72-306A. DEDUCTIBLE CONTRACT. (1) A surety issuing a worker’s compensation insurance contract may offer deductibles optional to the policyholder for benefits payable thereunder so long as the director of the department of insurance approves the contract.
(2) The director of the department of insurance shall approve a contract containing such a deductible if, but only if, he finds the following standards have been met:
(a) Claimants’ rights are properly protected and claimants’ benefits are paid without regard to any such deductible;
(b) Premium reductions reflect the type and level of the deductible, consistent with accepted actuarial standards;
(c) Premium reductions for deductibles are determined before application of any experience modification, premium surcharge or premium discount;
(d) Recognition is given to policyholder characteristics, including size, financial capabilities, nature of activities and number of employees;
(e) The policyholder is liable to the surety for the deductible amount in regard to benefits paid for compensable claims;
(f) The surety pays all of the deductible amount, applicable to a compensable claim, to the person or provider entitled to benefits and then seeks reimbursement from the policyholder for the applicable deductible amount;
(g) Failure to reimburse deductible amounts by the policyholder to the surety is treated under the policy in the same manner as nonpayment of premiums; and
(h) Losses subject to the deductible shall be reported and recorded as losses for purposes of ratemaking and application of the experience rating plan on the same basis as losses under policies providing first dollar coverage; and
(i) The contract otherwise complies with the statutes of this state.
(3) The premium tax required to be paid pursuant to section 72-523, Idaho Code, shall be calculated based on premiums which would have been charged but for the deductible. For all other taxes and assessments, including residual market assessments, based on premium, the amount of premium shall be determined after application of the deductible.
History:
[72-306A, added 1993, ch. 223, sec. 1, p. 759.]
Structure Idaho Code
Title 72 - WORKER'S COMPENSATION AND RELATED LAWS -- INDUSTRIAL COMMISSION
Chapter 3 - SECURITY FOR COMPENSATION
Section 72-301 - SECURITY FOR PAYMENT OF COMPENSATION.
Section 72-301A - ALTERNATIVE MEANS OF SECURING SELF-INSURANCE.
Section 72-302 - REGULATION OF DEPOSIT WITH STATE TREASURER.
Section 72-303 - QUALIFICATION SUBJECT TO REGULATION.
Section 72-304 - PROMPT COMPENSATION PAYMENTS REQUIRED — RULES AND REGULATIONS.
Section 72-305 - CLAIMS SERVICES AND MEDICAL SUPERVISION.
Section 72-306 - RECITALS IN INSURANCE CONTRACTS.
Section 72-306A - DEDUCTIBLE CONTRACT.
Section 72-307 - KNOWLEDGE OF EMPLOYER TO AFFECT SURETY.
Section 72-308 - INSOLVENCY OF EMPLOYER NOT TO RELEASE SURETY.
Section 72-309 - INSURANCE CONTRACT DEEMED REFORMED.
Section 72-310 - MISREPRESENTATION NOT TO AFFECT EMPLOYEE’S RIGHTS.
Section 72-311 - NOTICE OF SECURITY — CANCELLATION OF SURETY CONTRACT.
Section 72-312 - POSTING OF NOTICE REGARDING INSURANCE — PENALTY.
Section 72-313 - PAYMENT PENDING DETERMINATION OF POLICY COVERAGE.
Section 72-314 - PAYMENT OF LIABILITY OF PUBLIC EMPLOYER.
Section 72-315 - ERRONEOUS PAYMENT IN GOOD FAITH.
Section 72-316 - VOLUNTARY PAYMENTS OF INCOME BENEFITS.
Section 72-317 - PERIODICAL PAYMENTS.
Section 72-318 - INVALID AGREEMENTS — PENALTY.
Section 72-319 - PENALTY FOR FAILURE TO SECURE COMPENSATION.
Section 72-320 - COMPENSATION PREFERRED AS WAGES.
Section 72-321 - STATUTORY AGENT OF EMPLOYER WHO HAS NO BUSINESS LOCALE.
Section 72-322 - ASSIGNED RISK.
Section 72-323 - CREATION OF INDUSTRIAL SPECIAL INDEMNITY FUND.
Section 72-324 - MANAGEMENT OF INDUSTRIAL SPECIAL INDEMNITY FUND.
Section 72-325 - STATE TREASURER CUSTODIAN OF FUND — DUTIES.
Section 72-326 - DEPOSIT AND INVESTMENT OF FUND — INTEREST.
Section 72-327 - ASSESSMENT — METHOD OF CALCULATION AND PRORATION — TIME FOR PAYMENT.
Section 72-328 - COLLECTION OF DELINQUENT ASSESSMENTS — DUTY OF ATTORNEY GENERAL — PENALTIES.
Section 72-329 - DISBURSEMENTS.
Section 72-330 - LEGAL REPRESENTATION OF FUND.
Section 72-331 - PAYMENT OF ADMINISTRATIVE EXPENSES.
Section 72-332 - PAYMENT FOR SECOND INJURIES FROM INDUSTRIAL SPECIAL INDEMNITY ACCOUNT.