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This entry was published on 2021-08-13
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SECTION 76
Creation of state fund
Workers' Compensation (WKC) CHAPTER 67, ARTICLE 6
§ 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 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 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 section fifty of this chapter, representation and
services of the nature specified in paragraph five of subsection (a) of
section one thousand six hundred one of the insurance law and
subdivision three-d of 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.