the annual audit, as long as the electronic signature process complies with Florida’s Uniform Electronic Transaction Act. While the current Rule incorporates certain NCCI publications by reference, the proposed Rule explicitly provides certain audit procedures.
The proposed Rule also would raise the threshold for an on-site audit from $5,000 to $10,000. Any audit for under $10,000 would be handled by mail to save costs for both the employer and insurance carrier.
A final public hearing on proposed Rule 69O-189.003 has been scheduled for January 26, 2010 at 9:00 a.m. during a regular meeting of the Florida Cabinet. To view the meeting notice, click here.
New Florida Workers’ Compensation Employee Assistance and Ombudsman’s Office Dispute Letter Must Be Used After April 1, 2010
Technical changes to Rule 69L-26.004, F.A.C. requested by the Florida Division of Workers’ Compensation (“Division”) recently were approved.
Rule 69L-26.004 establishes that injured workers, or any other party to a dispute involving a workers’ compensation issue, must contact and request assistance from the Division’s Bureau of Employee Assistance and Ombudsman’s Office (“EAO”), as well as make a good faith effort to participate in the informal dispute resolution proceedings of the EAO.
A request for assistance will be accepted by the EAO and constitute contact with the EAO only if it is submitted on a completed Request for Assistance form (EAO-1) and is otherwise in compliance with these Rules.
In order to facilitate a Request for Assistance, employers or carriers must provide a notice that is commonly known as the “Employee Notification Letter” within three days as required by law.
A new “Employee Notification Letter” is posted on the Division’s website at the following address: http://www.myfloridacfo.com/WC/publications.html. Employers and carriers must begin using this letter on, or before April 1, 2010.
The technical changes to Rule 69L-26.004, F.A.C. include corrections in statutory citations, updates to Division web addresses and the addition of an e-mail address for contacting the EAO.
Should you have any comments or questions, please contact Colodny Fass.
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