BILL ANALYSIS                                                                                                                                                                                                    �






                 Senate Committee on Labor and Industrial Relations
                                 Ted W. Lieu, Chair

          Date of Hearing: April 24, 2013              2013-2014 Regular  
          Session                              
          Consultant: Gideon L. Baum                   Fiscal:Yes
                                                       Urgency: No
          
                                   Bill No: SB 487
                                  Author: Calderon
                        As Introduced/Amended: April 4, 2013
          

                                       SUBJECT
          
            Workers' compensation insurance: Self-Insured Group Security  
                                        Fund.


                                      KEY ISSUE

          Should the Legislature create a separate security fund for  
          Self-Insured Groups (SIGs) for the purposes of securing workers'  
          compensation liability?


                                      ANALYSIS
          
           Existing law  establishes a workers' compensation system that  
          provides benefits to an employee who suffers from an injury or  
          illness that arises out of and in the course of employment,  
          irrespective of fault.  This system requires all employers to  
          secure payment of benefits by either securing the consent of the  
          Department of Industrial Relations to self-insure or by securing  
          insurance against liability from an insurance company duly  
          authorized by the state.  

          Existing law  allows employers to self-insure either as an  
          individual employer,  or as one employer in a group of employers  .  
           Groups of self-insured employers are frequently referred to as  
          Self-Insured Groups or SIGs.  (Labor Code �3700)
           
          Existing law  provides that each year every private self-insuring  
          employer shall secure incurred liabilities for the payment of  
          compensation and the performance of the obligations of employers  
          imposed by renewing the prior year's security deposit or by  









          making a new deposit of security.  These funds are deposited  
          into the  Self-Insurers' Security Fund (SISF)  .  (Labor Code  
          �3701)

           Existing law  the deposit shall be an amount equal to the  
          self-insurer's projected losses, net of specific excess  
          insurance coverage. The calculation of projected losses and  
          expenses shall be reflected in a written actuarial report that  
          projects ultimate liabilities of the private self-insured  
          employer at the expected actuarial confidence level. The written  
          actuarial report shall be prepared by an actuary meeting the  
          qualifications prescribed by the director in regulation.  (Labor  
          Code �3701)

           Existing law  provides that if the Department of Industrial  
          Relations determines that a private self-insured employer has  
          failed to pay workers' compensation as required by this  
          division, the security deposit shall be utilized to administer  
          and pay the employer's compensation obligations.  (Labor Code  
          �3701.5)
           
          Existing law  provides that, if an employer fails to pay the  
          compensation to an injured worker, the award, upon application  
          by the injured worker or his or her beneficiaries, must be paid  
          by the director from the Uninsured Employers Benefits Trust  
          Fund.  (Labor Code �3716)
           
          This bill would create the Self-Insured Group Security Fund (SIG  
          Fund), a separate security fund for Self-Insured Groups (SIGs).

           This bill  would require that the SIG Fund is governed by a 7  
          member board: the Director of the Department of Industrial  
          Relations, 3 members from the SIG Boards, and 3 members SIG  
          administrators.   The SIG Fund members from the SIG Boards will  
          have 2 years terms; the administrators will have 4 year terms  .

           This bill  provides that, until July 1, 2014, the Self-Insurers'  
          Security Fund (SISF) must assume the workers' compensation  
          obligations of all insolvent self-insured employers, including  
          SIGs.

           This bill  provides that, after July 1, 2014, the SIG Fund has  
          Hearing Date:  April 24, 2013                            SB 487  
          Consultant: Gideon L. Baum                               Page 2

          Senate Committee on Labor and Industrial Relations 
          








          the right and obligation to obtain reimbursement from every  
          member of the insolvent SIG, up to the amount of the workers'  
          compensation obligations, including administrative and legal  
          costs.

           This bill  would also create an alternative process by which SIGs  
          can secure their incurred liabilities in the SIG Fund whereby  
          the SIG Fund posts a composite deposit that collectively secures  
          the aggregate liability of SIGs.  This is known as the "SIG  
          Alternate Composite Deposit Program."

           This bill  would also make technical and conforming changes to  
          allow the SIG Fund to operate fully and independently from the  
          Self-Insurers' Security Fund.


                                      COMMENTS

          
          1. What is a Self-Insured Group?

            A Self-Insured Group (SIG) is a mutual benefit corporation  
            that takes on the workers' compensation liabilities of its  
            employer members.  They are generally specialized by industry.  
             For example, the California Restaurant Mutual Benefit  
            Corporation (CRMBC), a restaurant SIG, only accepts  
            restaurants as members.  With 3,000 members and $1 billion in  
            payroll, CRMBC is the largest SIG in California.  In total,  
            there are 23 active SIGs in California with about $5.1 billion  
            in payroll.  As of August 1, 2012, 9 SIGs have gone insolvent.

            In joining a SIG, the employer and SIG become jointly and  
            severally liable for all workers' compensation liabilities.   
            While in theory a member of a SIG is only liable for their own  
            liabilities and can be assessed for their liabilities even  
            after they leave the SIG, collections become complicated in  
            the event of a rapid exodus of members and/or a SIG becoming  
            insolvent.  Under these circumstances, a scenario plays out  
            similarly to a run on the bank, with the members leaving and a  
            financially distressed forced to use limited resources to try  
            and pursue funds to prop up the SIG and fund remaining  
            liabilities.
          Hearing Date:  April 24, 2013                            SB 487  
          Consultant: Gideon L. Baum                               Page 3

          Senate Committee on Labor and Industrial Relations 
          









            When this results in an insolvent SIG, the Self-Insurers'  
            Security Fund (SISF) steps up and takes over the SIG and the  
            SIG's liabilities.  SISF then is also a party to court  
            proceedings regarding an insolvent SIG.  

            SB 487 seeks to carve SIGs out of SISF, requiring SIGs to form  
            their own security fund, as well as a specific governing  
            board, in order manage the workers' compensation liability of  
            Self-Insurance Groups.

          2. Unresolved Challenges in the Creation of SIG Fund:

            As currently written, SB 487 contains several issues that  
            would pose significant challenges to SISF, the SIG Fund, and  
            the workers' compensation system.  These are discussed below:

            Risk Shift to SISF:

            As currently written, SB 487 provides that SISF is liable for  
            workers' compensation liabilities prior to July 1, 2014, and  
            then from that point forward SIG Fund would incur SIG workers'  
            compensation liability.  This would leave SISF with the  
            obligations of SIGs that have failed as well as the pre-SB 863  
            liabilities of health SIGs, suggesting a significant risk  
            shift.  This would undermine SISF and possible generate  
            significant costs for self-insured employers.

            SIG Group Composition:

            As currently written, SB 487 SIG Fund is governed by a 7  
            member board.  Three of those slots are from the SIGs and  
            three are SIG administrators.  However, the SIG administrators  
            have terms that are  twice as long  as the employer/SIG  
            representatives.  This would place the individuals who are  
            truly liable at a disadvantage on their own governing board.

            Actuarial Standards:

            SB 863 created new actuarial standards for self-insured  
            employers, including that the  calculation of projected losses  
            and expenses shall be reflected in a written actuarial report.   
          Hearing Date:  April 24, 2013                            SB 487  
          Consultant: Gideon L. Baum                               Page 4

          Senate Committee on Labor and Industrial Relations 
          








            The written actuarial report shall be prepared by an actuary  
            meeting the qualifications prescribed by the director in  
            regulation.  This requirement also applies to SIGs.  As  
            written, however, the SIG Fund DOES NOT require the same  
            actuarial standards as SISF.  Therefore, SB 487 could have the  
             impact of lowering actuarial standards  for SIGs, increasing  
            the risk of SIG insolvencies.

          3.  Possible Amendments and Committee Actions:  

            In light of the unresolved problems, the Committee may wish to  
            amend SB 487 by removing the provisions of the SIG Fund and  
            instead require DIR and SISF to study the issue of the  
            creation of a SIG Fund, including an actuarial breakdown of  
            the costs and liabilities entailed with the creation of a new  
            security fund.

            Alternatively, SB 487 could be held in the policy process,  
            allowing the bill to be taken up in the second year of a two  
            year session after greater discussion between the author's  
            office, the proponents, and DIR and SISF.

          4.  Double Referral to Senate Committee on Insurance:  

            If SB 487 is approved by this Committee, it will be referred  
            to the Senate Committee on Insurance.

          5.  Proponent Arguments  :
            
            Proponents argue that, when well run and secured,  
            Self-Insurance Groups are an important tool for California's  
            employers in affordably securing liability against workers'  
            compensation costs.  Proponents also argue that the recent  
            spate of SIG insolvencies suggest a need for a need structure  
            and a new way forward.  Proponents believe that creating a  
            separate Self-Insured Group Security Fund will ensure that  
            injured workers get the benefits they need in the event of an  
            insolvency, as well as provide better administration to ensure  
            that the appropriate parties cover their full liabilities.

          6.  Opponent Arguments  :

          Hearing Date:  April 24, 2013                            SB 487  
          Consultant: Gideon L. Baum                               Page 5

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            None on file.

          7.  Prior Legislation  :

            SB 863 (DeLeon), Statutes of 2012, Chapter 363 created, among  
            other things, new actuarial standards for self-insured  
            employers.


                                       SUPPORT
          
          Associated California Self-Insured Businesses
          California Agricultural Products, Inc.
          California Contractors Network, Inc.
          California Farm Management, Inc.
          

                                     OPPOSITION
          
          None on file.





















          Hearing Date:  April 24, 2013                            SB 487  
          Consultant: Gideon L. Baum                               Page 6

          Senate Committee on Labor and Industrial Relations