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054.00.54-8. PLAN ADMINISTRATOR

AR ADC 054.00.54-8Arkansas Administrative Code

West's Arkansas Administrative Code
Title 054. Insurance Department
Division 00.
Rule 54. Arkansas Workers' Compensation Insurance Plan
Ark. Admin. Code 054.00.54-8
054.00.54-8. PLAN ADMINISTRATOR
Currentness
A. The Commissioner shall from time to time designate a Plan Administrator to administer and operate the Plan.
B. The Plan Administrator (or any successor Plan Administrator or Administrators) shall open and continually operate a centrally - located office within the State of Arkansas reasonably and readily accessible to the offices of the Commissioner and at a location and with such staffing, equipment and facilities as shall be reasonably acceptable to the Commissioner as being adequate to provide a high quality level of service to the people of the State of Arkansas.
C. The Plan Administrator shall file with the Commissioner for approval operating rules, procedures, and guidelines consistent with the provisions of this Rule and Regulation for the administration and operation of the Plan. The Plan Administrator shall publish and make available to all insurers and producers the operating rules, procedures, performance standards, and guidelines for the administration and operation of the Plan. Further, the Plan Administrator shall file for approval its schedule of fees which it proposes to remit to Producers for policies written and services provided under the Plan.
D. The Plan Administrator shall have the following duties and responsibilities in addition to any others set forth in this Plan, all of which are subject to the ultimate control and oversight of the Commissioner:
(1) administering, managing, and enforcing the Plan subject to the provisions contained herein;
(2) determining the methodology and formula for making assignments to servicing carriers pursuant to Section 15 and securing the necessary information in order to make the assignments;
(3) processing assigned risk applications pursuant to the requirements of this Plan;
(4) establishing eligibility criteria for servicing carriers and appointing servicing carriers, each of which shall be subject to the prior approval of the Commissioner;
(5) establishing written performance requirements for servicing carriers, including, but not limited to:
- verification of ongoing Plan eligibility of the employer
- timely and accurate issuance of policies and endorsements
- timely and accurate filings with administrative agencies, as required
- maintenance of premiums on policies consistent with manual rules, rates, rating plans, and classifications
- timely and accurate completion and billing of final audits
- collection of premium
- claim services, including investigation, disability management, and medical cost control
- loss control services and safety information to encourage employers to make safety a part of their business
- Cooperation with the Commissioner and with the Workers Compensation Commission and Arkansas Department of Labor in carrying out and effectuating the safety mandates of Act 796 of 1993 and such Rules and Regulations as may be promulgated thereunder
- payment of producer fees
- issuance of renewal proposals and non-renewal notices
- assurance of insured and insurer compliance with all terms and conditions of policy contract
- resolution of complaints and response to insured/producer inquiries
- reporting financial and statistical data to producers and insureds, as well as to the Commissioner
- requirement to consult with and keep insureds apprised of developments in incurred claim cases;
(6) keeping servicing carriers apprised of all required Performance Standards, monitoring servicing carrier performance and enforcing performance requirements and incentives;
(7) administering the dispute resolution mechanism as provided in Section 16;
(8) developing and implementing assigned risk operating rules and forms to the extent necessary to carry out the purposes of this Plan;
(9) informing the Commissioner of any insurer that is improperly not participating in this Plan; and
(10) monitoring the performance and operation of the Plan and initiating and requesting approval of amendments thereto as appropriate.
The Plan Administrator shall also be responsible for determining the expenses for the operation of the Plan, exclusive of the Plan Administrator's expenses incurred in connection with responsibilities it has under the Articles, and shall assess each insurer participating in the Plan for those expenses on an equitable basis as determined by the Plan Administrator and approved by the Commissioner.
E. Commencing with the first quarter of 1994 and quarterly thereafter, the Plan Administrator shall file with the Commissioner a statement of expenses for the operation of the Plan and a report of the quarterly results of the servicing carriers under the Plan. The report shall include written and earned premium; paid and incurred losses; administration and servicing carrier allowances and remuneration; such other factors or elements as the Commissioner may from time to time determine; and effective for the first quarter of 1995, it shall include servicing carrier complaints reported by employers or producers. The statement and report shall be filed within ninety (90) days of the close of the applicable quarter. In addition, with regard to insurers previously authorized as direct assignment carriers, the Plan Administrator shall file annually on or before October 1 of the following year, a report of the annual results of such direct assignment carriers similar to that applicable to servicing carriers.
Further, and within ninety (90) days following the end of the fourth quarter of 1994, and annually thereafter, the Plan Administrator shall file with the Commissioner a performance review and evaluation of each servicing carrier in accord with the “Performance Standards and Procedures for Measuring Servicing Carrier Performance” in Section 12 and the criteria set forth in paragraph D.(5) above.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 054.00.54-8, AR ADC 054.00.54-8
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