Free 129-AI.qxd - Missouri

MISSOURI DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS DIVISION OF WORKERS COMPENSATION WORKERS SAFETY PROGRAM

SELF-INSURED TRUST SAFETY PROGRAM INITIAL CERTIFICATION PROCEDURES The following represents a general outline of the procedures to be followed in certifying the safety programs of self-insured trusts. These procedures will be the same for trusts utilizing third party administrators (TPAs) and for self-administered trusts. The certification criteria for trusts generally follows the guidelines used for insurance carrier certification as outlined in 8 CSR 50-7.040. 1. Meeting with trust administrators or the person responsible for the delivery of occupational safety and health services to trust members. 2. Review of written safety and health programs used to service the trusts loss control needs. 3. Review of the educational materials available to trust members. 4. Review of credentials of loss control personnel. 5. Review of loss history of the trust members, including occupational injury and illness incidence rates, loss run information and current experience modification factor. 6. Review of loss control audits performed with individual trust members. 7. Identification of trust members with which to have on-site inspections. Inspections are performed for the purpose of determining the adequacy and appropriateness of the services and programs provided. A minimum of two on-site inspections will be performed for each trust. 8. On-site inspection audits and reports with recommendations are sent to the Self-Insurance Unit. Trusts that meet the guidelines will receive certification. Trusts that are unable to be certified will be given six months to comply with the recommendations. If recommendations are not satisfactorily acted upon in six months, the trust will be denied certification and referred to the Self-Insurance Unit for further action. 9. The Workers Safety Program will annually perform a review of each trusts safety program after the initial certification. The review will cover any changes made to the certified program and may include on-site visits. 10. Written allegation of safety violations may result in additional reviews.

WC-129 (03-01) AI