West Virginia Offices of the Insurance Commissioner 2009 Annual ...

Employer Coverage Unit
The Employer Coverage Unit consists of a team of six. This unit works with WV employers to insure
that they are compliant with current workers’ compensation laws as they relate to requirements for
coverage.
The unit has three primary functions. The first function focuses on compliance. The unit verifies
coverage for other agencies and governmental bodies. They also try to insure that all employers
required to carry workers’ compensation comply with the law. This is done by extracting expired
policy data provided by the National Council on Compensation Insurance (NCCI) and comparing to
other agency information to determine if coverage is needed. If an employer is found to be noncompliant,
the unit sets up a rogue account to assess the employer a fine. In 2009, the unit was
responsible for setting up 1,738 of these accounts. These fines are related to WV Code 23-2C-8(d)(3)
Workers’ Compensation Uninsured Employers Fund.
Since the opening of the private market in July 2008, the unit also has taken on the task of carrier
compliance with the Proof of Coverage (POC) system. Carriers that fail to report timely as required by
the POC guidelines are maintained and reported to Regulatory Compliance for further review.
The second primary function relates directly to the Uninsured Employers’ Fund. The unit serves as the
entry point of contact for the processing of workers’ compensation claims filed by employees of WV
employers who are uninsured. These claims are governed by Title 85 Series 8, The Workers’
Compensation Uninsured Employers’ Fund. This fund was established in order to provide a safety net
for workers who are injured while working for an illegally operating employer. Once a claim is
accepted into the Fund, the employer is responsible for reimbursement to the fund for all monies paid
on their behalf.
The third function is to review requests for exemptions from coverage from employers and make
appropriate determination of exemption.
State law does not require that exempt employers file an exemption but many do because of local
governments, individuals or contractors requiring proof that an employer has coverage or meets the
criteria for being exempt before they begin a job. In these cases, the Employer Coverage unit issues
letters of exemption to employers to present verifying they are not required to carry workers’
compensation insurance under current law. This function relates directly to Title 85, Series 9 Workers’
Compensation Policies, Coverage Issues and Related Topics.
In 2009, the Unit processed 2,938 exemption applications of which there were 2,269 exemptions
granted. These exemptions were entered into the West Virginia Offices of the Insurance
Commissioner’s Proof of Coverage (POC) system in order to include these employers for automated
compliance purposes. In addition to being the public’s contact for coverage verification, the Unit is
responsible for maintaining the POC system which is widely used for statutory coverage verification.
The unit works hand in hand with the Revenue Recovery Unit and Regulatory Compliance to
recognize and fine employers that are not carrying the mandatory coverage.
Other major accomplishments of the unit in 2009 included working with the IT department to program
and update some processes for a more timely assessment of fines.
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