Amerisure Mutual Insurance Co. v. Florida Department of Financial Services, Division of Workers' Compensation

156 So. 3d 520, 2015 WL 46515
CourtDistrict Court of Appeal of Florida
DecidedJanuary 1, 2015
Docket1D14-0873
StatusPublished
Cited by5 cases

This text of 156 So. 3d 520 (Amerisure Mutual Insurance Co. v. Florida Department of Financial Services, Division of Workers' Compensation) is published on Counsel Stack Legal Research, covering District Court of Appeal of Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Amerisure Mutual Insurance Co. v. Florida Department of Financial Services, Division of Workers' Compensation, 156 So. 3d 520, 2015 WL 46515 (Fla. Ct. App. 2015).

Opinion

BENTON, J.

Amerisure Mutual Insurance Company (Amerisure) appeals a final order of the Florida Department of Financial Services, Division of Workers’ Compensation (Department). We affirm. We reject appellant’s contention that the Department ignored the findings of fact the administrative law judge (ALJ) made and improperly substituted its conclusions of law for those of the ALJ. The Department correctly applied the governing statute.

As an insurance carrier authorized to transact a workers’ compensation line of business in Florida, Amerisure is subject to certain assessments: Amerisure is required to pay quarterly assessments to the Special Disability Trust Fund (SDTF) pursuant to section 440.49(9), Florida Statutes (2008), which provides in part:

(9) SPECIAL DISABILITY TRUST FUND.—
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(b)l. The Special Disability Trust Fund shall be maintained by annual assessments upon the insurance companies writing compensation insurance in the state, ... which assessments shall become due and be paid quarterly at the same time and in addition to the assessments provided in s. 440.51_
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3. The net premiums written by the companies for workers’ compensation in this state ... are the basis for computing the amount to be assessed as a percentage of net premiums. Such payments shall be made by each carrier and self-insurer to the department for the Special Disability Trust Fund in accordance with such regulations as the department prescribes.

Amerisure is also required to pay quarterly assessments to the Workers’ Compensation Administration Trust Fund (WCATF) pursuant to section 440.51(1), Florida Statutes (2008), which provides in part:

Expenses of administration.—
(1) The department shall estimate annually in advance the amounts necessary for the administration of this chapter. ...
(a) The department shall, by July 1 of each year, notify carriers and self-insurers of the assessment rate....
(b) The total expenses of administration shall be prorated among the carriers writing compensation insurance in the state and self-insurers. The net premiums collected by carriers and the amount of premiums calculated by the department for self-insured employers are the basis for computing the amount to be assessed....
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(5) Any amount so assessed against and paid by an insurance carrier ... shall be allowed as a deduction against the amount of any other tax levied by the state upon the premiums, assessments, or deposits for workers’ compen *523 sation insurance on contracts or policies of said insurance carrier.... Because deductions under this subsection are available to insurance carriers, s. 624.5091 does not limit such deductions in any manner.

(Boldface omitted.) Also applicable and pertinent to determination of a carrier’s assessments for these trust funds is section 624.5094, Florida Statutes (2008), which provides:

Casualty insurance premiums. — Notwithstanding any statutory provision to the contrary, for the purposes of calculating the annual assessments for the Special Disability Trust Fund under s. 440.49 and expenses of administration under s. 440.51, any amount paid or credited as dividends or premium refunds in the same calendar year by the insurer to its policyholders must be deducted from “net premium,” “net premiums written,” “direct premium,” and “net premium collected” for the calendar year. Such offset for dividends or premium refunds paid or credited for the current year must be applied against the current year’s net premium for that year’s assessment regardless of the policy year for which the dividends or premium refunds are being reimbursed.

(Boldface omitted.) The Division of Workers’ Compensation (Division) generated a one-page form (never promulgated as a rule) for carriers’ use in reporting net premiums and calculating quarterly assessments for the two trust funds. The form provided a space for the carrier to indicate whether net premium was positive or negative for the quarter and in what amount.

The form also had a space for carrying forward “debits” or “credits” from prior quarters and aggregating them with the current quarter’s net premium and assessment due. The initial premium for a workers’ compensation policy is based on an estimate of what the insured’s payroll and the classification of its employees will be during the coverage period, typically a year. Because assessments for the two trust funds must be paid quarterly, an insurer may overpay an annual assessment when positive net premiums in one or more early quarters are exceeded by negative net premium in subsequent quarter(s) in the same calendar year.

Amerisure’s SDTF Assessments

In 2008, Amerisure reported positive net premium totaling $32,934,173 for the first two quarters of the calendar year and paid SDTF assessments totaling $1,488,624. For the third quarter of 2008, Amerisure reported negative net premium (<$923,-750>), and paid no assessment. Based on Amerisure’s reported negative net premium for the third quarter, the Division’s form for the fourth quarter of 2008 indicated Amerisure had a “credit” of $41,745.36 for SDTF assessment purposes (determined by multiplying the reported negative net premium for the third quarter by the assessment rate of 0.0452). For the fourth quarter of 2008, Amerisure reported negative net premium (<$1,269,343>) and again paid no assessment. An additional credit of $57,374.30 was calculated for the fourth quarter (the fourth-quarter negative net premium multiplied by the assessment rate of 0.0452).

In this way, Amerisure paid $99,119.66 more in estimated payments (for the first two quarters of 2008) than it owed for its 2008 SDTF annual assessment, and ended the year with a credit reflecting the overpayment. In 2009, Amerisure reported negative net premiums all four quarters and paid no SDTF assessments for any *524 quarter. 1 The form the Division provided Amerisure with which to report its SDTF assessment for the first quarter of 2010, reflected a credit of $99,119.66, based on Amerisure’s actual overpayment of the 2008 annual assessment, but carried forward nothing for 2009 in which no assessments had been paid.

In 2010, Amerisure reported positive net premium of $828,566 for the first quarter of 2010, resulting in an SDTF assessment of $37,451.18 for the quarter. The Division reduced the $99,119.66 credit by that amount, so that the Division’s form for the second quarter of 2010 indicated Ameri-sure had a credit of $61,668.48. Amerisure reported a positive net premium of $1,282,179 for the second quarter of 2010, resulting in an assessment of $57,954.49 for that quarter. The Division again reduced the (remaining) credit by the amount of the assessment, so the Division’s form for the third quarter of 2010 reflected a “Prior Balance Carried Forward” of $3,713.99.

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Bluebook (online)
156 So. 3d 520, 2015 WL 46515, Counsel Stack Legal Research, https://law.counselstack.com/opinion/amerisure-mutual-insurance-co-v-florida-department-of-financial-services-fladistctapp-2015.