| Issued and entered August 21, 1995 by D. Joseph Olson, Commissioner
of Insurance
Section 551 of the Worker's Disability Compensation Act (Act),
MCLA 418.551, provides for assessments to be levied upon carriers
for purposes of the second injury fund and the silicosis, dust
disease, and logging industry compensation fund. This section
also specifies the basis for these assessments:
The assessment shall bear the same relationship that the total
compensation benefits, exclusive of payments made pursuant to
sections 315, 319, and 345, paid by each carrier in the state
bears to the total compensation benefits paid by all carriers
in the state.
Confusion has apparently arisen with regard to the basis for
assessment in the case of large deductible worker's compensation
insurance policies. The purpose of this bulletin is to provide
some clarification in that regard.
Large deductible worker's compensation insurance policies
provide that the insurer shall make all benefit payments and
the employer will reimburse the insurer for any amounts paid
up to the deductible limit. Employers purchasing such policies
are considered insured for purposes of the Act. Therefore, the
payments made by the insurer, including those made under the
deductible limit, are to be considered in the calculation of
the assessment pursuant to Section 551.
It has come to the Insurance Bureau's attention that some
insurers believe that employers are to be considered self-insured
for the amount of the deductible and insured for the amount
over the deductible, and therefore can be assessed as a self-insurer
for amounts paid under the deductible. This is not possible
under the Act. The Act defines "self- insurer" as
a group of employers who pool their liabilities as a group fund
in the manner provided by the Act, or as an individual employer
authorized to carry its own risk. An individual employer must
receive authorization from the director of the Bureau of Workers'
Disability Compensation in order to carry its own risk. Employers
purchasing large deductible worker's compensation insurance
policies do not have such authorization and therefore cannot
be assessed as a self- insurer under Section 551.
Therefore, the Bureau of Workers' Disability Compensation
cannot assess individual employers with large deductible policies
as self- insureds. Insurers' assessments are to be based on
all benefits paid, including those made under the deductible
limit.
Any questions regarding this bulletin should be directed to:
Market Standards Division
MI Insurance Bureau
611 West Ottawa, 2nd Floor
Lansing, MI 48933
(517) 373-0242 |
or |
Funds Administrator
MI Department of Labor
7201 West Saginaw St., Suite 110
Lansing, MI 48917
(517) 323-2444 |
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