SLS 14RS-590 ENGROSSED Page 1 of 8 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. Regular Session, 2014 SENATE BILL NO. 198 BY SENATOR RISER WORKERS' COMPENSATION. Ensures compliance with requirements for mandatory workers' compensation coverage. (8/1/14) AN ACT1 To amend and reenact R.S. 23:1168(A)(1) and (4) and (B), 1170(A) and (B), 1171,2 1171.1(A), (B), (C), (D)(1), and (E)(1), and 1291(C)(5) and to enact R.S. 23:1170(C)3 and 1171.1(F), and to repeal R.S. 23:1168(A)(5), relative to workers' compensation;4 to require for compliance; to provide for reporting of compliant coverage; to provide5 for penalties; to provide for matters to be determined by workers' compensation6 judges; and to provide for related matters.7 Be it enacted by the Legislature of Louisiana:8 Section 1. R.S. 23:1168(A)(1) and (4) and (B), 1170(A) and (B), 1171, 1171.1(A),9 (B), (C), (D)(1), and (E)(1), and 1291(C)(5) are hereby amended and reenacted and R.S.10 23:1170(C) and 1171.1(F) are hereby enacted to read as follows:11 §1168. Ways of securing compensation to employees12 A. An employer shall secure compensation to his employees in one of the13 following ways:14 (1) By insuring and keeping insured the payment of such compensation with15 any stock corporation, mutual association, or other concern authorized to transact the16 business of workers' compensation insurance in this state. When an insurer issues a17 SB NO. 198 SLS 14RS-590 ENGROSSED Page 2 of 8 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. policy to provide workers' compensation benefits pursuant to the provisions of the1 Workers' Compensation Act, the insurer shall file, or cause to be filed, with the2 director a notice in such form and detail as the director may prescribe by rule and3 regulation. The notice shall contain the name, address, and principal occupation of4 the employer, the number, effective date, and expiration date of the policy, and such5 other information as may be required by the director. The notice shall be filed by the6 insurer within thirty days after the effective date of the policy report to the National7 Council on Compensation Insurance all policy information in accordance with8 the reporting guidelines established by the National Council on Compensation9 Insurance. Proof of coverage must be filed no later than thirty days after the10 effective date of coverage and include the name of each business entity11 operating in the state of Louisiana for which coverage is provided.12 * * *13 (4) By using any combination of life, accident, health, property, casualty or14 other insurance policies offered:15 (a) By any stock corporation, mutual association or other concern authorized16 to transact the business of insurance in this state;17 (b) By any group of individual, unincorporated alien insurers with assets held18 in trust for the benefit of its United States policyholders in a sum not less than one19 hundred million dollars and which is authorized to transact insurance in at least one20 state; or21 (c) By any other insurer which has been approved by the commissioner of22 insurance, and has capital and surplus, or the equivalent thereof, of at least ten23 million dollars and its financial condition, as evidenced by its most recent annual24 statement, conforms substantially to the same standards of solvency which would be25 required if such insurer were licensed in this state.26 (5)(4) By furnishing satisfactory proof to the director of the employer's27 financial ability to pay such compensation. The director, pursuant to rules adopted28 by the office for an individual self-insured or own risk carrier, including but not29 SB NO. 198 SLS 14RS-590 ENGROSSED Page 3 of 8 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. limited to rules relative to security and excess coverage, shall require that an1 employer:2 * * *3 B.(1) The director may waive the requirements of Paragraph A(5)(4) of this4 Section if he finds any company able to pay benefits, and that the requirements of5 these provisions are unnecessary. He shall establish rules which set standards for6 such waiver.7 (2) The director shall waive the requirements of Paragraph A(5)(4) of this8 Section if any employer that is a municipality or other political subdivision of the9 state is able to demonstrate financial responsibility and ability to pay benefits by the10 filing of annual reports including statements of financial condition and summary loss11 data detailing past claims experience.12 * * *13 §1170. Penalty for failure to secure workers' compensation insurance; assessment14 and collection15 A. In addition to any other penalty prescribed by law, any employer who fails16 to secure compensation required by R.S. 23:1168 shall be liable for a civil penalty,17 to be assessed by the executive director or his designee workers' compensation18 judge, of not more than two hundred fifty dollars per employee for a first offense,19 and liable for a civil penalty of not more than five hundred dollars per employee for20 a second or subsequent offense; however, the maximum civil penalty for a first21 offense shall not exceed ten thousand dollars for all related series of violations. All22 civil penalties collected shall be deposited in the Office of Workers' Compensation23 Administrative Fund established in R.S. 23:1291.1(E).24 B. The financial and compliance officer of the office of worker's25 compensation workers' compensation judge shall assess and collect any civil26 penalty incurred under R.S. 23:1170(A) against any employer who fails to provide27 proof of compliance within fifteen days of any notice. Any penalty assessed and28 collected pursuant to this Section shall be forwarded to the fraud administrator29 SB NO. 198 SLS 14RS-590 ENGROSSED Page 4 of 8 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. for collection. In his discretion, the financial and compliance officer fraud1 administrator may remit, mitigate, or negotiate said penalty if proof of the2 mitigating circumstances is provided within fifteen days of notice of the assessment.3 In determining the amount of the penalty to be assessed, or the amount agreed upon4 in any negotiation, consideration shall be given to the appropriateness of such5 penalty in light of the life of the business of the employer charged, the gravity of the6 violation, and the extent to which the employer charged has complied with the7 provisions of R.S. 23:1168, or has otherwise attempted to remedy the consequences8 of the said violation. Individual proceedings shall be conducted pursuant to the9 provisions of R.S. 23:1171.10 C. In addition to any penalties assessed in accordance with the provisions11 of this Chapter, the workers' compensation judge shall order the employer to12 provide proof of compliance with R.S. 23:1168 within forty-five days of the13 order.14 §1171. Civil fine; hearing; appeal15 A. The financial and compliance officer shall determine from all of the16 evidence submitted by the employer a fair and equitable resolution of the violation,17 taking into consideration any mitigating circumstances timely submitted as required18 by R.S. 23:1170. The financial and compliance officer shall assess, upon19 examination of the information submitted, a penalty commensurate with the violation20 so adjudged. However, the employer may provide additional mitigating21 circumstances or evidence to the financial and compliance officer within ten days of22 the assessment, and a reevaluation of the penalty shall be conducted. Unless a formal23 hearing is requested pursuant to the provisions of R.S. 23:1171(B), the penalty shall24 become final within thirty days of assessment. Upon becoming final, the penalty25 shall be regarded as any other money judgment and may be pursued for collection26 as prescribed by law for any other such remedy.27 B. An employer may appeal the decision of the financial and compliance28 officer to the workers' compensation judge in the district in which the business of the29 SB NO. 198 SLS 14RS-590 ENGROSSED Page 5 of 8 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. employer is located or East Baton Rouge Parish by filing, within thirty days of the1 date of assessment, a written request for a formal hearing, which request should be2 filed on a disputed claim form. All appeals to the workers' compensation judge shall3 be de novo. A final order from a hearing may be appealed to the appropriate court4 of appeal in the manner described in R.S. 23:1310.5(B) for appealing decisions5 regarding disputed claims.6 §1171.1. Discontinuance of business; injunction; procedure7 A. The director, or his designee, shall investigate an employer if he receives8 information from any person or entity that such employer has failed to provide9 security for compensation as required by R.S. 23:1168. If such allegations can be10 reasonably substantiated, and the employer has previously been subject to a civil11 penalty pursuant to R.S. 23:1170 or criminal penalties pursuant to R.S. 23:1172,12 the director, or his designee, and the employer has previously been fined under13 R.S. 23:1170 or been penalized under R.S. 23:1172, the director shall notify the14 employer that, unless he can show proof of compliance with R.S. 23:1168 within15 fifteen days, he may shall be subject to further fines and penalties including but not16 limited to an injunction against further business operations a civil penalty pursuant17 to the provisions of R.S. 23:1170.18 B. If within fifteen days of the employer's receipt of such notice, he has not19 submitted to the director satisfactory proof of such compliance, the director shall set20 the matter for hearing in accordance with the procedures set forth by law for claims21 for workers' compensation benefits If such allegations can be reasonably22 substantiated and the employer has been fined under R.S. 23:1170 or penalized23 under R.S. 23:1172, the director shall notify the employer that unless he can24 show proof of compliance with R.S. 23:1168 within fifteen days, he shall be25 subject to further fines and penalties, including but not limited to an injunction26 against further business operations.27 C. If within fifteen days of the employer's receipt of such notice he has28 not submitted to the director satisfactory proof of such compliance, the director29 SB NO. 198 SLS 14RS-590 ENGROSSED Page 6 of 8 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. or his designee shall request the workers' compensation judge of any district1 where the employer does business to set the matter for hearing in accordance2 with the procedures set forth by law for claims for workers' compensation3 benefits. Upon the request of the director or his designee, the workers'4 compensation judge shall issue a rule to show cause to the employer why he5 should not be fined or penalized for failure to show proof of compliance with6 R.S. 23:1168 when requested.7 D. (1) If at such hearing, it is determined that the employer is in violation of8 his obligation under R.S. 23:1168, the workers' compensation judge may shall fine9 the employer in the manner provided pursuant to R.S. 23:1170(A) and shall order the10 employer to secure workers' compensation insurance and file evidence of coverage11 within ninety days of the order provide proof of compliance with R.S. 23:116812 within forty-five days of the order by securing the appropriate coverage. Should13 the employer fail to file such evidence, the workers' compensation judge shall assess14 a fine for a second offense and issue a cease and desist order prohibiting the15 employer from continuing its business operations until such time as the employer16 complies with R.S. 23:1168, and all fines issued are paid in full.17 * * *18 D. E. (1) After the issuance of a cease and desist order and upon the request19 of the director or the director's designee, the attorney general shall immediately20 institute proceedings for injunctive relief against the employer in the district court21 of any judicial district in this state where the employer does business. In such district22 court proceedings, a certified copy of any cease and desist order entered by the23 workers' compensation judge in accordance with this Section based upon evidence24 in the record shall be prima facie evidence of the facts found in such record.25 * * *26 E. F. The issuance of an order to cease and desist or the issuance of a27 temporary restraining order or an injunction against an employer for failure to insure28 or keep insurance in force as required by R.S. 23:1168 shall be in addition to any29 SB NO. 198 SLS 14RS-590 ENGROSSED Page 7 of 8 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. civil or criminal penalties imposed by any other provision of law or Paragraph C(1)1 of this Section.2 PART IV. ADMINISTRATION OF CLAIMS3 SUBPART A. OFFICE OF WORKERS' COMPENSATI ON ADMINISTRATION4 §1291. Creation, powers, and duties of the office of workers' compensation5 administration6 * * *7 C. There shall be established within the office the following sections:8 * * *9 (5) A workers' compensation fraud section, which shall administer the10 provisions of R.S. 23:1170, 1171, 1171.1, 1172, 1172.1, 1172.2, 1208, and 1295 by11 investigating allegations of workers' compensation fraud and non-compliance by12 employers.13 * * *14 Section 2. R.S. 23:1168(A)(5) is hereby repealed.15 The original instrument and the following digest, which constitutes no part of the legislative instrument, were prepared by Carla S. Roberts. DIGEST Riser (SB 198) Present law provides that an employer doing business in the state of Louisiana must provide workers' compensation coverage for the employees of the business. Present law provides that an employer may provide statutorily required workers' compensation coverage for employees by purchasing coverage from a stock corporation, mutual association, or other concern authorized to transact the business of workers' compensation insurance in this state. Present law provides that the workers' compensation insurer shall file notice of coverage with the director of the office of workers' compensation with the Workforce Commission. Proposed law retains present law but changes the requirement that the notice of coverage be sent to the National Council on Compensation Insurance instead of the director of the office of workers' compensation. Proposed law provides that proof of coverage must be filed no later than 30 days after the effective date of coverage and include the name of each business entity operating in the state of La. for which coverage has been obtained. Present law provides that in addition to any other penalty prescribed by law, any employer who fails to secure compensation required by present law shall be liable for a civil penalty, to be assessed by the executive director or his designee, of not more than $250.00 per SB NO. 198 SLS 14RS-590 ENGROSSED Page 8 of 8 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. employee for a first offense, and liable for a civil penalty of not more than $500.00 per employee for a second or subsequent offense; however, the maximum civil penalty for a first offense shall not exceed $10,000 for all related series of violations. Proposed law retains present law but provides that a workers' compensation judge shall assess any civil penalty against an employer who fails to provide proof of compliance within 15 days of any notice. Proposed law provides that, in addition to any penalties assessed, the workers' compensation judge shall order the employer to provide proof of workers' compensation coverage within 45 days of the order. Present law provides that the financial and compliance officer shall determine, based upon all of the evidence submitted by the employer, a fair and equitable resolution of the violation, taking into consideration any mitigating circumstances. Present law provides that the financial and compliance officer shall assess a penalty commensurate with the violation so adjudged. Present law provides that any appeal regarding a disputed claim shall be decided in the district court in which the business of the employer is located or East Baton Rouge Parish. Proposed law retains present law but provides that the workers' compensation judge shall conduct the hearing on the matter and an appeal may be made in the appropriate circuit court of appeal. Present law provides that the director shall investigate an employer if he receives information from any person or entity that such employer has failed to provide workers' compensation coverage for his employees. Present law provides that if such allegations can be reasonably substantiated, the director, shall notify the employer that, unless he can show proof of coverage, he may be subject to further fines and penalties including but not limited to an injunction against further business operations. Proposed law retains present law but provides that if such allegations can be reasonably substantiated and the employer has been fined or penalized under, the director, or his designee, shall notify the employer that unless he can show proof of coverage within 15 days, the employer will be subject to further fines and penalties including but not limited to an injunction against further business operations. Proposed law provides that if within 15 days of the employer's receipt of such notice he has not submitted to the director satisfactory proof of such compliance, the director or his designee shall request the workers' compensation judge of any district where the employer does business to set the matter for hearing and the workers' compensation judge shall issue a rule to show cause to the employer why he should not be fined or penalized for failure to show proof of workers' compensation coverage. Effective August 1, 2014. (Amends R.S. 23:1168(A)(1) and (4) and (B), 1170(A) and (B), 1171, 1171.1(A), (B), (C), (D)(1), and (E)(1), and 1291(C)(5); adds R.S. 23:1170(C) and 1171.1(F); repeals R.S. 23:1168(A)(5))