ORS 656.430
Certification of self-insured employer

  • employer groups
  • insurance policy requirements
  • revocation of certification
  • rules

(1)

Upon determining that an employer has qualified as a self-insured employer under ORS 656.407 (Qualifications of insured employers), the Director of the Department of Consumer and Business Services shall issue a certificate to that effect to the employer.

(2)

Coverage of a self-insured employer is effective on the date of certification unless a later date is specified in the certificate.

(3)

Two or more entities may not be included in the certification of one employer unless in each entity the same person, or group of persons, or corporation owns a majority interest. If an entity owns a majority interest in another entity which in turn owns the majority interest in another entity, all entities so related may be combined regardless of the number of entities in succession. If more than one entity is included in the certification of one employer, each entity included is jointly and severally liable for any compensation and other amounts due the Department of Consumer and Business Services under this chapter by any entity included in the certification.

(4)

In the term “majority interest,” as used in this section, “majority” means more than 50 percent.

(5)

If an entity other than a partnership:

(a)

Has issued voting stock, “majority interest” means a majority of the issued voting stock;

(b)

Has not issued voting stock, “majority interest” means a majority of the members; or

(c)

Has not issued voting stock and has no members, “majority interest” means a majority of the board of directors or comparable governing body.

(6)

If the entity is a partnership, majority interest must be determined in accordance with the participation of each general partner in the profits of the partnership.

(7)

Intentionally left blank —Ed.

(a)

Notwithstanding any other provision of this section, the director may certify five or more subject employers as a self-insured employer group, which is an employer for purposes of this chapter, if:

(A)

The director finds that the employers as a group meet the requirements of ORS 656.407 (Qualifications of insured employers) (1)(b) and (2);

(B)

The director determines that the employers as a group meet the insurance coverage retention and combined net worth requirements adopted by the director by rule;

(C)

The director finds that the grouping is likely to improve accident prevention and claims handling for the employer;

(D)

Each employer executes and files with the designated entity a written agreement, in such form as the director may prescribe, in which:
(i)
The employer agrees to be jointly and severally liable for the payment of any compensation and other amounts due to the Department of Consumer and Business Services under this chapter incurred by a member of the group; or
(ii)
The employer, if a city, county, special district described and listed in ORS 198.010 (“District” defined for chapter) or 198.180 (“District” defined for ORS 198.190), translator district formed under ORS 354.605 (Definitions for ORS 354.605 to 354.715) to 354.715 (Dissolution, liquidation and transfer proceedings), weed control district organized under ORS 569.350 (Necessity of eradication of weeds) to 569.445 (Duty to clean machinery before moving), intergovernmental agency created under ORS 225.050 (Joint construction, ownership and operation of waterworks), school district as defined in ORS 255.005 (Definitions) (9), public housing authority created under ORS chapter 456 or regional council of governments created under ORS chapter 190, agrees to be individually liable for the payment of any compensation and other amounts due to the department under this chapter incurred by the employer during the period of group self-insurance;

(E)

The director finds that the employer group is organized as a corporation or cooperative pursuant to ORS chapter 60, 62 or 65, is an intergovernmental entity created under ORS 190.003 (Definition for ORS 190.003 to 190.130) to 190.130 (Effect of ORS 190.125) or is a self-insurance program under ORS 30.282 (Local public body insurance) (3), and the bylaws of the employer group require the employer group to obtain fidelity bonds;

(F)

The director finds that the employer group has designated an entity responsible for:
(i)
Centralized claims processing in accordance with paragraph (b) of this subsection; and
(ii)
Payroll records, safety requirements, recording and submitting assessments and contributions and making such other reports as the director may require; and

(G)

The employer has presented a method approved by the director to notify the department of:
(i)
The commencement or termination of membership by employers in the group, and the effect thereof on the net worth of the employers in the group; and
(ii)
Whether an employer who terminates membership in the group continues to be a subject employer; and

(b)

Except for employer groups composed of cities, counties, special districts created under ORS 198.010 (“District” defined for chapter), intergovernmental agencies created under ORS 225.050 (Joint construction, ownership and operation of waterworks), school districts as defined in ORS 255.005 (Definitions), public housing authorities created under ORS chapter 456 and regional councils of governments created under ORS chapter 190, a group administrator may not be a group member or a member of the board of the group.

(8)

A self-insured employer must have excess insurance coverage appropriate for the employer’s potential liability under this chapter with an insurer authorized to do business in this state. A self-insured employer certified prior to November 1, 1981, must have excess insurance coverage appropriate for the employer’s potential liability under this chapter either with an insurer authorized to do business in this state or with any other insurer from whom such insurance can be obtained pursuant to ORS 744.305 to 744.405 (1985 Replacement Part). Evidence of such coverage must be submitted at the time application is made for self-insured certification in the form of an insurance binder providing the appropriate coverage effective the date of certification. The policy providing such coverage must be filed with the director not later than 30 days after the date the coverage is effective. Any changes in the insurer or the coverage must be filed with the department not later than 30 days after the effective date of the change. With respect to such coverage:

(a)

The policy must include a provision, approved by the director, for reimbursement to the department of all expenses paid by the department on behalf of the employer pursuant to ORS 656.614 (Self-Insured Employer Adjustment Reserve) (1) and 656.443 (Procedure upon default by employer or self-insured employer group) in the same manner as if the department were the insured employer, subject to the policy limitations on amounts and limits of liability to the insured employer; and

(b)

The period of coverage must be continuous and remain in effect until the certification is revoked or canceled.

(9)

Notwithstanding ORS 656.440 (Notice of certificate revocation), the director may revoke the certification of any self-insured employer after giving 30 days’ written notice if the employer:

(a)

Fails to comply with subsection (8) of this section;

(b)

In the case of an employer described in subsection (7) of this section, fails to comply with that subsection; or

(c)

Fails to comply with rules adopted by the director as required by subsection (11) of this section.

(10)

A self-insured employer must have an occupational safety and health loss control program as required by ORS 654.097 (Consultative services required).

(11)

The director, by rule shall:

(a)

Prescribe methods for determining and approving net worth.

(b)

Prescribe the types and approve the retention and limitation levels of excess insurance policies.

(c)

Establish reporting requirements.

(d)

Prescribe information to be submitted in applications for self-insured employer certifications.

(e)

Prescribe the form and manner of reporting commencement or termination in a self-insured employer group.

(f)

Prescribe the form, amount and manner for establishing and operating a common claims fund.

(g)

Prescribe such other requirements as the director considers necessary so that employers certified as self-insured employers will meet the financial responsibilities under this chapter.

(12)

For the purpose of certification as a self-insured employer group, cities, counties, special districts created under ORS 198.010 (“District” defined for chapter), intergovernmental agencies created under ORS 225.050 (Joint construction, ownership and operation of waterworks), school districts as defined in ORS 255.005 (Definitions), public housing authorities created under ORS chapter 456 and regional councils of governments created under ORS chapter 190 shall be considered by the director to be of the same industry.

(13)

Notwithstanding subsection (8) of this section, a public utility with assets of more than $500 million may obtain excess insurance coverage from an eligible surplus lines insurer. As used in this subsection, “public utility” has the meaning given that term in ORS 757.005 (Definition of public utility). [1975 c.556 §33; 1979 c.845 §1; 1981 c.535 §38; 1983 c.816 §9; 1985 c.739 §6; 1987 c.94 §107; 1987 c.800 §1; 1987 c.884 §58; 1989 c.602 §1; 1993 c.817 §2; 1999 c.280 §1; 2003 c.170 §6; 2005 c.189 §1; 2014 c.48 §4; 2017 c.118 §1]

Source: Section 656.430 — Certification of self-insured employer; employer groups; insurance policy requirements; revocation of certification; rules, https://www.­oregonlegislature.­gov/bills_laws/ors/ors656.­html.

656.001
Short title
656.003
Application of definitions to construction of chapter
656.005
Definitions
656.006
Effect on employers’ liability law
656.008
Extension of laws relating to workers’ compensation to federal lands and projects within state
656.010
Treatment by spiritual means
656.012
Findings and policy
656.017
Employer required to pay compensation and perform other duties
656.018
Effect of providing coverage
656.019
Civil negligence action for claim denied on basis of failure to meet major contributing cause standard
656.020
Damage actions by workers against noncomplying employers
656.021
Coverage exception for laborers under contracts with construction and landscape contractor licensees
656.023
Who are subject employers
656.025
Individuals engaged in commuter ridesharing not subject workers
656.027
Who are subject workers
656.029
Obligation of person awarding contract to provide coverage for workers under contract
656.031
Coverage for municipal volunteer personnel
656.033
Coverage for participants in work experience or school directed professional training programs
656.035
Status of workers in separate occupations of employer
656.037
Exemption from coverage for persons engaged in certain real estate activities
656.039
Election of coverage for workers not subject to law
656.041
City or county may elect to provide coverage for adults in custody
656.043
Governmental agency paying wages responsible for providing coverage
656.044
State Accident Insurance Fund Corporation may insure liability under Longshoremen’s and Harbor Workers’ Compensation Act
656.046
Coverage of persons in college work experience and professional education programs
656.052
Prohibition against employment without coverage
656.054
Claim of injured worker of noncomplying employer
656.056
Subject employers must post notice of manner of compliance
656.070
Definitions for ORS 656.027, 656.070 and 656.075
656.075
Exemption from coverage for newspaper carriers
656.126
Coverage while temporarily in or out of state
656.128
Sole proprietors, limited liability company members, partners, independent contractors may elect coverage by insurer
656.132
Coverage of minors
656.135
Coverage of deaf school work experience trainees
656.138
Coverage of apprentices, trainees participating in related instruction classes
656.140
Coverage of persons operating equipment for hire
656.154
Injury due to negligence or wrong of a person not in the same employ as injured worker
656.156
Intentional injuries
656.160
Effect of incarceration on receipt of compensation
656.170
Validity of provisions of certain collective bargaining agreements
656.172
Applicability of and criteria for establishing program under ORS 656.170
656.174
Rules
656.202
Compensation payable to subject worker in accordance with law in effect at time of injury
656.204
Death
656.206
Permanent total disability
656.208
Death during permanent total disability
656.209
Offsetting permanent total disability benefits against Social Security benefits
656.210
Temporary total disability
656.211
“Average weekly wage” defined
656.212
Temporary partial disability
656.214
Permanent partial disability
656.216
Permanent partial disability
656.218
Continuance of permanent partial disability payments to survivors
656.222
Compensation for additional accident
656.225
Compensability of certain preexisting conditions
656.226
Cohabitants and children entitled to compensation
656.228
Payments directly to beneficiary or custodian
656.230
Lump sum award payments
656.232
Payments to aliens residing outside of United States
656.234
Compensation not assignable nor to pass by operation of law
656.236
Compromise and release of claim matters except for medical benefits
656.240
Deduction of benefits from sick leave payments paid to employees
656.245
Medical services to be provided
656.247
Payment for medical services prior to claim acceptance or denial
656.248
Medical service fee schedules
656.250
Limitation on compensability of physical therapist services
656.252
Medical report regulation
656.254
Medical report forms
656.256
Considerations for rules regarding certain rural hospitals
656.258
Vocational assistance service payments
656.260
Certification procedure for managed health care provider
656.262
Processing of claims and payment of compensation
656.263
To whom notices sent under ORS 656.262, 656.265, 656.268 to 656.289, 656.295 to 656.325 and 656.382 to 656.388
656.264
Compensable injury, denied claim and other reports
656.265
Notice of accident from worker
656.266
Burden of proving compensability and nature and extent of disability
656.267
Claims for new and omitted medical conditions
656.268
Claim closure
656.273
Aggravation for worsened conditions
656.277
Request for reclassification of nondisabling claim
656.278
Board has continuing authority to alter earlier action on claim
656.283
Hearing rights and procedure
656.285
Protection of witnesses at hearings
656.287
Use of vocational reports in determining loss of earning capacity at hearing
656.289
Orders of Administrative Law Judge
656.291
Expedited Claim Service
656.295
Board review of Administrative Law Judge orders
656.298
Judicial review of board orders
656.304
When acceptance of compensation precludes hearing
656.307
Determination of issues regarding responsibility for compensation payment
656.308
Responsibility for payment of claims
656.310
Presumption concerning notice of injury and self-inflicted injuries
656.313
Stay of compensation pending request for hearing or review
656.319
Time within which hearing must be requested
656.325
Required medical examination
656.327
Review of medical treatment of worker
656.328
List of authorized providers and standards of professional conduct for providers of independent medical examinations
656.331
Contact, medical examination of worker represented by attorney prohibited without written notice
656.340
Vocational assistance procedure
656.360
Confidentiality of worker medical and vocational claim records
656.362
Liability for disclosure of worker medical and vocational claim records
656.382
Penalties and attorney fees payable by insurer or employer in processing claim
656.383
Attorney fees in cases prior to decision or after request for hearing
656.385
Attorney fees in cases regarding certain medical service or vocational rehabilitation matters
656.386
Recovery of attorney fees, expenses and costs in appeal on denied claim
656.388
Approval of attorney fees required
656.390
Frivolous appeals, hearing requests or motions
656.403
Obligations of self-insured employer
656.407
Qualifications of insured employers
656.419
Workers’ compensation insurance contracts
656.423
Cancellation of coverage by employer
656.427
Termination of workers’ compensation insurance contract or surety bond liability by insurer
656.430
Certification of self-insured employer
656.434
Certification effective until canceled or revoked
656.440
Notice of certificate revocation
656.441
Advancement of funds from Workers’ Benefit Fund for compensation due workers insured by certain decertified self-insured employer groups
656.443
Procedure upon default by employer or self-insured employer group
656.445
Advancement of funds from Workers’ Benefit Fund for compensation due workers insured by insurer in default
656.447
Sanctions against insurer for failure to comply with contracts, orders or rules
656.455
Self-insured employers to process claims and make records available at authorized locations
656.502
“Fiscal year” defined
656.504
Rates, charges, fees and reports by employers insured by State Accident Insurance Fund Corporation
656.505
Estimate of payroll when employer fails to file payroll report
656.506
Assessments for programs
656.508
Authority to fix premium rates for employers
656.526
Distribution of dividends from surplus in Industrial Accident Fund
656.536
Premium charges for coverage of reforestation cooperative workers based on prevailing wage
656.552
Deposit of cash, bond or letter of credit to secure payment of employer’s premiums
656.554
Injunction against employer failing to comply with deposit requirements
656.556
Liability of person letting a contract for amounts due from contractor
656.560
Default in payment of premiums, fees, assessments or deposit
656.562
Moneys due Industrial Accident Fund as preferred claims
656.564
Lien for amounts due from employer on real property, improvements and equipment on or with which labor is performed by workers of employer
656.566
Lien on property of employer for amounts due
656.576
“Paying agency” defined
656.578
Workers’ election whether to sue third person or noncomplying employer for damages
656.580
Payment of compensation notwithstanding cause of action for damages
656.583
Paying agency may compel election and prompt action
656.587
Paying agency must join in any compromise
656.591
Election not to bring action operates as assignment of cause of action
656.593
Procedure when worker or beneficiary elects to bring action
656.595
Precedence of cause of action
656.596
Damage recovery as offset against compensation
656.602
Disbursement procedures
656.605
Workers’ Benefit Fund
656.612
Assessments for department activities
656.614
Self-Insured Employer Adjustment Reserve
656.622
Reemployment Assistance Program
656.625
Reopened Claims Program
656.628
Workers with Disabilities Program
656.630
Oregon Institute of Occupational Health Sciences funding
656.632
Industrial Accident Fund
656.634
Trust fund status of Industrial Accident Fund
656.635
Reserve accounts in Industrial Accident Fund
656.636
Reserves in Industrial Accident Fund for awards for permanent disability or death
656.640
Creation of reserves
656.642
Emergency Fund
656.644
Petty cash funds
656.702
Disclosure of records of corporation, department and insurers
656.704
Actions and orders regarding matters concerning claim and matters other than matters concerning claim
656.708
Hearings Division
656.709
Ombudsman for injured workers
656.712
Workers’ Compensation Board
656.714
Removal of board member
656.716
Board members not to engage in political or business activity that interferes with duties as board member
656.718
Chairperson
656.720
Prosecution and defense of actions by Attorney General and district attorneys
656.722
Authority to employ subordinates
656.724
Administrative Law Judges
656.725
Duties and status of Administrative Law Judges
656.726
Duties and powers to carry out workers’ compensation and occupational safety laws
656.727
Rules for administration of benefit offset
656.730
Assigned risk plan
656.732
Power to compel obedience to subpoenas and punish for misconduct
656.735
Civil penalty for noncomplying employers
656.740
Review of proposed order declaring noncomplying employer or nonsubjectivity determination
656.745
Civil penalty for inducing failure to report claims
656.751
State Accident Insurance Fund Corporation created
656.752
State Accident Insurance Fund Corporation
656.753
State Accident Insurance Fund Corporation exempt from certain financial administration laws
656.754
Manager
656.758
Inspection of books, records and payrolls
656.772
Annual audit of State Accident Insurance Fund Corporation by Secretary of State
656.774
Annual report by State Accident Insurance Fund Corporation to Secretary of State
656.776
Notice to Secretary of State regarding action on audit report
656.780
Certification and training of claims examiners
656.790
Workers’ Compensation Management-Labor Advisory Committee
656.794
Advisory committee on medical care
656.795
Informational materials for nurse practitioners
656.797
Certification by nurse practitioner of review of required materials
656.798
Duty of insurer, self-insured employer and self-insured employer group to provide information to director
656.799
Informational materials for other health care professionals
656.802
Occupational disease
656.804
Occupational disease as an injury under Workers’ Compensation Law
656.807
Time for filing of claims for occupational disease
656.850
License
656.855
Licensing system for worker leasing companies
656.990
Penalties
Green check means up to date. Up to date