W. Va. Code R. § 85-24-3

Current through Register Vol. XLI, No. 35, August 30, 2024
Section 85-24-3 - Definitions

As used in these rules, the following terms have the stated meanings unless the context of a specific use clearly indicates another meaning is intended.

3.1. "Act" means the workers' compensation laws of the state of West Virginia which are codified at W. Va. Code § 23-1 et seq.
3.2. "Client employer" means an employer who participates with a qualified loss management service provider in accordance with and under the provisions of this rule.
3.3. "Commission" means the workers' compensation commission created pursuant to the provisions of W. Va. Code § 23-1-1.
3.4. "Credit factor" means a multiplier, determined in accordance with this rule, utilized to calculate premium tax credits.
3.5. "Director" means the executive director of the workers' compensation commissions who serves as the chief executive officer of the of the workers' compensation commission, provided by W. Va. Code § 23-1-4.
3.6. "Board" means the workers "compensation board of managers created pursuant to the provisions of W. Va. Code § 23-1-1a.
3.7. "Experience modification factor" means an actuarially determined multiplier of the premium tax base rate used to determine an individual employer's premium tax rate (Note: The experience modification factor has been historically referred to as the experience modification rate or EMR).
3.8. "Good standing" with the commission means that the employer has not defaulted on its obligations to make payments to the commission. Being in delinquent status, as provided for in W. Va. Code § 23-2-5(b), is not equivalent to being in default and does not deprive the employer of good standing with the commission.

The term default is defined in W. Va. Code, §§ 23-2-5(d), -5(e), -6, & -8. The term default also includes those situations under W. Va. Code, § 23-2-5(f)(2)-(4), where an employer returns to default status upon breaching a reinstatement agreement. If an employer fails to meet the requirements of those sections, then it is in default and is not in good standing with the commission.

3.9. "Incurred losses" are claims reserves consisting of compensation awards, medical payments, and claims expense payments.
3.10. "Injury" means compensable injuries or illnesses for which costs are incurred by the commission within the meaning of W. Va. Code, § 23-4-1 et seq.
3.11. "Joint labor and management safety committee" means a formally structured process to provide for and foster employee and employer involvement in safety reforms. Such structures include, but are not limited to, groups such as quality circles and self directed work teams. A tiered safety organization is permitted, if employees participate at each level of the organized committees.

A joint labor and management safety committee must exhibit the following characteristics to be considered acceptable:

a. Safety must be a priority of the group;
b. The group must have the authority to conduct safety inspections of the work area for which they are responsible and to determine and recommend corrective measures to management;
c. The group must meet regularly and minutes must be kept of the meetings;
d. Each member of the committee shall have an equal vote;
e. Members of the committee shall not experience any loss of wages or other retaliation while attending safety committee meetings or performing duties at the direction of the safety committee;
f. At least fifty percent (50%) of the members of the tiered safety organization and of each committee shall be employee representatives; and
g. All members of the committee shall be trained in matters related to workplace safety, such training shall include attendance at a seminar on basic safety programs sponsored or approved by the commission.
3.12. "Loss costs" are incurred losses on an accrual basis per one hundred dollars ($ 100.00) of payroll for the period under measurement.
3.13. "Operating personnel" means those individuals employed or utilized by a qualified loss management service provider to provide qualified loss management services to client employers. Such individuals include all specialists in safety, rehabilitation, and occupational health utilized by the qualified loss management service provider. Such individuals do not include clerical employees.
3.14. "Quarter" means the four calendar quarters: January 1 through March 31; April 1, through June 30; July 1 through September 30; and October 1 through December 31 of each calendar year.
3.15. "Regular subscriber" means an employer who is a subscriber to all parts of the compensation fund including the surplus fund.
3.16. "Self-insurer" and "self-insured employer" mean employers who have elected one or both of the options contained in W. Va. Code § 23-2-9, and who pay individually and directly, or from their own benefit fund or system of compensation, the compensation and other benefits provided to injured employees or their dependents under the Act.

W. Va. Code R. § 85-24-3