(2) To provide the information required in subdivision (b), the employer shall either:
(A) Provide the information on a form prescribed by the administrative director, either DWC Form GV-1, as set forth in Section 10203.1, or DWC Form GV-2, as set forth in Section 10203.2; or
(B) Provide the administrative director with written authorization to collect the information from the appropriate claims administrator. If the administrative director is unable to obtain the information with the written authorization, the employer shall remain responsible for obtaining and submitting the information.
(3) Groups of employers shall report the information required by this section on behalf of its members. The information shall be reported as to every individual employer covered by the 3201.5 or 3201.7 provision. Groups shall also report aggregated figures for all employers in the group covered by the 3201.5 or 3201.7 provision.
(b) The report shall contain the following information:
(1) The name of the individual employer and the union.
(2) The principal business of the employer.
(3) The dates the 3201.5 or 3201.7 provision were in effect during the previous calendar year.
(4) The name of the insurer, if any, and the insurance policy number. If self-insured, the name and certificate number of the self-insured employer.
(5) The name, address and telephone number of any administrator, ombudsperson, mediator or arbitrator employed in an alternative dispute resolution system.
(6) Hours worked by covered employees, reported by trade or craft.
(7) Payroll in accordance with the rules of the Workers' Compensation Insurance Rating Bureau [WCIRB]. Payroll shall be reported by class code as set by the WCIRB.
(8) The number of claims filed in the previous calendar year pursuant to Labor Code section 5401. The claims shall be reported in the following categories:
A. The number of claims that were medical only. As to those claims, there shall also be a report on the total amount of paid costs and the total amount of incurred costs.
B. The number of claims that included a claim for indemnity. As to those claims, there shall also be a report on total amount of paid costs and total amount of incurred costs in each of the following categories: temporary disability, permanent disability, life pensions, death benefits, vocational rehabilitation, medical services, and medical-legal expenses.
(9) The number of claims filed pursuant to Labor Code section 5401 in the previous calendar year that were resolved and the number that remained unresolved on December 31 of the previous calendar year. These numbers together should equal the total number reported in subdivision (b)(8). For the purpose of this section, resolved means one in which ultimate liability has been determined, even though payments may be made beyond the reporting period.
(10) Of the claims that were filed and/or resolved in the previous calendar year, the number that were resolved with a denial of compensability.
(11) Of the claims that were filed and/or resolved in the previous calendar year, the number that were resolved at each of the following stages: before mediation, at or after mediation, at or after arbitration, at or after the appeals board, or at or after the court of appeals. If the 3201.5 or 3201.7 provision contains another dispute resolution procedure, whether instead of or in addition to arbitration or mediation, the report must identify the type of procedure, its stage in the overall alternate dispute resolution process, and the same respective information regarding the resolution of claims.
(12) The title and case number of every application filed with the appeals board in the previous calendar year concerning a claim alleged by any party to fall within the 3201.5 or 3201.7 provision, regardless of whether the employee had the right to file such an application.
(13) The title and court number of every civil action, including petitions for writs and injunctions in any court, state or federal, filed in the previous calendar year, that concerned a claim alleged by any party to fall within the 3201.5 or 3201.7 provision.
(14) The number of injuries and illnesses reported on the United States Department of Labor OSHA Form No. 300 for those employees covered by the 3201.5 or 3201.7 provision. The same number multiplied by 200,000 and divided by hours worked (as reported in subdivision (b)(6)).
(15) The number of employees covered by the 3201.5 or 3201.7 provision who participated in vocational rehabilitation.
(16) If the 3201.5 or 3201.7 provision established a light-duty or return to work program, the number of employees who participated in that program.
(17) For employers covered by a 3201.7 provision, an employee survey that measures worker satisfaction with the 3201.7 alternative dispute resolution procedures. The survey shall be designed and administered by agreement between the employer and the union.
(c) In addition to the data above, the employer may include in its report any explanatory material, narrative account, or comment that the employer believes is necessary to understand the data.
(d) Notwithstanding this section, all employers shall be subject to the reporting requirements of the Workers' Compensation Information System, Title 8, Cal. Code Regs., Section 9700 et seq.
(e) The data obtained by the Administrative Director pursuant to Section 10203 shall be confidential and not subject to public disclosure under any law of this state. However, the Division of Workers' Compensation may create derivative works based on the collective bargaining agreements and data. Those derivative works shall not be confidential, but shall be public.
Authority: Sections 133, 3201.5 and 5307.3, Labor Code. Reference: Sections 3201.5, 3201.7 and 3201.9, Labor Code.
1. New section filed 2-14-96; operative 2-14-96. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 96, No. 7).
2. Amendment of subsections (a)(1), (b)3., (b)8., (b)9.-11. and (b)13.-15. filed 12-27-96; operative 12-27-96. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 96, No. 52).
3. Amendment of section and Note filed 4-22-2004 as an emergency; operative 4-22-2004 (Register 2004, No. 17). A Certificate of Compliance must be transmitted to OAL by 8-20-2004 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 4-22-2004 order, including further amendment of section, transmitted to OAL 8-20-2004 and filed 10-4-2004 (Register 2004, No. 41).
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