[31 Pa.B. 3841]
[Continued from previous Web Page] § 129.2. Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
AIPS--Form LIBC-210I, Insurer's Annual Report of Accident and Illness Prevention Services, which provides detailed information about services being maintained or provided by a workers' compensation insurer to its policyholders.
AIPPS--Form LIBC-220E, Annual Report of Accident and Illness Prevention Program Status, which provides detailed information about a self-insured employer's prevention program or prevention services being provided to employer members of a group self-insurance fund.
Accident analysis--The review of injury and illness records for the purpose of identifying trends, causal factors and methods of preventing and reducing work-related accidents and illnesses.
Accident and illness prevention services providers--A person or persons providing accident and illness prevention services for an insurer, individual self-insured employer or group self-insurance fund who meets the requirements in § 129.702 (relating to accident and illness prevention services providers credentials and experience).
Accident and illness prevention services--Services, within the context of the act, which include: surveys, proposed corrective actions, training programs, consultations, analyses of accident causes and industrial hygiene and industrial health services.
Act--The Workers' Compensation Act (77 P. S. §§ 1-1041.4 and 2501-2626).
Act 44--The act of July 2, 1993 (P. L. 190, No. 44).
Act 57--The act of June 24, 1996 (P. L. 350, No. 57).
Adequate--A Bureau of Workers' Compensation final determination that the insurer, individual self-insured employer or group self-insurance fund has fulfilled the program and service requirements as stated in this chapter.
Affiliated company--Employers which are closely related through common ownership or control.
Applicant-employer--An insured employer, an individual self-insured employer or an employer member of a group self-insurance fund having its own separate Federal Employer Identification Number (FEIN) applying to the Bureau for certification or certification renewal of its workplace safety committee.
Application--Form LIBC-372, Application for Certification of Workplace Safety Committee, used to apply for Department certification.
Audit--An inspection of documentation or other evidence relating to the adequacy of accident and illness prevention services or programs as authorized by section 1001(c) of the act (77 P. S. § 1038.1(c)).
Bureau--The Bureau of Workers' Compensation of the Department.
Centralized workplace safety committee--A safety committee comprised of personnel, both employer and employee representatives, who are selected from and reasonably represent those job functions located at all auxiliary or satellite employer locations, in addition to the headquarter facilities (if the headquarters facility is located in this Commonwealth) and which represents the health and safety concerns of all personnel at those auxiliary or satellite locations.
Certification--The Departmental approval of an applicant-employer's application for certification of its workplace safety committees.
Certification renewal--Form LIBC-372R, Certification Renewal Affidavit of Workplace Safety Committee, used to attest to the continued operation, according to Departmental requirements, of a previously certified workplace safety committee.
Commissioner--The Insurance Commissioner of the Commonwealth.
Consultation--Providing advice relative to existing and potential hazards.
Contracted accident and illness prevention services providers--A person or organization which meets the qualification standards in § 129.702 (relating to accident and illness prevention services providers requirement) under contract with an insurer, individual self-insured employer or group self-insurance fund for the purpose of maintaining or providing accident and illness prevention services and programs as required under the act.
Credential--A designation in the health and safety field recognized by the Department.
Department--The Department of Labor and Industry of the Commonwealth.
Director--The Director of the Bureau.
Effectiveness measures--Any one of the various statistical means used by an insurer, self-insured employer or group self-insurance fund to evaluate the adequacy of accident and illness prevention programs and services such as Occupational Health and Safety Administration (OSHA)/United States Department of Labor Bureau of Labor Statistics (BLS) incidence rate comparison, loss ratio or experience modification factor.
Emergency action plans--Plans to be at least annually reviewed by individual self-insured employers and which address the need for immediate action to protect employees due to the occurrence of life-threatening or endangering exposures. Examples of types of plans include: building and site evacuation; hazardous material spill; and urgent employee medical treatment.
Evaluation methods--Periodic reviews of accident and illness prevention services or programs to determine if actual health and safety concerns, experience and exposures are being addressed, and conducted at least annually.
Group self-insurance fund--A group of employers authorized by the Bureau to act as a self-insurance fund under section 802 of the act (77 P. S. § 1036.2).
Group self-insurance fund initial report of accident and illness prevention services--A report to be filed with the Bureau when an application for group self-insurance fund status is submitted which details accident and illness prevention services to be maintained for member companies.
Hazard identification methods--Methods used to conduct hazard identification and for providing proposed corrective actions for the purpose of eliminating or reducing occupational accidents, injuries and illnesses. Activities may include: providing solutions; explanations; resources; reference materials; and referrals.
Industrial health services--Services that include a consultation concerning the well-being of people in relation to their job and working environment. This consultation may produce proposed corrective actions aimed at identifying, controlling and preventing exposures as part of the implementation of a program of accident and illness prevention services.
Industrial hygiene services--Services that include consultation concerning suspected chemical, physical or biological exposures. This consultation may produce proposed corrective actions designed to control or prevent identified exposures and is directed toward implementing a program of accident and illness prevention services.
In-service status--The classification granted to an accident and illness prevention services provider who does not possess a Bureau-recognized credential under § 129.702.
Insurer--An entity or group of affiliated entities subject to The Insurance Company Law of 1921 (40 P. S. §§ 341--477(d)), including the State Workers' Insurance Fund, but not including self-insured employers or runoff self-insurers, with which an employer has insured its liability under section 305 of the act (77 P. S. § 501).
Insurer's initial report of accident and illness prevention services--Form LIBC-211I, Insurer's Initial Report of Accident and Illness Prevention Services, which shall be filed with the Insurance Department when an insurer applies for a license to write workers' compensation insurance in this Commonwealth which details accident and illness prevention services to be maintained by or provided to policyholders.
Loss run--A report containing an employer's incurred losses including the following information concerning an employee's injury or illness: type; cause; medical cost; compensation paid; and moneys reserved for claim payment.
Member--An employer participating in a group self-insurance fund.
Program coordinator--An employee or contracted individual selected by an individual self-insured employer or group self-insurance fund to coordinate the accident and illness prevention program.
Quorum--A majority of permanent workplace safety committee members.
Recommendations--Findings included in an audit report issued by the Bureau which must be satisfactorily implemented and supported by written documentation in order to achieve a final determination of adequate.
Renewal--A new policy offered by an insurer and accepted by an employer for the next annual anniversary date of the applicant-employer's workers' compensation insurance policy after certification of its workplace safety committee.
SWIF--The State Workers' Insurance Fund.
Self-insured employer--An individual self-insured employer who is authorized by the Department to self-insure its workers' compensation liability under section 305 of the act, or a group of employers authorized by the Department to act as a group self-insurance fund under section 802 of the act.
Self-insured employer's initial report of accident and illness prevention program--A report to be filed with the Bureau when an application for individual self-insurance is submitted which details the accident and illness prevention program to be maintained by the employer.
Suggestions--Findings of an audit or report evaluation issued by the Bureau which would improve accident and illness prevention programs and services but are not mandatory to achieve a final determination of adequate.
Survey--A review of past accident records or an onsite assessment, or both, to identify existing and potential hazards and the initiation of further corrective actions, as appropriate.
Training program--Training which enables employers and employees to enhance knowledge, skills, attitudes and motivations concerning health and safety issues, and requirements relating to operations, processes, materials and specific work environments.
Workplace--A permanent location in this Commonwealth of the applicant-employer at which full-time or permanent part-time workers perform their job duties or from which job assignments are made and administrative controls are exercised.
Workplace safety committee--A joint employer and employee committee established at a workplace for the purpose of hazard detection and accident and illness prevention activities.
Worksite--A temporary location at which full-time or permanent part-time workers perform their job duties for a limited period of time.
Subchapter B. INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES Sec.
129.101. Purpose. 129.102. Accident and illness prevention service requirements. 129.103. Obligation of an insured employer/policyholder. 129.104. Insurer's accident and illness prevention services providers requirements. 129.105. Reporting requirements for applicants for licensure. 129.106. Reporting requirements for licensed insurers. 129.107. Report findings. 129.108. Recordkeeping requirements. 129.109. Periodic audits of insurer's accident and illness prevention services. 129.110. Preaudit exchange of information. 129.111. Site of audit. 129.112. Written report of audit. 129.113. Plan of correction/reports of progress on correcting deficiencies. 129.114. Contesting final determinations. § 129.101. Purpose.
This subchapter interprets the requirements of the act that an insurer desiring to write workers' compensation insurance in this Commonwealth shall maintain or provide adequate accident and illness prevention services as a prerequisite for a license to write this insurance. Services shall be adequate to furnish accident and illness prevention required by the nature of the insurer's business or its policyholders' operations. This subchapter also establishes the criteria that the Department will employ in determining the adequacy of the services required to be maintained or provided by an insurer.
§ 129.102. Accident and illness prevention services requirements.
The Bureau will annually evaluate the following required accident and illness prevention services components for adequacy:
(1) Notice of availability of services. Notice that services required by this subchapter are available to the policyholder from an insurer shall appear in at least 10 point bold type and shall accompany each workers' compensation insurance policy delivered or issued for delivery in this Commonwealth. The notice shall include information about the 5% premium discount available to employers who form a certified workplace safety committee as described in this chapter. The required elements of the notice include the name, address and telephone number of the contact person or department for additional information about the services.
(2) Requirements to maintain accident and illness prevention services. An insurer shall have the capacity to provide services that are adequate to furnish accident and illness prevention required by the nature of the insurer's business or its policyholders' operations. Capacity to provide services is defined as an insurer having established means to deliver services such as those listed in paragraph (3) based upon anticipated policyholder requests for services or based upon an insurer's evaluation of policyholder requirements. Capacity to provide services shall be established by an insurer utilizing its own or contracted staff who shall meet the requirements established by the Department as outlined in Subchapter E (relating to accident and illness prevention services providers requirements).
(3) Requirements to provide accident and illness prevention services.
(i) An insurer shall provide accident and illness prevention services to policyholders who request them or based on the insurer's determination of the policyholders' operational requirements. Services shall be provided through an insurer's own or contracted staff who meet the requirements established by the Department in Subchapter E.
(ii) Services include the following:
(A) Surveys to identify existing or potential accident and illness hazards or safety program deficiencies. Surveys may, for example, be in the form of an underwriting risk analysis or an onsite review. If the insurer determines through a survey and analysis of survey results that the hazards or deficiencies are present, it shall propose corrective actions to the policyholder concerning the abatement of hazards or program deficiencies identified in the surveys. If one or more imminent danger situations are identified, the insurer shall inquire as to the corrective actions a policyholder has taken and propose further corrective actions if necessary.
(B) Providing or proposing corrective actions in the area of industrial hygiene services as requested by the policyholder or as determined by the insurer to meet the policyholders' operational requirements, for example, air quality testing.
(C) Providing or proposing corrective actions in the area of industrial health services as requested by the policyholder or as determined by the insurer to meet the policyholders' operational requirements, for example, health screenings or substance abuse awareness and prevention training policies and programs.
(D) Accident and illness prevention training programs which may include training for safety committee members as outlined under Subchapter F (relating to workplace safety committees).
(E) Consultations regarding specific safety and health problems and hazard abatement programs and techniques related to the introduction of new equipment or new materials.
§ 129.103. Obligation of an insured employer/policyholder.
An insured employer/policyholder requesting accident and illness prevention services as mandated by the act shall provide the necessary information and access to the insurer to permit the insurer to fulfill its requirements under the act.
§ 129.104. Insurer's accident and illness prevention services providers requirements.
(a) Accident and illness prevention services providers employed by or contracted with an insurer to perform accident and illness prevention services shall meet the requirements specified in Subchapter E (relating to accident and illness prevention services providers requirements).
(b) The Bureau may require that the insurer provide documentation or evidence to support that the requirements for accident and illness prevention services providers have been met by each individual providing accident and illness prevention services, whether employed or under contract, based on the criteria in Subchapter E.
§ 129.105. Reporting requirements for applicants for licensure.
(a) As part of their application for a certificate of authority submitted to the Insurance Department, applicants for a license to write workers' compensation insurance shall provide information concerning their accident and illness prevention services required under § 129.102 (relating to accident and illness prevention services requirements) using Form LIBC-211I, Insurer's Initial Report of Accident and Illness Prevention Services.
(b) As part of the process of licensing to write workers' compensation insurance in this Commonwealth, the Insurance Department will forward to the Bureau the report in subsection (a) for a determination of adequacy. The Bureau will provide a final determination of adequate or inadequate to the Commissioner.
§ 129.106. Reporting requirements for licensed insurers.
A licensed insurer shall, by June 1 of each year, provide the Bureau with information concerning accident and illness prevention services offered or provided to the insurer's policyholders during the preceding calendar year. The information shall be provided using the AIPS report. In addition, documentation required by other governmental regulatory agencies can be used as supporting evidence of accident and illness prevention services. Report information shall be subject to Bureau verification.
§ 129.107. Report findings.
(a) Upon receipt of a report required under § 129.105 (relating to reporting requirements applicants for licensure), the Bureau will review the report data, make a final determination of the adequacy or inadequacy of services and provide notification to the Commissioner and the insurer of its final determination.
(b) Upon receipt of a report required under § 129.106 (relating to requirements for licensed insurers), the Bureau will review the report data and make a final determination of adequacy or an initial determination of inadequacy of services. An inadequate determination may result in an audit of services before a final determination is made. The Bureau will provide notification to the Commissioner and the insurer of its final determination.
§ 129.108. Recordkeeping requirements.
Insurers shall maintain records of accident and illness prevention services by a policyholder for the most complete current calendar year and 2 preceding consecutive calendar years which include:
(1) The dates of the requests for services.
(2) The services requested or problems presented.
(3) Reports from site inspections performed.
(4) Other service reports including proposed corrective actions.
(5) The dates on which services were provided and the policyholder's responses to proposed corrective actions.
(6) The results of industrial hygiene and health surveys and consultations.
(7) Accident and illness prevention training conducted.
(8) Documentation supporting the funds expended for the delivery of accident and illness prevention services.
(9) Evidence of the effectiveness and accomplishments of accident and illness prevention services.
§ 129.109. Periodic audits of insurer's accident and illness prevention services.
(a) The Bureau may audit an insurer's accident and illness prevention services at least once every 2 years.
(b) The Bureau may audit an insurer's accident and illness prevention services if the insurer fails to file an AIPS by specified time frames or fails to meet the requirements of this subchapter.
(c) The notice of the audit will include the reasons for audit.
(d) At least 60-calendar days prior to an audit, the Bureau will notify the insurer in writing of the date on which the audit will occur.
§ 129.110. Preaudit exchange of information.
(a) At least 45-calendar days prior to the audit, the insurer shall provide the Bureau with:
(1) If not already submitted, a completed, annual AIPS report for the most recently completed calendar year and if requested, the AIPS reports for the 2 preceding consecutive calendar years including those of its affiliated companies, if applicable.
(2) A description of the type of accident and illness prevention services provided during the last completed calendar year and a list of current insured employers/policyholders specifying name and premium size grouping which: received services; requested but did not receive services; and have reported to the carrier that they have a certified workplace safety committee.
(3) The name, address, business telephone number, credentials, experience and status (whether employed or contracted) of each person acting as an accident and illness prevention services provider for the insurer.
(b) The Bureau will keep the list of insured employers/policyholders confidential.
(c) Within 10-calendar days of receipt of the list of policyholders, the Bureau will notify the insurer of the accounts selected for audit and the information required concerning these accounts.
(d) At least 15-calendar days prior to the date of the audit, the insurer shall provide the account information referenced in subsection (c) to the Bureau.
(e) If the information necessary for the audit is not furnished, the Bureau may cancel the audit, and a final determination of inadequate will be forwarded to the Director. The Director will provide notification to the Commissioner and to the insurer of its final determination. A rating may be challenged by the insurer in accordance with Subchapter G (relating to hearings).
§ 129.111. Site of audit.
(a) The audit of the insurer's accident and illness prevention services will take place at the insurer's main office in this Commonwealth unless otherwise agreed by the Bureau and the insurer. If the insurer has no office in this Commonwealth, the audit will take place at the Bureau's headquarters.
(b) At the site where the audit will occur, the insurer shall provide the documentation required by § 129.108 (relating to recordkeeping requirements) and any other documentation chosen by the insurer supporting the existence and adequacy of required services.
§ 129.112. Written report of audit.
(a) After the conclusion of the audit, the Bureau will issue a written report containing its findings. The report will indicate whether the Bureau has issued a final determination of adequate or an initial determination of inadequate with regard to an insurer's accident and illness prevention services.
(b) The Bureau will notify the insurer of a final determination of adequate.
(c) The Bureau will provide written notification to the insurer of specific deficiencies and recommendations for corrective action if it assigns an initial determination of inadequate. Within 60-calendar days from the date of the audit report, the insurer shall provide written documentation that it has complied with the Bureau's recommendations. If the insurer believes that it will take more than 60 days to implement the recommendations, it shall file a plan of correction in accordance with § 129.113 (relating to plan of correction/reports of progress on correcting deficiencies). At the end of the 60-calendar day correction period, a final determination of adequate or inadequate will be assigned. The insurer will receive notification of this final determination. The Commissioner will receive notification of final determinations of inadequate.
§ 129.113. Plan of correction/reports of progress on correcting deficiencies.
An insurer shall file a plan of correction to implement audit report recommendations referenced in § 129.112(c) (relating to written report of audit) for any deficiency requiring more than 60 days to correct. The plan shall include a timetable for correction acceptable to the Bureau. Progress reports shall be filed by the insurer detailing corrective actions at the end of each 30-day period of the correction plan period. The Bureau may audit the insurer's accident and illness prevention services if the insurer fails to file progress reports, implement recommendations, or provide acceptable documentation of corrective actions. At the end of the correction plan period, a final determination of adequate or inadequate will be made, and the insurer will be notified of the determination. The Commissioner will be notified of final determinations of inadequate.
§ 129.114. Contesting final determinations.
An insurer may contest a final determination of inadequate under Subchapter G (relating to hearings).
Subchapter C. INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS Sec.
129.401. Purpose. 129.402. Program requirements. 129.403. Individual self-insured employer's accident and illness prevention services providers requirements. 129.404. Reporting requirements for applicants for individual self-insurance status. 129.405. Reporting requirements for individual self-insured employers. 129.406. Report findings. 129.407. Recordkeeping requirements. 129.408. Periodic audits of individual self-insured employer's accident and illness prevention program. 129.409. Preaudit exchange of information. 129.410. Site of audit. 129.411. Written report of audit. 129.412. Plan of correction/reports of progress on correcting deficiencies. 129.413. Contesting final determinations. § 129.401. Purpose.
This subchapter interprets the requirements of the act that an individual self-insured employer shall maintain an adequate accident and illness prevention program as a prerequisite for retention of its self-insured status. The subchapter establishes the criteria that the Bureau will employ in determining the adequacy of the accident and illness prevention program required to be maintained by an individual self-insured employer.
§ 129.402. Program requirements.
(a) An individual self-insured employer shall maintain an adequate accident and illness prevention program and maintain records for this program for the 3 most current, complete fiscal years. The program shall include the following elements:
(1) A safety policy statement.
(2) A designated accident and illness prevention program coordinator.
(3) Assignment of responsibilities for developing, implementing and evaluating the accident and illness prevention program.
(4) Program goals and objectives.
(5) Methods for identifying and evaluating hazards and developing corrective actions for their mitigation.
(6) Industrial hygiene surveys required by the nature of the individual self-insured employer's workplace and worksite environments, for example, air quality testing.
(7) Industrial health services required by the nature of the individual self-insured employer's workplace environment, for example, health screenings, substance abuse awareness and prevention training programs.
(8) Accident and illness prevention orientation and training.
(9) Regularly reviewed and updated emergency action plans.
(10) Employee accident and illness prevention suggestion and communications programs.
(11) Mechanisms for employee involvement, which may include establishment of a workplace safety committee as described in Subchapter F (relating to workplace safety committees).
(12) Established safety rules and methods for their enforcement.
(13) Methods for accident investigation, reporting and recordkeeping.
(14) Prompt availability of first aid, CPR and other emergency treatments.
(15) Methods for determining and evaluating program effectiveness. These may include:
(i) Comparison of the individual self-insured employer's incidence rate as derived using the OSHA/BLS formula to the current OSHA/BLS industry-wide rate published annually in the BLS Survey of Occupational Injuries and Illnesses.
(ii) Comparison of individual employer injury and illness rates determined by means of a formula prescribed by the Bureau to current, Statewide rates by industry published annually by the Bureau in the Pennsylvania Work Injuries and Illnesses Report.
(iii) Experience modification factor.
(iv) Loss ratio.
(v) Other methods used by individual self-insured employers deemed appropriate by the Bureau.
(16) Protocols or standard operating procedures, when applicable to the workplace and worksite environments for:
(i) Electrical and machine safeguarding.
(ii) Personal protective equipment.
(iii) Hearing and sight conservation.
(iv) Lockout/tagout procedures.
(v) Hazardous materials handling, storage and disposal procedures.
(vi) Confined space entry procedures.
(vii) Fire prevention and control practices.
(viii) Substance abuse awareness and prevention policies and programs.
(ix) Control of exposure to bloodborne pathogens.
(x) Preoperational process reviews.
(xi) Other protocols as may be appropriate for the individual self-insured employer's operations.
(b) Individual self-insured employers shall maintain records describing the comparison methods chosen from subsection (a)(15) for the most current complete fiscal year and 2 preceding consecutive fiscal years. Those records shall contain at a minimum:
(1) The annual calculated rates for the methods chosen.
(2) A copy of the calculations used to determine the annual rates.
(3) A copy of the sources containing the complete data used in calculating the annual rates.
§ 129.403. Individual self-insured employer's accident and illness prevention services providers requirements.
(a) Accident and illness prevention services providers employed by an individual self-insured employer or serving through a contract to perform accident and illness prevention services shall meet the requirements in Subchapter E (relating to accident and illness prevention services providers requirement).
(b) The Bureau may require that the individual self-insured employer provide documentation or evidence to support that the requirements for accident and illness prevention services providers have been met by each individual providing accident and illness prevention services, whether employed or under contract, based on the criteria in Subchapter E.
§ 129.404. Reporting requirements for applicants for individual self-insurance status.
(a) As part of its application for individual self-insurance status submitted to the Bureau, an applicant for individual self-insurance status shall provide the Bureau with detailed information on its accident and illness prevention program as required under § 129.402 (relating to program requirements) using form LIBC-221E, Initial Report of Accident and Illness Prevention Program.
(b) As part of the process of granting individual self-insurance status, the Bureau will use this information to determine whether to grant individual self-insurance status.
§ 129.405. Reporting requirements for individual self-insured employers.
(a) At the time of reapplication for renewal of self-insurance status, an individual self-insured employer shall, as required under section 815 of the act (77 P. S. § 1036.15), provide the Bureau with detailed information on its accident and illness prevention program using the AIPPS report, for the last complete fiscal year preceding the date of the renewal application.
(b) In addition, documentation required by other governmental regulatory agencies can be used as supporting evidence of accident and illness prevention programs.
(c) Report information shall be subject to Bureau verification.
§ 129.406. Report findings.
Upon receipt of a report required under § 129.404 (relating to reporting requirements for individual self- insurance status employers), the Bureau will review the report data and make a final determination of adequacy or an initial determination of inadequacy of programs. An inadequate determination may result in an audit of services before a final determination is made. The Bureau will provide notification to the employer of its final determination.
§ 129.407. Recordkeeping requirements.
Individual self-insured employers shall maintain records of accident and illness prevention program services for the most complete fiscal year and 2 preceding consecutive fiscal years which include:
(1) Number and dates of surveys conducted.
(2) Proposed corrective actions and their disposition.
(3) Training programs conducted.
(4) Consultations held.
(5) Analyses of accident causes.
(6) Industrial hygiene services provided.
(7) Industrial health services provided.
(8) Qualified service providers utilized to provide program services whether contracted or employed.
§ 129.408. Periodic audits of individual self-insured employer's accident and illness prevention program.
(a) The Bureau may audit an individual self-insured employer's accident and illness prevention program at least once every 2 years.
(b) A combined audit may be conducted for affiliated companies of an individual self-insured employer if the same facilities, accident and illness prevention program, and accident and illness prevention services providers are used by each of the companies.
(c) The Bureau may audit an individual self-insured employer's accident and illness prevention program if the individual self-insured employer fails to file an AIPPS by specified time frames or fails to meet the requirements of this subchapter.
(d) The notice of the audit will include the reasons for audit.
(e) At least 60 calendar days prior to an audit, the Bureau will notify the individual self-insured employer in writing of the date on which the audit will occur.
§ 129.409. Preaudit exchange of information.
(a) At least 45-calendar days prior to the audit, the individual self-insured employer shall provide the Bureau with:
(1) If not already submitted, a completed annual AIPPS report for the most recently completed fiscal year and, if requested, the AIPPS reports for the 2 preceding consecutive fiscal years including those of its affiliated companies, if applicable.
(2) The name, address and telephone number of the contact person.
(3) A description of the types of accident and illness prevention program services provided during the last completed fiscal year.
(4) The name, address, business telephone number, credentials, experience and status (whether employed or contracted) of each person acting as an accident and illness prevention services provider for the individual self-insured employer.
(b) At least 15-calendar days prior to the date of the audit, the individual self-insured employer shall provide the Bureau with information on forms prescribed by the Bureau that describe the employer's accident and illness prevention program.
(c) If the information necessary for the audit is not furnished, the Bureau may cancel the audit, and a final determination of inadequate will be forwarded to the Director. The Director will provide notification of its final determination to the employer and initiate appropriate action regarding continuance of self-insurance status. A final determination of inadequate may be challenged by the individual self-insured employer in accordance with Subchapter G (relating to hearings).
§ 129.410. Site of audit.
(a) The audit of the individual self-insured employer's accident and illness prevention program will take place at the employer's main office in this Commonwealth unless otherwise agreed by the Bureau and the employer. If the individual self-insured employer has no office in this Commonwealth, the audit will take place at the Bureau's headquarters.
(b) At the site where the audit will occur, the individual self-insured employer shall provide the documentation required by § 129.406 (relating to report findings) and any other documentation chosen by the employer supporting the existence and adequacy of required program elements.
§ 129.411. Written report of audit.
(a) After the conclusion of the audit, the Bureau will issue a written report containing its findings. The report will indicate whether the Bureau has issued a final determination of adequate or an initial determination of inadequate with regard to an individual self-insured employer's accident and illness prevention program.
(b) The Bureau will notify the individual self-insured employer of a final determination of adequate.
(c) The Bureau will provide written notification to the individual self-insured employer of specific deficiencies and recommendations for corrective action if it assigns an initial determination of inadequate. Within 60 calendar days from the date of the audit report, the individual self-insured employer shall provide written documentation that it has complied with the Bureau's recommendations. If the individual self-insured employer believes that it will take more than 60 days to implement the recommendations, it shall file a plan of correction in accordance with § 129.412 (relating to plan of correction/reports of progress on correcting deficiencies). At the end of the 60 calendar day correction period, a final determination of adequate or inadequate will be assigned. The individual self-insured employer will receive notification of this final determination.
§ 129.412. Plan of correction/reports of progress on correcting deficiencies.
An individual self-insured employer shall file a plan of correction to implement audit report recommendations referenced in § 129.411(c) (relating to written report of audit) for any deficiency requiring more than 60 days to correct. The plan shall include a timetable for correction acceptable to the Bureau. Progress reports shall be filed by the individual self-insured employer detailing corrective actions at the end of each 30-day period of the correction plan period. The Bureau may audit an individual self-insured employer's accident and illness prevention program if an individual self-insured employer fails to file progress reports, implement recommendations or provide acceptable documentation of corrective actions. At the end of the correction plan period, a final determination of adequate or inadequate will be made, and the individual self-insured employer will be notified of the determination.
§ 129.413. Contesting final determinations.
An individual self-insured employer may contest a final determination of inadequate under Subchapter G (relating to hearings).
Subchapter D. GROUP SELF-INSURANCE FUND'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS Sec.
129.451. Purpose. 129.452. Program requirements. 129.453. Group self-insurance fund accident and illness prevention services providers requirements. 129.454. Reporting requirements for applicants for group self-insurance fund status. 129.455. Reporting requirements for group self-insurance funds. 129.456. Report findings. 129.457. Service requirements. 129.458. Recordkeeping requirements. 129.459. Periodic audits of group self-insurance fund's accident and illness prevention program. 129.460. Preaudit exchange of information. 129.461. Site of audit. 129.462. Written report of audit. 129.463. Plan of correction/reports of progress on correcting deficiencies. 129.464. Contesting final determinations. § 129.451. Purpose.
This subchapter establishes the criteria that the Bureau will employ in determining the adequacy of the accident and illness prevention program required by a group self-insurance fund under the act as a prerequisite for retention of group self-insurance fund status.
§ 129.452. Program requirements.
(a) A group self-insurance fund shall maintain or provide an adequate accident and illness prevention program and maintain records for this program for the 3 most current fiscal years. The program shall contain the following elements:
(1) A safety policy statement.
(2) A designated accident and illness prevention program coordinator.
(3) An assignment of responsibilities for implementing and evaluating the accident and illness prevention program.
(4) Program goals and objectives.
(5) Mechanisms for employee involvement, which may include establishment of a workplace safety committee including a safety committee as described in Subchapter F (relating to workplace safety committees).
(6) Employee accident and illness prevention suggestion and communications programs.
(7) Methods for accident investigation, reporting and recordkeeping.
(8) Methods for determining and evaluating program effectiveness. These may include:
(i) Comparison of the group self-insurance fund incidence rate as derived using the OSHA/BLS formula to the current, published OSHA/BLS industry-wide rate.
(ii) Comparison of the group self-insurance fund injury and illness rates determined by means of a formula prescribed by the Bureau to current, published Statewide rates by industry.
(iii) Experience modification factor.
(iv) Loss ratio.
(v) Other methods used by group self-insurance funds deemed appropriate by the Bureau.
(9) Protocols or standard operating procedures, when applicable, to the workplace and worksite environments for:
(i) Electrical and machine safeguarding.
(ii) Personal protective equipment.
(iii) Hearing and sight conservation.
(iv) Lockout/tagout procedures.
(v) Hazardous materials handling, storage and disposal procedures.
(vi) Confined space entry procedures.
(vii) Fire prevention and control practices.
(viii) Substance abuse awareness and prevention policies and programs.
(ix) Control of exposure to bloodborne pathogens.
(x) Preoperational process reviews.
(xi) Other protocols or standard operating procedures appropriate for members' workplace and worksite operations.
(b) Group self-insurance funds shall maintain records describing the comparison methods chosen from subsection (a)(8) for the most current fiscal year and 2 preceding consecutive fiscal years. Those records shall contain at a minimum:
(1) The annual calculated rates for the methods chosen.
(2) A copy of the calculations used to determine the annual rates.
(3) A copy of the sources containing the complete data used in calculating the annual rates.
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