| (a) Initial annual report by insurance company.
(1) Not later than April 1, 2014, each insurance company
writing workers' compensation insurance in Texas as of the effective
date of this section shall file with the division an initial annual
report on its accident prevention services. An insurance company that
writes its first workers' compensation insurance policy after the
effective date of this section shall file with the division an initial
annual report on its accident prevention services not later than the
effective date of its first workers' compensation insurance policy.
(2) An initial annual report required by this subsection
shall be filed in the format and manner prescribed by the division
and shall include:
(A) insurance company's name;
(B) group name;
(C) name, email, phone number, and mailing address
of the primary loss control contact for Texas;
(D) National Association of Insurance Commissioners
(NAIC) number;
(E) company's A.M. Best rating;
(F) changes in ownership, organizational structure,
or management of the insurance company since the last annual report
that affect the provision of accident prevention services;
(G) for each of the accident prevention services listed
in §166.2(a)(1) - (7) of this title (relating to Adequacy of
Accident Prevention Services):
(i) criteria, including the specific time frame and
manner, that the insurance company will use to evaluate and determine
a policyholder's need for accident prevention services required by
the nature of its policyholder's operations based on frequency and
severity of claims and risk exposures, including how the insurance
company will ascertain the date of the final determination;
(ii) the specific time frame and manner in which an
insurance company will make an offer of accident prevention services
to policyholders once a determination has been made;
(iii) the specific time frame and manner in which services
will be provided to policyholders;
(iv) specify each entity that will provide the services,
such as the insurance company, contracted provider, or contracted
policyholder; and
(v) how the provision of services to policyholders
will be documented;
(H) the manner in which an insurance company determines
a loss ratio;
(I) insurance company qualification requirements for
employing or contracting with accident prevention personnel;
(J) method for assuring that the accident prevention
personnel provide the requisite level of service to the insurance
company's policyholders;
(K) total number of workers' compensation policies
in effect as of December 31 of the report year;
(L) number of policies in the following premium groups
that received any type of workers' compensation accident prevention
services:
(i) less than $25,000;
(ii) $25,000 - $100,000; and
(iii) more than $100,000;
(M) total dollar amount spent for accident prevention
services for Texas workers' compensation policyholders;
(N) number of policyholder requests for service;
(O) number of policyholder requests for service fulfilled;
(P) number of surveys performed;
(Q) number of work-related fatalities incurred by policyholders;
(R) evidence of the effectiveness of and accomplishments
in accident prevention; and
(S) contact information of and certification by an
insurance company representative that the information submitted under
this subsection is correct and complete.
(b) Subsequent annual reports by insurance company.
(1) Subsequent to an insurance company's initial annual
report under subsection (a) of this section, an insurance company
shall file with the division an annual report on its accident prevention
services not later than April 1 of each calendar year.
(2) An annual report required by this subsection shall
be filed with the division in the format and manner prescribed by
the division and shall include the:
(A) insurance company's name;
(B) group name;
(C) name, email, phone number, and mailing address
of the primary loss control contact for Texas;
(D) NAIC number;
(E) information in subsection (a)(2)(E) - (R) of this
section that has changed since the last annual report; and
(F) contact information of and certification by an
insurance company representative that the information submitted under
this subsection is correct and complete.
(c) The initial and subsequent annual reports shall
not include the expenses or the costs of underwriting visits to a
policyholder's premises unless accident prevention services are provided
during the visit. In that case, the proportionate costs of the accident
prevention services may be included in the report.
(d) When resuming writing workers' compensation insurance
in Texas, any insurance company that has not written workers' compensation
insurance with exposures in Texas for 12 months or more shall submit,
not later than the effective date of its first workers' compensation
policy, the initial annual report required under this section.
(e) Insurance companies are responsible for timely
and accurate reporting under this section. A report required by this
section is considered filed with the division only when it accurately
contains all of the required data elements and is received by the
division.
(f) This section is effective October 1, 2013.
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