WAC 296-17-90428
Disqualification of a retro group
A sponsoring organization will forfeit the right to sponsor a retro group if:
- The retro group is required to pay additional net premium assessments in three consecutive coverage periods.
| Note: The retro group will be placed in probationary status if they are required to pay additional net premium in two consecutive coverage periods. Once a group is placed on probationary status, the department will review the group's workplace safety and accident prevention plan and its methods for cooperation with department claims management activities. Following the review, the department will make recommendations for corrective steps that may be taken to improve the group's performance. In the event that the group's performance is not improved and the same retrospective rating group is required to pay an additional net premium assessment in the third consecutive coverage period, that group shall be denied future enrollment in the state's retrospective rating plan at the next enrollment. In addition, the sponsoring entity of the failed group may not sponsor another group in the same business or industry category for five coverage periods (sixty months) from the ending date of the failed group's last coverage. |
- The organization encourages a participating member to pay a medical service provider directly for treatment of participating members' employees.
| Note: Upon discovery of this violation, L&I will disqualify the retro group affected from further participation in the program and will issue an order and notice of decision to the sponsoring organization outlining the alleged violation. A sponsoring organization found to have participated in this activity will lose their right to ever sponsor a retro group in the future. All refunds earned by a retro group disqualified for this activity and not yet distributed by L&I will be forfeited. |
[Statutory Authority: RCW 51.18.010(1) (www.leg.wa.gov). 02-23-089, § 296-17-90428, filed 11/20/02, effective 1/1/03.]
This rule applies to retro coverage period(s) established prior to January 1, 2011.
The courts can take judicial notice of the Washington Administrative Code (WAC) only as published by the Office of the Code Reviser (www.leg.wa.gov). The text contained in this Web page may reflect minor changes when compared with the WAC.
