TITLE exempt-filings

Texas Department of Insurance

Proposed Action on Rules

The Commissioner of Insurance or his designee at a public hearing under Docket Number 2416 scheduled for September 7, 1999, at 9:00 a.m. in Room 100 of the Texas Department of Insurance Building, 333 Guadalupe Street in Austin Texas will consider amendments proposed by the staff of the Workers' Compensation Division to the Texas Basic Manual of Rules, Classifications and Experience Rating Plan for Workers' Compensation and Employers' Liability Insurance (Manual). The purposes of these amendments to the Manual are to add, amend and delete rules as necessary, to eliminate conflicting language within the Manual and to provide clarification to rules, endorsements and forms by amending existing language.

The proposed changes by the staff are summarized as follows: 1. Clarify that the rules contained in the Manual are to be read in harmony with the standard workers' compensation policy language, adopted endorsements, the workers' compensation law and the Texas Insurance Code; 2. Amend the classification used in the example to reflect a classification that includes shop operations; 3. Clarify that a safety award received by an employee as a supplement to his/her wages, is not considered remuneration for purposes of calculating workers' compensation premium; 4. Clarify that the formula contained in the rule is used to determine the basis of premium to calculate workers' compensation premium if there are no verifiable payroll records for leased or rented vehicles that operate under Code 7382; 5. Clarify that the expense constant is not used in determining premium discount, experience rating modification, retrospective rating or premium incentives for small employers; 6. Clarify that the minimum premium shall be pro-rated on policies issued for a period less than one year; 7. Delete the entire section on Texas Maintenance Tax Surcharge Recoupment and other references to the Maintenance Tax Surcharge throughout the Manual; 8. State in the rules that insurance companies are responsible for maintaining documentation to support schedule ratings; 9. State in the rules that if a policy is written for a period less than one year or is cancelled prior to the expiration date, the premium on the policy is projected to a full year to determine eligibility for the premium incentive for small employers; 10. Add a new section to the Experience Rating Plan that allows for a preliminary modifier to be calculated when new experience rating values are not available; Once new experience rating values have been approved, then it may be necessary to recalculate the modifier; 11. Clarify that test modifiers for interstate rated risks cannot be negotiated or used in calculating premium; 12. Delete the Employers' Liability Coverage Endorsement WC 00 03 03 as it is not applicable. The rule that allowed an employers' liability only policy to be sold in Texas was eliminated from the Manual effective 1-1-94; 13. Amend the language in the Cancellation section of the Texas Amendatory Endorsement to conform to the language set forth in the Texas Labor Code concerning cancellation of workers' compensation policies; 14. Add language to Texas Aggregate Deductible Endorsement and Texas Accident/Aggregate Deductible Endorsement stating that if the policyholder cancels the policy, the aggregate deductible will not be reduced to a pro rata amount based on the time the policy was in force. This change eliminates a conflict that exists between the rule and the endorsement; 15. Add the standard workers' compensation policy as adopted by the Commissioner to the Forms Section of the Manual. Several clerical errors are being corrected with the adoption of the policy into the Forms Section of the Manual; 16. Add the Information Page to the Forms Section of the Manual; and 17. Make editorial changes throughout the Manual to correct punctuation, typographical errors, reference to the statutes and reference to rules contained in the Manual.

The Commissioner has jurisdiction over this matter pursuant to the Insurance Code, Articles 5.56, 5.57, 5.60 and 5.96.

A copy of the of the full text of the proposed amendments is available for review in the Office of the Chief Clerk of the Texas Department of Insurance, 333 Guadalupe Street, Austin, Texas 78714-9104. For further information or to request copies of the amendments, please contact Ms. Angie Arizpe (512) 463-6326, (refer to Ref. Number W-0799-12-I).

The staff and the Commissioner request that written comments to these proposed amendments be submitted prior to the public hearing on September 7, 1999. The written comments should be directed to Lynda H. Nesenholtz, General Counsel and Chief Clerk, Texas Department of Insurance, P. O. Box 149104, MC 113-2A, Austin, Texas 78714-9104. An additional copy of the comments should be submitted to Nancy Moore, Deputy Commissioner, Workers' Compensation, Texas Department of Insurance, P. O. Box 149092, Austin, Texas 78701-9092. Public testimony at the hearing on September 7, 1999, is also invited and encouraged.

This notification is made pursuant to the Insurance Code, Article 5.96, which exempts it from the requirements of the Government Code, Chapter 2001 (Administrative Procedure Act).

TRD-9904537

Gene C. Jarmon

Assistant General Counsel

Texas Department of Insurance

Filed: July 28, 1999


The Commissioner of Insurance (Commissioner) will hold a public hearing under Docket Number 2417 on September 7, 1999, at 9:00 a.m., in Room 100 of the Texas Department of Insurance Building, 333 Guadalupe Street in Austin, Texas to consider a petition by the staff of the Texas Department of Insurance (TDI) proposing the adoption of revised Texas Workers' Compensation Classification Relativities (classification relativities) to replace those adopted in Commissioner's Order Number 98-0998 dated August 26, 1998; the adoption of a revised table to amend the Texas Basic Manual of Rules, Classification, and Experience Rating Plan for Workers' Compensation and Employers' Liability Insurance (Basic Manual) concerning the Expected Loss Rates and Discount Ratios used in experience rating; the adoption of revised tables to amend the Basic Manual concerning the W and B values and the State Accident Limitations used in the Experience Rating Formula, the Admiralty/F.E.L.A. Operations Liability Limit Table, the Offshore Operations Liability Limit Table, and the Tables of Premium Credits for Promulgated Deductibles; and the adoption of revised tables to amend the Retrospective Rating Plan Manual for Workers' Compensation and Employers' Liability Insurance (Retro Manual) concerning the Table of Insurance Charges - Group Assignments, Table of Classifications by Hazard Group, and Excess Loss Premium Factors Table.

In its petition, the staff requests consideration of a schedule of the revised classification relativities and tables amending the Basic Manual and Retro Manual. The revised classification relativities schedule is proposed to replace the classification relativities schedule adopted in Commissioner's Order 98-0998 effective January 1, 1999. The tables amending the Basic Manual concern the Expected Loss Rates and Discount Ratios, the W and B values and the State Accident Limitations used in the Experience Rating Formula, the Admiralty/F.E.L.A. Operations Liability Limit factors, Offshore Operations Liability Limit factors, and the Premium Credits for Promulgated Deductibles. The tables amending the Retro Manual concern Insurance Charges - Group Assignments, Table of Classifications by Hazard Group, and Excess Loss Premium Factors.

The staff requests that the proposed revised classification relativities be available for adoption by insurers immediately, but that their use be mandatory for all policies with an effective date on or after January 1, 2000. The staff further requests that the revised tables amending the Basic Manual and Retro Manual be made effective for workers' compensation policies with an effective date on or after January 1, 2000.

The Commissioner has jurisdiction of this matter pursuant to the Texas Insurance Code, Article 5.60, 5.55C, 5.77, and 5.96. Article 5.60 (a) of the Texas Insurance Code authorizes the Commissioner to determine hazards by classes and fix classification relativities applicable to the payroll in each class for workers' compensation insurance. Article 5.60 (d) provides that the Commissioner revise the classification system at least once every five years. Article 5.55C requires TDI to perform an actuarial analysis to determine the amount of rate reduction applicable to policies utilizing a deductible plan under this article. It further requires TDI to periodically review the amount of rate reduction. Article 5.77 authorizes TDI to promulgate premium discount plans, retrospective rating plans and other systems, plans or formulas if the rates thereby provided are not excessive, inadequate or unfairly discriminatory. Article 5.96 authorizes TDI to promulgate, adopt, approve, amend, or repeal standard and uniform rating manuals, rating plans, classification plans, statistical plans and policy and endorsement forms for various lines of insurance, including workers' compensation insurance.

The classification relativities currently in effect were based on experience data reflecting workers' compensation experience from policies with effective dates in 1991 through 1995. The proposed classification relativities are based on the analysis of experience data from policies with effective dates in 1992 through 1996. The staff's proposed classification relativities reflect changes in experience that occur over time, due to such things as technological advances and improvements in safety programs. The indicated resulting relativities were balanced to the level of the current relativities through the application of off-balance factors. This provides for a revenue neutral set of relativities in relation to the current relativities. The staff proposes to limit changes in the classification relativities to +25% and -25%. These limited relativities have been balanced overall to the level of the current relativities. This would help to minimize possible rate shock due to large indicated changes in the relativities.

Modifications to the classification relativities require concurrent changes in the Table II of the Basic Manual concerning the Expected Loss Rates and Discount Ratios. The current Table II, which became effective on January 1, 1999, contains expected loss rates that were based on the level of losses used to experience rate a policy effective on July 1, 1999 and reflect the current classification relativities. Staff proposes an adjustment to make the expected loss rates more reflective of the level of losses that would be used to experience rate policies that would be effective in 2000, and reflect the proposed classification relativities. Staff also proposes to cap changes in the expected loss rates to +25% and -25%.

The W and B values are used to assign credibility to an insured's actual experience in the experience rating formula. The staff proposes to adjust the W and B values to reflect changes in payrolls and cost in more recent years. The State Accident Limitations are used to limit the losses that enter into the experience rating formula. The staff proposes to adjust these limits to reflect the current level of claims costs. Staff proposes $107,000 as the Texas Per Claim Accident Limitation and $214,000 as the Texas Multiple Claim Accident Limitation.

The Admiralty/F.E.L.A. Operations Liability Limit Table is used to determine the additional premium to be charged an employer that chooses higher limits of employers' liability coverage under Admiralty law or F.E.L.A. The staff proposes an increase based on available experience.

The Offshore Operation Liability Limits Table is used to determine the additional premium to be charged if an employer chooses higher limits of liability coverage for oil, gas, or other mineral operations on or over water. The staff proposes to adjust the table similarly to the adjustments in the Admiralty/F.E.L.A. Operations Liability Limit Table.

TDI is required to periodically review the amount of the premium credits in the Table of Premium Credits for Promulgated Deductibles. The staff proposes to adjust the credits in the Table of Premium Credits for Promulgated Deductibles to reflect the most recently available loss distributions of individual claims and aggregate loss distributions by insured.

The Table of Insurance Charges - Group Assignments is used to identify the columns of the Retro Manual's Table M that an insurer is to use to determine the insurance charge element of an insured's retrospective premium. The staff proposes to update the table based in part on the table currently being used in other jurisdictions.

The Table of Classifications by Hazard Group is used in determining the cost of a limitation applied to individual claims entering the retrospective rating formula. The staff proposes to update the Table of Classifications by Hazard Group assignments based on the most recent countrywide classification experience adjusted to reflect the Texas classification system.

The Excess Loss Premium Factors are used to determine the cost of limiting the amount of individual losses that enter into the retrospective premium formula. The staff proposes to adjust this table to reflect the most recently available loss distributions by injury type.

Copies of the full text of the staff petition and the proposed revised schedule and table are available for review in the Office of the Chief Clerk of the Texas Department of Insurance, 333 Guadalupe Street, Austin, Texas, 78714-9104. For further information or to request copies of the petition and proposed revised schedule and table, please contact Angie Arizpe at (512) 463-6326 (refer to Ref. Number W-0799-13-I).

Comments on the proposed changes must be submitted in writing within 30 days after publication of the proposal in the Texas Register to Lynda Nesenholtz, the Office of Chief Clerk, P. O. Box 149104, MC 113-2A, Austin, Texas, 78714-9104. An additional copy of the comment should be submitted to Philip Presley, Chief Property and Casualty Actuary, P. O. Box 149104, MC 105-5F, Austin, Texas, 78714-9104.

This notification is made pursuant to the Texas Insurance Code, Article 5.96, which exempts action taken under this article from the requirements of the Administrative Procedure Act (Government Code, Title 10, Chapter 2001).

TRD-9904538

Gene C. Jarmon

Assistant General Counsel

Texas Department of Insurance

Filed: July 28, 1999