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.

Cross References

   This section cited in 34 Pa. Code §  129.454 (relating to reporting requirements for applicants for group self-insurance fund status).

§ 129.453. Group self-insurance fund accident and illness prevention services providers requirements.

 (a)  Accident and illness prevention services providers employed by a group self-insurance fund or serving through a contract 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 the group self-insurance fund to 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.

§ 129.454. Reporting requirements for applicants for group self-insurance fund status.

 (a)  As part of its application for group self-insurance fund status submitted to the Bureau, an applicant for self-insurance fund status shall provide the Bureau with detailed information on its accident and illness prevention program that will be offered or provided to group self-insurance fund members as required under §  129.452 (relating to program requirements) using form LIBC-231G, Initial Report of Accident and Illness Prevention Program Status.

 (b)  As part of the process of granting group self-insurance fund status, the Bureau will use this information to determine whether to grant group self-insurance fund status.

Cross References

   This section cited in 34 Pa. Code §  129.456 (relating to Board findings).

§ 129.455. Reporting requirements for group self-insurance funds.

 (a)  A group self-insurance fund shall provide the Bureau with detailed information on its accident and illness prevention program using the AIPPS report along with the annual report to the Bureau required under section 815 of the act (77 P. S. §  1036.15).

 (b)  A group self-insurance fund shall also provide information describing the established methods used to identify individual group self-insurance fund members requiring accident and illness prevention services. A group self-insurance fund shall also provide data describing accident and illness prevention services efforts for the identified members and the effectiveness of these efforts in improving injury and illness rates.

 (c)  In addition, documentation required by other governmental regulatory agencies can be used as supporting evidence of accident and illness prevention programs.

 (d)  Report information shall be subject to Bureau verification.

Cross References

   This section cited in 34 Pa. Code §  129.456 (relating to report findings).

§ 129.456. Report findings.

 (a)  Upon receipt of a report required under §  129.454 (relating to reporting requirements applicants for group self-insurance fund status), the Bureau will review the report data and make a final determination of the adequacy or inadequacy of programs and provide notification to the group self-insurance fund applicant.

 (b)  Upon receipt of a report required under §  129.455 (relating to reporting requirements for group self-insurance funds), 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 programs before a final determination is made. The Bureau will provide notification to the group self-insurance fund of its final determination.

§ 129.457. Service requirements.

 A group self-insurance fund shall maintain or provide through its own or contracted accident and illness prevention services providers the following accident and illness prevention services to members:

   (1)  Onsite surveys to identify existing or potential accident and illness hazards or safety program deficiencies. If through a survey and analysis of survey results it is determined that the hazards or deficiencies are present, corrective actions shall be proposed to the group self-insurance fund member concerning the abatement of hazards or program deficiencies identified in the surveys. If one or more imminent danger situations or program deficiencies are identified, the group self-insurance fund shall inquire as to the corrective actions the group self-insurance fund member has taken and propose further corrective actions if necessary.

   (2)  Analyses of the causes of accidents and illnesses at the members’ worksites.

   (3)  Providing or proposing corrective actions in the area of industrial hygiene services as requested by the group self-insurance fund member or as determined by the group self-insurance fund to meet the group self-insurance fund members’ operational requirements, for example, air quality testing.

   (4)  Providing or proposing corrective actions in the area of industrial health services as requested by the group self-insurance fund member or as determined by the group self-insurance fund to meet the group self-insurance fund members’ operational requirements, for example, health screenings or substance abuse awareness and prevention training policies and programs.

   (5)  Accident and illness prevention training programs which may include training for safety committee members as outlined under Subchapter F (relating to workplace safety committees).

   (6)  Consultations regarding specific safety and health problems and hazard abatement programs and techniques.

   (7)  Review of planned or newly introduced industrial materials, processes, equipment, layouts and techniques to identify potential hazards and to recommend methods to mitigate any hazards identified.

§ 129.458. Recordkeeping requirements.

 (a)  Group self-insurance funds shall maintain records of accident and illness prevention programs or services for each member for the most complete current fiscal year and 2 preceding consecutive fiscal years which include:

   (1)  The dates of requests for services.

   (2)  The services requested or problems presented.

   (3)  The dates of the group self-insurance fund’s responses.

   (4)  The dates on which services were provided and member responses to proposed corrective actions.

   (5)  The number of hours expended providing services including both onsite and preparatory time.

   (6)  The final disposition of requests.

   (7)  The number of service visits.

   (8)  Other service reports including proposed corrective actions.

   (9)  The results of industrial hygiene and industrial health surveys and consultations.

   (10)  Accident and illness prevention training conducted.

   (11)  Safety-related materials provided.

   (12)  Member responses to group self-insurance fund proposed corrective actions.

 (b)  Group self-insurance funds shall annually solicit comments from their members regarding the effectiveness of the accident and illness prevention program provided by the group self-insurance fund. This information shall be made available to the Bureau upon request for the next current fiscal year and 2 preceding consecutive fiscal years.

Cross Reference

   This section cited in 34 Pa. Code §  129.461 (relating to site of audit).

§ 129.459. Periodic audits of group self-insurance fund’s accident and illness prevention program.

 (a)  The Bureau may audit a group self-insurance fund’s accident and illness prevention program at least once every 2 years.

 (b)  The Bureau may audit a group self-insurance fund’s accident and illness prevention program if the group self-insurance fund fails to file an AIPPS report by specified time frames or meet the requirements of this subchapter.

 (c)  A combined audit may be conducted for affiliated companies of a group self-insurance fund if the same facilities, accident and illness prevention program, and accident and illness prevention services are used by each of the companies.

 (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 group self-insurance fund administrator in writing of the date on which the audit will occur.

§ 129.460. Preaudit exchange of information.

 (a)  At least 45-calendar days prior to the audit, the group self-insurance fund administrator shall provide the Bureau with:

   (1)  If not already submitted, a completed annual AIPPS report as prescribed by the Bureau for the most recently completed fiscal year and, if requested, the AIPPS reports for 2 preceding consecutive fiscal years including those of its affiliated companies, if applicable.

   (2)  A list of the group self-insurance fund members, including the company name, address, telephone number and contact person.

   (3)  The types of accident and illness prevention program services provided to selected group self-insurance fund members during the last completed group self-insurance fund 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 group self-insurance fund.

 (b)  The Bureau will keep the list of group self-insurance fund members confidential.

 (c)  At least 15-calendar days prior to the date of the audit, the group self-insurance fund administrator shall provide the Bureau with information on forms prescribed by the Bureau that describe the selected group self-insurance fund member’s accident and illness prevention program.

 (d)  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 notify the group self-insurance fund administrator of its final determination and initiate appropriate action regarding continuance of group self-insurance fund status. A final determination of inadequate may be challenged by the group self-insurance fund administrator in accordance with Subchapter G (relating to hearings).

§ 129.461. Site of audit.

 (a)  The audit of the group self-insurance fund’s accident and illness prevention program will take place at the group self-insurance fund administrator’s main office in this Commonwealth unless otherwise agreed by the Bureau and the group self-insurance fund administrator. If the group self-insurance fund 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 group self-insurance fund shall provide the documentation required by §  129.458 (relating to recordkeeping requirements) and any other documentation chosen by the group self-insurance fund supporting the existence and adequacy of required program elements.

§ 129.462. 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 a group self-insurance fund’s accident and illness prevention program.

 (b)  The Bureau will notify the group self-insurance fund administrator of a final determination of adequate.

 (c)  The Bureau will provide written notification to the group self-insurance fund administrator 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 group self-insurance fund shall provide written documentation that it has complied with the Bureau’s recommendations. If the group self-insurance fund believes that it will take more than 60 days to implement the recommendations, it shall file a plan of correction in accordance with §  129.463 (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 group self-insurance fund administrator will receive notification of this final determination.

Cross References

   This section cited in 34 Pa. Code §  129.463 (relating to plan of correction/reports of progress on correcting deficiencies).

§ 129.463. Plan of correction/reports of progress on correcting deficiencies.

 A group self-insurance fund shall file a plan of correction to implement audit report recommendations referenced in §  129.462(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. Monthly progress reports shall be filed by the group self-insurance fund detailing corrective actions at the end of each 30-day period of the correction plan period. The Bureau may audit a group self-insurance fund’s accident and illness prevention program if the group self-insurance fund fails to file progress reports, implement recommendations, or provide acceptable documentation of corrective actions. The group self-insurance fund will be notified of the determinations made by the Bureau.

Cross References

   This section cited in 34 Pa. Code §  129.462 (relating to written report of audit).

§ 129.464. Contesting final determinations.

 A group self-insurance fund administrator may contest a final determination of inadequate under Subchapter G (relating to hearings).



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