OAL Orders CDI to Make Change Urged by IIABCal

The California Office of Administrative Law has given final approval to new regulations governing creation of a website, required to be created by the Workers Compensation Insurance Rating Bureau, to permit interested parties to “verify” that businesses have obtained workers’ comp insurance.

The final version of the regulations, which take effect March 12, 2011, includes a change IBA West urged the California Department of Insurance to make—and which OAL required CDI to adopt—protecting policy numbers from disclosure on the website.

Legislation requiring creation of the website expressly precluded policy numbers and inception and/or expiration dates of those policies from disclosure; however, the implementing regulations proposed by CDI did not, in IBA West’s view, adequately track the statutory language to ensure such data would not be made public.

In written testimony IBA West submitted to CDI in December, the Association urged the Department to amend the regulations to expressly prohibit inclusion of policy numbers on the site.  The CDI declined to make that change, but OAL required CDI to include that change in the final version of the regulations.

Section 2593.3(c) of the regulations, which sets forth restrictions on public access in the web site, now adds “policy numbers” to the data exempt from disclosure.

The complete text of the final version of the regulations appears below:

California Code of Regulations

TITLE 10. INVESTMENT
CHAPTER 5. INSURANCE COMMISSIONER
SUBCHAPTER 3. INSURERS
ARTICLE 21. WORKERS' COMPENSATION RATING ORGANIZATION 
INTERNET WEB SITES

[ARTICLE 21 IS A NEW ARTICLE AND IS ADDED TO SUBCHAPTER 3 TO READ:]

§ 2593. Authority and Purpose

The regulations set forth in this article are required to carry out the provisions of Section 11752.75 of Article 3 of Chapter 3 of Part 3 of Division 2 of the Insurance Code. The purpose of these regulations is to provide the standards required to allow a person to submit a query on a rating organization's Internet Web site for workers' compensation insurance coverage information concerning a specified employer on a specified date and to allow for employers to dispute with the rating organization or the employer's insurance company incorrect information displayed on the Internet Web site.

Note: Authority cited: Section 11752.75, Insurance Code. Reference cited: Section 11752.75, Insurance Code.

§ 2593.1. Definitions

For purposes of this Article:

(a) "Coverage Information" means the name of the employer, the employer's address or other identifying information, the date specified in the query for coverage information, and the name of the insurer on the date specified in the query for the coverage information.

(b) "Employer" means the person or entity that is a named insured on the workers' compensation insurance policy for which a query regarding coverage information is being made.

(c) "FEIN" means Federal employer identification number.

(d) "Insurer" means a California admitted workers' compensation insurance company that provided workers' compensation coverage to the specified employer on the specified date.

(e) "Policy" means a workers' compensation insurance policy issued by a California admitted workers' compensation insurance company.

(f) "Policy Information" means workers' compensation insurance policy data reported by a California admitted insurance company to a rating organization.

(g) "Query" means an inquiry on the rating organization's insurance coverage Internet Web site regarding workers' compensation coverage information for a specified employer on a specified date.

Note: Authority cited: Section 11752.75, Insurance Code. Reference cited: Section 11752.75, Insurance Code.

 

§ 2593.2. Employer Query Identifying Information

A query shall allow for, but is not limited to, the following identifying information on an employer to inquire about the employer's coverage information on a specified date: Name of the employer; Name of the employer and a full or partial address of the employer, including, but not limited to, street name, city, and state; or FEIN.

Note: Authority cited: Section 11752.75, Insurance Code. Reference cited: Section 11752.75, Insurance Code.

 

§ 2593.3. Web Site Access Restrictions

(a) A rating organization may establish protocols, rules, or other limitations and restrictions on its coverage Internet Web site to limit access to information concerning employer workers' compensation insurance coverage so as to allow for only queries for a specified employer on a specified date.

(b) The coverage Internet Web site shall prohibit the automated retrieval of information and shall give clear notice on the Internet Web site of this prohibition.

(c) The rating organization shall limit a person's use of the coverage Internet Web site to prevent unlimited or multiple queries of the information that could be used to determine policy inception or expiration dates or policy numbers or used for other purposes for which it was not intended by employing reasonable security or authentication measures to prevent multiple or automated retrieval of employer coverage information while not hindering the public's access to it. Such measures may include limiting the amount of time a person may use the Web site, limiting the number of queries in a single session, employing a challenge-response system, or any other criteria that meets generally accepted industry practices for limiting access to information on a Web site.

(d) The rating organization shall limit query results to identify as best as possible the specified employer being sought and to avoid query results that may list employers related by other criteria, such as employer safety groups or clients of labor contractors and professional employer organizations.

(1) When an employer is being queried for by using the employer's name, only employers with similar names or a portion of that name may be displayed as a result of the query.

(2) When an employer is being queried for by FEIN, only the employer associated with that FEIN may be displayed as a result of the query.

Note: Authority cited: Section 11752.75, Insurance Code. Reference cited: Section 11752.75, Insurance Code.

 

§ 2593.4. Disclaimers

(a) The rating organization may provide disclaimers in its coverage Internet Web site regarding the limitations or deficiencies of the coverage information available on the Internet Web site or the policy information it collects from insurers.

(b) In addition to the disclaimers required pursuant to Insurance Code Section 11752.75, the rating organization shall also provide disclaimers regarding the following:

(1) The result of a query is not evidence or verification of workers' compensation insurance coverage, which should be obtained from or verified by the insurer directly.

(2) The results of a query should be confirmed both with the employer and the insurer before it is used for any purpose.

(3) Coverage information may not be available or complete for all employers due to limitations with the policy information, such as similar or duplicate employer names, multiple or alternate locations and addresses for employers, or more than one named insured employer on an insurance policy.

(4) The coverage Internet Web site may only provide coverage information for five years prior to the date of the query.

(5) If employer coverage information is not found on the coverage Internet Web site it may be due to the employer being self-insured, and inquiries concerning self-insured employers should be directed to the California Office of Self Insurance Plans.

Note: Authority cited: Section 11752.75, Insurance Code. Reference cited: Section 11752.75, Insurance Code.

 

§ 2593.5. Updating Coverage Information

The rating organization shall post, update, or correct coverage information for an employer on its coverage Internet Web site in a timely manner following the submission of the policy information by insurers. The time to post, update, or correct the information on the web site shall not be more than thirty (30) days from the time the information is received from the insurer.

Note: Authority cited: Section 11752.75, Insurance Code. Reference cited: Section 11752.75, Insurance Code.

 

§ 2593.6. Disputes

(a) An employer may dispute the accuracy of its coverage information displayed on a rating organization's Internet Web site by either contacting the insurer who provided the policy information for the coverage period or contacting the rating organization.

(b) If the insurer is contacted by an employer regarding the accuracy of its coverage information displayed on the rating organization's coverage Internet Web site, the insurer shall have thirty (30) days from the date it receives the employer's dispute to review and respond to the employer in writing and, if applicable, to provide corrected policy information to the rating organization. The response to the employer shall include the following:

(1) Whether or not the coverage information is accurate and, if applicable, any corrections that are being made.

(2) The name and contact information of the representative of the insurer who handled the dispute.

(c) The rating organization shall provide a toll-free telephone number and an email address that shall be conspicuously posted on its coverage Internet Web site for employers to contact the rating organization regarding the accuracy of coverage information displayed on the rating organization's coverage Internet Web site.

(d) If the rating organization is contacted by an employer regarding the accuracy of the coverage information displayed on its coverage Internet Web site, the rating organization shall have thirty (30) days from the date it receives the employer's dispute to confirm with the appropriate insurer that the coverage information displayed correctly reflects the policy information reported and respond to the employer in writing. The response to the employer shall include the following:

(1) Whether or not the coverage information correctly reflects the policy information reported and, if applicable, what is being corrected.

(2) The name and contact information of the representative of the insurer who handled the dispute.

(3) A notice that if the employer continues to believe the coverage information is inaccurate, that the employer should contact the insurer and its representative to determine if any further changes to the policy information are needed.

(e) Only the employer to whom the coverage information pertains may dispute with the insurer or the rating organization the accuracy of the coverage information displayed on the rating organization's coverage Internet Web site. The insurer or the rating organization may take reasonable steps to determine that the person disputing the accuracy of the information on the coverage Internet Web site is the employer, or a representative of the employer, for whom the information pertains.

(f) Only disputes regarding the accuracy of the policy information reported to the rating organization by the insurer and the coverage information displayed on the rating organization's Internet Web site shall be subject to this Article. Any disputes concerning the existence or extent of an insurance contract or the terms of either the contract or its insurance coverage shall not be subject to this Article.

Note: Authority cited: Section 11752.6 and 11752.75, Insurance Code. Reference cited: Section 11752.75, Insurance Code.

 

§ 2593.7. Statistics To Be Maintained By The Rating Organization

The rating organization shall maintain statistics on usage, user complaints, and employer complaints or disputes to the rating organization or insurers concerning coverage information, along with any resulting correction of the policy or coverage information by the insurer or the rating organization for the coverage Internet Web site, to provide the necessary information to the insurance commissioner to monitor, evaluate, and report on whether the coverage Internet Web site is achieving its intended purpose.

Note: Authority cited: Section 11750.3, 11751.1 and, 11752.75, Insurance Code. Reference cited: Section 11752.75, Insurance Code.