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Ocga 349136 Statistical Data Submitted By Insurance Company To Rating Organization Verification By Employer Issuance Of Experience Modification Worksheets To Insured

(a) Before an insurance company is authorized to submit statistical data on an employer to any licensed rating organization for purposes of determining the employer’s experience modification factor, the insurance company must verify with the employer the accuracy of the data. In so verifying, the insurance company shall provide to the employer: (1) the data to be submitted; and (2) a statement in boldface type, to be signed by an authorized representative of the employer, and submitted by the insurance company to the licensed rating organization along with the statistical data. Said statement shall indicate that the statistical data to be submitted have been reviewed by the authorized representative of the employer; that said data are accurate; and that an insurance company representative has explained to the employer’s representative that the statistical data to be submitted may affect the employer’s premium for workers’ compensation insurance coverage.

(b) When a licensed rating organization issues an insured’s experience modification worksheet to the insured’s workers’ compensation insurance company, the licensed rating organization shall submit a copy of the worksheet to the insured.

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