287.335. Determinations review board, created, purpose--code classifications, classification system, review of, duties.

MISSOURI STATUTES AND CODES

287.335. Determinations review board, created, purpose--code classifications, classification system, review of, duties.

Determinations review board, created, purpose--code classifications,classification system, review of, duties.

287.335. 1. There is hereby established the "Workers' CompensationDeterminations Review Board" within the department of insurance, financialinstitutions and professional registration which shall exist to reviewdeterminations by an insurer or advisory organization regarding uniform codeclassifications, basic manual rule interpretations, uniform experience ratingplan rule interpretations, calculations of an individual employer'smodification factor, Missouri assigned risk plan underwriting ruleinterpretations, and any other related uniform rule interpretations notaddressed by department rule or regulation. The board shall consist of fivepersons who shall be voting members appointed by the governor, with the adviceand consent of the senate, who shall serve at the pleasure of the governor.Three members shall be representative of the interests of employers with atleast one being representative of employers whose employees are represented bya labor union and at least one being representative of employers whoseemployees are not represented by a labor union. One member shall be arepresentative of the interests of insurers, and one member shall be arepresentative of the interests of independent insurance agents. One memberrepresenting employers shall act as chairman of the board elected by theboard. Not more than three members of the board shall belong to the samepolitical party. Each member shall serve for a term of three years, exceptthat of the members first appointed, two shall be appointed for a term of oneyear, two for a term of two years, and one for a term of three years.Vacancies on the board shall be filled for the unexpired term in the samemanner as original appointments are made. The state actuary and arepresentative of a rating organization licensed by the state shall benonvoting members of the board, and their duties shall include advising theboard on matters relating to code classifications, including the creation ofnew code classifications. The board members shall not receive anycompensation, except that such members shall be reimbursed for actual andnecessary expenses incurred in the performance of their duties. In addition,the board may employ staff to perform the administrative duties of the board.The department of insurance, financial institutions and professionalregistration may charge a fee against the classification agent as the directordeems appropriate.

2. Upon application of any employer, the board shall review the codeclassification made on that employer. If the board determines that theclassification was erroneous, it may change the classification by placing theemployer under a different code classification already established or bycreating a new classification code, if the board determines that there issufficient experience to merit a new classification code. The establishmentof the rate for a new classification code shall be filed with the director ofthe department of insurance, financial institutions and professionalregistration by either the affected employer or employers or by any recognizedrating organization within ninety days of the establishment of the newclassification code by the board. The director of the department ofinsurance, financial institutions and professional registration shall reviewthe filed rate according to section 287.955. Upon application of anyemployer, the board shall review the calculation of an employer's experiencemodification factor and may order a recalculation in the experiencemodification factor if calculated erroneously under the formula as approved bythe director of the department of insurance, financial institutions andprofessional registration, including an adjustment for any recovery from athird party pursuant to the employer's right of subrogation. An appeal fromthe determination of an appropriate classification by the board may be made tothe director of the department of insurance, financial institutions andprofessional registration. The board may review code classifications ofindividual self-insured employers and self-insured employers in a groupinsurance arrangement.

3. The board may also recommend changes to the uniform classificationsystem.

4. The advisory organization that makes a uniform classification systemfor use in setting rates in this state shall provide to the affected party orhis designated agent, at a reasonable charge, information used or consideredin determining the development purpose, scope and intended application of anyclassification comprising such uniform classification system.