Rating organization - study of workers' compensation rates - premium reductions - adoption of rules.

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(1) A corporation, an unincorporated association, a partnership, or an individual, whether located within or outside this state, may make application to the commissioner for a license as a rating organization for such kinds of insurance or subdivisions thereof as are specified in its application and shall file therewith:

  1. A copy of its constitution, its articles of agreement or association or its certificate ofincorporation, and its bylaws, rules, and regulations governing the conduct of its business;

  2. A list of its members and subscribers;

  3. The name and address of a resident of this state upon whom notices or orders of thecommissioner or process affecting such rating organization may be served; and (d) A statement of its qualifications as a rating organization.

  1. If the commissioner finds that the applicant is competent, trustworthy, and otherwisequalified to act as a rating organization and that its constitution, articles of agreement or association or its certificate of incorporation, and its bylaws, rules, and regulations governing the conduct of its business conform to the requirements of law, the commissioner shall issue a license specifying the kinds of insurance or subdivisions thereof for which the applicant is authorized to act as a rating organization. Every such application shall be granted or denied in whole or in part by the commissioner within sixty days after the date of its filing. Licenses issued pursuant to this section shall remain in effect for three years unless sooner suspended or revoked by the commissioner. The fee for said license shall be twenty-five dollars; except that the commissioner by rule or as otherwise provided by law may reduce the amount of the fee if necessary pursuant to section 24-75-402 (3), C.R.S., to reduce the uncommitted reserves of the fund to which all or any portion of the fee is credited. After the uncommitted reserves of the fund are sufficiently reduced, the commissioner by rule or as otherwise provided by law may increase the amount of the fee as provided in section 24-75-402 (4), C.R.S.

  2. Licenses issued pursuant to this section may be suspended or revoked by the commissioner, after hearing upon notice, in the event the rating organization ceases to meet the requirements of this section.

  3. Every rating organization shall notify the commissioner promptly of every change in:

  1. Its constitution, its articles of agreement or association or its certificate of incorporation, and its bylaws, rules, and regulations governing the conduct of its business;

  2. Its list of members and subscribers;

  3. The name and address of the resident of this state designated by it upon whom notices or orders of the commissioner or process affecting such rating organization may be served.

(5) (a) The commissioner shall organize a working group composed of representatives of employer and employee organizations, regulatory agencies, and the insurance industry including, but not limited to, representatives of businesses insured for worker's compensation in the state of Colorado and an insurance actuary to study issues concerning workers' compensation rates, including, but not limited to, definitions of excessive, inadequate, and discriminatory rates, profits, expenses, and loss-ratio standards for insurance companies, and powers the commissioner should have concerning the rate-setting process.

  1. The commissioner and the working group shall also review the appropriateness ofallowing insurance carriers to provide up-front premium discounts as opposed to providing only premium dividends to insureds based on participation in risk-management programs.

  2. The commissioner shall promulgate rules and regulations which establish standardsfor risk-management services which shall be offered by community, technical, or local district colleges or by insurance carriers offering workers' compensation insurance pursuant to articles 40 to 47 of title 8, C.R.S. Business entities which accept such risk-management services and comply with the standards established by the commissioner shall be entitled to a premium dividend if any such business entity's loss experience under the risk-management program indicates such premium dividend is warranted. In developing such rules and regulations, the commissioner shall consider the information developed by the workers' compensation costcontainment board. In such rules and regulations, the commissioner shall require insurance carriers to inform policyholders in a clear and conspicuous manner of the availability of cost containment certification by the workers' compensation cost containment board pursuant to section 8-14.5-107, C.R.S.

  3. The commissioner shall promulgate rules and regulations which establish that allinsurance companies in this state offering workers' compensation insurance pursuant to articles 40 to 47 of title 8, C.R.S., shall provide a premium differential on all policies when the policyholder has selected an authorized treating physician or physicians. Such premium differential shall be clearly stated to all policyholders in an appropriate communication medium on an annual basis.

  4. On or before October 1, 1994, the commissioner shall promulgate rules which establish, for purposes of section 8-44-115, C.R.S., standards for determining:

  1. When a motor vehicle accident has not been caused, wholly or in part, by an employee or the employer of such employee;

  2. A loss limitation to be included in the calculation of workers' compensation insurance experience modifications when a motor vehicle accident has not been caused, wholly or in part, by an employee or the employer of such employee;

  3. The distribution, among workers' compensation classifications, of any loss remaining after deduction of the loss limitation established under subparagraph (II) of this paragraph (e); and

  4. (A) When the use of a motor vehicle is an integral part of an employer's business.

(B) Rules promulgated pursuant to this subparagraph (IV) shall be based on the job classification system for workers' compensation insurance in use on January 1, 1994.

Source: L. 79: Entire part R&RE, p. 369, § 8, effective July 1. L. 90: (5) added, p. 616, § 2, effective April 12. L. 91: (5)(c) amended, p. 1354, § 3, effective April 20. L. 92: (5)(c) amended, p. 1817, § 2, effective July 1. L. 94: (5)(e) added, p. 1367, § 2, effective October 1. L. 97: (5)(a) amended, p. 1478, § 22, effective June 3. L. 98: (2) amended, p. 1327, § 29, effective June 1.

Editor's note: This section is similar to former § 10-4-306 as it existed prior to 1979.


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