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Virginia Administrative Code
Title 16. Labor And Employment
Agency 30. Virginia Workers' Compensation Commission
Chapter 80. Regulations Governing Individual Self-Insurance under the Virginia Workers' Compensation Act
1/27/2023

16VAC30-80-50. Notice of approval or denial.

A. After reviewing the application, the commission will approve it (with or without conditions), deny it, or request additional information.

B. If the commission approves the application, the applicant will be informed of the decision, and requested to provide the following:

1. A surety bond written by a company licensed by the State Corporation Commission to write such bonds in Virginia. The bond must be in the amount specified by the commission, and provided on the currently approved version of the commission bond form (VWC Form No. 21A).

2. Proof of excess coverage provided by a company approved by the State Corporation Commission to write such coverage in Virginia. The coverage must be in the amount stipulated in the application, subject to any modifications in limits or retention level that may have been specified as a condition of the commission's approval of the application. The coverage may not be provided by any captive or subsidiary of the self-insurer, or by any captive or subsidiary of the self-insurer's parent company.

3. A copy of the agreement between the applicant and the proposed third party administrator (if not already provided as part of the application).

4. A copy of a parental guarantee if required by the commission. The guarantee must be provided on the currently approved version of the commission's parental guarantee form (VWC Form No. 22).

5. Documentation that any additional conditions of the commission's approval have been met.

C. Once all required materials have been provided by an approved applicant, the commission will provide a Certificate of Self-Insurance (VWC Form No. 22A). This certificate continues in force so long as the applicant meets all its requirements as a self-insurer under this regulation, under other commission rules and regulations, and under the provisions of the Virginia Workers' Compensation Act.

D. If the approved applicant fails to provide the required information within 60 days of the notification of approval, the application shall be considered withdrawn, but may be reactivated under the provisions of 16VAC30-80-50 E 5.

E. If the commission disapproves the application, the applicant will be informed of the action.

1. If the applicant wishes to discuss the reasons for denial in detail, a specific request may be provided either in writing or verbally.

2. If, on the basis of the discussion, the applicant wishes the commission to reconsider the application, a written request for such reconsideration must be made within 30 days from the date on which the applicant was notified of disapproval. The request must indicate the grounds for the reconsideration, and must provide evidence that any reasons for disapproval have been corrected or that the information previously provided to the commission was incomplete or incorrect.

3. The commission will reconsider the application within 60 days, and provide a written response to the applicant.

4. If the commission requires additional information, either for an initial review, or for a subsequent request for reconsideration of a disapproval, the applicant will have 30 days in which to provide the required information. If the information is not provided within that time period, the application will be considered withdrawn.

5. An application that has been withdrawn, either during review or after initial approval, may be reactivated so long as it has been no more than 180 days since the original application was submitted.

6. Applicants who have withdrawn their applications or have had their applications rejected may reapply at any time, but must meet all of the application requirements.

Statutory Authority

§§ 65.2-201 and 65.2-801 of the Code of Virginia.

Historical Notes

Derived from VR405-20-01 § 5, eff. January 13, 1993.

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