8.__Jurisdiction.__The board has jurisdiction over claims for reimbursement of expenses incurred by an employer that has implemented a rehabilitation plan pursuant to this section, whether approved or ordered by the board.__Payments may be made to rehabilitation providers or others who provide services under a rehabilitation plan pursuant to this section, whether approved or ordered by the board.__Payments may be made to rehabilitation providers or others who provide services under such a plan.__In all claims matters relating to reimbursement of insurers pursuant to section 213, subsections 3 and 4, the Supplemental Benefits Oversight Committee has jurisdiction both as to assessment authority and responsibility for ordering expenditures from the Employment Rehabilitation Fund.

A.__The Employment Rehabilitation Fund is not bound as to any question of law or fact by reason of any award or any adjudication to which the fund was not a party or in relation to which the fund was not notified, at least 21 days prior to the award or adjudication, that the fund might be subject to liability for the injury or death of an employee.

B.__An employer shall notify the board of any possible claim for subsequent injury reimbursement against the Employment Rehabilitation Fund as soon as practicable, but in no event later than one year after the injury or death of an employee. Failure to provide timely notice bars the claim.

C.__The State, members of the Supplemental Benefits Oversight Committee, service agents or subcontractors of service agents are not liable for a claim against the Employment Rehabilitation Fund that is in excess of the fund's current ability to pay.

D.__Following notice of a hearing as required by the Maine Administrative Procedure Act, the Supplemental Benefits Oversight Committee may adopt rules necessary to facilitate timely and proper administration of the affairs of the Employment Rehabilitation Fund relating to obligations of the Employment Rehabilitation Fund pursuant to section 213, subsections 3 and 4.__The rules adopted pursuant to this paragraph are routine technical rules as defined in Title 5, chapter 375, subchapter II-A.

Sec. 4. 39-A MRSA §355, sub-§8-A is enacted to read:

8-A.__Contractual powers.__The Supplemental Benefits Oversight Committee shall, through written agreement, contract with persons or entities qualified by good business reputation, training, education and experience to act as a service agent to perform the day-to-day duties of administrator of the Employment Rehabilitation Fund's responsibilities relating to section 213, subsections 3 and 4.__Such a person or entity must hold all requisite licenses, registrations or permits issued by an appropriate authority to engage in activities and assume responsibilities as delegated pursuant to the terms of the contract.__The service agent may subcontract with attorneys acceptable to the committee to advise or defend the fund in legal actions as necessary.__Expenses of the service agent, upon approval by the committee, are chargeable to the fund.

Sec. 5. 39-A MRSA §355, sub-§9, as enacted by PL 1991, c. 885, Pt. A, §8 and affected by §§9 to 11, is repealed and the following enacted in its place:

9.__Legal representation.__The Attorney General, when requested, shall provide legal representation for claims brought against the Employment Rehabilitation Fund by employers and rehabilitation service providers that relate to rehabilitation plans ordered or approved pursuant to this section.__In administering the fund's reimbursement of claims costs of employers and insurers qualified under section 213, subsections 3 and 4, the Supplemental Benefits Oversight Committee may, either directly or through service agents to whom authority to contract has been delegated, seek the advice and counsel of the Attorney General or retain private counsel through service contracts.__ Reasonable costs of legal representation by attorneys retained by the committee are chargeable to the fund.

A.__The reasonable expense of prosecution or defense by the Attorney General of claims made against the Employment Rehabilitation Fund are payable out of the fund subject to the approval of the board.

Sec. 6. 39-A MRSA §355-A is enacted to read:

§355-A.__Supplemental Benefits Oversight Committee

There is created the Supplemental Benefits Oversight Committee, referred to in this section as the "committee," comprising a voluntary coalition of parties in interest.__The committee is charged with monitoring, facilitating and providing general oversight in the administration of reimbursement to insurers of workers' compensation benefits funded by the Employment Rehabilitation Fund pursuant to section 213, subsections 3 and 4.__The committee consists of 5 members.__Two

members must represent employers, 2 members must represent insurers and one member must represent labor interests.__A list of qualified persons who are available to serve on the committee must be maintained by the board.__Each member, in the event of disputed issues, has one vote, which the member shall exercise.__ When replacement participation in the committee's membership is necessitated by a potential or actual conflict of interest, alternative members must be drawn from the list of qualified individuals maintained by the board.

A member of the committee is not liable in a civil action for an act performed in good faith in the execution of duties as a member of the committee.__A member of the committee may not participate in deliberations under consideration by the Employment Rehabilitation Fund if that member is personally interested in the case or is employed by or otherwise a representative of a person who is pecuniarily interested in the case.__The committee's responsibilities include, but are not limited to:

1.__Review; evaluation.__Review and evaluation, upon request of parties in interest, of pending workers' compensation claim settlements, including those that may be discharged by lump-sum settlement.__In such cases the committee has power to bind the Employment Rehabilitation Fund with respect to the value specified in agreements relating to settlements that is reimbursable from the fund.__The review must extend to a determination of the monetary obligation of the fund to the party seeking reimbursement.

2.__Request of determination.__When sitting in review of requests for determination of the level of reimbursement payable from the Employment Rehabilitation Fund, the committee shall schedule the review within 14 days of the receipt of the request or at a later time that is mutually acceptable to the parties.

3.__Day-to-day operations.__Delegation of day-to-day business operations of the Employment Rehabilitation Fund to a service agent qualified pursuant to section 355, subsection 8-A.__Terms and conditions of the contract must empower the service agent as specified in section 356, subsection 5-A.

Sec. 7. 39-A MRSA §356, sub-§1, as enacted by PL 1991, c. 885, Pt. A, §8 and affected by §§9 to 11, is repealed and the following enacted in its place:

1.__Assessment.__The board may levy an assessment on each insurer based on the insurer's actual paid losses during the previous calendar year.

A.__A service agent to whom the committee has delegated authority pursuant to a written contract may levy periodic assessments on each insurer in the proportion that the net direct written workers' compensation premiums of each insurer for the calendar year preceding the assessment bears to the net direct written workers' compensation premiums of all insurers that provided that coverage in the State in the same calendar year.

B.__A service agent to whom the committee has delegated authority pursuant to a written contract may levy periodic assessments on each self-insured employer based upon the self-insured employer's actual paid losses during the previous calendar year.

C.__Assessments must be levied with such frequency as to reasonably meet the cash flow needs of the Employment Rehabilitation Fund to timely discharge its obligations relating to reimbursement costs payable under section 213, subsections 3 and 4.

D.__Rates and premiums charged for workers' compensation policies are not considered excessive if a reasonably calculated surcharge is made to recoup assessments paid to the Employment Rehabilitation Fund.__A surcharge made must be specifically identified in a policy.__The surcharge made is not subject to premium taxes.

Sec. 8. 39-A MRSA §356, sub-§5-A is enacted to read:

5-A.__Duties of service agent.__A service agent retained under section 355 must, pursuant to terms of the contract, be held to account as a fiduciary in the administration of the Employment Rehabilitation Fund's assets and conduct of the business of the fund.

A.__A service agent shall acknowledge and reimburse claims of insurers consistent with the terms of a settlement effected among parties to the settlement as long as the service agent has been accorded notice and opportunity to participate regarding negotiation of the terms and conditions of the settlement.

B.__A service agent is contractually empowered to levy assessments in the name of the Employment Rehabilitation Fund, institute assessment collection procedures including legal actions if necessary, process qualified requests for reimbursement from the fund in a timely manner, deposit money in the possession of the fund with the Treasurer of State if the funds are not needed to meet immediate cash

flow demands and commit the fund to agreed levels of insurer reimbursement based upon review and assessment of prospects of consentual settlement.

C.__A service agent with whom the committee has contracted shall make recommendations to the committee regarding rule- making standards determined necessary to properly administer the affairs of the Employment Rehabilitation Fund.

SUMMARY

This bill reassigns responsibility for administration of the Employment Rehabilitation Fund to a voluntary coalition comprising representatives of the employment community, insurance companies and a bona fide labor organization. The bill sets procedures for funding and processing claims for reimbursement of benefit expenses incurred by insurers and employers that self- insure workers' compensation. The transfer of responsibilities relieves the budget of the Workers' Compensation Board of expenses of administration of the fund.