Section 25E Self-insurance groups; definitions - Massachusetts Statutes

Section 25E. Sections twenty-five E to twenty-five U, inclusive, shall apply to workers’ compensation self-insurance groups. A workers’ compensation self-insurance group that is issued a certificate of approval by the commissioner shall not be deemed to be insurers or insurance companies and shall not be subject to the provisions of the insurance laws and regulations of the commonwealth except as otherwise provided herein. Workers’ compensation self-insurance groups shall be subject to all provisions of this chapter and all regulations promulgated hereunder governing the conduct of insurers with respect to the payment of workers’ compensation benefits, and shall be subject to all fees, fines, penalties and assessments levied upon insurers for failure to comply with the claim procedures of this chapter.

The commissioner may promulgate rules and regulations as necessary to carry out the provision of sections twenty-five E to twenty-five U, inclusive.

As used in this section and sections twenty-five F to twenty-five U, inclusive, the following words, unless the context requires otherwise, shall have the following meanings:—

“Administrator”, an individual, partnership, corporation or unincorporated association engaged by a workers’ compensation self-insurance group’s board of trustees to carry out the policies established by the group’s board of trustees and to provide daily management of the group.

“Insolvent” or “Insolvency”, the inability of a workers’ compensation self-insurance group to pay its outstanding lawful obligations as they mature in the regular course of business, as may be shown either by an excess of its required reserves and other liabilities over its assets or by its not having sufficient assets to reinsure all of its outstanding liabilities after paying all accrued claims owed by it.

“Net premium”, premium derived from standard premium adjusted by any advance premium discounts.

“Standard premium”, the premium derived from the manual rates adjusted by experience modification factors but before advance premium discounts.

“Workers’ compensation”, when used as a modifier of benefits, liabilities or obligations, shall mean both workers’ compensation and employer’s liability.

“Public employer workers’ compensation self-insurance group”, or “public employer group”, a not-for-profit association consisting of five or more employers, all of whom are public entities, who enter into agreements to pool their liabilities for workers’ compensation benefits and employer’s liability in this state.

“Workers’ compensation self-insurance group” or “group”, a public employers group or a not-for-profit unincorporated association or a corporation formed under the provisions of chapter one hundred and eighty consisting of five or more employers who are engaged in the same or similar type of business, who are members of the same bona fide industry, trade or professional association which has been in existence for not less than two years or who are parties to the same or related collective bargaining agreements, and who enter into agreements to pool their liabilities for workers’ compensation benefits and employer’s liability in this state.

“Commissioner of insurance”, the commissioner of the department of insurance.