Del. Code 18, § 2607 : Insurance Code — Workers' Compensation Rating — Membership in advisory organization

2 Sep 2016

Current through 2016 Legislative Session, Act 399

(a) The Commissioner shall designate an advisory organization to assist the Commissioner in gathering, compiling and reporting relevant statistical information. Every workers' compensation insurer shall record and report its workers' compensation experience to the designated advisory organization as set forth in the uniform statistical plan approved by the Commissioner.

(b) Each workers' compensation insurer shall be a member of the workers' compensation advisory organization. Each workers' compensation insurer may adhere to the policy forms filed by the advisory organization.

(c) Every workers' compensation insurer shall adhere to a uniform classification system and uniform experience rating plan that has been filed with the Commissioner by the advisory organization and approved by the Commissioner; provided, however that:

(1) An insurer may develop subclassifications within the uniform classification system for which a rate or rates may be made;

(2) Any subclassification developed under paragraph (c)(1) of this section shall be filed with the advisory organization and the Commissioner 30 days prior to use; and

(3) If the insurer fails to demonstrate that the data produced under a subclassification can be reported in a manner consistent with the advisory organization's uniform statistical plan and classification system, the Commissioner shall disapprove the subclassification.

The advisory organization shall file a rating plan with the Department of Insurance not later than 90 days after the adoption of a health care payment system provided for by § 2322B(14) of Title 19, and shall also file a rating plan not later than 90 days after the adoption of health care practice guidelines provided for by § 2322C(7) of Title 19. Thereafter, the advisory organization shall file a rating plan at least annually. Within 60 days of each such rating plan becoming effective pursuant to this chapter, each authorized insurer shall make a rate filing pursuant to § 2609 of this title.

(d) Subject to the approval of the Commissioner, the advisory organization shall develop and file rules reasonably related to the recording and reporting of data pursuant to the uniform statistical plan, uniform experience rating plan and the uniform classification system.

(e) The methodology of the experience rating plan required under subsection (c) of this section shall have as a basis:

(1) Reasonable eligibility standards;

(2) Incentives for loss prevention; and

(3) A premium differential so as to encourage safety.

(f) The uniform experience rating plan shall be the exclusive means of providing prospective premium adjustment based upon measurement of the loss producing characteristics of an individual insured. An insurer may file a rating plan that provides for retrospective premium adjustments based upon an insured's past experience.

Del. C. § 2607

69 Del. Laws, c. 163, §1; 70 Del. Laws, c. 172, § 10; 74 Del. Laws, c. 348, § 1; 76 Del. Laws, c. 1, § 2.;