West Virginia Code § 23-2-9

Election of employer or employers' group to be self-insured and to provide
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own system of compensation; exceptions; self administration; rules; penalties;
regulation of self-insurers.
(a) Notwithstanding any provisions of this chapter to the contrary, the following types of
employers or employers' groups may apply for permission to self-insure their workers'
compensation risk. e
(1) The types of employers are:
(A) Any employer who is of sufficient capability and financial resuponsibility to ensure the
payment to injured employees and the dependents of fatally injured employees of benefits
provided in this chapter at least equal in value to the compensation provided for in this
chapter;
(B) Any employer or group of employers as provided in §23-2-9(a)(1)(A) of this code of such
capability and financial responsibility that maintainls its own benefit fund or system of
compensation to which its employees are not srequired or permitted to contribute and whose
benefits are at least equal in value to those provided in this chapter; or
(C) Any employer who is signatory to a collective bargaining agreement that allows for
participation in a group workers' compensation insurance program may join with any other
employer or employers that are signatory to a collective bargaining agreement or
agreements that allow for participation in a group workers' compensation program and
jointly apply to the Insurance Commissioner to collectively self-insure their obligations under
this chapter. The employers must collectively meet the conditions set forth in
§23-2-9(a)(1)(A) and (B) of this code. There shall be joint and several liability for all
employers who choose to jointly self-insure under the provisions of this article.
(2) In order to be approved for self-insurance status, the employer shall:
(A) Submit all information requested by the Insurance Commissioner;
(B) Provide security or bond, in an amount and form determined by the Insurance
Commissioner, which shall balance the employer's financial condition based upon an
analysis of its audited financial statements and the full accrued value of current liability for
future claim payments based upon generally accepted actuarial and accounting principles of
the employer's existing and expected liability;
(C) Meet the financial responsibility requirements set forth in rules promulgated by the
industrial council;
(D) Obtain and maintain a policy of excess insurance if required to do so by the Insurance
Commissioner; and
(E) Have an effective health and safety program at its workplaces.
(3) Upon a finding that the employer has met all of the requirements of this section and any
rules promulgated thereunder, the employer may be permitted self-insurance status. An
annual review of each self-insurer's continuing ability to meet its obligations and the
requirements of this section shall be made by the Insurance Commissioner. At the time of
such review, the Insurance Commissioner may require that the self-insured employer post a
bond or security or obtain and maintain an excess insurance policy. This review shall also
include a recalculation of the amount of any security, bond, or policy of exceess insurance
previously required to be posted or obtained under any provision of this chapter or any rules
promulgated thereunder. Failure to provide the required amount or forrm of security or bond
or to obtain or maintain the required excess insurance policy may cause the employer's self-
insurance status to be terminated by the Insurance Commissioner.
(4) Whenever a self-insured employer furnishes security or btond, including replacement and
amended bonds and other securities, as surety to ensure the employer's or guarantor's
payment of all obligations under this chapter for which the security or bond was furnished,
the security or bond shall be in the most current form or forms approved and authorized by
the Insurance Commissioner for use by the employer or its guarantors, surety companies,
banks, financial institutions, or others in its behalf for that purpose.
(b)(1) Notwithstanding any provision in this chapter to the contrary, self-insured employers
shall, effective July 1, 2004, adminisgter their own claims. The Insurance Commissioner shall,
pursuant to rules promulgated by the industrial council, regulate the administration of
claims by employers granted peermission to self-insure their obligations under this chapter. A
self-insured employer shall comply with rules promulgated by the industrial council
governing the self-admiLnistration of its claims.
(2) An employer or employers' group that self-insures its risk and self-administers its claims
shall exercise all authority and responsibility granted to the Insurance Commissioner or
private carriers in this chapter and provide notices of action taken to effect the purposes of
this chapter to provide benefits to persons who have suffered injuries or diseases covered by
thisW chapter. An employer or employers' group granted permission to self-insure and self-
administer its obligations under this chapter shall at all times be bound and shall comply
fully with all of the provisions of this chapter. Furthermore, all of the provisions contained in
§23-4-1 et seq. of this code pertaining to disability and death benefits are binding on and
shall be strictly adhered to by the self-insured employer in its administration of claims
presented by employees of the self-insured employer. Violations of the provisions of this
chapter and such rules relating to this chapter as may be approved by the industrial council
may constitute sufficient grounds for the termination of the authority for any employer to
self-insure its obligations under this chapter.
(c) Each self-insured employer shall, on or before the last day of the first month of each
quarter or other assigned reporting period, file with the Insurance Commissioner a certified
statement of the total gross wages and earnings of all of the employer's employees subject to
this chapter for the preceding quarter or other assigned reporting period.
(d)(1) If a self-insured employer defaults in the payment of any portion of surcharges or
assessments required under this chapter or rules promulgated thereunder, or in any
payment required to be made as benefits provided by this chapter to the employer's injured
employees or dependents of fatally injured employees, the Insurance Commissioner shall, in
an appropriate case, determine the full accrued value based upon generally accepted
actuarial and accounting principles of the employer's liability, including the costs of all
awarded claims and of all incurred but not reported claims. The amount deteermined may, in
an appropriate case, be assessed against the employer. The Insurance Commissioner may
demand and collect the present value of the defaulted liability. Interestr shall accrue upon the
demanded amount as provided in §23-2-13 of this code until the liability is fully paid.
Payment of all amounts then due to the Insurance Commissioner and to the employer's
employees is a sufficient basis for reinstating the employer to good standing with the
Insurance Commissioner and removing the employer from dtefault status.
(2) The assessments and surcharges required to be paid by self-insured employers pursuant
to the provisions of this chapter and the rules promulgated thereunder are special revenue
taxes under and according to the provisions of state workers' compensation law and are
considered to be tax claims, as priority claims or administrative expense claims according to
those provisions under the law provided in the United States bankruptcy code, Title 11 of the
United States Code. In addition, as the same was previously intended by the prior provisions
of this section, this amendment and reenactment is for the purpose of clarification of the
taxing authority of the Insurance Commissioner.
(e) Any self-insured employer which has had a period of inactivity due to the nonemployment
of employees which resuLlts in its reporting of no wages on reports to the Insurance
Commissioner for a period of four or more consecutive quarters may have its status
inactivated and shall apply for reactivation to status as a self-insured employer prior to its
reemployment of employees. Despite the inactivation, the self-insured employer shall
continue to make payments on all awards for which it is responsible. Upon application for
reactivation of its status as an operating self-insured employer, the employer shall document
that it meets the eligibility requirements needed to maintain self-insured employer status
under this section and any rules adopted to implement it. If the employer is unable to
requalify and obtain approval for reactivation, the employer shall, effective with the date of
employment of any employee, purchase workers' compensation insurance as provided in
§23-2C-1 et seq. of this code, but shall continue to be a self-insurer as to the prior period of
active status and to furnish security or bond and meet its prior self-insurance obligations.
(f) Self-insured employers may withdraw from self-insured status and purchase workers'
compensation insurance as provided in §23-2C-1 et seq. of this code, but said self-insured
employers shall remain liable for their self-insured employer claims liabilities for each claim
with a date of injury or last exposure prior to the effective date of insurance coverage.
(g) Any employer subject to this chapter, who elects to carry the employer's own risk by
being a self-insured employer and who has complied with the requirements of this section
and of any applicable rules, shall not be liable to respond in damages at common law or by
statute for the injury or death of any employee, however occurring, after the election's
approval and during the period that the employer is allowed to carry the employer's own
risk.
(h) An employer may not hire any person or group to self-administer claims under this
chapter as a third-party administrator unless the person or group has been determined to be
qualified to be a third-party administrator by the Insurance Commissioner peursuant to rules
adopted by the industrial council. Any person or group whose status as a third-party
administrator has been revoked, suspended, or terminated by the Insurrance Commissioner
shall immediately cease administration of claims and shall not administer claims unless
subsequently authorized by the Insurance Commissioner.

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