§ 58-47-100 – Examinations.
58-47-100. Examinations. G.S. 58-2-131 through G.S. 58-2-134 apply to groups. (1997-362, s. 3; 1999-132, s. 11.7.)
58-47-100. Examinations. G.S. 58-2-131 through G.S. 58-2-134 apply to groups. (1997-362, s. 3; 1999-132, s. 11.7.)
58-47-105. Dividends and other distributions. (a) Group dividends and other distributions shall be made in accordance with G.S. 58-7-130, 58-8-25(b), and 58-19-30. A group shall be in compliance with this Part before payment of dividends or other distributions to its members. No group shall pay dividends or other distributions to its members until two years […]
58-47-110. Premium rates. (a) As used in this section: (1) "Bureau" means the North Carolina Rate Bureau in Article 36 of this Chapter. (2) "Expenses" means that portion of a premium rate attributable to acquisition, field supervision, collection expenses, and general expenses, as determined by the group. (3) "Multiplier" means a group’s determination of the […]
58-47-115. Premium payment requirements. Groups shall collect members’ premiums for each policy period in a manner so that at no time the sum of a member’s premium payments is less than the total estimated earned premium for that member. (1997-362, s. 3.)
58-47-120. Board; composition, powers, duties, and prohibitions. (a) Each group shall be governed by a board or other governing body comprising no fewer than three persons, elected for stated terms of office, and subject to the Commissioner’s approval. All board members shall be residents of this State or members of the group. At least two-thirds […]
58-47-125. Admission and termination of group members. (a) Prospective group members shall submit applications for membership to the board. The board, a designated employee of the group, or TPA shall approve an application for membership under the bylaws of the group. Members shall have bona fide offices in this State and members’ employees shall be […]
58-47-130. Disclosure. Every group through its board, TPA, service company, agents, or other representatives shall require, before accepting an application, each applicant for membership to acknowledge in writing that the applicant has received the following: (1) A document disclosing that the members are jointly and severally liable for the obligations of the group. (2) A […]
58-47-135. Assessment plan and indemnity agreement. (a) Each group shall establish an assessment plan that provides for a reasonable and equitable mechanism for assessing its members. The plan and any amendments shall be approved by the Commissioner. The plan shall include descriptions of the circumstances that initiate an assessment, basis, and allocation to members of […]
58-47-140. Other provisions of this Chapter. The following provisions of this Chapter apply to workers’ compensation self-insurance groups that are subject to this Article: G.S. 58-1-10, 58-2-45, 58-2-50, 58-2-70, 58-2-100, 58-2-105, 58-2-155, 58-2-161, 58-2-180, 58-2-185, 58-2-190, 58-2-200, 58-3-71, 58-3-81, 58-3-100, 58-3-120, 58-6-25, 58-7-21, 58-7-26, 58-7-30, 58-7-33, 58-7-73, and Articles 13, 19, 30, 33, 34, and […]
58-47-150. Definitions. As used in this Part: (1) "Books and records" means all files, documents, and databases in a paper form, electronic medium, or both. (2) "Self-insurer" means a group of employers licensed by the Commissioner under Part 1 of this Article or a single employer licensed by the Commissioner under Article 5 of Chapter […]
58-47-155. TPAs and service companies; authority; qualifications. (a) No person shall act as, offer to act as, or hold himself or herself out as a TPA or a service company with respect to risks located in this State for a self-insurer unless that person complies with this Article. (b) A TPA or service company shall […]
58-47-160. Written agreement; composition; restrictions. (a) No person may act as a TPA or service company without a written agreement between the TPA or service company and the self-insurer. The written agreement shall be retained by the self-insurer and the TPA or service company for the duration of the agreement and for five years thereafter. […]
58-47-165. Books and records. (a) Every TPA or service company shall maintain and make available to the self-insurer complete books and records of all transactions performed on behalf of the self-insurer. The books and records shall be maintained by the self-insurer, TPA, or service company in accordance with G.S. 58-47-180. (b) The Commissioner shall have […]
58-47-170. Payments to TPA or service company. If a self-insurer uses the services of a TPA, the payment to the TPA of any premiums or charges for insurance by or on behalf of the insured party is considered payment to the self-insurer. The payment of return premiums or claim payments forwarded by the self-insurer to […]
58-47-175. Approval of advertising. A TPA or service company may use only the advertising pertaining to or affecting the business underwritten by a self-insurer that has been approved in writing by the self-insurer before its use. (1997-362, s. 3.)
58-47-180. Premium collection and payment of claims. (a) The TPA or service company, at a minimum, shall: (1) Periodically render an accounting to the self-insurer detailing all transactions performed by the TPA or service company pertaining to the business underwritten, premium or other charges collected, and claims paid by the self-insurer, when applicable. (2) Deposit […]
58-47-185. Notices; disclosure. (a) When the services of a TPA are used, the TPA shall provide a written notice approved by the self-insurer to covered members advising them of the identity of, and relationship among, the TPA, the member, and the self-insurer. (b) When a TPA collects funds, the reason for collection of each item […]
58-47-190. Compensation. A TPA or service company shall not enter into any agreement or understanding with a self-insurer that makes the amount of the TPA’s or service company’s commissions, fees, or charges contingent upon savings affected in the adjustment, settlement, and payment of losses covered by the self-insurer’s obligations. This section does not prohibit a […]
58-47-195. Examinations. TPAs and service companies may be examined under G.S. 58-2-131 through G.S. 58-2-134. (1997-362, s. 3; 1999-132, s. 11.8.)
58-47-200. Unfair trade practices. TPAs and service companies are subject to Article 63 of this Chapter. (1997-362, s. 3.)