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<chapter num="09" heading="Group Self-Insurance for Workers' Compensation" title_num="31" subtitle_num="08">
  <regulation prefix="Regulation" num=".01" heading="Scope.">
    <text>This chapter applies only to workers' compensation self-insurance groups (“group” or “groups”) organized pursuant to Insurance Article, Title 25, Subtitle 3, Annotated Code of Maryland, and not to groups organized pursuant to Labor and Employment Article, §9-402(a), Annotated Code of Maryland.</text>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Definitions.">
    <paragraph num="A.">
      <text>All terms defined in Insurance Article, Title 25, Subtitle 3, Annotated Code of Maryland, which are used in this chapter have the same meaning as in Insurance Article, Title 25, Subtitle 3, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Insolvent” or “insolvency” means the inability of a group to pay its outstanding lawful obligations as they mature in the regular course of business as may be shown either by an excess of its required reserves and other liabilities over its assets or by its not having sufficient assets to reinsure all of its outstanding liabilities after paying all accrued claims owed by it.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Net premium” means premium derived from standard premium adjusted by any advance premium discounts.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Standard premium” means the premium derived from the pure loss manual rate adjusted by the expense factors and by experience modification factors, but before advance premium discounts.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Incorporation by Reference.">
    <text>The Basic Manual for Workers' Compensation and Employees Liability Insurance (2001 Edition), published by the National Council on Compensation Insurance (NCCI) is incorporated by reference.</text>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Business and Industry Classifications.">
    <paragraph num="A.">
      <text>A group may be formed only by employers who are engaged in the same or a similar type of business or who are members of the same bona fide trade or professional association which has been in existence for not less than 5 years.</text>
    </paragraph>
    <paragraph num="B.">
      <text>For the first 5 years of its existence or until such time as the self-insured group's experience is such that its data becomes fully credible, a group shall classify employees as set forth in the Basic Manual for Workers' Compensation and Employees Liability Insurance (2001 Edition), published by the National Council on Compensation Insurance (NCCI).</text>
    </paragraph>
    <paragraph num="C.">
      <text>If the group submits justification to the Commissioner showing that it has fully credible data from which a change in classification could be supported from an actuarial perspective and what the deviation from the NCCI classification would be and the Commissioner approves same, then the group may use such classifications.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Minimum Premium Amounts.">
    <paragraph num="A.">
      <text>During a group's first year of operation it shall have an annual premium of at least $500,000, all of which shall have been paid to the group not later than the end of the ninth month of the group's first year of operation.</text>
    </paragraph>
    <paragraph num="B.">
      <text>For each year after the first year of operation, the annual premium shall be at least $500,000 unless the Commissioner determines that a greater amount is required based on the Commissioner's examination of the group's annual statement of financial condition.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Surety Bonds.">
    <paragraph num="A.">
      <text>Each group shall obtain and maintain a surety bond for the protection of group members and their employees in an amount not less than $500,000 unless the Commissioner specifies a different amount.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The Commissioner may, in the Commissioner's discretion, waive the requirement of §A of this regulation and permit a group to deposit and maintain in trust with the State Treasurer, for the protection of group members, employees and creditors, cash or government securities of the type described in Insurance Article, §5-701(b), Annotated Code of Maryland, in an amount not less than the amount specified in §A of this regulation.</text>
    </paragraph>
    <paragraph num="C.">
      <text>Each administrator and service company shall obtain a fidelity bond in an amount not less than $100,000, and a performance bond in an amount not less than $50,000, before providing services to a workers' compensation self-insurance group.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Excess Insurance Coverage.">
    <paragraph num="A.">
      <text>Each group shall maintain excess insurance coverage in an amount not less than $1,000,000 per occurrence and not less than $5,000,000 in the aggregate over a commercially available and reasonable attachment point subject to review of the Commissioner.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A group shall send a copy of its excess insurance policy to the Commissioner in the following circumstances:</text>
      <paragraph num="(1)">
        <text>Within 60 days of the renewal or replacement of an existing policy unless, within 90 days after its inception date, such policy will be provided to the Commissioner pursuant to §B(3) of this regulation;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Within 60 days of an amendment to an existing policy unless, within 90 days after its inception date, such amended policy will be provided to the Commissioner pursuant to §B(3) of this regulation;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Annually as provided in COMAR 31.08.09.13B; or</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Upon request of the Commissioner.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>The Commissioner may, in the Commissioner's discretion, take the following actions by notifying the group in writing:</text>
      <paragraph num="(1)">
        <text>Increase the minimum amount of excess insurance coverage to assure adequacy of coverage for each group; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Require the group to obtain and maintain excess coverage with a specified attachment point upon consideration of, but not limited to, the following factors relating to the group:</text>
        <paragraph num="(a)">
          <text>Size of group, that is, the number of members and premium volume;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Financial condition of group;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Group's risk versus surplus position;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Group's loss development history; and</text>
        </paragraph>
        <paragraph num="(e)">
          <text>The availability of reinsurance at specific attachment points at economically feasible rates.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>Instead of maintaining excess insurance coverage as set forth in §A of this regulation, a group may deposit and maintain in trust with the State Treasurer, cash or government securities of the type described in Insurance Article, §5-701(b), Annotated Code of Maryland, in an amount at least equal to the minimum excess insurance coverage required by §A of this regulation.</text>
    </paragraph>
    <paragraph num="E.">
      <text>A policy of excess insurance may not be recognized by the Commissioner unless the policy is:</text>
      <paragraph num="(1)">
        <text>Issued by an insurer admitted to do business in Maryland unless the Commissioner, in his discretion, allows the coverage to be placed with an approved surplus lines carrier; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Not subject to cancellation or nonrenewal for any reason except nonpayment of premium except upon 45 days notice sent by certified mail to the group and to the Commissioner.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".08" heading="Application for Certificate of Authority.">
    <paragraph num="A.">
      <text>A person or entity may not act as a workers' compensation self-insurance group except as so authorized by the Commissioner.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Application for a certificate of authority shall be made to the Commissioner on a form prescribed by him and shall include a $25 nonrefundable filing fee.</text>
    </paragraph>
    <paragraph num="C.">
      <text>The application form shall be accompanied by the following:</text>
      <paragraph num="(1)">
        <text>A list of the names of the members of the group, to include each member’s:</text>
        <paragraph num="(a)">
          <text>Corporate name;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Main business address;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>State of domicile; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Date upon which the member’s fiscal year ends;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>Proof of compliance with the requirements of these regulations;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>A copy of the group's articles of association, if any;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>A copy of agreements with the administrator and with any service company;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>A copy of the group's bylaws, which shall contain, at a minimum:</text>
        <paragraph num="(a)">
          <text>A copy of or written description of the underwriting standards for acceptance and continuance in the group;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A copy of or written description of the method for selecting the board of trustees and administrator of the group;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>A list of the members of the board of trustees and the term of office of the board of trustees; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>A copy of or written description of the method for amending the group's bylaws;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(6)">
        <text>A copy of regulations adopted by the trustees, which shall be binding on the administrator and service company and which shall contain, at a minimum:</text>
        <paragraph num="(a)">
          <text>A description of the manner in which excess funds and claim reserves shall be invested;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A description of the frequency and extent of loss control and safety engineering services provided to members of the group;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>The size of the common claim fund;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>A schedule for the collection of premiums, including a definition of “delinquent premium”;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>A copy of or written description of the membership, admission, and expulsion procedures;</text>
        </paragraph>
        <paragraph num="(f)">
          <text>A copy of or written description of the delineation of authority granted to the administrator, board of trustees, and service company; and</text>
        </paragraph>
        <paragraph num="(g)">
          <text>A copy of the procedures for handling disputes regarding premium payments by members;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(7)">
        <text>A copy of the agreement between the group and each member securing the payment of workers' compensation benefits;</text>
      </paragraph>
      <paragraph num="(8)">
        <text>A list of the initial board of trustees and administrator of the group;</text>
      </paragraph>
      <paragraph num="(9)">
        <text>The address in this State where the books and records of the group will be maintained at all times;</text>
      </paragraph>
      <paragraph num="(10)">
        <text>A financial statement on a form acceptable to the Commissioner showing the financial ability of the group to pay the workers' compensation obligations of its members;</text>
      </paragraph>
      <paragraph num="(11)">
        <text>Proof of payment to the group by each member of not less than 25 percent of that member's first year estimated annual net premium on a date prescribed by the Commissioner;</text>
      </paragraph>
      <paragraph num="(12)">
        <text>A statement outlining the guidelines used to determine the types of businesses eligible for membership in the group;</text>
      </paragraph>
      <paragraph num="(13)">
        <text>Copies of executed agreements with each member assuming joint and several liability for obligations of the group in the event of insolvency of the Self-Insurers' Guaranty Fund;</text>
      </paragraph>
      <paragraph num="(14)">
        <text>A description of the arrangements whether in-house or under contract, for handling claims; and</text>
      </paragraph>
      <paragraph num="(15)">
        <text>A report on the financial condition of each member in a format acceptable to the Commissioner, based on each member’s most recent fiscal year-end data, which shall include the following information for each member:</text>
        <paragraph num="(a)">
          <text>Total assets;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Total liabilities and net worth;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Total sales or revenues;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Net profit;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>The member’s fiscal year-end date; and</text>
        </paragraph>
        <paragraph num="(f)">
          <text>The basis for reporting the financial information, including whether the report was prepared by a certified public accountant and presented in conformity with generally accepted accounting principles.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>At the request of the Commissioner, the group shall submit additional financial information or financial statements for any or all members of the group.</text>
    </paragraph>
    <paragraph num="E.">
      <text>To obtain and maintain its certificate of authority, a group shall comply with the following requirements, as well as with any other requirements established by law or regulation:</text>
      <paragraph num="(1)">
        <text>Provide notice to the Commissioner as soon as practicable of any change in the information required to be filed under §B or C of this regulation; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Maintain combined net assets of all members of at least $1,000,000 as shown by the most recent annual financial report of one or more members, each of which is prepared by an independent certified public accountant and in conformity with generally accepted accounting principles, and submitted on behalf of the group as a whole.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".09" heading="Commissioner Attorney for Service of Process on Groups.">
    <text>Every group shall be deemed to have appointed the Commissioner its attorney to receive service of legal process issued against it in this State and this appointment shall be irrevocable, shall bind any successor in interest and shall remain in effect for so long as there is any obligation or liability of the group in this State for workers' compensation benefits.</text>
  </regulation>
  <regulation prefix="Regulation" num=".10" heading="Termination of Certificate of Authority.">
    <text>The Commissioner may not grant the request of any group to terminate its certificate of authority until the group has insured or reinsured all incurred workers' compensation obligations, including both known claims and expenses associated with them, with an authorized insurer under an agreement filed with and approved in writing by the Commissioner.</text>
  </regulation>
  <regulation prefix="Regulation" num=".11" heading="Merger of Groups.">
    <paragraph num="A.">
      <text>The Commissioner may approve a merger of groups engaged in the same or a similar type of business only if the resulting group assumes in full all obligations of the merging groups.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The Commissioner shall hold a hearing on the merger, pursuant to Insurance Article, §§2-203 and 2-210—2-214, Annotated Code of Maryland, if requested to do so by a member of either group.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".12" heading="Fiscal Examinations.">
    <paragraph num="A.">
      <text>The Commissioner may make an examination of the affairs, transactions, records, and assets of any group as often as the Commissioner deems necessary to determine the group's financial solvency and for the protection of the interest of the people of Maryland, but the examination may not be less frequent than once every 5 years.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Each group shall pay to the Commissioner an annual sum of $500 to be used to defray the cost of examinations.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".13" heading="Annual Submission of Financial Reports and Other Reports.">
    <paragraph num="A.">
      <text>On or before 90 days following the end of a group's fiscal year, each group shall submit to the Commissioner a fiscal year-end audited financial report, prepared by an independent certified public accountant, in conformity with generally accepted accounting principles, which shall be on a form prescribed by the Commissioner which shall include, but not be limited to:</text>
      <paragraph num="(1)">
        <text>Actuarially appropriate reserves for:</text>
        <paragraph num="(a)">
          <text>Known claims and expenses associated with them;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Claims incurred but not reported and expenses associated with them;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Unearned premiums; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Bad debts, for which reserves shall be shown as liabilities;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>An actuarial opinion in compliance with the current edition of the Financial Analysis Handbook published by the National Association of Insurance Commissioners and given by a member of the American Academy of Actuaries or a person who has otherwise demonstrated his or her actuarial competence to the satisfaction of the Commissioner, regarding reserves for:</text>
        <paragraph num="(a)">
          <text>Known claims and expenses associated with them; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Claims incurred but not reported and expenses associated with them.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>A copy of a group’s excess insurance policy for the current calendar year shall be submitted with the fiscal year-end audited financial report required by §A of this regulation.</text>
    </paragraph>
    <paragraph num="C.">
      <text>On or before 90 days following the end of a group's fiscal year, each group shall submit to the Commissioner a report, in a format acceptable to the Commissioner, regarding the financial condition of each member based on the member’s most recent fiscal year-end data, containing the information described in COMAR 31.08.09.08C(15). The report shall be signed by an executive officer of the group.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".14" heading="Rebates and Temporary Suspension of Member Contributions.">
    <paragraph num="A.">
      <text>Any monies for a fund year in excess of the amount necessary to fund all undiscounted losses and loss adjustment expenses for that fund year, actuarially determined by a member of the American Academy of Actuaries or a person who has otherwise demonstrated his or her actuarial competence to the satisfaction of the Commissioner, may be rebated to members of the group.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A rebate for any fund year shall be paid only to those employers who remain participants in the group for the entire fund year.</text>
    </paragraph>
    <paragraph num="C.">
      <text>Instead of rebating excess monies, a group may temporarily suspend premium contributions for a period of time calculated to result in no excess for the succeeding fund year.</text>
    </paragraph>
    <paragraph num="D.">
      <text>No rebates or suspension of premium contributions shall be made when a group is insolvent or otherwise causes the group to be considered in a financially hazardous condition pursuant to §9-102 of the Insurance Article of the Annotated Code of Maryland.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".15" heading="Prohibited Unfair Trade Practices.">
    <paragraph num="A.">
      <text>The following actions by a group are prohibited unfair trade practices and are violations of this regulation:</text>
      <paragraph num="(1)">
        <text>Excluding an employer from a group for any reason based in whole or in part upon race, color, creed, sex, or blindness of the employer or its employees, or for any arbitrary, capricious, or unfairly discriminatory reason;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Excluding an employer from a group by the application of standards which are not reasonably related to the group's economic and business purposes; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Requiring the existence of special conditions, facts, or situations as a condition to acceptance or continuance in a group of a particular employer in an arbitrary, capricious, or unfairly discriminatory manner based in whole or in part upon race, creed, color, sex, religion, national origin, place of residency, or blindness or other physical handicap or disability of the employer or its employees.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>If, after written notice and opportunity for a hearing, the Commissioner finds that a group has committed a prohibited unfair trade practice, as defined in this regulation, the Commissioner may exercise the powers conferred upon him by Insurance Article, §25-308, Annotated Code of Maryland.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Insurance Article, §§2-108, 2-109, 9-102, Title 25, Subtitle 3, and 27-501, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: December 26, 1988 (15:26 Md. R. 2982)</annotation>
    <annotation type="History" subtype="Administrative History">Chapter recodified from COMAR 09.30.73 to COMAR 31.08.09 effective September 7, 1998 (25:18 Md. R. 1439)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04 amended as an emergency provision effective October 28, 2002 (29:23 Md. R. 1809); amended permanently effective February 3, 2003 (30:2 Md. R. 76)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .05A, B amended as an emergency provision effective October 28, 2002 (29:23 Md. R. 1809); amended permanently effective February 3, 2003 (30:2 Md. R. 76)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .06A amended as an emergency provision effective October 28, 2002 (29:23 Md. R. 1809); amended permanently effective February 3, 2003 (30:2 Md. R. 76)</annotation>
    <annotation type="History" subtype="Administrative History">Chapter revised effective June 30, 2008 (35:13 Md. R. 1182)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .06A amended effective January 1, 2018 (44:4 Md. R. 256)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .07 amended effective January 1, 2018 (44:4 Md. R. 256)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .08 amended effective January 1, 2018 (44:4 Md. R. 256)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .13 amended effective January 1, 2018 (44:4 Md. R. 256)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .14A amended effective January 1, 2018 (44:4 Md. R. 256)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .14D adopted effective January 1, 2018 (44:4 Md. R. 256)</annotation>
  </annotations>
</chapter>