Florida Regulations 69L-5.106

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§ 69L-5.106 Financial Statement or Financial Summary. (repealed)

Repealed. (03-09-10)

Failure to provide the following information in the name of the self-insurer when due shall be cause for revocation of privilege: (1) Financial statement shall show, at all times, a net worth of at least $1,000,000 or a financial summary showing a minimum tangible net worth of $250,000,000 for those qualifying under the alternate method pursuant to Rule 4L- 5.104, F.A.C. The financial statement or financial summary must demonstrate the self-insurer has the financial strength to ensure the payment of all current and estimated future compensation claims when due, as determined by the division. The statements and summaries must be submitted not later than four (4) months following the end of the self-insured employer's fiscal year. (2) The following conditions shall apply to the financial statement or financial summary: (a) The financial statement, or summary shall be in the name of the business holding the self-insurance privilege; (b) The financial statement, or financial summary shall be accompanied by a certification by an owner, partner or corporate officer that there has been no material adverse change in the financial condition of the self-insured since the date of the last financial statement or financial summary; (3) All separate legal entities which are included in the self-insurer's privilege shall submit financial statements in accordance with this rule. Separate financial statements shall be submitted for each entity unless consolidated or combined financial statements are submitted. (4) If a self-insured entity is either purchased in whole or part by another company which is not self-insured in Florida, or is structurally separated as result of reorganization, their self-insurance privilege may continue provided the new owners submit Form |^SI-1a|, Re-Application for Self-Insurance, their financial statements annually, and execute an indemnity agreement (|^Form SI-11|) guaranteeing the performance of the original self-insurer. The re-application form, Form SI-1a, and the Idemnity Agreement, Form |^Form SI-11|, are hereby incorporated by reference into Rule Chapter 4L-5, F.A.C. The version of the forms required by this rule shall bear the date September 1996 (9/96). Copies of both forms may be obtained from the Division of Workers' Compensation, Bureau of Monitoring and Audit, Self-Insurance Section, 200 East Gaines Street, Tallahassee, FL 32399-4224. (5) The division shall require additional financial information if it determines, based upon the self-insurer's financial statement or financial summary, that there has been or may be a significant change in the self-insurer's financial condition compared to the most recent financial statement. (6) The division shall conduct an overall evaluation of the self-insurer's financial condition to determine if the self-insurer has the financial strength necessary to ensure the payment of all current and estimated future compensation benefits when due. Failure to maintain such financial strength shall constitute good cause for: (a) Revocation of the self-insurance privilege, (b) Increasing The security deposit, (c) Requirement for quarterly financial filing, or (d) A combination thereof. If the division has determined the self-insurer does not have the required financial strength and intends to revoke the self-insurance privilege, the self-insurer may elect to continue self-insuring pursuant to Section 440.38(1)(b)2., Florida Statutes. Specific Authority 440.591, 440.38(2)(b) FS. Law Implemented 440.38(1)(b), (2)(b) FS. History New 10-1-82, Formerly 38F-5.47, Amended 6-12-91, 12-19-93, 5-14-96, Formerly 38F-5.047, Amended 5-19-97, Formerly 38F-5.106.