N.Y.
Workers' Compensation Law Section 76
Creation of state fund
1.
There is hereby continued in the department of labor a fund known as “the state insurance fund”, for the purpose of insuring employers against liability for personal injuries or death sustained by their employees, including liability other than liability assumed by contract imposed upon employers by reason of a suit or claim brought against the employer by another to recover the amount of damages obtained from such other by an employee of the employer for injuries or in case of death by his dependents for death sustained by such employee arising out of and in the course of his employment and to pay such damages, and of assuring to the persons entitled thereto the compensation and benefits provided by this chapter or by any act providing for compensation now or hereafter enacted by the congress of the United States of America if such liability is incident to an employment carried on in this state, and every such payment shall constitute an element of loss for the purpose of establishing premium rates. Such fund shall consist of all premiums received and paid into the fund, of property and securities acquired by and through the use of moneys belonging to the fund and of interest earned upon moneys belonging to the fund and deposited or invested as herein provided. Such fund shall be applicable to the payment of losses sustained on account of insurance, to the payment of expenses in the manner provided in this chapter and to the payment of premiums for reinsurance in any insurance corporation of the whole or any part of any policy obligations. 1-a.a.
The purposes of the state insurance fund are hereby enlarged to permit it to enter agreements with insurers licensed to write workers’ compensation insurance in states outside New York to issue policies to state insurance fund policyholders covering those policyholders’ obligations to secure the payment of workers’ compensation benefits under the laws of states other than New York. The state insurance fund shall also be authorized to receive premiums into its workers’ compensation fund for policies written under such agreements and to pay from such fund:(i)
reimbursement of all losses and loss adjustment expenses under such policies; and(ii)
fees and other costs, including but not limited to those for claims services, relating to such agreements. An agreement under this subdivision shall not include the provision of claims services for any claim under this chapter.b.
For a policyholder to be eligible for insurance in states other than New York provided through agreements entered into under this subdivision, either:(i)
the policyholder’s workers’ compensation premiums with the state insurance fund covering its employees under this chapter must be greater than the premiums charged to cover the policyholder’s obligations to pay workers’ compensation benefits in all states, in the aggregate, other than New York when covered under such agreements; or(ii)
the payroll for the policyholder’s operations in New York must be greater than the policyholder’s payroll in all states, in the aggregate, other than New York when covered under such agreements for the prior policy period. For determining eligibility, “premiums” mean estimated premiums as determined by the state insurance fund at the beginning of the policy period. In addition, for a policyholder to be eligible for insurance in states other than New York through the state insurance fund, the policyholder must meet the state insurance fund’s underwriting criteria for other states coverage as specified by rules of the commissioners.2.
The purposes of the state insurance fund herein created are hereby enlarged to provide insurance for the payment of the benefits required by § 204 (Disability and family leave during employment)section two hundred four of this chapter including benefits for family leave. A separate fund is hereby created within the state insurance fund, which shall be known as the “disability benefits fund”, and which shall consist of all premiums received and paid into said fund on account of such insurance, all securities acquired by and through the use of moneys belonging to said fund and of interest earned upon moneys belonging to said fund and deposited or invested as herein provided. Said disability benefits fund shall be applicable to the payment of benefits, expenses and assessments on account of insurance written pursuant to article 9 (Disability Benefits)article nine of this chapter. Premiums for policies providing disability and family leave benefits in accordance with this article shall be calculated in accordance with applicable provisions of the insurance law, including subsection (n) of section four thousand two hundred thirty-five of such law. The state insurance fund shall have authority to discount or surcharge on established premium rates based on sound actuarial principles. 2-b. The purposes of the state insurance fund created in this section are hereby enlarged to provide for the insurance by the state insurance fund of the payment of the benefits required by section one hundred sixty-ddd of the executive law.3.
The respective assets and liabilities of the workers’ compensation and disability benefits funds provided in this section shall be and remain separate except that advances may be made from either fund for the payment of benefits and for administrative expenses, subject to annual reimbursement. Whenever used in this article the terms “state insurance fund”, “state fund” and “fund” shall be deemed to include both the workers’ compensation fund and the disability benefits fund unless the context otherwise indicates.4.
The purposes of such state insurance fund are hereby further enlarged to permit it to furnish to self-insurers, as defined in subdivision three of § 50 (Security for payment of compensation)section fifty of this chapter, representation and services of the nature specified in paragraph five of subsection (a) of Insurance Law § 1601 (Authority to invest in subsidiaries)section one thousand six hundred one of the insurance law and subdivision three-d of § 50 (Security for payment of compensation)section fifty of this chapter.5.
No monies of the state insurance fund shall be transferred to any other fund, nor shall any such monies be applied to the making of any payment for any purpose other than the purposes set forth in this article.
Source:
Section 76 — Creation of state fund, https://www.nysenate.gov/legislation/laws/WKC/76 (updated Aug. 13, 2021; accessed Oct. 26, 2024).
