TITLE 28.INSURANCE

Part 4. STATE OFFICE OF RISK MANAGEMENT

Chapter 251. STATE EMPLOYEES--WORKERS' COMPENSATION

Subchapter E. RISK ALLOCATION PROGRAM

28 TAC §§251.501, 251.503, 251.505, 251.507, 251.509, 251.511, 251.513, 251.515, 251.517, 251.519

The State Office of Risk Management, (the Office), proposes a new Subchapter E, §§251.501, 251.503, 251.505, 251.507, 251.509, 251.511, 251.513, 251.515, 251.517, and 251.519 governing the establishment of an allocation program for state agency workers' compensation and risk management costs (Allocation Program) and addressing the manner in which the cost of workers' compensation and risk management programs will be assessed to covered agencies.

The 77th Texas Legislature recently enacted House Bill 2976 which amended § 412.012 of the Labor Code and added new §§412.0121, 412.0122, 412.0123, and 412.0124 to the Texas Labor Code, Chapter 412. The Office proposes the new subchapter to implement new §412.0123, define terms used in new §412.0123, and establish the processes involved in allocating the costs of the program .

Section 251.501 specifies that the purpose of the rules is to implement the Allocation Program as required by Texas Labor Code, Chapter 412, §412.0123.

Section 251.503 defines terms used in the subchapter.

Section 251.505 sets forth the procedures the Office will use in determining the amount of expected losses and the amount that will be collected from all participating agencies.

Section 251.507 sets forth the factors and the formula that will be used to determine each participating agency's proportionate cost for paying for workers' compensation coverage. Staff is proposing a relative weighting and formula designed to fairly allocate the cost of risk which would establish the default value for the 2002 assessment.

Section 251.509 makes provision for participation in the workers' compensation program for agencies either omitted from the assessment process or newly created , establishes special circumstance calculations, and defines the scope of assessments and liability for such agencies.

Section 251.511 establishes the requirements for reports provided to, and by, the Office relating to the collection of workers' compensation assessments.

Section 251.513 establishes deadlines for payments to be received by the Office for agency assessments and permits an optional deadline for assessments paid from funds not held in the state treasury.

Section 251.515 sets forth the procedure by which program participants may request the Board of Directors of the Office consider new factors or modify the weighting of relevant factors in the assessment process.

Section 251.517 allows participating agencies to unitize elements of their organization for the purposes of internally allocating the cost of the agency's worker's compensation coverage.

Section 251.519 establishes the procedure for the re-appropriation of the existing claim fund to make the initial allocation revenue-neutral for program participants.

Jonathan D. Bow, General Counsel, has determined that for the first year of the first five years the proposed sections will be in effect, there will be no fiscal impact to state and local governments as a result of the enforcement or administration of the proposed rules. State agencies may see reduced or increased costs in subsequent years based on each agency's relative injuries and workers' compensation losses. Any additional costs for agencies to comply with the proposed subchapter result from the legislative enactment of §412.0123 and not from the proposed subchapter. The proposed subchapter is only applicable to state agencies and there will be no effect on large, small or micro-businesses. There is no impact on local employment or the local economy as a result of the proposal.

Mr. Bow has determined that for each year of the first five years the proposed sections are in effect, the anticipated public benefit is that the Allocation Program will provide adequate funding for losses due to injuries to state employees and provide effective incentives to system participants to reduce injuries and losses to state workers to the benefit of taxpayers.

To be considered, written comments on the proposal must be received no later than 5 p.m. thirty days after date of publication. Comments should be delivered to Jonathan D. Bow, General Counsel, State Office of Risk Management, 300 W 15th St., 6th Floor, Austin, TX 78701, or P.O. Box 13777, Austin, TX 78711-3777.

Any requests for a public hearing should be submitted separately to the General Counsel.

The subchapter is proposed under the authority granted by Texas Labor Code, Chapter 412, 412.031. Section 412.031 provides the Board may adopt rules necessary to implement the state's Workers' Compensation and Risk Management programs.

The following statutes are affected by the proposed new subchapter: Texas Labor Code, Chapter 412, §§412.012, 412.0121, and 412.053.

§251.501.Purpose.

The purpose of this subchapter is to:

(1)

equitably distribute the cost of funding workers' compensation losses, the cost of administering claims, and the cost of providing loss control services to participating state agencies;

(2)

encourage the development and implementation of risk management programs and practices designed to minimize occupational injuries and illnesses; protect state property; and provide appropriate safety and health training for all state employees;

(3)

pool large and small risks to enable catastrophic loss(es) to be spread throughout all participating state agencies; and

(4)

encourage compliance with State Office of Risk Management regulations, and the policies and programs recommended in Risk Management For Texas State Agencies within the following areas of risk: property exposures; workers' compensation exposures; and liability exposures.

§251.503.Definitions.

The following words and terms, when used in this subchapter, shall have the following meanings:

(1)

Payroll--The total dollars paid for gross salary for all covered Full-Time Equivalents (FTEs), as reported by covered agencies.

(2)

Injury Frequency Rate (IFR)--The number of accepted claims, as reported by the State Office of Risk Management (the Office), per 100 covered FTEs.

(3)

Claims Cost--The net amount of payments made on claims, minus subrogation and restitution costs, as reported by the Office.

(4)

Covered Agency--A department, board, commission, or institution of this state with workers' compensation coverage under Chapter 501 of the Texas Labor Code (Labor Code).

(5)

Covered FTE--An FTE covered under workers' compensation coverage under Chapter 501 of the Labor Code.

(6)

Plan Year--The state fiscal year beginning on September 1 and ending on August 31 the following year.

(7)

Risk Management For Texas State Agencies --Risk management guidelines published by the Office for implementation and use by covered state agencies.

§251.505.Total assessment.

(a)

Each plan year the Office will calculate the total amount to be collected from covered agencies to pay the aggregate costs of:

(1)

workers' compensation losses; and

(2)

the Office's risk management program.

(b)

The office will commission an actuarial study each plan year for the purpose of projecting the total amount of workers' compensation losses which will be paid in the following plan year. The board of the State Office of Risk Management (the Board) will set the amount to be collected based on the actuarial study, with the goal of collecting an amount sufficient to pay the expected losses.

(c)

The total assessment will be the total of:

(1)

the projected workers' compensation costs for the following plan year;

(2)

any amount which the Office has borrowed in the previous plan year for paying workers' compensation costs or any carryover of funds from the previous plan year (expressed as a negative amount); and

(3)

the cost of the Office's risk management program.

§251.507.Calculating the allocation of the total assessment.

(a)

The total assessment will be divided among participating agencies based on each agency's:

(1)

payroll as a percentage of all participating agencies' payroll;

(2)

injury frequency rate as a percentage of the total of all participating agencies' injury frequency rates;

(3)

claim costs as a percentage of all claims payments made on behalf of participating agencies; and

(4)

such other relevant factors as the Board may determine.

(b)

The Office will use a weighted three-year rolling average to calculate payroll and injury frequency rate for each covered agency. In the weighted average the most recent completed plan year will constitute 50% of the total for that factor, the next most recent plan year will be given 33% of the total, and the earliest plan year will be given 17% of the total for the factor.

(c)

The Office will use a simple three-year rolling average to calculate claim costs for each covered agency.

(d)

Subject to modification by the Board pursuant to §251.515 of this subchapter, the factors used in the calculation shall be weighted as follows:

(1)

Payroll--20%;

(2)

Injury frequency rate--40%;

(3)

Claims cost--40%.

§251.509.Omitted or newly created agencies.

(a)

In the event that a covered agency is omitted from the annual assessment for any plan year, that agency will promptly:

(1)

remit to the Office an assessed amount based on projected payroll, as reported by the agency; and

(2)

reimburse the Office for all covered losses incurred in that plan year in excess of the assessed amount.

(b)

Notwithstanding §251.507(b) of this subchapter:

(1)

if an agency has existed for only the two most recent plan years of the weighted three-year rolling average period, then the most recent completed plan year shall constitute 60% of the total for the weighted factors and the next most recent plan year shall constitute 40% of the total for the weighted factors;

(2)

if an agency has existed for only the most recent plan year of the weighted three-year rolling average period, then the most recent completed plan year shall constitute 100% of the total for the weighted factors; and

(3)

the assessment for an agency that was not in existence during any of the plan years of the weighted three-year rolling average period shall be calculated using that agency's current or projected payroll, as reported by the agency, and the agency's actual claims costs, if any.

§251.511.Required reports.

(a)

In addition to other reports required under this chapter, each covered agency shall report to the Office not later than February 1 of each plan year their total payroll and the number of covered FTEs, by funding source for the prior plan year. The report shall be made in the form and manner required by the Office.

(b)

In addition to other reports provided by the Office to covered state agencies, the Office will report to each covered agency not later than March 1 of each plan year the agency's injury frequency rate and claims cost for the three most recent plan years. The Office may satisfy this requirement by posting the information required on its web site.

(c)

The reports required by this section may be amended, supplemented or corrected at any time prior to June 1 of the plan year. The calculation of assessments to agencies will be made using the data contained in these reports as of June 1 of each year.

§251.513.Date of payment for assessments.

(a)

Each covered agency's assessment payment must be received by the Office not later than September 1 of each plan year except as otherwise provided by this rule.

(b)

Upon approval of the Office, the portion of an agency's assessment which will be paid from funds not held in the state treasury may be paid in two installments. An agency authorized by the Office to exercise this option must pay at least 50% of the agency's total assessment by September 1 of the plan year with the balance of the assessment due not later than January 15 of the plan year.

§251.515.Changes in the factors or weighting used in the assessment.

(a)

The Board may modify the factors and/or relative weights set forth in §251.507 of this subchapter in open meeting and after notice as provided by the Open Meetings Act.

(b)

Any person may request that the Board make specific changes to modify the factors and/or relative weights used in calculating agency assessments. Specific requests for changes must be delivered to the General Counsel for the Office by June 1 of any plan year to be considered for adoption in the following plan year.

(c)

Any modification of the factors and/or weights used in calculating agency assessments will be made in accordance with the statement of purpose contained in §251.501 of this subchapter.

(d)

The Office shall publish on its website the effective factors and/or weights to be used in calculating agency assessments on or before the 15th day following any modifications made by the Board pursuant to subsection (a) of this section.

§251.517.Unitization of agency assessments.

An agency may allocate the assessment authorized in these rules internally to promote the purposes set forth in §251.501. In allocating costs internally an agency is not bound to use the same factors and weighting established in these rules. The Office will provide data, to the extent that it is available, to assist agencies in properly allocating costs to the internal units designated by the agency.

§251.519.Distribution of existing claim fund appropriation.

(a)

The Office will make recommendations to the Comptroller of Public Accounts regarding the distribution of funds appropriated to the Office on a one-time basis for FY2002 and FY2003. Funds distributed to participating agencies will become a part of the base-line appropriation for the agency receiving them. Agencies will receive an appropriation of the same amount in FY2003 that was calculated for that agency in FY2002.

(b)

The amount distributed to each agency will be calculated to make the assessment "revenue neutral" as it impacts general revenue funds held in the state treasury.

(c)

The Office will recommend an amount be distributed to an agency calculated by subtracting from the agency's assessment an amount equal to 25% of the agency's paid workers' compensation losses for FY2000 and the expected Risk Management contract amount which would have been charged without the change in funding methods. That total will be multiplied by the percentage of salary expenditures for FY2000 funded by general revenue to determine the expected additional general revenue appropriation necessary to maintain a revenue neutral status for general revenue funds in FY2002.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on June 21, 2001.

TRD-200103511

Jonathan D. Bow

General Counsel

State Office of Risk Management

Earliest possible date of adoption: August 5, 2001

For further information, please call: (512) 936-1502