053-2 Wyo. Code R. §§ 2-3 - Experience Rating
(a) One (1)
experience modification rating (EMR) shall be assigned to each employer number
for those eligible employers under the Act. An employer who elects to establish
a separate employer number for each separate legal entity of the employer's
businesses shall be assigned an experience rating for each employer
number.
(b) An employer's EMR is
computed by using three (3) years claims experience [or maximum available
portions of three (3) years] for each eligible employer.
(i) Private sector employers will receive an
EMR based on three (3) years claims experience effective January 1 of their
fifth (5th) calendar year.
(ii)
Public sector employers will receive an EMR based on three (3) years claims
experience effective July 1 of their sixth (6th) fiscal year.
(c) Pursuant to W.S. §
27-14-207(j), the non-resident employer must direct their insurance company to
submit their EMR history directly to the Division.
(i) If a non-resident employer expanding or
moving their operations to Wyoming has previously been self-insured, and does
not have any experience history available from a third party workers' insurance
company, they will be assigned an EMR of one (1) and will be charged at the
industry base rate for their classification.
(ii) The Division will use the employers
experience history to calculate the EMR according to the current EMR split-plan
calculation.
(d) For an
employer having less than one (1) full year (private employers follow a fiscal
year; public employers follow a calendar year) of premium obligation during the
EMR period, the employer's EMR will be equal to a modification of one
(1).
(e) For an employer having
greater than one (1) full year of premium obligation during the EMR period, but
less than three (3) full years of premium obligation, the actual premium
obligation will be based on the employer's actual experience as recorded by the
Division in the quarterly or monthly reports in the premium year.
(f) The Division, through the qualified
actuary, as defined by W.S. § 27-14-201(b), shall annually determine key
parameters of the EMR plan to meet the requirements of W.S. §
27-14-201(d). The Division will notify each employer who qualifies for an EMR
of the key parameters, (i, ii, iii) of this sub-section, on the yearly EMR
notice. The key parameters will also be published on the Division website for
any employer to inspect.
(i) Split Point. The
claim cost amount at which an employer's EMR moves from the measure of
frequency to the measure of severity.
(ii) Group Premium Rate. There will be five
(5) groups for premium bands. Each Group Premium Rate will have a credit/debit
maximum percent amount to affect the employer's EMR. At no time shall this
exceed +/- eighty-five percent (85%). Individual employer groups are based on
the amount of premium over a three (3) year period and the actuarial process.
Group 1 not to exceed +/- 20%
Group 2 not to exceed +/- 25%
Group 3 not to exceed +/- 45%
Group 4 not to exceed +/- 65%
Group 5 not to exceed +/- 85%
(iii) Chargeable Minimum and Maximum - There
will be a claim cost minimum on medical only cases, which are not ratable to
the employer and will not affect the EMR. There will also be a claim cost
maximum at which point claim cost above the maximum single loss are not ratable
and will not affect the EMR.
(g) For employers in Group I, the experience
adjustment for claims occurring within the three (3) year EMR period shall be
as follows:
(i) Zero percent (0%) if the
employer's account has been charged with one (1) claim which exceeds the annual
minimum claim cost amount.
(ii)
Twenty percent (20%) penalty if the employer's account has been charged with
two (2) or more claims which exceed the annual minimum claims cost
amount.
(iii) Twenty percent (20%)
credit if the employer's account has not been charged with a claim exceeding
the annual minimum claims cost amount.
(h) The formula for computing the split plan
EMR is defined below
Click here to view image
Click here to view image
Where: Zp = Credibility Primary Value
Ap = Actual Primary Losses
Ep = Expected Primary Losses
Ze = Credibility Excess Value
Ae = Actual Excess Losses
Ee = Expected Excess Losses
E = Expected Losses
(See Glossary of Terminology in Section 15.)
(i) Contesting EMR. Any employer
may contest the annual EMR or case reserve amounts assigned by the Division.
Contest shall be made by filing a written objection with the Division within
thirty (30) days after notification by the Division as provided in W.S. §
27-14-201(h). The Division shall resolve the matter administratively within
forty-five (45) days after the filing of the objection. If the matter is not
resolved within forty-five (45) days then the Division shall refer the
objection to an independent hearing officer appointed for such purpose,
pursuant to these rules and the Wyoming Administrative Procedure Act.
(j) Contesting Chargeability of Claims Costs.
An employer may apply for nonchargeability of claims costs pursuant to W.S.
§ 27-14-201(d).
(i) An employer who is
current on premium payments required by the Act may contest the chargeability
of claims costs by filing a written application with the Division on a form
supplied by the Division.
(ii) The
application to determine chargeability must be filed no later than one (1) year
after the determination of compensability for an injury occurring on or after
July 1, 2015.
(iii) Upon receipt of
said application, the Division shall schedule a time and date for a hearing.
The employer shall be notified of the time and date of the hearing.
(iv) The hearing shall be conducted pursuant
to the Division's Rules, Chapter 1, Section 4 or
https://rules.wyo.gov/Search.aspx?mode=1
(v) The hearing shall be conducted by a panel
from the Division, including the Administrator of the Workers' Compensation
Division, the Program Manager of Employer Services, the Program Manager of
Claims, the District Manager from the appropriate district, the claims analyst
assigned to the underlying claim, a representative from OSHA, and a
representative from the Attorney General's Office.
(vi) The employer will present its case to
the panel after which the panel shall take the issue under advisement and issue
a written, final determination.
(vii) If an employer fails to appear for the
hearing, the initial determination on chargeability will become the final
agency action.
Notes
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