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Report on Self Insurance Groups - page 5 / 40





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Report on Self Insurance Groups

individually identifiable may be publicly disclosed and the compliance status of any SIG may be publicly disclosed.

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    ―Compliance status‖ is intended to include the rosters of active SIGs and member employers already published by OSIP, as well as the identity of SIGs which have and have not timely filed reports or complied with requirements such as funding loss reserve and timely filing reports or paying security deposits.

Either amend the Corporations Code to permit SIGs to return surplus funds to members or expressly provide that surplus funds from any program year may only be used to reduce contributions required for a different program year. Establish a judicial procedure to consolidate all state court litigation arising from the insolvency of a SIG into one liquidation proceeding.

Regulatory Recommendations:

Require that every member or prospective member and the agent or broker for every member or prospective member shall be provided a copy of the group’s most current financial report and other prescribed reports, provided that a SIG may first require that the member, prospective member, agent, or broker executes a nondisclosure agreement in a form approved by the Director. Adopt regulations as necessary to carry out the statutory provisions, including:

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    Criteria for the publication of status information on SIGs that are out of compliance with statutory or regulatory requirements;

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      Guidelines for statistical information that can be released without revealing confidential information about identifiable SIGs; and

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      Amendment of Regulation 15405, Confidentiality, to permit sharing confidential information with authorized representatives of SISF.

Make group administrators accountable for performance:

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    The Director should establish qualifications and licensing for program

administrators, as it has for third-party adjusting agents (TPAs).


increased prohibitions against conflict of interest. The new regulations prohibit certain conflicts such as the roles of program administrator and the certified public accountant (CPA). Weigh the arguments that may be made for or against prohibitions of other potential conflicts, such as actuary and program administrator. Audit additional aspects of performance beyond claims adjusting:

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    A complete independent audit should not be limited to the accuracy of the financial statement. It should include key points of regulatory compliance such as the identity and terms of all reinsurance, the identity and essential terms of all


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