CHAPTER 626
RATE REGULATION IN WORKER'S COMPENSATION INSURANCE
626.02 Definitions.
626.03 Scope of application.
626.06 Rating bureau.
626.09 General provisions concerning the bureau.
626.11 Rate standards.
626.12 Rating methods.
626.125 Qualified loss management program.
626.13 Approval of rates and rating plans.
626.14 Filings open to inspection.
626.22 Disapproval of rates.
626.25 Use of rates.
626.31 Operation and control of bureau.
626.32 Development of rates by bureau.
626.35 Worker's compensation insurance contracts.
626.51 Other rate service organizations.
Ch. 626 Cross-reference Cross-reference: See definitions in ss. 600.03 and 628.02.
Ch. 626 Note NOTE: Chapter 148, laws of 1975, which created this chapter of the statutes, contained notes explaining the revision. See the 1975 session law volume.
626.02 626.02 Definitions. In this chapter, unless the context indicates otherwise:
626.02(1) (1) "Bureau" means the Wisconsin compensation rating bureau provided for in s. 626.06.
626.02(2) (2) "Rate service organization" has the meaning designated for the term under s. 625.02 (2).
626.02 History History: 1975 c. 148; 1983 a. 189.
626.03 626.03 Scope of application. This chapter applies to all worker's compensation insurance written on risks or operations in this state, employers' liability insurance when written in connection with worker's compensation insurance or insurance covering any part of the liability of an employer exempted from insuring the employer's liability for compensation under s. 102.28.
626.03 History History: 1975 c. 148, 199.
626.06 626.06 Rating bureau. The Wisconsin compensation rating bureau is continued and every insurer writing any insurance specified under s. 626.03 is a member of it.
626.06 History History: 1975 c. 148.
626.09 626.09 General provisions concerning the bureau.
626.09(1)(1)Purposes. The bureau has the following purposes:
626.09(1)(a) (a) To establish, maintain and administer rules, regulations, classifications, rates and rating plans to govern the transaction of insurance included in s. 626.03;
626.09(1)(b) (b) To cooperate with other rate service organizations and with insurers in the development of rules, rates and rating plans and insurance policies and forms;
626.09(1)(c) (c) To secure and analyze statistical and other data required to accomplish these purposes;
626.09(1)(d) (d) To inspect and classify risks;
626.09(1)(e) (e) To file with the commissioner on behalf of its members every manual of classifications, rules and rates, every rating plan and every modification of any of them proposed for use in this state;
626.09(1)(f) (f) To assist the commissioner and insurers in the promotion of safety in industry; and
626.09(1)(g) (g) To assist in any matter necessary for the accomplishment of these purposes.
626.09(2) (2)Licensing. The bureau's license which it holds under s. 205.03 (2), 1973 stats., immediately prior to January 17, 1976 shall continue as its license under s. 625.32, and thereafter the bureau shall be treated as if it had applied for and had received a license under s. 625.32.
626.09(3) (3)Examinations. Sections 601.43 to 601.45 apply to the bureau.
626.09(4) (4)Fees. Section 601.31 (1) (c) 2. applies to the bureau.
626.09 History History: 1975 c. 148; 1979 c. 102 s. 237.
626.11 626.11 Rate standards.
626.11(1)(1)General. Rates determined under this chapter shall not be excessive, inadequate or unfairly discriminatory.
626.11(2) (2)Excessiveness. Rates determined under this chapter are not excessive merely because a reasonable margin is allowed for a profit.
626.11(3) (3)Adequacy. The commissioner shall approve a minimum adequate pure premium for each classification under which worker's compensation insurance is written. No insurer writing any insurance specified under s. 626.03 may use a pure premium less than that approved by the commissioner.
626.11 History History: 1975 c. 148, 199.
626.12 626.12 Rating methods. In determining whether rates comply with the standards under s. 626.11, the following criteria shall be applied:
626.12(1) (1)Basic factors in rates. Due consideration shall be given to past and prospective loss and expense experience within and outside this state, to catastrophe hazards and contingencies, to a reasonable margin for profit, to dividends, savings or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members or subscribers, and to all other relevant factors.
626.12(2) (2)Classification. Risks may be classified in any reasonable way for the establishment of rates and minimum premiums. Classification rates may be modified to produce rates for individual risks in accordance with rating plans which establish standards for measuring variations in hazards or expense provisions, or both. Such standards may measure any differences among risks that can be demonstrated to have a probable effect upon losses or expenses.
626.12(3) (3)Physical impairment. Rates or rating plans may not take into account the physical impairment of employes. Any employer who applies or promotes any oppressive plan of physical examination and rejection of employes or applicants for employment shall forfeit the right to experience rating. If the department of industry, labor and job development determines that grounds exist for such forfeiture it shall file with the commissioner a certified copy of its findings, which shall automatically suspend any experience rating credit for the employer. The department shall make the determination as prescribed in ss. 103.005 (5) (b) to (f), (6) to (11), (13) (b) to (d) and (16), so far as such subsections are applicable, subject to review under ch. 227. Restoration of an employer to the advantages of experience rating shall be by the same procedure.
626.12 History History: 1975 c. 148; 1995 a. 27 ss. 7037, 9130 (4).
626.125 626.125 Qualified loss management program.
626.125(1) (1)Elements of program. The bureau may file with the commissioner under s. 626.13 a qualified loss management program that contains all of the following elements:
626.125(1)(a)1.1. Subject to subd. 2., the bureau shall restrict eligibility for participation in the qualified loss management program to an employer that has obtained any insurance specified in s. 626.03, that is eligible for an experience rating under s. 626.12 (1), that is eligible for coverage under a mandatory risk-sharing plan under s. 619.01 (1) and that, as of July 1, 1995, has a rate of not less than $10 on the risk classification that generates the most manual premium for that employer.
626.125(1)(a)2. 2. Notwithstanding subd. 1., the bureau may broaden eligibility for participation in the qualified loss management program to an entire specific classification of employers that have obtained any insurance specified in s. 626.03 and that are ineligible for coverage under a mandatory risk-sharing plan under s. 619.01 (1) if the bureau determines that permitting that entire specific classification of employers to participate in the qualified loss management program is necessary to support the effective delivery of safety training to a high-risk industry.
626.125(1)(b) (b) The bureau shall grant a prospective premium credit to an eligible employer that subscribes to a loss management action plan prepared by a loss management firm approved under sub. (2) that specifies the activities that the eligible employer will perform to reduce its loss experience.
626.125(1)(c) (c) The bureau shall base the initial prospective premium credit granted to an eligible employer on the qualifications of the loss management firm that prepared the loss management action plan subscribed to by the eligible employer and on the improvement in the loss experience of the eligible employer anticipated by the bureau, in accordance with generally accepted actuarial principles, as a result of the loss management action plan.
626.125(1)(d) (d) The bureau shall base subsequent prospective premium credits granted to an eligible employer on the aggregate loss experience of all eligible employers served by the loss management firm serving the eligible employer.
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