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:
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:
(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:
(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.
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
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 Amerisure 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. Amerisure reported a positive net premium of $937,504.00 for the third quarter, resulting in an assessment of $13,688.00 for the third quarter. Reducing this by the "prior balance carried forward" resulted in an amount due of $9,974.01.
Similarly, in 2008, Amerisure reported positive net premiums for the first three quarters of the calendar year totaling $37,925,003 and paid WCATF assessments totaling $94,813. For the fourth quarter of 2008, Amerisure reported a negative net premium of $1,271,387, and paid no assessment. In this way, Amerisure paid $3,178.47 more (in estimated payments during the first three quarters of 2008) than it owed for its 2008 WCATF annual assessment. In 2009, Amerisure reported negative net premiums in each quarter and paid no WCATF assessments.
On September 16, 2012, Amerisure submitted an application for refunds of monies paid to the SDTF and the WCATF from October 26, 2010 through July 26, 2012.
The Department took the position that to allow Amerisure to obtain in addition the cash refunds Amerisure requested "would be inconsistent with the provisions" of Sections 440.49(9)(b) and 440.51(1), Florida Statutes. The Department concluded Amerisure was not entitled to any money from the State Treasury or to any "credits" based on the negative net premiums reported during 2009 because it paid no assessments into either the WCATF or the SDTF in 2009.
Amerisure then filed a petition for a formal administrative hearing, challenging the notice of intent to deny its applications for refund, and alleging that unadopted rules were the basis of the notice of intent to deny. Amerisure contended the Department treated "credit balances" accrued in 2009 as "excess credits," which had to be forfeited at the end of the calendar
The administrative law judge (ALJ) rejected the Department's position that "credits" based on negative net premiums in 2009 never actually assumed any legal significance. The ALJ cited the entries on the reporting forms sent to Amerisure each quarter and reasoned in her recommended order that the forms indicated "credits" had accrued in 2009. The recommended order recited that Department staff acknowledged "eliminating" the 2009 "credits" when the 2010 quarterly reporting forms were sent to Amerisure.
In the recommended order, the ALJ attributed the Department's denial of refunds to the first of two putative, unadopted rules. The recommended order identified two statements as agency policies that met the definition of a rule but had not been adopted through the rulemaking process: (1) any credits accruing in a calendar year in which net premiums are negative for each quarter are excess credits that are eliminated at year end and cannot be carried over to the next calendar year; and (2) credits can be carried forward for a three-year period from one calendar year to the next as long as the insurer had at least one quarter per calendar year with positive net premium; although after three years the credits are eliminated unless the insurer requests a refund. Finding the Department had not demonstrated circumstances excusing a lack of rulemaking as contemplated by section 120.57(1)(e), the ALJ determined Amerisure was entitled to recover fees and costs pursuant to section 120.595(4)(a), Florida Statutes.
The ALJ determined that a "credit" was created "by Amerisure paying more out in refunds and dividends than it wrote or collected in premium.... The Department implicitly acknowledged that reality when it calculated a credit for each quarter in 2009 and included that credit on the forms it forwarded to Amerisure for its quarterly reports." The ALJ recommended that the "Department enter a final order ... reinstating Amerisure's 2009 credits as credits toward future assessments due to the Trust Funds." But, as the recommended order itself acknowledges, the governing statutes say nothing whatsoever about credits for "paying more out in refunds and dividends" than premiums received in a calendar year or carrying any such putative credits forward.
The ALJ determined the Department's position was "not a simple application of the law to the information provided, because no statute referenced by the Department makes any mention of excess credits and how they are to be treated." The statute makes no mention of "credits," excess or otherwise. Indeed, the ALJ concluded that the Department's elimination of the 2009 "credits" was based on an erroneous interpretation of section 624.5094 on grounds that the provision "does not address credits in any way, and certainly does not mandate that credits be eliminated should a carrier have four quarters in a year where negative premiums were reported." That the statute does not "address credits in any way" led the Department to different conclusions.
The Department rejected the ALJ's view that Amerisure accrued credits that could be applied against subsequent years' SDTF and WCATF assessments as a result of negative net premium in the year 2009. Focusing on the statutes, not the forms, the final order ruled the ALJ had
The Department's final order stated the ALJ's legal conclusions were in error because "there is neither statutory nor constitutional authority for the Division to create free-standing tax credits redeemable from the State Treasury for the benefit of a private insurance carrier that paid nothing [for the year 2009] in assessments to the Division." The final order concluded instead:
Regarding the purportedly dispositive, unadopted rule, the Department again emphasized that there was no statutory authority for calculating "credits" on the basis asserted by Amerisure, given the plain meaning of section 624.5094: "Simply put, an insurer that has not paid an assessment is not entitled to a refund of a portion of that `non-assessment' just because it has experienced a `negative net premium' for an entire assessment year.... What the Recommended Order brands as an illicit non-rule policy of `eliminating' the `excess credits' ignores that the supposed `policy' is merely ... the plain meaning of the applicable statutes."
In rejecting the ALJ's conclusions of law, the final order did not ignore or reject any finding of fact the ALJ made. An agency may not reject an ALJ's findings of fact "without first finding, after a review of the entire record, that the ALJ's factual findings were not supported by
The final order discussed the various forms filled out by Amerisure and the Department in the present case in some detail. The fact that the credit based on reported negative net premium in 2008 was carried forward while the "credit" based on 2009 reported negative net premium was not carried forward was addressed head on in the final order:
(Internal citations omitted.) That the quarterly forms indicated increasing "credits" during 2009 based on the quarterly reports of negative net premium is not disputed by the Department. The ALJ's statement that the forms "clearly indicated accrued credits," to the extent this references the increasing amount of the "credit" indicated in each succeeding quarter, is a factual finding supported by competent, substantial evidence, a factual finding the Department accepted.
To the extent the ALJ determined Amerisure had "accrued credits" that had "come into existence as an enforceable claim or right" under any set of facts, however, such a determination must necessarily have been a legal conclusion.
At issue finally is a question of statutory interpretation, as to which the standard of review is de novo. An agency
Sullivan v. Fla. Dep't of Envtl. Prot., 890 So.2d 417, 420 (Fla. 1st DCA 2004).
Amerisure's contention that a carryforward of a "credit" from a year in which it paid no assessment is necessary in order for it to be made "whole" overlooks the basic fact that the governing statutes levy an assessment on carriers — not on policyholders. See §§ 440.49(9)(b)1., Fla. Stat. (2008) ("The Special Disability Trust Fund shall be maintained by annual assessments upon the insurance companies writing compensation insurance in the state....") (emphasis supplied); 440.51(1)(b), Fla. Stat. (2008) ("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 ... are the basis for computing the amount to be assessed.") (emphasis supplied); 440.51(5), Fla. Stat. (2008) ("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' compensation insurance on contracts or policies of said insurance carrier....") (emphasis supplied).
The insurance carrier does not act as an agent of the state to collect and remit assessments levied on the employers it insures in the way retailers collect sales taxes their customers owe.
The applicable statutory provisions call for calculating assessments one year at a time. Section 624.5094 only authorizes deductions or offsets "against the current
For all the same reasons, the Department did not err in rejecting the ALJ's conclusion that the Department improperly applied unadopted rules to "eliminate" Amerisure's 2009 "excess credits." An "unadopted rule" is "an agency statement that meets the definition of the term `rule,' but that has not been adopted pursuant to the requirements of" section 120.54, Florida Statutes. § 120.52(20), Fla. Stat. (2014). "Rule" means "each agency statement of general applicability that implements, interprets, or prescribes law or policy or describes the procedure or practice requirements
"An agency ... may not base agency action that determines the substantial interests of a party on an unadopted rule." § 120.57(1)(e)1., Fla. Stat. (2014). The Department did not do so here.
Statements in the proposed draft rules and draft policy and procedures manual
The Department's construction and application of section 624.5094 in the present
Affirmed.
LEWIS, C.J. and RAY, J., concur.
(Boldface omitted.) See also § 212.17, Florida Statutes (2014):
(Boldface omitted.)
In explanation of the conclusion that these findings established statements of policy that constituted unadopted rules, the ALJ stated only that the Department had held the stated position "at least since 2004" and "the Department's position is not a simple application of the law to the information provided, because no statute referenced by the Department makes any mention of excess credits and how they are to be treated." The fundamental problem with the ALJ's conclusion is that section 624.5094 precludes carrying forward negative net premium from one calendar year to a subsequent calendar year, thereby precluding the "credits" at issue in the first place.
The fact that "credit" calculations based on Amerisure's 2009 quarterly reports of negative net premium appeared on the quarterly assessment forms was not sufficient to establish that Amerisure had a statutorily authorized entitlement to such "credits" so that the Department was required to establish authority (by statute or rule) to "eliminate" the credits. The notation of credits (or debits) on the Division's pre-printed forms appears to be a bookkeeping device to carry forward information from one quarter to the next, a result of the fact that the assessments at issue are actually annual assessments even though the statutes set forth quarterly reporting requirements. It is therefore both irrelevant and completely understandable that nothing in section 624.5094 "mandates that credits be eliminated under any circumstances."