BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 684
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          Date of Hearing:   June 27, 2011

                           ASSEMBLY COMMITTEE ON INSURANCE
                                 Jose Solorio, Chair
                    SB 684 (Corbett) - As Amended:  June 23, 2011

           SENATE VOTE :   23-13
           
          SUBJECT  :   Workers' compensation: arbitration clauses

           SUMMARY  :   Requires dispute resolution clauses entered into 
          between an employer and a workers' compensation insurer to 
          specify that California law applies and the venue is to be in 
          California, except as specified.  Specifically,  this bill  :  

          1)Provides that any agreement between an employer and a workers' 
            compensation insurer concerning dispute resolution, other than 
            a settlement agreement resolving a particular dispute, 
            including an arbitration clause, shall:

             a)   Contain a choice of law provision that selects 
               California law as the law to be applied to any dispute;

             b)   Contain a forum selection clause that identifies 
               California as the proper venue for any proceedings arising 
               out of a dispute; and

             c)   Be disclosed to the employer in writing at the time a 
               quote or offer of insurance is made to the employer.

          2)Defines "employer" to be an employer whose California payroll 
            constitutes the majority of the employer's payroll.

          3)Provides that, notwithstanding the requirement that the forum 
            for dispute resolution and the choice of law be California, 
            employers and workers' compensation insurers may expressly 
            agree, after freely negotiating, on a forum and choice of law 
            other than California.

          4)Specifies that a failure to comply with the above requirements 
            renders the dispute resolution agreement void and 
            unenforceable.

          5)Provides that, notwithstanding the bill's provisions, any 
            dispute between the employer and the workers' compensation 








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            insurer regarding rates, classification, experience rating, or 
            other insurance issues for which authority to resolve the 
            dispute has been granted to the Insurance Commissioner (IC) 
            shall not be subject to alternative dispute resolution between 
            the employer and insurer.

          6)Contains legislative findings and declarations to the effect 
            that requiring California employers to be subject to the law 
            of other states, and to conduct dispute resolution proceedings 
            in other states, is a burden on these employers.

           

          EXISTING LAW  :

          1)Provides for a comprehensive system of workers' compensation 
            benefits to be paid to employees who are injured on the job.

          2)Requires every employer in the state to obtain a policy of 
            workers' compensation insurance from an insurer licensed to 
            transact this insurance in the state, or obtain a certificate 
            of self-insurance from the Department of Industrial Relations.

          3)Authorizes employers to purchase "high-deductible" workers' 
            compensation insurance policies, subject to certain 
            conditions, whereby the employer is effectively self-insured 
            below the deductible, even though the insurer is initially 
            responsible for payment of benefits.

          4)Prohibits a workers' compensation insurer from using a policy 
            form or endorsement unless it is filed with the IC's 
            designated statistical agent and either approved by the IC, or 
            30 days have passed from the filing with the IC.

           FISCAL EFFECT  :   The Senate Appropriations Committee referred 
          this bill to the Senate Floor pursuant to Senate Rule 28.8, 
          indicating that state costs, if any, are insignificant.

           COMMENTS  :   

           1)Purpose  .  According to the author, the use of unfiled side 
            agreements to workers' compensation policies "can be a 
            hardship for California employers, especially small businesses 
            without the resources to travel outside the state, or without 
            offices located in the state where the arbitration takes 








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            place.  This practice has become a major problem for 
            businesses and a financial burden."

           2)Large deductible policies  .  Employers -- as a practical matter 
            only larger employers --  that believe they can save workers' 
            compensation expenses by retaining some of the risk are 
            authorized to purchase policies that involve a large 
            deductible - sometimes as small as $100,000 or $250,000, but 
            for much larger companies, often $5 to $10 million.  As 
            between the employer and insurer, this retained risk under the 
            deductible is the employer's obligation.  However, the law 
            requires the insurer to provide the benefits to the injured 
            worker in the first instance.  As a result, the insurer and 
            employer have to enter into an agreement concerning how the 
            employer will repay the insurer for fronting the employer's 
            contractual obligation.  These agreements range from very 
            simple arbitration and choice of law and forum agreements, to 
            complex agreements that define in great detail how the risks 
            and financial relationship between the insurer and employer 
            will be structured, including how disputes will be resolved.  
            These are the agreements that are the subject of the bill.

           3)Case law  .  Committee staff has been presented with a number of 
            unpublished court decisions that deal with the issue of 
            whether the so-called side agreements that are the subject of 
            this bill are required to be filed with the Insurance 
            Commissioner.  One case, an unpublished Court of Appeal 
            decision,  Ceradyne, Inc. v. Argonaut Insurance Company, 4th 
            Dist., Div. 3, case no. G039873  , held that arbitration clauses 
            relating to workers' compensation insurance policies that have 
            not been submitted to the IC for approval are unenforceable.  
            Other cases have come to the opposite conclusion, and ordered 
            the disputes to be arbitrated as provided in the agreements.

           4)Sophisticated policyholders  .  The primary objection to the 
            bill is that the policyholders who are "protected" by the 
            bill's provisions are sophisticated, larger-sized businesses 
            that have chosen to assume a certain level of risk by choosing 
            to enter into a large deductible workers' compensation policy 
            with an insurer.  Presumably, these businesses have concluded 
            that they can save money by managing a portion of their 
            workers' compensation risks on their own.  There is a 
            cost-benefit analysis that must go into this decision, and 
            choice of law and choice of venue for dispute resolution 
            should problems arise between the insurer and employer over 








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            the splitting of the various risks are a part of that 
            analysis.  As one insurer has phrased it, "We are happy to 
            negotiate a different venue and choice of law, but the 
            policyholder understands that it may increase its costs to do 
            so, and the policyholder may value the tangible lower costs 
            more than the uncertain value of different venue and choice of 
            law benefits."  It can be argued that an employer that lacks 
            the sophistication to engage in this analysis ought not be 
            purchasing a large deductible policy in the first place, and 
            if it chooses to enter into a risky arrangement that it is 
            unsuited to handle, it should not be bailed out by 
            legislation.

           5)Support  .  Pacific Hospital of Long Beach writes in support 
            because, with respect to its workers' compensation policies, 
            it was not aware of arbitration clauses until after disputes 
            arose.  In Pacific Hospital's matters, side agreements 
            required reliance on New York law to resolve a purely 
            California dispute.  Roxborough, Pomerance, Nye, & Adriani, an 
            employer's rights law firm that handles many cases like 
             Ceradyne  and the Pacific Hospital situation, writes that the 
            late delivery of these side agreements is increasingly common. 
             In litigating the cases, sometimes the employer prevails, and 
            sometimes not, but always at great expense to the employer.  
            The supporters argue that the employer at that point in time 
            has little choice but to accept the agreement.  The bill seeks 
            to address this problem by rendering the agreement void and 
            unenforceable if disclosure of the agreement was not presented 
            to the employer, in writing, contemporaneously with a written 
            quote that offers to provide insurance.

           6)Opposition  .  Workers compensation insurers argue that these 
            agreements are between insurers and large, sophisticated 
            employers, and the bill impedes the right to freely contract 
            for provisions that are beneficial to both sides.  
            Specifically, they argue that large, often multi-state 
            employers that are assuming risk are capable of negotiating 
            terms that may be more favorable or less favorable, and more 
            expensive or less expensive.  There are valid business reasons 
            why an employer might want broader freedom to negotiate the 
            issues covered by the bill than is allowed.  In this regard, 
            the insurers point out that the current workers' compensation 
            insurance market is competitive, and if an employer does not 
            like the conditions being offered by an insurer, it has market 
            alternatives.  With respect to the  Ceradyne  case, the American 








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            Insurance Association suggests that it was an unusual 
            situation where the employer was unaware of the "agreement" 
            until a substantial period of time after the policy was 
            purchased.

          In addition, the insurers argue that these side agreements are 
            not standard form contracts like the insurance policy itself.  
            They are agreements negotiated between two sophisticated 
            parties, and the form changes from party to party, making it 
            impractical to have been previously filed by the insurer when 
            each agreement is reached with an employer.

           7)Recent amendments  .  In response to the analysis of the bill 
            for the June 22 hearing, the author proposed two amendments.  
            The first amendment added choice of law to the provision 
            allowing negotiation between the parties.  The second 
            amendment clarified the scope of governmental authority that 
            may not be subject to dispute resolution as between the 
            parties.  At the hearing, the author proposed a third 
            amendment, eliminating the form filing provisions that had 
            been in the bill.  The effect of this last amendment would be 
            to leave existing law on form filing intact, and eliminate the 
            implication in the bill that a technical filing violation 
            would have the effect of voiding a contractual provision that 
            an employer had freely entered into.  The Committee opted to 
            have the bill put over in order to see these amendments in 
            print, and the bill before the Committee on June 27 reflects 
            these amendments.

           8)Ongoing discussions  .  Representatives of the IC, the author, 
            insurers, and Committee staff have engaged in continuing 
            discussions with respect to policy as well as drafting.  It 
            appears that there is the prospect for further refinements 
            relating to the definition of "employer," the scope of 
            disputes subject to the bill's provisions, the form of the 
            disclosure requirements, and the savings clause relating to 
            the Insurance Commissioner's authority.  However, the drafting 
            and vetting among the various parties' principals is not 
            expected to occur prior to the June 27 hearing of this bill.  
            Rather, it is anticipated that these issues will be finalized 
            by the time the bill is heard in the Judiciary Committee.  
            Despite these refinements moving the parties closer, it is not 
            clear that the anticipated further amendments will result in a 
            full agreement among all parties.









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           9)Prior legislation  .  AB 2490 (Jones) of 2010 contained 
            provisions similar to the recently amended version of this 
            bill.  It was vetoed by the Governor.  In his veto message, 
            former Governor Schwarzenegger stated: 
              
              This bill is unnecessary because there is no evidence to 
             demonstrate that a problem exists.  In my view, the bill 
             risks reducing the competitive market for workers' 
             compensation California now enjoys due to our reforms.  The 
             broad language in the bill leaves open the potential for 
             costly regulatory interpretation that will impact the cost of 
             workers' compensation insurance.  The high deductible 
             contract negotiations the bill seeks to impact are conducted 
             by sophisticated participants on both sides of the table that 
             are well versed in all aspects of workers' compensation and 
             other insurance products.  Therefore, I am not convinced the 
             issue addressed by the bill will result in keeping workers' 
             compensation costs down which is the most significant concern 
             to California employers.
              
           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Department of Insurance (Sponsor)
          California Applicants' Attorneys Association
          Ceradyne, inc.
          Congress of California Seniors
          A.O. Reed & Co.
          Pacific Hospital of Long Beach
          Nick Roxborough, Esq., Roxborough, Pomerance, Nye, & Adriani, 
          counsel for Ceradyne

           
          Opposition 
           
          California Chamber of Commerce
          Association of California Insurance Companies
          American Insurance Association (AIA)
          Civil Justice Association of California
          Liberty Mutual Insurance Company

           Analysis Prepared by  :    Mark Rakich / INS. / (916) 319-2086 










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