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A.
California law requires employers to have
workers' compensation insurance. Even
out-of-state employers may need workers'
compensation coverage if an employee is
regularly employed in California or a
contract of employment is entered into here.
A.
Generally, if you are the sole owners of
the business, coverage for yourselves, is
optional if you wish to pursue it. You would
need to have workers' compensation coverage
for any employees you may hire. You should
consult with your attorney, insurance agent
or broker, or carrier regarding the
specifics of you situation and your options.
A.
Generally, all employees of the company,
as legally defined, including corporate
officers and directors, must be included in
the policy unless they are the sole owners
of the firm, in which case they may elect
not to be covered. Several sections of the
California Labor Code must be considered
here. You should consult with your attorney,
insurance agent or broker, or your carrier
regarding the specifics of your situation.
A.
You can get workers' compensation
insurance coverage from any of the more than
300 private licensed insurers authorized to
sell such policies in California. While you
can purchase the policy directly from an
insurer, most policies are sold through an
insurance agent or broker.
The
largest workers' compensation carrier is
State Compensation Insurance Fund (State
Fund). If you can't find an insurer willing
to cover your business, State Fund is
required to provide you with coverage.
If
you belong to a trade association you might
want to check with them first - some trade
groups negotiate special rates for their
members. Your local chamber of commerce may
also be a source of good advice.
A.
Some employers mainly large businesses
self insure for workers' compensation. Self
insurance requires state approval, a net
worth of at least $5 million, net income of
$500,000 per year and posting a security
deposit. Contact your broker or the state's
Office of Self Insurance Plans for
information on self insurance.
The
self insured employer has the option of
administering their own workers'
compensation claims or contracting with a
third party administrator (TPA) to provide
these services. For the small-business
employer, group self insurance may be
possible call Self Insurance Plans for
information.
A.
Workers' compensation insurance premium
rates were deregulated several years ago.
They may now vary from carrier to carrier.
Like any good consumer, you should shop
around for a carrier that best meets your
needs. Cost is one consideration, but there
are other factors you should look at: the
services they provide, how convenient will
it be to work with them how familiar they
are with your industry, etc. If you have a
broker or agent, check with that person.
A.
Your workers' compensation claims
administrator - generally your insurance
carrier or third party administrator if you
are self insured and have one - provides the
claim form in the quantities you require.
The form can also be found in the Standard
Register. A downloadable copy can be found
in
Section 10118 of Title 8, California Code of
Regulations.
A.
You should report that opinion to your
workers' comp claims administrator. Tell
them all the facts you know, any witnesses
that you may be aware of, and the people
they should talk to.
A.
Report this to your claims administrator
and make sure you include all the facts that
you have. You should follow up any phone or
verbal report with a letter.
A.
An employer's failure to have workers'
compensation coverage is a criminal offense.
Section 3700.5 of the California Labor Code
specifies that it is a misdemeanor
punishable by either a fine of up to $10,000
or imprisonment in the county jail for up to
one year, or both. Additionally, the state
issues penalties of up to $100,000 against
illegally uninsured employers.
If
your insurance coverage lapsed and an
employee was injured on the job, you are
responsible for ensuring that all claims
related bills are paid. Contact the
information and assistance officer at the
local DWC district office for further
information. You may also contact the
Uninsured Employers' Fund.
A.
The Uninsured Employer's Fund (UEF) is a
special state unit within the Division of
Workers' Compensation that pays benefits to
injured workers when there is an illegally
uninsured employer.
A.
No, it is illegal for an employer to pay
medical bills directly. You must file a
claim form (DWC form 1) with your claims
administrator for all injuries that require
more than first aid.
A.
A number of factors go to into
determining the annual premium that your
insurance carrier will charge. These
include: your industry classification; your
company's past history of work related
injuries (known as your experience
modification), your payroll; any special
underwriting adjustments, such as use of a
certified Health Care Organization; and any
special group or dividend programs that you
may be eligible for. Further information and
advice on how to lower your rates can be
found in the employer's guide, which can be
ordered or downloaded
here.
A.
Employers must post a notice of
compensation carrier poster in a conspicuous
place at the work site. This poster provides
employees information on the company's
workers' compensation coverage and where to
get medical care for work injuries. Specific
requirements are contained in
sections 3550-3553 of the California Labor
Code. Failure to post this notice is a
misdemeanor that can result in a civil
penalty of up to $7,000 per violation.
Contact your insurer to get the posting
notice and the required information that
must be included on it.
A.
You should request a certificate of
insurance from your insurance carrier.
A.
Yes. If the Division of Labor Standards
Enforcement (State Labor Commissioner)
determines that an employer has failed to
secure workers' compensation coverage, a
stop order will be issued and served (Labor
Code Section 3710.1). This order
prohibits the use of employee labor until
the coverage is obtained, and failure to
observe it is a misdemeanor punishable by
imprisonment in the county jail for up to 60
days or by a fine of up to $10,000, or both.
(Labor
Code Section 3710.2). The Division of
Labor Standards Enforcement will also assess
a penalty of $1,000 per employee employed at
the time the stop order is issued and
served. (Labor
Code section 3722(a)).
In
addition, if an injured worker files a
workers' compensation claim that goes before
the WCAB, and the workers' compensation
judge finds that the employer had not
secured insurance as required by law, then,
when the adjudication becomes final, the
uninsured employer may be assessed a penalty
of $10,000 per employee employed at the time
of injury if the worker's case was found to
be compensable, or $2,000 per employee
employed at the time of injury if the
worker's case was noncompensable, up to a
maximum of $100,000 [Labor
Code section 3722(b)].
Finally, as noted in a previous question,
failure to secure workers' compensation
insurance when you knew, or reasonably
should have known, that it is required, is a
misdemeanor "punishable by imprisonment in
the county jail for up to one year, or by a
fine of up to ten thousand dollars ($10,000)
or by both that imprisonment and fine." (Labor
Code Section 3700.5)
A.
You may report an uninsured employer to
the
nearest district office of the Division of
Labor Standards Enforcement. The nearest
office is also listed in the state
government section of the white pages of
your local telephone directory.
A.
No. Workers' compensation insurance is
part of the cost of doing business. An
employer cannot ask employees to help pay
for the insurance premium.
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