Article 6. Workers' Compensation Loss Control Consultation Services, Annual Health and Safety Loss Control Plan--Requirements and Procedures
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(a) Section 339.6(b)(2) requires the insurer's annual plan to include a methodology for selecting targeted employers and section 339.6(c) requires the annual plan to demonstrate that the insurer has reliably identified as targeted employers those of its insureds who have the greatest workers' compensation losses and most significant preventable health and safety hazards, and that the insurer's loss control consultation services will effectively serve the needs of targeted employers.
(b) The Division will review the annual plan to determine the effectiveness of the insurer's targeting methodology. Targeting methodologies may be different depending on the insurer and the type of insureds served, but shall utilize an effective combination of any of the following factors, or similar factors:
(1) Type, number, and rate of occupational injuries and illnesses;
(2) Number of workers' compensation claims, or injuries and illnesses, per payroll or premium dollar;
(3) Severity of workers' compensation claims, or injuries and illnesses, per payroll or premium dollar;
(4) Experience modification rating, or other ways of comparing the employer's loss experience to similar employers;
(5) Data from the insurers' previous evaluations of the employer; and
(6) Cal/OSHA citation history.
EXCEPTION: Other information, e.g., direct written premium per employer or the number of employees per employer, may be used as additional factors to be considered in selecting targeted employers. However, such information shall not be used in a manner which results in exclusion of those insureds who have the greatest workers' compensation losses and most significant preventable health and safety hazards.
NOTE: Authority cited: Sections 54 and 55, Labor Code; and section 11721, Insurance Code. Reference: Section 11721, Insurance Code.
1. New section filed 1-10-94 as an emergency; operative 1-10-94 (Register 94, No. 2). A Certificate of Compliance must be transmitted to OAL by 5-10-94 or emergency language will be repealed by operation of law on the following day.
2. New section refiled with amendment of subsection (c) and redesignated Exception 4-26-94 as an emergency; operative 4-26-94 (Register 94, No. 17). A Certificate of Compliance must be transmitted to OAL by 8-24-94 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 4-26-94 order transmitted to OAL and filed 10-6-94 (Register 94, No. 40).
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