LICENSING POLICY OF THE WORKCOVER AUTHORITY FOR SELF-INSURERS AND GROUP SELF INSURERS LICENSED UNDER SECTION 211 OF THE WORKERS COMPENSATION ACT, 1987

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1 LICENSING POLICY OF THE WORKCOVER AUTHORITY FOR SELF-INSURERS AND GROUP SELF INSURERS LICENSED UNDER SECTION 211 OF THE WORKERS COMPENSATION ACT, 1987 Self-insurance relieves an employer or corporate group of employers from obtaining a workers compensation policy of insurance and allows such employers to carry their own underwriting risk. Self-insurers are responsible for the payment of their claim liabilities and for the management of those claims. Therefore, WorkCover has a responsibility to ensure that workers outstanding claims are adequately protected and will be met. The introduction of the WorkCover scheme in June 1987 required insurers to maintain separate statutory trust funds for employers premiums and outstanding claims. Liabilities are, therefore, secured by this statutory mechanism. Self-insurers are not required to maintain separate trust funds to secure outstanding claims liabilities. Assets representing provisions for outstanding claims are not separated from the other assets of self-insurers. Self-insurers are an integral part of the WorkCover Scheme. Their status is derived from the Workers Compensation Act 1987 which provides for employers to be licensed by WorkCover subject to meeting certain licensing criteria. These licensing criteria have been established to ensure The protection of injured workers against self-insurer insolvency The viability and commitment of self-insurers to maintain self-insurance in the long term That appropriate injury and claims management and occupational health and safety systems are implemented and maintained by self-insurers The provision of timely and accurate data on claims to WorkCover This is the policy adopted by WorkCover in relation to the licensing of self-insurers. All applications for licence will be considered on their merits. Whilst WorkCover will consider the policy in exercising its statutory powers and discretion in relation to licensing, it may exercise those powers and discretion other than in accordance with the policy where it believes the circumstances require. The licensing policy will also be periodically reviewed and may be changed following such a review. LICENSING POLICY Section 210 and 211 of the 1987 Act refers to the application and determination of self-insurer licences. The following licensing criteria should be read in conjunction with those sections. self-insurer:doc:master2.pol

2 -2-1. Types of Licence Group Insurer and Self Insurer WorkCover may grant a self-insurer licence to an employer [single licence] or to a holding company and all wholly owned subsidiaries of the company that are employers in New South Wales [group licence]. Under a group licence there is no provision for selective inclusion of subsidiaries by the applicant. The legislation specifies that only wholly owned subsidiary companies are to be included in the group licence. For group licences the applicant company would generally be the ultimate holding company in Australia. 2. Term of Licence and Continuity of Licence A licence will be granted for a standard period of 3 years and be capable of renewal for further 3-year terms. WorkCover has discretion to grant licences for shorter terms if it believes circumstances are warranted. As licences are granted based on certain circumstances (including ownership and control) existing at a point in time, self insurers must notify WorkCover, in writing and within 10 business days, of becoming aware of any change in the effective control of the Licensee or any change in ownership of the Licensee exceeding 20% of its shareholding. In such an event the continuity of the licence will be subject to review by WorkCover. 3. Minimum Employee Number Applicants for a new self-insurer licence, either single or group, must have a minimum of 500 employees in NSW. This requirement is not applicable for licence renewals. Employees means all permanent staff of the applicant, whether full-time or part-time. WorkCover may use its discretion to grant a licence to an employer which does not meet this requirement if such an employer currently holds a self-insurer licence issued by another workers compensation jurisdiction. 4. Financial Viability and Strength A self-insurer must have sufficient financial resources to meet its liabilities and be able to demonstrate long term financial viability by way of audited financial statements prepared in accordance with generally accepted accounting principles for the previous five years. WorkCover must be satisfied that self-insurers:

3 -3- (i) are adequately capitalised, without any undue reliance on external borrowings - i.e. are conservatively geared; (ii) (iii) have a strong and sound financial position based on net tangible assets; have a sound profit history and positive cash flow. In determining financial viability and strength, WorkCover is not restricted to the exclusive use of the above financial indicators. 5 Lodgement of Annual Report and Audited Financial Statements Self Insurers must prepare and lodge with WorkCover, each financial year, a copy of the annual report (including audited financial statements) for the Licensee and, if it is a subsidiary of an Australian holding company, for its ultimate holding company as well. The financial statements must be provided within 4 months of the end of the relevant financial year or such longer period as WorkCover may allow. Self-insurers must also make and disclose, as a separate item in its annual balance sheet, a provision which is not less than the net central estimate of the claims liability as assessed by a qualified actuary. 6. Provision of Security All self-insurers (other than government employers who are exempted by S213 of the Act) must lodge either a deposit with WorkCover or provide a bank guarantee to secure total outstanding claims liabilities. A deposit is defined as cash, which WorkCover will invest for a fixed term on the self-insurer s behalf, or securities issued or guaranteed by the NSW or Commonwealth Governments. The bank guarantee must be: in a form approved by WorkCover; irrevocable until WorkCover is satisfied that there is no longer any outstanding claims liability; and payable on demand. In order to accurately assess the outstanding claims liability, a self-insurer must provide WorkCover with a report completed by an actuary in accordance with PS300 on an annual basis certifying the amount of total claims liability incurred as a self-insurer. The

4 -4- actuary must adopt the assumptions advised by WorkCover regarding the appropriate discount rate and claims administration expenses in determining the total claims liability. The amount of liability to be secured by deposit and/or bank guarantee will be calculated by WorkCover as follows: (i) central estimate of outstanding claims liability at balance date, plus; (ii) a prudential margin of 30%. In the case of a new licensee, the initial amount of security will be equivalent to the tariff premium for the ensuing twelve months plus a prudential margin of 30%. The amount of security will be reviewed annually and adjusted, where necessary, to the above requirements. 7. Provision of Cross/Holding Company Guarantee This requirement is applicable to group self-insurer licences. All companies in the group licence must execute a cross guarantee in a form approved by WorkCover under which each of the companies guarantee the other companies liabilities to workers under the Act and independent of the Act. WorkCover may use its discretion to take a holding company guarantee as an alternative to a cross guarantee in certain circumstances. 8 Reinsurance A self-insurer must obtain and maintain unlimited reinsurance cover during the currency of the licence, so as to restrict its liabilities under the Act and independently of the Act to a maximum amount approved by the Authority in respect of any one event. The reinsurance cover must be provided by an insurance company authorised by the Australian Prudential Regulation Authority. A retention amount under the above policy or policies, provided that it is within the range of $100,000 - $1,000,000 per event is acceptable to WorkCover. Retentions in excess of $1,000,000 will require prior approval by WorkCover. In such instances WorkCover will require the self-insurer to undertake and provide an assessment of the likely cost of risk retention and the appropriateness of the level of retention sought as part of the approval process. 9. Injury Management Self-insurers are expected to comply with the statutory requirements of Chapter 3 of the Workplace Injury Management and Workers Compensation Act 1998 regarding injury

5 -5- management. Applicants for licence will be required to demonstrate that they have developed an injury management program for the timely, safe and durable return to work of injured workers. Applicants must demonstrate that they have the systems and staff to implement and monitor the effectiveness of the processes and procedures described in the Injury Management Program. Self-insurers must achieve a satisfactory standard of injury management performance. WorkCover will conduct injury management audits on self-insurers periodically. To assist self-insurers to monitor their compliance with legislative requirements, WorkCover has developed an Injury Management Self-Audit Guide for use by selfinsurers. Self-insurers will be required to report self-audit results at least 6 months prior to their licence expiry date and lodge any revised injury management program to WorkCover. 10. Claims Management and Administration A self-insurer must demonstrate a capacity for injury and claims management. WorkCover expects that skilled claims staff with a thorough knowledge of workers compensation law and administration will be employed to give prompt consideration to claims and to pay compensation in a timely manner. The continuity of a licence is dependent on a professional standard of injury and claims management and administration and compliance with all relevant guidelines issued by WorkCover. WorkCover may use its discretion to approve outsourcing arrangements for injury and claims management to a suitably qualified third party, subject to it being satisfied that such an arrangement will not lead to a decrease in established service standards to injured workers. WorkCover must also be satisfied that its powers will not be impaired as a result of any proposed outsourcing typically WorkCover will require a legally enforceable undertaking from the third party to, for example, gain entry to premises and access to information. Any outsourcing of injury and claims management requires the prior approval of WorkCover. Notwithstanding any approved outsourcing arrangement, WorkCover will hold the licensee responsible for maintaining a satisfactory standard of injury and claims management and administration. Self-insurers must not enter into any transaction the effect or purported effect of which is to transfer the whole or any part of its New South Wales s workers compensation liabilities without WorkCover s prior written approval. 11. Occupational Health and Safety

6 -6- A self-insurer must demonstrate that its Occupational Health and Safety systems and practices comply with relevant legislative requirements. Self-insurers have the flexibility to use a variety of proprietary or in-house OHS management systems. The proposed WorkCover Self-insurer OHS model, An Occupational Health and Safety Model for Self-insurers July 2005, details the criteria which shall be implemented in the workplace of all self-insurers. These criteria shall be used for the purposes of audit verification by WorkCover and the licensing requirements of self-insurer organisations. WorkCover will measure the self-insurers performance against the Model criteria. This information will be used as a part of the licence review process. Self-insurers are required to tailor the Model criteria to meet the specific health and safety needs of all personnel in their employ and to account for OHS issues arising from the conduct of the organisation s business activities. In developing this proposed Model, philosophies commensurate with international systems standards for the management of quality assurance were applied to health and safety process to provide self-insurers the flexibility to integrate OHS with other areas of management. These principles are perpetuated in the Self-insurer Model and ensures consistency with principles and philosophies of the ISO 9000 series. This Model also enables self-insurers to avail themselves of more recent Australian Standards for OHS management, such as AS Occupational Health and Safety Management Systems Specification with guidance for use. The alignment of the OHS Model with recognised standards of management provides a suitable framework for the evaluation of health and safety systems and the effectiveness of such systems to deliver injury and illness prevention in the workplace. Self-insurers are expected to demonstrate an OHS management system that is operating at no less than OHS System Procedure Implementation performance level, as defined in WorkCover s proposed Model. Self-insurers are required to conduct self-audits of their OHS management system against the elements of the Model and furnish a report to WorkCover on an annual basis. The Australian Standard for Quality Auditing (AS/NZS 19011) provides a comprehensive auditing methodology and is consistent with the quality approach underpinning the Model. However, self-insurers may use any audit methodology that demonstrates performance and provides appropriate measurement against the Model. Audits shall be conducted regularly by appropriately qualified and experienced employees. Self-insurers may also engage the services of an independent auditor as part of their internal audit procedure to obtain objective verification of conformance to the elements of the Model. 12. Provision of Data

7 -7- A self-insurer is required to provide monthly claims data in a form approved by WorkCover and within the timeframes specified by WorkCover. An applicant must demonstrate that it has appropriate systems to provide timely and accurate claims data in accordance with WorkCover s requirements from the commencement of the licence. Financial or other penalties may apply to self-insurers who fail to provide timely and accurate data. 13. Contributions by Employers exiting the Managed Fund Scheme Section 208AA provides for contributions to the Premiums Adjustment Fund to be made by employers who on or after 1 July 1998 became or becomes a self-insurer. As an alternative to the making of a contribution to the Premiums Adjustment Fund, the selfinsurer may enter into an agreement with WorkCover to assume responsibility for the outstanding claim liabilities against the self-insurer that would otherwise be payable by the Managed Fund insurer who previously insured the employer. WorkCover will make available the methodology for tail assessment and protocol for entering into any such agreement as a separate document to this policy. 14. Compliance with Statutory Requirements and Licence Conditions Self-insurers must comply with all statutory requirements and conditions of licence for licence continuity. Failure to meet such requirements may constitute a basis for licence suspension, cancellation or non-renewal. Before taking such action, WorkCover will provide the self-insurer a reasonable opportunity to rectify any breach. 15. Claims Run-Off Should a self-insurer no longer hold a licence, it will still be held responsible for the management of the tail of claims incurred whilst licensed as a self-insurer. The former licensee will be expected to manage and administer run off claims in a professional manner and continue to co-operate in the provision of claims data and other specified information to WorkCover. Run-off arrangements will be subject to WorkCover approval. Security held by WorkCover and other guarantee arrangements will remain in force until WorkCover is satisfied that all claims have been discharged or adequately provided for pursuant to s.216 of the WorkCover Compensation Act Application Requirements WorkCover has issued application guidelines for new self-insurer licences.

8 -8- An application fee of $25,000 [single employer] or $30,000 [group employer] is payable at the time of application. Application fees are exempt from GST. This application fee is only payable in respect of an application for a new licence and not for licence renewals.

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