(a) Access card. In this chapter, access card means
any card or other payment method that may be used by a claimant to
initiate an electric fund transfer from an insurance carrier's bank
account. The term "access card" does not include stored value cards
or prepaid cards that store funds directly on the card and that are
not linked to an insurance carrier's bank account.
(b) Mutual agreement. An insurance carrier may pay
income or death benefits through an access card to a claimant if there
is written mutual agreement signed by the insurance carrier and the
claimant. The insurance carrier shall maintain accurate records of
the mutual agreement for, at a minimum, 401 weeks from the date of
injury. The written mutual agreement shall contain an acknowledgement
that the claimant received and agreed to the written disclosure in
subsection (f) of this section.
(c) Agent of the insurance carrier. Any person with
whom an insurance carrier utilizes or contracts for the purpose of
providing service or fulfilling duties under this section is an agent
of the insurance carrier under §180.1(3) of this title (relating
to Definitions).
(d) Requirements and prohibited fees. An insurance
carrier shall:
(1) permit the claimant to withdraw the entire amount
of the balance of an access card in one transaction;
(2) not reduce income or death benefits paid to a claimant
through an access card for the following fees, surcharges, and adjustments:
(A) overdraft services under which a financial institution
pays a transaction (including a check or other item) when the claimant
has insufficient or unavailable funds in the account;
(B) ATM withdrawal or a point of sale purchase for
more than the card holds and the transaction is denied;
(C) ATM balance inquiries;
(D) withdrawing money from network ATMs;
(E) withdrawing money from a teller;
(F) customer service calls;
(G) activating the card;
(H) fees for card inactivity;
(I) closing account;
(J) access card replacement through standard mail;
(K) withdrawing the entire payment in one transaction;
(L) point of sale purchases; or
(M) any other fees or charges that are not authorized
under subsection (e) of this section.
(e) Permitted fees. The claimant may be charged for
the following:
(1) access card replacement through an expedited mail
service;
(2) international transaction fees; and
(3) out-of-network ATM fees.
(f) Required disclosure. Insurance carriers shall provide
a written disclosure to the claimant contemporaneously with the written
mutual agreement under subsection (a) of this section. The written
disclosure shall include:
(1) a summary of the claimant's liability for unauthorized
electronic fund transfers;
(2) the telephone number and address of the person
or office to be notified when the claimant believes that an unauthorized
electronic fund transfer has been or may be made;
(3) the type of electronic fund transfers that the
claimant may make and any limitations on the frequency of transfers;
(4) any fees imposed for electronic fund transfers
or for the right to make transfers including a statement that fees
may be imposed by ATM operator that is out-of-network;
(5) fees for expedited card replacement or international
transaction fees will be removed from the balance maintained in the
bank account linked to the access card;
(6) a summary of the claimant's right to receipts and
periodic statements;
(7) all bank locations and network ATMs in the United
States where the claimant may access his or her funds at no cost;
(8) a statement informing the claimant that they have
a right to receive payments directly into their personal bank account
through direct deposit.
(g) Plain language requirement. An insurance carrier
shall provide a written disclosure and notice of term or condition
changes under this section that:
(1) are printed in not less than 12-point font;
(2) include the full text in English, Spanish, and
any other language common to the claimant population;
(3) are written in a clear and coherent manner and
wherever practical, words with common and everyday meaning shall be
used to facilitate readability; and
(4) are appropriately divided and captioned in a meaningful
sequence such that each section contains an underlined, boldfaced,
or otherwise conspicuous title or caption at the beginning of the
section that indicates the nature of the subject matter included in
or covered by the section.
(h) Access card information. An access card issued
to the claimant under the section:
(1) shall not bear any information that could reasonably
identify the claimant as a participant in the workers' compensation
system.
(2) shall include on the front or back of the access
card a toll-free customer service number and website address. Customer
service personnel shall be available by phone Monday through Friday,
during normal business hours as outlined in §102.3 of this title
(relating to Computation of Time).
(i) Written notice of term or condition changes. The
insurance carrier shall provide a written notice to the claimant at
least 21 days before the effective date of any change in a term or
condition of the mutual agreement or disclosure, including terminating
the access card program, increased fees, or liability for unauthorized
electronic fund transfers. Any terms or conditions that violate the
requirements of this section are null and void and may result in administrative
penalties for the insurance carrier. An insurance carrier shall provide
a written notice of term or condition changes that:
(1) provides a comparison of the current terms and
the changes; and
(2) references the claimant's ability to request a
change in payment outlined in §124.5(i) of this title (relating
to Mode of Payment Made by Carriers).
(j) Account closure. An insurance carrier may close
the account by issuing a check to the claimant with the remaining
balance of the access card if the account has been inactive for 12
months or longer.
(k) Recoupment of payment. The insurance carrier shall
not remove money from the claimant's account or access card except
to remove permitted fees under subsection (e) of this section or to
close the account for inactivity of a period of 12 months or more.
An insurance carrier seeking to recoup overpayments shall follow the
procedures outlined in §126.16 of this title (relating to Procedures
for Recouping Overpayments of Income Benefits).
(l) Paid date. An insurance carrier is considered to
have made an income or death benefit payment the date the payment
is available on the claimant's access card.
(m) No granting of rights. Nothing in the section shall
be construed to grant any rights otherwise prohibited under federal
law.
(n) Effective date. This section is effective for income
or death benefit payments due on or after June 1, 2015.
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