NAC616B.567. Report and evaluation of estimated expenditures for claims in annual report; calculation of reserve for reopened claims.

     1. An association shall calculate the estimated expenditure for each claim reported in the annual report on claims. The estimated expenditure for a claim is the total liability attributable to the industrial accident or occupational disease, including the total amount of money disbursed as benefits for the claim, and the estimated additional cost, including future costs actually and potentially due, which may result from the settlement of a claim, regardless of when it will be paid.

     2. The Commissioner may revise an estimated expenditure for a claim which he or she determines is inaccurate or inadequate. A revision will be made only after the association has been notified in writing and given an opportunity to object to the revision.

     3. A reserve for reopened claims will be calculated by the Division of Insurance based upon a percentage of the actual expenses paid on all closed claims. The percentage will be based upon the following sliding scale according to the number of uninterrupted years the association has been in a program of self-insurance:

     (a) Inception to 5 years in the program, 3 percent;

     (b) Six to 10 years in the program, 2 percent;

     (c) Eleven to 15 years in the program, 1 percent; and

     (d) More than 15 years in the program, 0.5 percent.

     4. The number of years an association has been self-insured will be based upon the State’s fiscal year beginning July 1 and ending June 30. If the date of certification is on or before December 31, a full year will be calculated for the first year of certification. If the date of certification is January 1 or after, the beginning year of certification will not be counted. The number of uninterrupted years an association has been self-insured will be calculated from the last date on which it was certified.

     (Added to NAC by Comm’r of Insurance, eff. 3-22-96)