Insurance Premiums Order (Retro-Paid Loss Premium Method) 2009–2010
In ForceNSW
Jurisdiction
New South Wales
Act Number
171 of 2009
Collection
regulation
Plain English Summary
7/10 complexity
This Order prescribes how employers who choose the Section 168A ‘retro‑paid loss’ option must have their workers’ compensation premiums calculated: an initial deposit premium and then recalculated adjusted premiums at five set adjustment dates, with formulas, caps/floors, group‑member options and a $175 minimum (cl.6–8; sch.1–4). Employers pay the premiums; insurers (and employers in groups) must apply the specified formulas and factors, which standardises timing and numeric rules but increases calculation and compliance effort (cl.4, sch.3–4).
This Order prescribes the mechanical method for calculating premiums for a specific class of workers compensation insurance policies, namely those taken under the optional alternative in section 168A of the Act known as retro-paid loss premium policies. Clause 6 states the Order supplies the alternative method for the purposes of section 168A of the Act: premiums are calculated at the policy commencement (the deposit premium) and are then recalculated at five scheduled adjustment dates (the adjusted premium), in accordance with the schedules and formulae contained in the Order (cl 6; Schedule 1). The adjustment dates are fixed in the Order as 15, 24, 36, 48 and 60 months after the commencement of the period of insurance; these dates are defined in cl 3(2) as “adjustment date” (cl 3(2)).
The Order applies only to employers for whom the optional alternative method under s 168A of the Act applies, and only to retro-paid loss premium policies that take effect on or after 4 pm on 30 June 2009 and before 4 pm on 30 June 2010 (cl 4(1)-(2)). Clause 4(3) provides continuity: if no substitute insurance premiums order covering retro-paid loss premium policies is made before 4 pm on 30 June 2010, this Order continues to apply to such policies pending a replacement order. The Order also incorporates, subject to express differences, provisions of the General Order; clause 3(1) establishes that words and expressions have the same meanings as in the General Order unless this Order provides otherwise, and clause 4(4) imports the General Order (other than its clauses 3 and 4) to retro-paid loss premium policies unless displaced by this Order.
Mechanically, the Order requires the initial deposit premium and each adjusted premium to be calculated by formulae set out in Schedules 1 (general employers) and 2 (members of a group). Key inputs into those formulae include the employer’s basic tariff premium (T), the total cost of claims for the relevant policy period excluding journey and recess claims (C), experience adjustment factors (S or SG, from Schedule 3), claims adjustment factors (V or VG, from Schedule 4), and other tariff components arising from the General Order such as premiums adjustment contribution (Q), dust diseases contribution (D), Mine Safety Fund premium adjustment (M) and apprentice incentive amount (A) (Schedule 1, cl 2). The Order also sets bounds on premiums: deposit and adjusted premiums must not be less than the minimum premium of $175 (cl 7) and must respect the Pmin and Pmax bounds defined in Schedule 1 and Schedule 2. For employers in groups, Schedule 2 provides three alternative recalculation options and group aggregation formulae, including group deposit premium and group adjusted premium calculations, together with corresponding Pmin/PGmin and Pmax/PGmax bounds.
Current sections
Direct links to the current provisions in Insurance Premiums Order (Retro-Paid Loss Premium Method) 2009–2010.
(3) The explanatory note does not form part of this Order.
4
Application of Order
4 Application of Order
4 Application of Order
(1) This Order applies only to and in respect of policies of insurance for employers to whom the optional alternative method of calculating premiums under section 168A of the Act applies (retro-paid loss premium policies).
(2) This Order applies to and in respect of retro-paid loss premium policies that are to be or have been issued or renewed so as to take effect on or after 4 pm on 30 June 2009 and before 4 pm on 30 June 2010.
(3) If, before 4 pm on 30 June 2010, an insurance premiums order that applies only to and in respect of retro-paid loss premium policies has not been made in respect of such policies of insurance taking effect on or after that time, this Order applies to and in respect of those policies pending the making of such an order.
(4) The General Order (other than clauses 3 and 4) applies to and in respect of retro-paid loss premium policies, unless this Order provides otherwise.
(5) This Order does not apply to a policy of insurance issued or renewed by a specialised insurer that is exempted from insurance premiums orders by clause 147 of the Workers Compensation Regulation 2003.
5
Classification of large employers
5 Classification of large employers
5 Classification of large employers
A large employer within the meaning of the General Order is classified a large employer under this Order.
6
Retro-Paid Loss Premium Method of premium calculation
6 Retro-Paid Loss Premium Method of premium calculation
6 Retro-Paid Loss Premium Method of premium calculation
For the purposes of section 168A of the Act, the alternative method is to calculate the premium for a policy of insurance at the commencement of the period of insurance (the deposit premium), and then recalculate the premium at each adjustment date (the adjusted premium), in accordance with this Order.
7
Minimum premium
7 Minimum premium
7 Minimum premium
Despite any other provision of this Order, a deposit premium and an adjusted premium in respect of any policy of insurance is to be no less than $175.
8
Calculation of required deposit: section 172A of Act
8 Calculation of required deposit: section 172A of Act
8 Calculation of required deposit: section 172A of Act
(1) The required deposit for an employer in relation to a policy of insurance is to be calculated in accordance with the following formula:
(a) before the first adjustment date:
(b) on and from the first adjustment date:
where:
RD is the required deposit in respect of the period of insurance to which the policy relates.
Pmax is the maximum premium that is payable by the employer calculated in accordance with Schedule 1.
PD is the deposit premium payable by the employer calculated in accordance with Schedule 1.
P is the premium payable by an employer for a policy of insurance calculated in accordance with Schedule 1.
(2) However, if the employer is a member of a group, subclause (1) does not apply and the required deposit for an employer in relation to a policy of insurance is to be calculated in accordance with the following formula:
(a) before the first adjustment date:
(b) on and from the first adjustment date:
where:
RD is the required deposit in respect of the period of insurance to which the policy relates.
PGmax is the maximum premium that is payable by the members of the group in respect of the period of insurance to which the group’s policies relate calculated in accordance with Schedule 2.
PGd is the deposit premium payable by the members of the group in respect of the period of insurance to which the group’s policies relate calculated in accordance with Schedule 2.
PEd is the deposit premium that is payable by the employer who is a member of a group calculated in accordance with Schedule 2.
PG is the group premium payable by the members of the group in respect of the period of insurance to which the group’s policies relate calculated in accordance with Schedule 2.
PE is the premium for the time being payable by an employer who is a member of a group in respect of the period of insurance to which the policy relates (including, where adjustments are required to be made to that premium by reason of the operation of this Order, the premium so payable by reason of those adjustments).
9
Schedules form part of Order
9 Schedules form part of Order
9 Schedules form part of Order
Schedules 1–4 form part of this Order.
Schedule 1
Method of calculation of deposit premium and adjusted premium—general
Schedule 1 Method of calculation of deposit premium and adjusted premium—general
Schedule 1 Method of calculation of deposit premium and adjusted premium—general
(Clause 8)
Schedule 2
Method of calculation of deposit premium and adjusted premium—member of a group
Schedule 2 Method of calculation of deposit premium and adjusted premium—member of a group
Schedule 2 Method of calculation of deposit premium and adjusted premium—member of a group
(Clause 8)
Schedule 3
Experience adjustment factor
Schedule 3 Experience adjustment factor
Schedule 3 Experience adjustment factor
(Schedule 1, clause 2 and Schedule 2, clause 6)
Schedule 4
Claims adjustment factor
Schedule 4 Claims adjustment factor
Schedule 4 Claims adjustment factor
(Schedule 1, clause 2 and Schedule 2, clause 6)
sch.4-sec
General
sch.4-sec General
General
The claims adjustment factor for an employer (“V”) (or for a group (“VG”)) at the adjustment date set out in Column 1 of the Table to this clause is, if the employer has (or all the members of the group of employers of which the employer is a member have) elected a large claim limit for the purposes of clause 137 (5) of Workers Compensation Regulation 2003 of:
(a) $350,000—the factor set out in Column 2 of the Table corresponding to that date, and
(b) $500,000—the factor set out in Column 3 of the Table corresponding to that date.
Table
| Column 1 | Column 2 | Column 3 |
| Adjustment date | Adjustment factor “V” (or “VG”) for $350,000 large claim limit | Adjustment factor “V” (or “VG”) for $500,000 large claim limit |
| First adjustment date (being commencement of policy period plus 15 months) | 3.05 | 2.95 |
| Second adjustment date (being commencement of policy period plus 24 months) | 2.10 | 2.00 |
| Third adjustment date (being commencement of policy period plus 36 months) | 1.80 | 1.70 |
| Fourth adjustment date (being commencement of policy period plus 48 months) | 1.75 | 1.67 |
| Fifth adjustment date (being commencement of policy period plus 60 months) | 1.75 | 1.67 |
Source text: opening excerpt
Sourced from legislation.nsw.gov.au, CC BY 4.0.
1 Name of Order
1 Name of Order
1 Name of Order
This Order is the Insurance Premiums Order (Retro-Paid Loss Premium Method) 2009–2010.
2 Commencement
2 Commencement
2 Commencement
This Order commences at 4 pm on 30 June 2009 and is required to be published in the Gazette.
3 Interpretation
3 Interpretation
3 Interpretation
(1) In this Order, words and expressions have the same meanings as they have in the General Order, unless this Order provides otherwise.
(2) In this Order:
adjustment date, in relation to a policy of insurance, means each of the following dates:
(a) the date that is 15 months after the date of the commencement of the period of insurance (the first adjustment date),
(b) the date that is 24 months after the date of the commencement of the period of insurance (the second adjustment date),
(c) the date that is 36 months after the date of the commencement of the period of insurance (the third adjustment date),
(d) the date that is 48 months after the date of the commencement of the period of insurance (the fourth adjustment date),
(e) the date that is 60 months after the date of the commencement of the period of insurance (the fifth adjustment date).
cost of claims has the same meaning as in Division 4 of Part 20 of the Workers Compensation Regulation 2003.
General Order means:
(a) the Insurance Premiums Order 2009–2010, or
(b) if no such order has been made, the Insurance Premiums Order 2008–2009.
(3) The explanatory note does not form part of this Order.
4 Application of Order
4 Application of Order
4 Application of Order
(1) This Order applies only to and in respect of policies of insurance for employers to whom the optional alternative method of calculating premiums under section 168A of the Act applies (retro-paid loss premium policies).
Schedule 4 fixes claims adjustment factors by reference to whether the employer (or all members of the group) has elected a large claim limit under clause 137(5) of the Workers Compensation Regulation 2003, with two options $350,000 and $500,000, and specifies the multiplier for each adjustment date (Schedule 4 Table). The Order excludes specialised insurers that are exempted from insurance premiums orders by clause 147 of the Workers Compensation Regulation 2003 (cl 4(5)). Finally, Schedules 1-4 are explicitly part of the Order (cl 9).
Main concepts
The Order rests on a small set of interlocking technical concepts and formula components. These are concrete inputs that drive the premium numbers.
Retro-paid loss premium method. The central concept is a method where an initial deposit premium is paid at policy commencement and the premium is revisited at prescribed later dates to reflect the actual costs experienced during the policy period. Clause 6 sets this out: the deposit premium is calculated at commencement and approximated later as the adjusted premium at each adjustment date.
Adjustment dates. Defined in cl 3(2) as 15, 24, 36, 48 and 60 months after the commencement of the period of insurance. The adjustment dates are the trigger points for recalculation of the premium (cl 3(2); Schedule 1, cl 1(2)).
Cost of claims. The Order uses the term “cost of claims” as defined in Division 4 of Part 20 of the Workers Compensation Regulation 2003 (cl 3(2)). Importantly, several Schedule definitions exclude the cost of journey claims and recess claims under sections 10 and 11 of the Act from the C and CG figures (Schedule 1 cl 2; Schedule 2 cl 6). That exclusion materially affects the base claim cost used in the premium formulae.
Basic tariff premium (T) and related tariff components. The deposit and adjusted premiums include a basic tariff premium, T, calculated under the General Order (Schedule 1 cl 2). The formulas also incorporate the experience adjustment factor (S or SG) from Schedule 3, the claims adjustment factor (V or VG) from Schedule 4, and other tariff add-ons from the General Order such as Q, D, M and A (Schedule 1 cl 2 definitions). The Order therefore operates as a modification layer on top of the baseline tariff architecture established in the General Order.
Experience adjustment factor (S; SG). Schedule 3 prescribes a formula for the experience adjustment factor for single employers (S) and for groups (SG). The factor references T and the sum of members’ tariffs TG, thereby linking past experience and group composition to how much an employer’s premium moves with actual claim costs.
Claims adjustment factor (V; VG). Schedule 4 sets fixed multipliers for V or VG keyed to the adjustment date and the elected large claim limit ($350,000 or $500,000). The V factor multiplies the measured cost-of-claims input to scale the premium adjustment, introducing an explicit ex ante recognition of tail-cost risk via the large claim election.
Bounds on premium movement: Pmin and Pmax. Schedule 1 defines Pmax and Pmin that cap and floor adjusted premiums. Pmin formulas differ by whether the recalculation occurs at the first/second adjustment date or the third/fourth/fifth adjustment date (Schedule 1 cl 2). These bounds constrain volatility in adjustments.
Group treatment and options. Schedule 2 provides a parallel set of deposit and adjusted premium calculations for employers who are members of a group. It requires calculation of group deposit and group adjusted premiums (PGd and PG) using aggregated measures TG and CG, a group experience factor SG and group claims factor VG. Schedule 2 also supplies three options for how a member’s adjusted premium is derived (clauses 3-5), with a specific fallback in Option 2 where CG = 0 instructing the member to adopt the Option 1 formula.
Minimum premium floor. Clause 7 imposes a hard minimum: deposit and adjusted premiums must not be less than $175. This is a direct override of formula outcomes where those formulas would produce amounts below $175.
Incorporation of the General Order and cross-references to the Workers Compensation Regulation 2003. The Order explicitly relies on the General Order for definitions, the basic tariff premium and other contribution items, and refers to the Workers Compensation Regulation 2003 for the definition of cost of claims and for the treatment of specialised insurer exemptions and the large claim election (cl 3(1)-(2); cl 4(4)-(5); Schedule 4).
These concepts interact to create a multi-stage, data-driven pricing mechanism that shifts some of the claims experience risk from the insurer to the employer over a multi-year horizon, subject to the floor and ceiling constraints set by the Order.
Who it affects
The Order applies to a narrow, defined set of actors and has specific exclusions. The primary person that ultimately bears the premium obligation is the employer who holds a retro-paid loss premium policy. Clause 4(1) limits application to employers “to whom the optional alternative method of calculating premiums under section 168A of the Act applies (retro-paid loss premium policies).” Therefore ordinary employers on standard tariff arrangements are outside the scope unless they opt into the section 168A alternative.
The insurer or premium administrator who issues or renews a retro-paid loss premium policy is a secondary affected party. The Order prescribes how premiums must be calculated, so insurers will need to implement the formulas and the periodic recalculations at the prescribed adjustment dates. Clause 4(2) specifies the timing window in which the Order applies to policies issued or renewed: policies taking effect on or after 4 pm on 30 June 2009 and before 4 pm on 30 June 2010. Clause 4(3) creates a contingency that keeps the Order in force for later policies if no replacement retro-paid loss premium order is made before 4 pm on 30 June 2010.
Small categories of insurers and policies are carved out. Clause 4(5) excludes policies issued or renewed by a specialised insurer that is exempted from insurance premiums orders by clause 147 of the Workers Compensation Regulation 2003. That carve-out shifts those specialised insurers and their policyholders out of this Order’s mechanical regime.
Where an employer is a member of a group, Schedule 2 directly governs premium calculations for both the group and the member employers. The group itself, defined in the Schedule 2 definitions, is therefore an actor with premium aggregation obligations: the Order requires aggregation of members’ tariff premiums (TG), cost of claims for the group (CG) and calculation of group deposit and adjusted premiums (PGd and PG) (Schedule 2 cl 6).
Other actors who will be affected in practice include accountants and payroll teams of employers because of cashflow and budgeting implications arising from deposit premiums and future adjustments. Claims administrators and actuaries will be affected due to the requirement to produce accurate cost-of-claims figures, excluding journey and recess claims, and to apply the claims adjustment multipliers from Schedule 4. Finally, regulators and auditors will be affected insofar as the General Order and the Workers Compensation Regulation 2003 are cross-referenced and compliance must be demonstrated against both instruments (cl 3(1)-(2); cl 4(4)-(5)).
The Order affects commercial choices that employers and groups make, because the values of V/VG depend on an election of large claim limit prescribed under clause 137(5) of the Workers Compensation Regulation 2003 (Schedule 4). That election exists in the Regulation and has a direct material effect on premium multipliers in this Order. The Order therefore interacts with decisions made under the Regulation, producing downstream effects for premium adjustments.
Key duties and rights
The Order establishes procedural duties for how premiums must be calculated and bounds that limit outcomes. It also embeds certain rights indirectly by specifying formulaic ceilings, floors and exclusions.
Duties imposed by the Order are primarily formulaic and timing related. Clause 6 requires that for the purposes of s 168A of the Act the alternative method of premium calculation is the one set out in this Order: calculate the deposit premium at policy commencement and then recalculate at each adjustment date in accordance with the applicable schedule (cl 6). Clause 8 sets out the required deposit calculation for employers and for employers who are members of a group, including different formulae before and on/after the first adjustment date (cl 8). Schedule 1, clause 1 obliges the user of the Order to apply the prescribed formulae to calculate deposit and adjusted premiums for general employers (Schedule 1 cl 1(1)-(2)). Schedule 2 imposes parallel duties for members of groups and requires the selection and application of one of the Options for recalculation (Schedule 2 cl 1-5).
There is a duty to observe the minimum premium of $175 for both deposit and adjusted premiums (cl 7). There is also an obligation to ensure adjusted premiums remain within Pmin and Pmax bounds calculated under Schedule 1 (Schedule 1 cl 1(2) and cl 2 definitions of Pmax and Pmin). For groups, the group adjusted premium PG must not be less than PGmin or greater than PGmax (Schedule 2 cl 6).
The Order places a duty, inherent in the formula inputs, to exclude journey claims and recess claims when calculating the cost of claims C and CG for the premium calculations (Schedule 1 cl 2; Schedule 2 cl 6). The Order also requires use of the basic tariff premium T and other tariff components Q, D, M and A as calculated under the General Order, which imports duties existing in that General Order into this methodology (Schedule 1 cl 2; cl 4(4)). The claims adjustment factor must be determined according to Schedule 4 and tied to the employer or group’s election under clause 137(5) of the Workers Compensation Regulation 2003 (Schedule 4).
Rights are mostly implicit and protective rather than affirmative. The Pmin and Pmax structures protect employers and insurers against unconstrained premium movement by placing ceilings and floors on adjustment outcomes (Schedule 1 cl 2). The minimum premium of $175 guarantees a predictable floor for premium receipts (cl 7). Groups are granted options with different calculation methods under Schedule 2, which effectively gives groups a choice among three methods to determine how the group’s and members’ adjusted premiums are derived (Schedule 2 cl 3-5). Schedule 2 also contains a specific right/mechanism where, if CG equals zero, Option 2 reverts to Option 1 for the member premium calculation (Schedule 2 cl 4). Clause 4(3) offers a continuity right to affected policies should a new order not be made by 30 June 2010 by keeping this Order in force until replaced.
The Order does not specify administrative process rights such as appeal mechanisms against a calculation. Any contest about a premium calculation would need to be resolved under the Act, the General Order, or other administrative review or dispute mechanisms that govern premium-setting and worker compensation premium disputes, but that procedural framework is not set out within this Order.
Penalties and enforcement
The Order itself contains no express penalties, fines or criminal offences. It is a subordinate instrument prescribing a calculation method “for the purposes of section 168A of the Act” (cl 6). Enforcement and penalties related to non-compliance with premium requirements, false statements to obtain a lower premium, or related misconduct would therefore be matters for the primary legislation (the Act) and the General Order’s enforcement provisions, if any, and not set out in this Order. The Order references and imports the General Order (cl 4(4)), which may contain enforcement or administrative compliance mechanisms; readers must consult the General Order and the Act for any sanctioning regime. Clause 3(1) explicitly sets definitions as having the same meaning as in the General Order unless this Order provides otherwise, which implies enforcement and procedural architecture will be those established in the General Order and the Act.
Schedule 4 links directly to elections under the Workers Compensation Regulation 2003 (clause 137(5) and clause 147 are cited in the Order), which suggests non-compliance with the Regulation could have knock-on effects for the calculation of V/VG, but the Order does not itself prescribe enforcement for breaches of that Regulation. If an insurer or employer were to apply the formulae incorrectly, any regulatory action would arise from the Act or other instruments that govern the insurer’s conduct, not from this Order’s text.
Because the Order establishes the method used to determine legally required premiums under s 168A, failing to apply the Order when the alternative method applies could lead to incorrect premium calculation and downstream legal consequences under the Act. The precise enforcement mechanics and penalties therefore must be sourced from the Act and the General Order rather than from this instrument. This Order is procedural and definitional rather than penal in character.
How it interacts with other laws
The Order is explicitly framed as an instrument that must be used “for the purposes of section 168A of the Act” (cl 6). It therefore operates as a subordinate rule under that statutory provision. Clause 3(1) makes the General Order the default source of meanings unless this Order provides otherwise; clause 4(4) imports the General Order (other than clauses 3 and 4) to apply to retro-paid loss premium policies unless displaced. Consequently, the Order interacts directly with two existing legal instruments: the General Insurance Premiums Order (the General Order) and the Workers Compensation Regulation 2003.
The Order borrows the definition of “cost of claims” from Division 4 of Part 20 of the Workers Compensation Regulation 2003 (cl 3(2)). Schedule 4 expressly ties the claims adjustment factor to an election under clause 137(5) of the Workers Compensation Regulation 2003, and clause 4(5) exempts specialised insurers that the Regulation exempts under clause 147. Thus the practical application of V or VG depends on an election and classification that are governed by the Regulation, not by this Order. Users must therefore consult the Regulation to determine whether a large claim limit has been properly elected and whether a specialised insurer exemption applies.
The Order also relies on the General Order to compute the basic tariff premium T and other components (Schedule 1 cl 2). Several variables, such as Q (premiums adjustment contribution), D (dust diseases contribution), M (Mine Safety Fund premium adjustment) and A (apprentice incentive amount), are defined as being calculated in accordance with the General Order (Schedule 1 cl 2). That means the retro-paid loss premium formulae are structurally dependent on the tariff architecture and contribution settings established in the General Order. Any amendment to the General Order that changes T, Q, D, M or A will feed into deposit and adjusted premiums derived under this Order.
The Order also interacts temporally with other instruments: it applies to policies taking effect in a one-year window from 4 pm, 30 June 2009 to before 4 pm, 30 June 2010, and clause 4(3) provides a bridge if a new order is not made by 30 June 2010. That temporal interaction means drafts or later orders will supersede this one; care is needed when reconciling overlapping or successive instruments.
Finally, the Order’s treatment of groups and group calculations likely intersects with other legal concepts such as group definitions under the General Order or corporate group definitions under relevant corporate and taxation law, but this Order itself defines the required aggregation measures (TG, CG) and sets out how group premiums and member premiums are to be calculated (Schedule 2). Any legal disputes about group composition or the allocation of claims costs between members will therefore require cross-reference to the General Order, the Act and the Workers Compensation Regulation 2003 for resolution.
Amendment history
The extant text provided is the Insurance Premiums Order (Retro-Paid Loss Premium Method) 2009-2010. Clause 2 states the Order commences at 4 pm on 30 June 2009 and must be published in the Gazette (cl 2). Clause 4(2) limits its direct application to policies taking effect between 4 pm on 30 June 2009 and before 4 pm on 30 June 2010, making the instrument explicitly time-limited to the 2009-2010 period for primary application (cl 4(2)). Clause 4(3) creates an express mechanism to keep the Order operative for later policies if a replacement retro-paid loss premium order is not made before 4 pm on 30 June 2010; therefore the Order contains a contingency that permits it to remain in effect pending a successor instrument (cl 4(3)).
Schedules 1-4 are declared to form part of this Order (cl 9). Clause 3(3) specifies that the explanatory note does not form part of the Order. The instrument explicitly cross-references the General Order (cl 3(1); cl 4(4)) and the Workers Compensation Regulation 2003 (cl 3(2); cl 4(5); Schedule 4 references), demonstrating that any historical or future amendment to those instruments would have consequential effects on interpretation and application of this Order.
The text provided does not show later amendments, revocations or replacement orders. No amendment schedules, instrument change notes or repeal provisions are included in the material supplied. Because the Order is time-limited in application and expressly contingent on the making of a replacement order, its operational life and any amendment history should be traced in the official legislative database and the Gazette entries that record commencement and any successor orders. The Order’s own clauses establish the initial commencement date and the window of primary application, and they provide a limited bridge to continuity if a successor instrument is not made by the specified time.
In practice, users should verify whether a later Insurance Premiums Order for retro-paid loss premium policies was made after the 2009-2010 instrument and whether that later order amended, replaced, or repealed this instrument. That follow-up is outside the text provided here and must be confirmed by consulting the official legislative history and Gazette notices.
Litigation history
The Order itself contains no case law, judicial interpretations, or references to decisions. The provided text does not list any litigation concerning the Order. Because this is an instrument of technical premium calculation established under the Act and referencing the General Order and Workers Compensation Regulation 2003, any litigation that would implicate the Order would likely appear in proceedings concerning premium calculation disputes, administrative law challenges, or statutory interpretation of s 168A of the Act. Those cases, if they exist, are not cited in the Order and are not in the supplied text.
Accordingly, within the boundaries of the material provided there is no litigation history to summarise. Practitioners should search judicial databases and administrative tribunal decisions for disputes arising from retro-paid loss premium calculations, group premium allocations under Schedule 2, or elections under clause 137(5) of the Workers Compensation Regulation 2003 that affect V/VG. That case law may exist independently of the Order and may illuminate issues such as the application of the Pmin/Pmax constraints, treatment of excluded claims (journey and recess), and proper construction of group aggregation rules. The Order itself, however, does not supply litigation history or precedent citations.
Gotchas
This Order contains several features that create operational and compliance traps if overlooked.
Temporal application window and continuity contingency. The Order applies primarily to policies taking effect between 4 pm 30 June 2009 and before 4 pm 30 June 2010 (cl 4(2)). Clause 4(3) keeps the Order in force for subsequent policies only if no replacement retro-paid loss premium order is made before 4 pm on 30 June 2010. Failure to check whether a successor order exists could lead to application of an incorrect methodology.
Minimum premium override. Clause 7 imposes a minimum premium of $175 for both deposit and adjusted premiums. This is a hard floor that overrides any lower formula result. If system calculations produce smaller figures because of low claims or application of Pmin mechanics, the $175 floor must be enforced.
Exclusion of journey and recess claims. Schedule 1 and Schedule 2 explicitly exclude the cost of journey claims and recess claims under sections 10 and 11 of the Act from C and CG. If claims datasets used for calculation do not correctly exclude these categories, C and CG will be overstated and adjusted premiums will be incorrectly high.
Dependence on General Order definitions and components. Several variables (T, Q, D, M, A) are defined or calculated under the General Order and are imported into this Order (Schedule 1 cl 2; cl 4(4)). Using inconsistent or outdated tariff inputs from a superseded or amended General Order will produce incorrect premiums. The General Order is deliberately referenced as providing baseline tariff elements.
Claims adjustment factor tied to large claim election. Schedule 4 requires identification of whether the employer or group has elected a large claim limit under clause 137(5) of the Workers Compensation Regulation 2003. That election materially changes V/VG (for example, 3.05 at first adjustment date under $350,000 versus 2.95 under $500,000). If an employer’s election is misrecorded, the multiplier applied will be incorrect. Determination of whether the employer or all members have elected a limit is a fact-specific enquiry tied to the Regulation.
Group aggregation complexity and option selection. Schedule 2 requires aggregation across members (TG, CG) and the group-level calculation PG/PGd. Members then derive their adjusted premiums under one of three Options. Selecting the wrong Option or misallocating group claims CE between members can materially alter member premiums. Option 2 contains a special-case fallback where CG equals zero leads to member premiums being calculated under Option 1; failure to apply that special case will produce inconsistent outcomes.
Pmin and Pmax bounds differ by adjustment date. Schedule 1 defines Pmin differently for first/second adjustment date than for third/fourth/fifth adjustment dates. The existence of different Pmin values requires time-aware implementation and careful date handling at recalculation points. Pmax is also defined in Schedule 1 and must be observed.
Data and timing mismatch risks. Adjustment dates extend up to 60 months after policy commencement. Employers and insurers must reconcile claim cost data that may change over time. The Order does not specify exact cut-off processes for finalising claim cost figures at an adjustment date, and dispute resolution mechanisms are not provided in this text, creating operational risk about what counts as final costs at each date.
Reference to external regulation for exemptions and definitions. Clause 4(5) and Schedule 4 refer to clauses 147 and 137(5) of the Workers Compensation Regulation 2003. Users must consult that Regulation to confirm a specialised insurer exemption or the large claim election details. Omitting that cross-check will lead to misapplication of V/VG or misclassification of an insurer.
Minimum deposit interplay with required deposit formula. Clause 8 prescribes required deposit formulae (different when the employer is a member of a group), but clause 7 enforces a $175 minimum. Implementers must ensure both clauses are respected simultaneously.
No administrative appeal or error-correction procedure in this Order. The instrument sets mechanical obligations but does not supply complaint, correction, or appeal procedures; those will be governed by the Act and the General Order. Practitioners should not assume a remedy exists within the Order itself.
How to comply
A practical compliance roadmap for employers, insurers and advisers follows directly from the Order’s mechanics. The steps below set out what must be done, when, what inputs are required, and recordkeeping considerations.
Establish whether the Order applies. Verify that the employer is operating under the optional alternative method in s 168A of the Act (cl 4(1)). Confirm the policy’s effective date falls within the primary application window (on or after 4 pm 30 June 2009 and before 4 pm 30 June 2010 per cl 4(2)), or, if outside that window, confirm whether no replacement retro-paid loss premium order was made by 4 pm 30 June 2010 such that cl 4(3) keeps this Order in effect.
Confirm whether the insurer is a specialised insurer. Check clause 147 of the Workers Compensation Regulation 2003 to determine whether the insurer is exempt and thus outside the Order’s application (cl 4(5)).
Determine group status. Establish whether the employer is a member of a group. If yes, Schedule 2 applies rather than Schedule 1 (Schedule 2 cl 1). For groups, identify all members and be prepared to aggregate member tariff premiums (TG), group cost of claims (CG), and other group-level inputs.
Obtain baseline tariff inputs from the General Order. Calculate or obtain the basic tariff premium T and any related components Q, D, M and A as required by Schedule 1 cl 2. Use the General Order’s specified calculation method relevant to the policy period (cl 3(1); Schedule 1 cl 2).
Calculate the deposit premium at commencement. For non-group employers, apply the Schedule 1 deposit formula at policy commencement (Schedule 1 cl 1(1)). For group members, apply Schedule 2 clause 2 deposit formula to derive PEd and PGd as required. Ensure the result is not less than $175 (cl 7) and respects any Pmin/Pmax constraints if applicable at that point.
Prepare for recalculation at each adjustment date. Note the five adjustment dates (15, 24, 36, 48, 60 months after commencement) per cl 3(2). On each adjustment date, the adjusted premium P is to be calculated using Schedule 1 cl 1(2) for single employers or the appropriate Schedule 2 option for group members (Schedule 1 cl 1(2); Schedule 2 cl 3-5). Ensure formulas are applied in a time-aware fashion because Pmin differs by early versus later adjustment dates (Schedule 1 cl 2).
Calculate claim cost inputs correctly. Produce C (single) or CG (group) using the “cost of claims” definition from Division 4 of Part 20 of the Workers Compensation Regulation 2003, ensuring journey claims and recess claims under ss 10 and 11 of the Act are excluded (Schedule 1 cl 2; Schedule 2 cl 6). Maintain transparent, auditable records showing the exclusion of these claim types.
Determine claims adjustment factor V or VG. Consult the employer’s or group’s election under clause 137(5) of the Workers Compensation Regulation 2003 to decide whether the relevant large claim limit is $350,000 or $500,000. Apply the corresponding V or VG multiplier from the Schedule 4 Table appropriate to the adjustment date (Schedule 4). Maintain documentation of the election and its applicability to the employer or all members (Schedule 4).
Compute experience adjustment factor S or SG. Use Schedule 3 formulas to compute S for single employers or SG for groups. That requires T or TG and applies the prescribed formula in Schedule 3. For groups, TG must be calculated in accordance with Schedule 2 cl 6 interpretations.
Enforce bounds and minimums. After computing the adjusted premium, ensure P is not less than Pmin or more than Pmax as defined in Schedule 1 (Schedule 1 cl 1(2) and cl 2). For group-level PG, ensure it is between PGmin and PGmax (Schedule 2 cl 6). Finally ensure deposit and adjusted premiums are not less than $175 (cl 7).
Account for tariff components from the General Order. Add or subtract Q, D, M and A as specified in Schedule 1 cl 2; ensure these items are current and correctly computed under the General Order.
Recordkeeping and audit trail. Store full calculation workpapers for deposit and each adjusted premium, including source data for C/CG, T/TG, S/SG, V/VG, the chosen Schedule 2 Option if in a group, and evidence of any elections under the Workers Compensation Regulation 2003. Keep records for the period necessary to demonstrate compliance with the adjustment regime up to 60 months from policy commencement given the longest adjustment date. Where an insurer issues group-level invoices or reallocates group adjustments to members, retain allocation schedules showing how CE was apportioned.
Communicate to employers and members. Provide clear disclosure at the point of sale and in renewal communications that the initial deposit premium will be recalculated at the listed adjustment dates and that actual costs excluding journey and recess claims will drive adjustments subject to Pmin/Pmax and the $175 floor. For groups, explain the Option chosen and the implications for member premiums.
Reconcile and settle adjustments. On each adjustment date, calculate the adjusted premium and reconcile any difference between deposit paid and adjusted premium. The Order itself does not set payment timing rules or dispute resolution procedures; coordinate payment or refund actions pursuant to the Act, insurer contractual terms, the General Order and any applicable regulatory guidance.
Monitor regulatory changes. Because the Order depends on the General Order and provisions of the Workers Compensation Regulation 2003, monitor both instruments for amendments that affect T, Q, D, M, A, the definition of cost of claims, large claim election rules and specialised insurer exemptions. If any referenced instrument changes, update calculation processes promptly.
Following these steps will align practical premium administration with the Order’s technical requirements. The principal compliance risks arise from incorrect claim classification (particularly failing to exclude journey/recess claims), misapplication of V/VG due to the wrong large claim election being used, failure to enforce the $175 floor and Pmin/Pmax constraints, and the complexity introduced by group aggregation and Option selection in Schedule 2.
Section 6Retro-Paid Loss Premium Method of premium calculation
(2) This Order applies to and in respect of retro-paid loss premium policies that are to be or have been issued or renewed so as to take effect on or after 4 pm on 30 June 2009 and before 4 pm on 30 June 2010.
(3) If, before 4 pm on 30 June 2010, an insurance premiums order that applies only to and in respect of retro-paid loss premium policies has not been made in respect of such policies of insurance taking effect on or after that time, this Order applies to and in respect of those policies pending the making of such an order.
(4) The General Order (other than clauses 3 and 4) applies to and in respect of retro-paid loss premium policies, unless this Order provides otherwise.
(5) This Order does not apply to a policy of insurance issued or renewed by a specialised insurer that is exempted from insurance premiums orders by clause 147 of the Workers Compensation Regulation 2003.
5 Classification of large employers
5 Classification of large employers
5 Classification of large employers
A large employer within the meaning of the General Order is classified a large employer under this Order.
6 Retro-Paid Loss Premium Method of premium calculation
6 Retro-Paid Loss Premium Method of premium calculation
6 Retro-Paid Loss Premium Method of premium calculation
For the purposes of section 168A of the Act, the alternative method is to calculate the premium for a policy of insurance at the commencement of the period of insurance (the deposit premium), and then recalculate the premium at each adjustment date (the adjusted premium), in accordance with this Order.
7 Minimum premium
7 Minimum premium
7 Minimum premium
Despite any other provision of this Order, a deposit premium and an adjusted premium in respect of any policy of insurance is to be no less than $175.
8 Calculation of required deposit: section 172A of Act
8 Calculation of required deposit: section 172A of Act
8 Calculation of required deposit: section 172A of Act
(1) The required deposit for an employer in relation to a policy of insurance is to be calculated in accordance with the following formula:
(a) before the first adjustment date:
(b) on and from the first adjustment date:
where:
RD is the required deposit in respect of the period of insurance to which the policy relates.
Pmax is the maximum premium that is payable by the employer calculated in accordance with Schedule 1.
PD is the deposit premium payable by the employer calculated in accordance with Schedule 1.
P is the premium payable by an employer for a policy of insurance calculated in accordance with Schedule 1.
(2) However, if the employer is a member of a group, subclause (1) does not apply and the required deposit for an employer in relation to a policy of insurance is to be calculated in accordance with the following formula:
(a) before the first adjustment date:
(b) on and from the first adjustment date:
where:
RD is the required deposit in respect of the period of insurance to which the policy relates.
PGmax is the maximum premium that is payable by the members of the group in respect of the period of insurance to which the group’s policies relate calculated in accordance with Schedule 2.
PGd is the deposit premium payable by the members of the group in respect of the period of insurance to which the group’s policies relate calculated in accordance with Schedule 2.
PEd is the deposit premium that is payable by the employer who is a member of a group calculated in accordance with Schedule 2.
PG is the group premium payable by the members of the group in respect of the period of insurance to which the group’s policies relate calculated in accordance with Schedule 2.
PE is the premium for the time being payable by an employer who is a member of a group in respect of the period of insurance to which the policy relates (including, where adjustments are required to be made to that premium by reason of the operation of this Order, the premium so payable by reason of those adjustments).
9 Schedules form part of Order
9 Schedules form part of Order
9 Schedules form part of Order
Schedules 1–4 form part of this Order.
Schedule 1 Method of calculation of deposit premium and adjusted premium—general
Schedule 1 Method of calculation of deposit premium and adjusted premium—general
Schedule 1 Method of calculation of deposit premium and adjusted premium—general
(Clause 8)
1 Calculation of deposit premium and adjusted premium
1 Calculation of deposit premium and adjusted premium
1 Calculation of deposit premium and adjusted premium
(1) The method for calculating the premium for a policy of insurance at the commencement of the period of insurance (the deposit premium) is as follows:
(2) The method for recalculating the premium for the policy of insurance at each adjustment date (the adjusted premium) is as follows:
but is not less than Pmin and not more than Pmax.
2 Interpretation
2 Interpretation
2 Interpretation
In this Schedule:
P is the adjusted premium for the time being payable by the employer in respect of the period of insurance to which the policy relates (including, where adjustments are required to be made to that premium by reason of the operation of this Order, the premium so payable by reason of those adjustments).
C is the total of the cost of claims for the employer in respect of the period of insurance (not including the cost of any claims under sections 10 (Journey claims) and 11 (Recess claims) of the Act).
V is the claims adjustment factor for the employer determined with respect to the period of insurance to which the policy relates in accordance with Schedule 4 of this Order.
PD is the deposit premium payable by the employer in respect of the period of insurance to which the policy relates.
Pmax is the maximum premium that is payable by the employer in respect of the period of insurance to which the policy relates, calculated as follows:
Pmin is the minimum premium that is payable by the employer in respect of the period of insurance to which the policy relates, calculated as follows:
(a) in relation to a premium calculated at the first or second adjustment date:
(b) in relation to a premium calculated at the third, fourth or fifth adjustment date:
V5 is the claims adjustment factor for the employer determined with respect to the period of insurance to which the policy relates in accordance with Schedule 4 of this Order in relation to the fifth adjustment date.
T is the basic tariff premium for the employer, calculated with respect to the period of insurance in accordance with the General Order.
S is the experience adjustment factor for the employer determined with respect to the period of insurance in accordance with Schedule 3 of this Order.
Q is the premiums adjustment contribution, if any, for the employer calculated with respect to the period of insurance in accordance with the General Order.
D is the dust diseases contribution, if any, for the employer calculated with respect to the period of insurance in accordance with the General Order.
M is the Mine Safety Fund premium adjustment, if any, for the employer calculated with respect to the period of insurance in accordance with the General Order.
A is the apprentice incentive amount, if any, for the employer calculated with respect to the period of insurance in accordance with the General Order.
Schedule 2 Method of calculation of deposit premium and adjusted premium—member of a group
Schedule 2 Method of calculation of deposit premium and adjusted premium—member of a group
Schedule 2 Method of calculation of deposit premium and adjusted premium—member of a group
(Clause 8)
1 Application of Schedule
1 Application of Schedule
1 Application of Schedule
Despite Schedule 1, if an employer is a member of a group, the provisions of this Schedule apply.
2 Premium at commencement of policy period
2 Premium at commencement of policy period
2 Premium at commencement of policy period
The method for calculating the premium for the policy of insurance at the commencement of the period of insurance (the deposit premium) is as follows:
3 Option 1
3 Option 1
3 Option 1
For members of a group to which Option 1 applies, the method for recalculating the premium for the policy of insurance at each adjustment date (the adjusted premium) is as follows:
4 Option 2
4 Option 2
4 Option 2
For members of a group to which Option 2 applies, the method for recalculating the premium for the policy of insurance at each adjustment date (the adjusted premium) is as follows:
However, if CG= 0, then the premium is to be calculated in accordance with the formula set out for Option 1 in clause 3.
5 Option 3
5 Option 3
5 Option 3
For members of a group to which Option 3 applies, the method for recalculating the premium for the policy of insurance at each adjustment date (the adjusted premium) is as follows:
6 Interpretation
6 Interpretation
6 Interpretation
(1) Terms that have a meaning in Schedule 1 have the same meaning in this Schedule.
(2) In this Schedule:
PEd is the deposit premium payable by the employer who is a member of a group in respect of the period of insurance to which the policy relates.
PGd is the group deposit premium payable by the members of the group calculated as follows:
PGmin is the minimum premium that is payable by the members of the group in respect of the period of insurance to which the group’s policies relate, calculated as follows:
(a) in relation to a premium calculated at the first or second adjustment date:
(b) in relation to a premium calculated at the third, fourth or fifth adjustment date:
PGmax is the maximum premium that is payable by the members of the group in respect of the period of insurance to which the group’s policies relate, calculated as follows:
TE is the basic tariff premium for the employer who is a member of a group calculated:
(a) where the period of insurance to which the premium relates is 12 months—in accordance with Schedule 3 of the General Order with respect to that period of insurance, or
(b) where the period of insurance to which the premium relates is not 12 months—in accordance with Schedule 3 of the General Order as if the policy to which the premium relates had a period of insurance of 12 months.
TG is the sum of the basic tariff premiums for all the members of a group calculated:
(a) where the period of insurance to which the premium relates is 12 months—in accordance with Schedule 3 of the General Order with respect to that period of insurance, or
(b) where the period of insurance to which the premium relates is not 12 months—in accordance with Schedule 3 of the General Order as if the policies to which the premiums relate had a period of insurance of 12 months.
SG is the experience adjustment factor for a group of which the employer is a member determined with respect to the period of insurance to
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