OAR 436-085-0030: Premium Assessment; Manner and Intervals for Payments; Experience Rating Modification Factors: Self-Insured Employers and Self-Insured Employer Groups

(1) As used in this rule, the term "self-insured employers" includes self-insured employer groups. (2) Self-insured employers must report and pay premium assessments using a completed Form 900, “Payroll and Assessment Quarterly Report - Retrospective rating plan,” or Form 937, “Payroll and Assessment Quarterly Report - Normal plan.” The report must be certified to be true and accurate by an authorized representative of the self-insured employer. (3) For premium assessment purposes, the premium of all self-insured employers will be calculated using rates developed by the director. The rates for each fiscal year will be developed by applying a multiplier determined by the director to the manual rates published by the National Council on Compensation Insurance effective and published by April 1 of the previous fiscal year. (a) The multiplier will be no greater than the average of all loss cost multipliers filed with the Division of Financial Regulation effective and filed by April 1 of the previous fiscal year, weighted by market share. (b) For the purpose of determining the multiplier, the director may consider factors including, but not limited to, the net difference between the maximum multiplier possible under subsection (a) of this section and the modifier used in the preceding fiscal year. (4) Self-insured employers may choose to have their premium calculated using either: (a) The normal method of calculation, which is manual premium modified by experience rating and premium discount; or (b) A one-year retrospective rating plan developed by the Division of Financial Regulation and approved by the director. However, any employer becoming self-insured after July 1 may not choose a retrospective rating plan for that fiscal year. (5) On or before May 31 of each year, the director will issue a bulletin notifying all self-insured employers of the premium rates and retrospective rating plans to be used in the fiscal year beginning July 1. (6) On or before July 1 of each year, a self-insured employer may change its current method of premium calculation by submitting written notification of its choice to the director. Once chosen, the method may not be changed for that fiscal year and remains in effect until the self-insured employer chooses to change the method. (7) A self-insured employer must use the normal method of premium calculation unless it has notified the director that it chooses to use a one-year retrospective rating plan. (8) A self-insured employer must report and pay premium assessment based on the self-insured employer’s premium and the premium assessment rate in effect under OAR 440-045 no later than: (a) October 31, for the quarter ending September 30; (b) January 31, for the quarter ending December 31; (c) April 30, for the quarter ending March 31; and (d) July 31, for the quarter ending June 30. (9) Premium assessment for a self-insured employer that has chosen to have its premium calculated using a retrospective rating plan must be based on 80 percent of the self-insured employer’s assessable premium until adjusted by retrospective rating. (10) All premium adjustments resulting from retrospective rating plans or payroll audits must be made using the premium assessment rate or rates in effect for the period being adjusted. (11) When retrospective rating adjustments are made to periods where more than one assessment rate applied, the adjusted premium will be prorated in direct proportion to the self-insured employer’s assessable premium for each period. Total premium assessment due for the entire period will be adjusted on the same basis. (12) The director will determine an experience rating modification factor for each self-insured employer. (a) The director will calculate experience rating modification factors using the method provided by the National Council on Compensation Insurance in the Experience Rating Plan Manual - 2003 Edition , except that the director will use only Oregon claims and payroll exposure, and will assign a policy period of July 1 through the following June 30. A copy of the Experience Rating Plan Manual - 2003 Edition is available for review during regular business hours at the Workers’ Compensation Division, 350 Winter St. NE, Salem OR 97301. (b) The self-insured employer’s authorized claims processing location(s) must provide the director with the loss information necessary to calculate the experience rating modification factor. (c) If sufficient Oregon experience is not available to calculate an experience rating modification factor based on Oregon experience only, the director will assign the self-insured employer an experience rating modification factor of 1.00. (d) If payroll information submitted by a self-insured employer is determined to be incorrect, the director may order, or the self-insured employer may request, a revision of experience rating modification factors using that data. Only payroll information reported in the last three calendar years may be corrected. The director will recalculate all experience rating modification factors previously calculated using the incorrect payroll information. (e) When the director orders an adjustment to the experience rating modification factor for a particular policy period, the adjustment will be applied retroactively to the beginning of the period. Any resulting increase in the assessment is payable on demand. Any resulting decrease may be applied against the next quarterly assessment payment. ( 13 ) The director may waive a self-insured employer’s reporting requirement on the self-insured employer’s request after confirming that the self-insured employer has had no Oregon payroll for four consecutive quarters. The waiver will remain in effect until the self-insured employer has Oregon payroll.