N.C. Gen. Stat. § 58-87-10
Workers' Compensation Fund for the benefit of certain safety workers
Redline — June 1, 2021 → current.View current text →
Current — June 1, 2022
As of June 1, 2021
(1) Definitions. -. As used in this section, the following terms apply: Eligible entity. — One of the following entities that support eligible units and members of eligible units: North Carolina State Firefighters’ Association.
(1) Definitions. — As used in this section, the following terms apply: Eligible entity. — One of the following entities that support eligible units and members of eligible units: North Carolina State Firefighters’ Association.
(2) The North Carolina Association of Fire Chiefs, Incorporated.
(2) The North Carolina Association of Fire Chiefs, Incorporated.
(3) North Carolina Association of Rescue and Emergency Medical Services, Inc.
(3) North Carolina Association of Rescue and Emergency Medical Services, Inc.
(4) Eligible unit. - A fire department or rescue/EMS unit that (i) is not part of a unit of local government and (ii) is exempt from State income tax under G.S. 105-130.11.
(4) Eligible unit. — A fire department or rescue/EMS unit that (i) is not part of a unit of local government and (ii) is exempt from State income tax under G.S. 105-130.11.
(5) Creation. - The Workers' Compensation Fund is created in the Department of Insurance as an expendable trust fund. Accordingly, interest and other investment income earned by the Fund accrues to it, and revenue in the Fund at the end of a fiscal year remains in the Fund and does not revert.
(5) Creation. — The Workers’ Compensation Fund is created in the Department of Insurance as an expendable trust fund. Accordingly, interest and other investment income earned by the Fund accrues to it, and revenue in the Fund at the end of a fiscal year remains in the Fund and does not revert.
(6) Use. - Revenue in the Workers' Compensation Fund shall be used to provide workers' compensation benefits to (i) members of eligible units and (ii) the employees and volunteers of eligible entities. Chapter 97 of the General Statutes governs the payment of benefits from the Fund. Benefits are payable for compensable injuries or deaths that occur on or after July 1, 1996.
(6) Use. — Revenue in the Workers’ Compensation Fund shall be used to provide workers’ compensation benefits to (i) members of eligible units and (ii) the employees and volunteers of eligible entities. Chapter 97 of the General Statutes governs the payment of benefits from the Fund. Benefits are payable for compensable injuries or deaths that occur on or after July 1, 1996.
(7) Administration. — The State Fire and Rescue Commission, established under G.S. 58-78-1, shall administer the Workers’ Compensation Fund and shall perform this duty by contracting with a third-party administrator. The contracting procedure is not subject to Article 3C of Chapter 143 of the General Statutes. The reasonable and necessary expenses incurred by the Commission in administering the Fund shall be paid out of the Fund by the State Treasurer. The Commission may adopt rules to implement this section.
(7) Administration. — The State Fire and Rescue Commission, established under G.S. 58-78-1, shall administer the Workers’ Compensation Fund and shall perform this duty by contracting with a third-party administrator. The contracting procedure is not subject to Article 3C of Chapter 143 of the General Statutes. The reasonable and necessary expenses incurred by the Commission in administering the Fund shall be paid out of the Fund by the State Treasurer. The Commission may adopt rules to implement this section.The State Fire and Rescue Commission shall include the provisions of Section 2(d) of S.L. 2014-64 in all future contracts with its workers’ compensation third party administrators.
(8) Revenue Source. - Revenue is credited to the Workers' Compensation Fund from a portion of the proceeds of the tax levied under G.S. 105-228.5(d)(3). In addition, every eligible unit and eligible entity that elects to participate shall pay into the Fund an amount set annually by the State Fire and Rescue Commission to ensure that the Fund will be able to meet its payment obligations under this section. The amount shall be set as an amount for each member of the roster of the eligible unit or for each employee or volunteer of an eligible entity, and the amount may vary based on whether an individual is a volunteer, a part-time employee, or a full-time employee. The payment shall be made to the State Fire and Rescue Commission on or before July 1 of each year. The Commission shall remit the payments it receives to the State Treasurer, who shall credit the payments to the Fund.
(8) Revenue Source. — Revenue is credited to the Workers’ Compensation Fund from a portion of the proceeds of the tax levied under G.S. 105-228.5(d)(3). In addition, every eligible unit and eligible entity that elects to participate shall pay into the Fund an amount set annually by the State Fire and Rescue Commission to ensure that the Fund will be able to meet its payment obligations under this section. The amount shall be set as an amount for each member of the roster of the eligible unit or for each employee or volunteer of an eligible entity, and the amount may vary based on whether an individual is a volunteer, a part-time employee, or a full-time employee. The payment shall be made to the State Fire and Rescue Commission on or before July 1 of each year. The Commission shall remit the payments it receives to the State Treasurer, who shall credit the payments to the Fund.
(9) Funding Study. - The Department of Insurance shall annually conduct an actuarial study that shall do all of the following: Calculate the amount required to meet the needs of the Fund, projecting at least five years into the future.
(9) Funding Study. — The Department of Insurance shall annually conduct an actuarial study that shall do all of the following: Calculate the amount required to meet the needs of the Fund, projecting at least five years into the future.
(10) Report on the nature of the claims paid by the Fund and any claims-related trends that impact the financial status of the Fund.
(10) Report on the nature of the claims paid by the Fund and any claims-related trends that impact the financial status of the Fund.
(11) Calculate how much revenue from the State and from member premiums would be required to meet the needs of the Fund for each of the following scenarios: The Fund receives twenty percent (20%) of the net proceeds from the tax collected under G.S. 105-228.5(d)(3).
(11) Calculate how much revenue from the State and from member premiums would be required to meet the needs of the Fund for each of the following scenarios: The Fund receives twenty percent (20%) of the net proceeds from the tax collected under G.S. 105-228.5(d)(3).
(12) Member premiums do not change from the prior year.
(12) Member premiums do not change from the prior year.
(13) Member premiums fully fund the Fund without any State support.
(13) Member premiums fully fund the Fund without any State support.
(14) Be published no later than February 1 of each year. Upon publishing the study, the Department shall notify the following of its publication: The Office of State Budget and Management.
(14) Be published no later than February 1 of each year. Upon publishing the study, the Department shall notify the following of its publication: The Office of State Budget and Management.
(15) The House Appropriations Committee.
(15) The House Appropriations Committee.
(16) The Senate Appropriations/Base Budget Committee.
(16) The Senate Appropriations/Base Budget Committee.
(17) The Fiscal Research Division.
(18) Allocation of Taxes. - The study conducted under subsection (f) of this section shall be reviewed by the Office of State Budget and Management. On or before March 1 of each year, the Office of State Budget and Management, in consultation with the Department of Insurance, must notify the Secretary of Revenue of the amount required to meet the needs of the Fund, as determined by the study, for the upcoming fiscal year. The Secretary of Revenue shall remit that amount, subject to the twenty percent (20%) limitation in G.S. 105-228.5(d)(3), to the Fund.
The State Fire and Rescue Commission shall include the provisions of Section 2(d) of S.L. 2014-64 in all future contracts with its workers' compensation third party administrators.
Additionally, beginning in 2016 and every five years thereafter, the study shall include (i) a comparison of Fund premium levels to the premium levels of employees of municipal fire and rescue departments and (ii) a calculation of the amount of revenue generated by experience-rating premium surcharges and, if necessary, recommend changes to experience-rating premium surcharges given claim trends. The Department may contract with a third party to conduct the study required under this section, and the cost of the study may be paid from the Fund. However, if the Department contracts with the same actuary that the Volunteer Safety Workers’ Compensation Board contracts with to perform the study under this section, then the Department shall not pay the actuary for data collection and analysis that the actuary has already performed as part of its loss reserve analysis for the Board.
(17) The Fiscal Research Division. Additionally, beginning in 2016 and every five years thereafter, the study shall include (i) a comparison of Fund premium levels to the premium levels of employees of municipal fire and rescue departments and (ii) a calculation of the amount of revenue generated by experience-rating premium surcharges and, if necessary, recommend changes to experience-rating premium surcharges given claim trends. The Department may contract with a third party to conduct the study required under this section, and the cost of the study may be paid from the Fund. However, if the Department contracts with the same actuary that the Volunteer Safety Workers’ Compensation Board contracts with to perform the study under this section, then the Department shall not pay the actuary for data collection and analysis that the actuary has already performed as part of its loss reserve analysis for the Board.
History
(1995, c. 507, s. 7.21A(a); 1999-132, s. 1.2; 2013-360, s. 20.2(d), (e); 2014-64, s. 2(a), (b), (d); 2016-51, s. 6.)
Third-party Administrator Contract Requirements. - Session Laws 2014-64, s. 2(d), provides: "When renewing its existing contract with its third-party administrator, which contract expires on June 30, 2014, or contracting with a different third-party administrator, the State Fire and Rescue Commission shall, through its contract, require its workers' compensation third-party administrator to do all of the following:
"(1) Establish a performance management system to set loss prevention goals and track and measure the effectiveness of loss prevention interventions.
"(2) Evaluate how additional data analytics software or cost models could help manage claim costs.
"(3) Determine the expenditures per department allocated to loss prevention services geared toward experience-rating reductions and compare the expenditures allocated per department to the experience-rating premium surcharges paid by each department.
"(4) Assess the different ways in which the Rating Modification Model could be adjusted to generate more revenue and incentivize departments to be more engaged in loss prevention services; and, if warranted, implement changes to the Experience Rating Modification Model based on the approval of the Volunteer Safety Workers' Compensation Fund Board.
"(5) Track all legal claims and associated expenses open as of July 1, 2014, and filed thereafter, including information on the reasons each claim was filed and the conditions of the settlement or court ruling, and then share the information and analysis from the database with the Volunteer Safety Workers' Compensation Fund Board at every quarterly board meeting.
"(6) Track suspected and confirmed fraudulent claims open as of July 1, 2014, and filed thereafter and then share the information and analysis from the database with the Volunteer Safety Workers' Compensation Fund Board at every quarterly board meeting.
"(7) Track information for all claims awarded indemnity compensation affected by the minimum weekly compensation provision, as provided in G.S. 97-2(5), that are open on July 1, 2014, and filed on or after July 1, 2014. The database should include the following:
"a. The date of the volunteer's injury.
"b. A detailed description of the injury.
"c. The volunteer's (paid) occupation, or status as a "student" or "unemployed.
"d. The volunteer's weekly wages from his or her regular paid occupation.
"e. The amount of indemnity compensation awarded per week based on weekly wages from the regular, paid occupation.
"f. Whether the claim is affected by the minimum weekly compensation provision.
"g. The volunteer's post-injury return date to volunteer duties.
"(8) Report to the Volunteer Safety Workers' Compensation Fund Board at every quarterly meeting on all claims awarded indemnity compensation affected by the minimum compensation provision. The report shall include the following:
"a. The total indemnity compensation awarded for each claim, as well as the compensation per week and the number of weeks of compensation.
"b. For each claim, the difference between the indemnity compensation awarded per week to the volunteer and the volunteer's weekly wages from his or her regular, paid occupation.
c. For each claim, the difference between the total indemnity compensation awarded to the volunteer for number of weeks unable to return to volunteer duties and the volunteer's total wages from regular, paid occupation for the same time period.
"d. The total number of claims affected by the minimum weekly compensation provision (within a specified time period).
"e. The total workers' indemnity compensation amount awarded for all claims affected by the minimum weekly compensation provision (within a specified time period).
"f. The difference between the total indemnity compensation awarded to volunteers and the total of all volunteers' wages from their regular, paid occupations for the same time period (within a specific time period).
"(9) Track information for all claims awarded indemnity compensation in which a volunteer can return to his or her paid occupation but not his or her volunteer duty that are open on July 1, 2014, and filed on or after July 1, 2014. The database should include the following:
"a. Whether the volunteer has the ability to perform his or her paid occupation but not his or her volunteer duty.
"b. The volunteer's weekly wages from his or her regular, paid occupation.
"c. The amount of indemnity compensation awarded per week based on weekly wages from regular, paid occupation.
"d. The volunteer's post injury return date to volunteer duties.
"(10) Report to the Volunteer Safety Workers' Compensation Fund Board at every quarterly meeting on the claims awarded indemnity compensation in which the volunteer can return to his or her paid occupation but not to his or her volunteer duty. The report shall include:
"a. The total number of claims where the volunteer is being awarded indemnity compensation when they can return to their regular, paid occupations (within a specified time period).
"b. The total indemnity compensation awarded for each claim, as well as the compensation per week and the number of weeks of compensation.
"c. The total indemnity compensation awarded for all claims (within a specified time period).
"(11) Include a form in the claims-closing material for volunteers who will not be able to return to their regular, paid occupations even though they can return to their volunteer duties, and track these claims and associated wages lost and prepare a report to share with the Volunteer Safety Workers' Compensation Fund Board at every quarterly meeting.
"(12) Develop a model return-to-work program for use by fire and rescue departments that participate in the Fund and work with a limited number of departments to implement and test the program for a two-year time period.
"(13) Develop metrics by which to determine if the return-to-work program reduces workers' compensation costs.
"By January 1, 2015, the State Fire and Rescue Commission shall report to the Fiscal Research Division, the House Appropriations Subcommittee on General Government, and the Senate Appropriations Committee on General Government and Information Technology on the status of the Commission's data collection and analysis efforts and shall include in the report a copy of the State Fire and Rescue Commission's contract with the third-party administrator.
"This subsection is effective when this act becomes law."
(18) Allocation of Taxes. — The study conducted under subsection (f) of this section shall be reviewed by the Office of State Budget and Management. On or before March 1 of each year, the Office of State Budget and Management, in consultation with the Department of Insurance, must notify the Secretary of Revenue of the amount required to meet the needs of the Fund, as determined by the study, for the upcoming fiscal year. The Secretary of Revenue shall remit that amount, subject to the twenty percent (20%) limitation in G.S. 105-228.5(d)(3), to the Fund.
Official source: North Carolina General Assembly. Reproduced from public-domain North Carolina statutes; confirm against the official source for the current text. Not legal advice.