SLS 14RS-590 REENGROSSED Page 1 of 9 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, 1171.1,2 and 1291(C)(5) and to enact R.S. 23:1170(C), and to repeal R.S. 23:1168(A)(5),3 relative to workers' compensation; to require for compliance; to provide for reporting4 of compliant coverage; to provide for penalties; to provide for matters to be5 determined by workers' compensation judges; and to provide for related matters.6 Be it enacted by the Legislature of Louisiana:7 Section 1. R.S. 23:1168(A)(1) and (4) and (B), 1170(A) and (B), 1171, 1171.1, and8 1291(C)(5) are hereby amended and reenacted and R.S. 23:1170(C) is hereby enacted to read9 as follows:10 §1168. Ways of securing compensation to employees11 A. An employer shall secure compensation to his employees in one of the12 following ways:13 (1) By insuring and keeping insured the payment of such compensation with14 any stock corporation, mutual association, or other concern authorized to transact the15 business of workers' compensation insurance in this state. When an insurer issues a16 policy to provide workers' compensation benefits pursuant to the provisions of the17 SB NO. 198 SLS 14RS-590 REENGROSSED Page 2 of 9 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. Workers' Compensation Act, the insurer shall file, or cause to be filed, with the1 director a notice in such form and detail as the director may prescribe by rule and2 regulation. The notice shall contain the name, address, and principal occupation of3 the employer, the number, effective date, and expiration date of the policy, and such4 other information as may be required by the director. The notice shall be filed by the5 insurer within thirty days after the effective date of the policy report to the National6 Council on Compensation Insurance all policy information in accordance with7 the reporting guidelines established by the National Council on Compensation8 Insurance. Proof of coverage must be filed no later than thirty days after the9 effective date of coverage and include the name of each business entity10 operating in the state of Louisiana for which coverage is provided.11 * * *12 (4) By using any combination of life, accident, health, property, casualty or13 other insurance policies offered:14 (a) By any stock corporation, mutual association or other concern authorized15 to transact the business of insurance in this state;16 (b) By any group of individual, unincorporated alien insurers with assets held17 in trust for the benefit of its United States policyholders in a sum not less than one18 hundred million dollars and which is authorized to transact insurance in at least one19 state; or20 (c) By any other insurer which has been approved by the commissioner of21 insurance, and has capital and surplus, or the equivalent thereof, of at least ten22 million dollars and its financial condition, as evidenced by its most recent annual23 statement, conforms substantially to the same standards of solvency which would be24 required if such insurer were licensed in this state.25 (5)(4) By furnishing satisfactory proof to the director of the employer's26 financial ability to pay such compensation. The director, pursuant to rules adopted27 by the office for an individual self-insured or own risk carrier, including but not28 limited to rules relative to security and excess coverage, shall require that an29 SB NO. 198 SLS 14RS-590 REENGROSSED Page 3 of 9 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. employer:1 (a) Deposit with the director securities or a surety bond in an amount2 determined by the director which would be at least an average of the yearly claims3 for the last three years.4 (b) Provide proof of excess coverage with such terms and conditions as is5 commensurate with their ability to pay the benefits required by the provisions of the6 Workers' Compensation Act.7 B.(1) The director may waive the requirements of Paragraph A(5)(4) of this8 Section if he finds any company able to pay benefits, and that the requirements of9 these provisions are unnecessary. He shall establish rules which set standards for10 such waiver.11 (2) The director shall waive the requirements of Paragraph A(5)(4) of this12 Section if any employer that is a municipality or other political subdivision of the13 state is able to demonstrate financial responsibility and ability to pay benefits by the14 filing of annual reports including statements of financial condition and summary loss15 data detailing past claims experience.16 * * *17 §1170. Penalty for failure to secure workers' compensation insurance; assessment18 and collection19 A. In addition to any other penalty prescribed by law, any employer who fails20 to secure compensation required by R.S. 23:1168 shall be liable for a civil penalty,21 to be assessed by the executive director or his designee workers' compensation22 judge, of not more than two hundred fifty dollars per employee for a first offense,23 and liable for a civil penalty of not more than five hundred dollars per employee for24 a second or subsequent offense; however, the maximum civil penalty for a first25 offense shall not exceed ten thousand dollars for all related series of violations. All26 civil penalties collected shall be deposited in the Office of Workers' Compensation27 Administrative Fund established in R.S. 23:1291.1(E).28 B. The financial and compliance officer of the office of worker's29 SB NO. 198 SLS 14RS-590 REENGROSSED Page 4 of 9 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. compensation workers' compensation judge shall assess and collect any civil1 penalty incurred under R.S. 23:1170(A) against any employer who fails to provide2 proof of compliance within fifteen days of any notice. Any penalty assessed and3 collected pursuant to this Section shall be forwarded to the fraud administrator4 for collection. In his discretion, the financial and compliance officer fraud5 administrator may remit, mitigate, or negotiate said the penalty if proof of the6 mitigating circumstances is provided within fifteen days of notice of the assessment.7 In determining the amount of the penalty to be assessed, or the amount agreed upon8 in any negotiation, consideration shall be given to the appropriateness of such9 penalty in light of the life of the business of the employer charged, the gravity of the10 violation, and the extent to which the employer charged has complied with the11 provisions of R.S. 23:1168, or has otherwise attempted to remedy the consequences12 of the said violation. Individual proceedings shall be conducted pursuant to the13 provisions of R.S. 23:1171.14 C. In addition to any penalties assessed in accordance with the provisions15 of this Chapter, the workers' compensation judge shall order the employer to16 provide proof of compliance with R.S. 23:1168 within forty-five days of the17 order.18 §1171. Civil fine; hearing; appeal19 A. The financial and compliance officer shall determine from all of the20 evidence submitted by the employer a fair and equitable resolution of the violation,21 taking into consideration any mitigating circumstances timely submitted as required22 by R.S. 23:1170. The financial and compliance officer shall assess, upon23 examination of the information submitted, a penalty commensurate with the violation24 so adjudged. However, the employer may provide additional mitigating25 circumstances or evidence to the financial and compliance officer within ten days of26 the assessment, and a reevaluation of the penalty shall be conducted. Unless a formal27 hearing is requested pursuant to the provisions of R.S. 23:1171(B), the penalty shall28 become final within thirty days of assessment. Upon becoming final, the penalty29 SB NO. 198 SLS 14RS-590 REENGROSSED Page 5 of 9 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. shall be regarded as any other money judgment and may be pursued for collection1 as prescribed by law for any other such remedy.2 B. An employer may appeal the decision of the financial and compliance3 officer to the workers' compensation judge in the district in which the business of the4 employer is located or East Baton Rouge Parish by filing, within thirty days of the5 date of assessment, a written request for a formal hearing, which request should be6 filed on a disputed claim form. All appeals to the workers' compensation judge shall7 be de novo. A final order from a hearing may be appealed to the appropriate court8 of appeal in the manner provided in R.S. 23:1310.5(B) for appealing decisions9 regarding disputed claims.10 §1171.1. Discontinuance of business; injunction; procedure11 A. The director, or his designee, shall investigate an employer if he receives12 information from any person or entity that such employer has failed to provide13 security for compensation as required by R.S. 23:1168. If such allegations can be14 reasonably substantiated, and the employer has previously been subject to a civil15 penalty pursuant to R.S. 23:1170 or criminal penalties pursuant to R.S. 23:1172,16 the director, or his designee, and the employer has previously been fined under17 R.S. 23:1170 or been penalized under R.S. 23:1172, the director shall notify the18 employer that, unless he can show proof of compliance with R.S. 23:1168 within19 fifteen days, he may shall be subject to further fines and penalties including but not20 limited to an injunction against further business operations a civil penalty pursuant21 to the provisions of R.S. 23:1170.22 B. If within fifteen days of the employer's receipt of such notice, he has not23 submitted to the director satisfactory proof of such compliance, the director shall set24 the matter for hearing in accordance with the procedures set forth by law for claims25 for workers' compensation benefits If such allegations can be reasonably26 substantiated and the employer has been fined under R.S. 23:1170 or penalized27 under R.S. 23:1172, the director shall notify the employer that unless he can28 show proof of compliance with R.S. 23:1168 within fifteen days, he shall be29 SB NO. 198 SLS 14RS-590 REENGROSSED Page 6 of 9 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. subject to further fines and penalties, including but not limited to an injunction1 against further business operations.2 C. If within fifteen days of the employer's receipt of such notice he has3 not submitted to the director satisfactory proof of such compliance, the director4 or his designee shall request the workers' compensation judge of any district5 where the employer does business to set the matter for hearing in accordance6 with the procedures set forth by law for claims for workers' compensation7 benefits. Upon the request of the director or his designee, the workers'8 compensation judge shall issue a rule to show cause to the employer why he9 should not be fined or penalized for failure to show proof of compliance with10 R.S. 23:1168 when requested.11 D.(1) If at such hearing, it is determined that the employer is in violation of12 his obligation under R.S. 23:1168, the workers' compensation judge may shall fine13 the employer in the manner provided pursuant to R.S. 23:1170(A) and shall order the14 employer to secure workers' compensation insurance and file evidence of coverage15 within ninety days of the order provide proof of compliance with R.S. 23:116816 within forty-five days of the order by securing the appropriate coverage. Should17 the employer fail to file such evidence, the workers' compensation judge shall assess18 a fine for a second offense and issue a cease and desist order prohibiting the19 employer from continuing its business operations until such time as the employer20 complies with R.S. 23:1168, and all fines issued are paid in full.21 (2) Any cease and desist order issued by the workers' compensation judge22 under Paragraph (C)(1) of this Subsection shall include specific findings of fact23 based upon evidence of all of the following:24 (a) The employer received notice of the hearing.25 (b) The employer employs employees for whom it must secure workers'26 compensation insurance or be authorized to self-insure under the provisions of this27 Chapter.28 (c) The employer has willfully failed to provide security for compensation29 SB NO. 198 SLS 14RS-590 REENGROSSED Page 7 of 9 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. as required by R.S. 23:1168 and there has been a final determination in a matter in1 which the employer has been fined under R.S. 23:1170 or penalized under R.S.2 23:1172.3 (d) The employer continues to operate its business in the absence of such4 security for compensation.5 (3) There shall be a presumption that an employer who has previously been6 civilly fined for a second offense, or has previously been criminally penalized, has7 willfully failed to secure his obligation under R.S. 23:1168.8 (4) A cease and desist order shall not issue prior to a hearing and there shall9 be no interruption of an employer's business operation if he submits satisfactory10 proof to the workers' compensation judge of his compliance with R.S. 23:1168,11 regardless of whether he may have been in violation thereof previously.12 D.E. (1) After the issuance of a cease and desist order and upon the request13 of the director or the director's designee, the attorney general shall immediately14 institute proceedings for injunctive relief against the employer in the district court15 of any judicial district in this state where the employer does business. In such district16 court proceedings, a certified copy of any cease and desist order entered by the17 workers' compensation judge in accordance with this Section based upon evidence18 in the record shall be prima facie evidence of the facts found in such record.19 (2) Such injunctive relief may include the issuance of a temporary restraining20 order under Louisiana Code of Civil Procedure Article 3601 et seq., which order21 shall enjoin the employer from continuing its business operations until it has22 procured the required insurance or authorization to self-insure or has posted adequate23 security with the court pending the procurement of such insurance or authorization.24 The court, in its discretion, shall determine the amount that shall constitute adequate25 security.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 REENGROSSED Page 8 of 9 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 noncompliance by12 employers.13 * * *14 Section 2. R.S. 23:1168(A)(5) is hereby repealed.15 The original instrument was prepared by Carla S. Roberts. The following digest, which does not constitute a part of the legislative instrument, was prepared by Cathy R. Wells. 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, SB NO. 198 SLS 14RS-590 REENGROSSED Page 9 of 9 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. to be assessed by the executive director or his designee, of not more than $250.00 per 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, and 1291(C)(5); adds R.S. 23:1170(C); repeals R.S. 23:1168(A)(5)) Summary of Amendments Adopted by Senate Senate Floor Amendments to engrossed bill 1. Makes technical corrections, including citation.