DWD 80.61(3)(d)2.c. c. The notification of department and bureau of any entity status change resulting from ensuing reorganization;

DWD 80.61(3)(d)2.d. d. Becoming the full risk insurer for any contractor or subcontractor not having purchased a worker’s compensation policy during the time the contractor or subcontractor is under contract on the wrap-up project, except as to an employer granted self-insurance; and

DWD 80.61(3)(d)2.e. e. Becoming the full risk insurer for any contractor or subcontractor not insured or self-insured while working on the wrap-up project.

DWD 80.61(3)(d)3. 3. The designated wrap-up carrier shall submit a certified copy of a statement from an officer authorizing and directing the execution of the application and agreement.

DWD 80.61(3)(e) (e) Application for contractors and subcontractors. The owner shall submit an application for divided insurance on forms available from the department for each contractor and subcontractor scheduled to work on the project.

DWD 80.61(3)(em) (em) Waiver of requirements. The department may waive one or more requirements in pars. (b) to (e) if it determines that a waiver will not impair the construction owner’s ability to ensure minimum confusion about insurance coverage and maximum safety on the construction project site.

DWD 80.61(3)(f) (f) Reimbursement for expenses incurred by department. The department shall be reimbursed for those expenses incurred because of the designated carrier wrap-up program. Where the department specifically consents to divided-insurance or partial-insurance on a wrap-up project, the owner shall reimburse the department, within 30 days after the date of a written request by the department, a sum determined by the department not to exceed 2% of the total audited worker’s compensation premium charged, with payment not to exceed 1% of the estimated worker’s compensation premium upon initial request. If an additional levy is determined to be necessary, a request shall be made for a sum that results in a total charge not to exceed 2% of the total audited worker’s compensation premium charged.

DWD 80.61(3)(g) (g) Inapplicability to other employers. Subsection (3) does not apply to any group of employers other than those specified in this section on any other type of operations nor to any single contract or policy of insurance for any group or association of employers.

DWD 80.61 History History: Cr. Register, September, 1982, No. 321, eff. 10-1-82; am. (2) (a) 1., (3) (b) 3. and (3) (d) 3., r. and recr. (3) (e), Register, September, 1986, No. 369, eff. 10-1-86; am. (2) (a) 2. to (c), Register, April, 1990, No. 412, eff. 5-1-90; cr. (3) (em), Register, April, 1994, No. 460, eff. 5-1-94; CR 15-030: am. (3) (c) 1., 2. a. to f. Register October 2015 No. 718, eff. 11-1-15.

DWD 80.62 DWD 80.62 Uninsured employers fund.

DWD 80.62(1) (1) Purpose. The purpose of this section is to clarify the department’s procedures for handling claims for compensation to injured workers under s. 102.81 (1), Stats. This section also defines the financial standards and actuarial principles which the department will use to monitor the adequacy of the cash balance in the fund to pay both known claims and claims incurred but not reported under s. 102.81 (1), Stats.

DWD 80.62(2) (2) Definitions. In this section:

DWD 80.62(2)(a) (a) “Agent” means a third-party administrator or other person selected by the department to assist in the administration of the uninsured employers fund program.

DWD 80.62(2)(b) (b) “Case reserve” means the best estimate documented in the claim-loss file of all liability to pay compensation on a claim under s. 102.81 (1), Stats.

DWD 80.62(2)(c) (c) “Claim” means an injury suffered by an employee of an uninsured employer for which the uninsured employer is liable under s. 102.03, Stats., and which is reported to the department on a form approved by the department for reporting work-related injuries.

DWD 80.62(2)(d) (d) “Fund” means the uninsured employers fund in s. 102.80, Stats.

DWD 80.62(2)(e) (e) “Incurred but not reported reserve” or “IBNR reserve” means the best actuarial estimate of liability to pay compensation under s. 102.81 (1), Stats., for injuries which occurred on or prior to the current accounting date, for which there is no claim yet reported to the department.

DWD 80.62(2)(f) (f) “Insolvent” means inadequate to fund all claims under s. 102.81 (1), Stats.

DWD 80.62(2)(g) (g) “Solvent” means adequate to pay all claims under s. 102.81 (1), Stats.

DWD 80.62(2)(h) (h) “Ultimate reserve” means the best actuarial estimate of aggregate case reserves from all claims, the expected future development of claims that have been reported, and IBNR reserve.

DWD 80.62(2)(i) (i) “Uninsured employer” means an employer who is subject to ch. 102, Stats., under s. 102.04 (1), Stats., and who has not complied with the duty to insure or to obtain an exemption from the duty to insure under s. 102.28 (2) or (3), Stats.

DWD 80.62(3) (3) Reporting a claim.

DWD 80.62(3)(a) (a) In addition to the notice to an employer required under s. 102.12, Stats., an employee shall report a claim for compensation under s. 102.81, Stats., to the department on a form provided by the department within a reasonable time after the employee has reason to believe that an uninsured employer may be liable for the injury.

DWD 80.62 Note Note: To obtain a form to report a claim for compensation, contact the Department of Workforce Development, Worker’s Compensation Division, 201 East Washington Avenue, P.O. Box 7901, Madison, Wisconsin 53707 or call [phone].

DWD 80.62(3)(b) (b) After receiving a claim under par. (a), the department shall determine whether the employer is an uninsured employer by reviewing its own records and the records maintained by the Wisconsin compensation rating bureau. Within 14 days after receiving a claim under par. (a), the department shall send the employer written notice that a claim has been reported and that the department has made an initial determination that the employer is, or is not, an uninsured employer with respect to the claimed injury. The department shall send a copy of the notice to the employee who filed the claim. If the department later modifies its initial determination regarding the employer’s insurance status with respect to a claim reported under this section, it shall promptly notify the employer and the employee of the reason for the modification and the likely impact of this change on the claim, if any. The employer shall notify its insurance carrier of any modification if the department determines that the employer is an insured employer.

DWD 80.62(3)(c) (c) If the department determines that the employer is an uninsured employer it shall promptly seek reimbursement as provided in s. 102.82 (1), Stats., and additional payments to the fund as provided in s. 102.82 (2), Stats. The department may also initiate penalty proceedings under s. 102.85, Stats. If the department determines that the employer is not an uninsured employer it shall notify the parties and close the claim. Nothing in this section shall prevent the department from taking other appropriate action on a claim including penalties and interest due under ss. 102.16 (3), 102.18 (1) (b) and (bp), 102.22 (1), 102.35 (3), 102.57 and 102.60, Stats.

DWD 80.62(4) (4) Paying a claim. Within 14 days after a claim is reported to the department, the department or its agent shall mail the first indemnity payment to the injured employee, deny the claim or explain to the employee who filed a claim the reason that the claim is still under review. The department or its agent shall report to the employee regarding the status of the claim at least once every 30 days from the date of the first notification that the claim is under review until the first indemnity payment is made or the claim is denied.

DWD 80.62(5) (5) Employee cooperation.

DWD 80.62(5)(a) (a) An employee who makes a claim shall cooperate with the department or its agent in the investigation or payment of a claim.