1 August 2017 THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE 2995

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1 August 2017THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE2995PETROLEUM AND GEOTHERMAL ENERGY ACT 2000Surrender of Geothermal Exploration Licence—GEL 611NOTICE is hereby given that I have accepted the surrender of the abovementioned geothermal exploration licence under the provisionsof the Petroleum and Geothermal Energy Act 2000, pursuant to delegated powers dated 31 March 2017:No. ofLicenceGEL 611LicenseeOsiris Energy LtdLocalityEffective Date ofSurrenderReferenceOtway Basin15 July 2017F2012/000749Dated 21 July 2017.B. A. GOLDSTEIN,Executive Director,Energy Resources Division,Department of the Premier and Cabinet,Delegate of the Minister for Mineral Resources and EnergyPETROLEUM AND GEOTHERMAL ENERGY ACT 2000Suspension of Petroleum Exploration Licence—PEL 629PURSUANT to Section 90 of the Petroleum and Geothermal Energy Act 2000, notice is hereby given that pursuant to delegated powersdated 31 March 2017, the abovementioned Petroleum Exploration Licence has been suspended for the period from and including2 June 2017 until 1 June 2018.The expiry date of PEL 629 is now determined to be 1 September 2022.Dated 21 July 2017.B. A. GOLDSTEIN,Executive Director,Energy Resources Division,Department of the Premier and Cabinet,Delegate of the Minister for Mineral Resources and EnergyRETURN TO WORK ACT 2014Code of Conduct for Self-Insured EmployersPreambleSubsection 129 (5) (d) of the Return to Work Act 2014 (the Act) states that registration as a self-insured employer under that section issubject to a condition that the self-insured employer will comply with any code of conduct for self-insured employers determined by theCorporation from time to time and published in the Gazette.NOTICEPURSUANT to subsection 129 (5) (d) of the Act, I hereby give notice that the attached document is the Code of Conduct forSelf-Insured Employers determined by the Corporation and published in the South Australian Government Gazette. The Code ofConduct for Self-Insured Employers will have effect from the date of Gazettal.Confirmed as a true and accurate record of the decision of the Corporation.Dated 24 July 2017.J. YUILE, Board Chair

2996THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE1 August 2017ReturntoWorkSACode of conduct forself-insured employersVersion 2Author:Release Date:Review Date:RegulationAs published in the Government GazetteJune 20 9Return to work.Return to life. Government ofSouth Australia

1 August 2017THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE2997ContentsGLOSSARY . .PREAMBLE . .CHAPTER . . .Obligations of a self-insured emp loyer . . . . . .Application . . . . . . . . 2.Obligations of a self-insured employer . . .3.Exercise of de legated powers and discretions . . ·4·Self-insured employer fee . . . . .s.Financial distress . . . . . . . .6.Actuarial reports . .7.Guarantees . . . . . .8.Excess of loss insurance . . . . .g.Annual reports . . o.Schedule 3 of the Regulations . . .n.Provision of data . . 2.Notification of lump sum payments . . . . 3.App lication of the Statement of Service Standards . . 4.Employe r's duty to provide suitable employment and notice of termination of employment. . . . . s.Cooperation on information exchange .

2998THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE1 August 20171.16.Incidence of Liabilit y . . . . . .1.17.Continuous Disclosure .1.18.Other terms . . . .CHAPTER 2 . .2.ELIGIBILITY AND ASSESSMENT CRITERIA . . .2.1.Application . . . .2.2.Satisfaction ofReturnToWorkSA .2.3.Section 129 (11) of the Act assessment criteria . . . .CHAPTER 3 . .3·APPLICATIONS FOR INITIAL GRANT OF REGISTRATION AS A SELF-INSURED EMPLOYER . .3.1.Scope .3.2.How to apply .3·3·Expression of interest . .3 Application . . . . . . .3·5·Assessment process .3.6.Va luation of Liabi lity Transfer Payment . . . .3·7·Decision by the Board .3.8.Group registration . . . . .3·9·Effective date of registration .3.10.Initial period of regi stration . .CHAPTER 4 . .4·EVALUATIONS .

1 August 2017THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE29994.1.Application . . . .4.2.Application for renew al . . .4·3·Eva luations . . . .4·4·Review process .CHAPTERs . . .5·GROUP SELF-INSURED EMPLOYERS AND CORPORATE RESTRUCTURE . .5.1.App lication . . .5.2.Group employers . . . .5·3·Subsidiary of a foreign company which is a holding company . .5-4·Amalgamations . . .CHAPTER 6 . .6.REDUCTION, REVOCATION, AND APPEALS . .6.1.App lication . . .6.2.Notification . . . . .6.3.Statutory criteria . .6.4.Process of reduction or revocation of reg istration . .6.5.Removal of delegation .6.6.Prosecution . . . . . .6.7.Appea ls to the Minister .CHAPTER 7 . .7·TERMINATION/EXPIRATION OF REGISTRATION .7.1.Application . .

3000THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE1 August 20177.2.De legatio n of powers and disc ret ions . . . . . . . .7·3·Assumption of liabilities . . . .7·4·Va luat ion of capita lised liabilit ies . . . . . . . .7·5·Run off of claims . . .7.6 .Treatment of Claim files on cessation of self -insu rance . . . . . .

1 August 2017THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE3001Please refer to the fol lowing definitions w hen reading and interpreting the Code.GLOSSARYMeaningActthe Return to Work Act 2014Boardthe Boa rd of Management of Return ToWorkSA as constituted by the RTWCA.Code of conduct (Code)the self-insured employer code as amended from t ime to time and publ ished in t heGazette pursuant to section 129(5)(d)Compensation Fundthe Compensation Fund pursuant to section 135 of the ActCrownthe State of South Australia and any agency or instrumentality of t he Crow n in rightof the State of South Austra lia.Current Assetscash and other assets that can be converted to cash with in a year.Current Liabilitiesamounts due to be paid to creditors w ith in t w e lve months.employeremployer has t he same meaning as in section 4 of the Act and includes whereapplicable a group of employers.fo reign companyhas t he same meaning as in section 129 of the ActFul l time equivalentemployeesmeasure of employees based on no less than 35 hours per worker per week.Gazetteas defined in section 4(1) of t he Acts Interpretation Act 1915group of self-insuredemployersa group of self-insu red emp loyers registered under section 129(3) of t he Actholding companyhas t he same meaning as in section 129 of t he Actindustrial associationas defined by section 4 of the ActLabour hire workera labou r hire w orker is a person engaged through a labour hire company. Theseworke rs may be employed directly by the labour hire company, or by the labour hirecompany t hroug h a third party .Loan Capitalcurrent borrowings plus non-current borrow ingsNet profit before taxnet profit before ta xNet Salesrevenue from sale of goods or servicesnon-compl iancea breach of, or fa il ure to comply, w ith the Act, any Regulations or dete rminationsmade under t he Act or a term or condition of reg istrationnumber of employeesfo r the purposes of section 129(11) of the Act the numbe r of employees is calculatedin a manner consistent with Clause 2.3.1Operating Cash Flownet cash flow from operating activities. Does not include cash fl ows f rom investingactivities.Regulationsthe Return to Wo rk Regulations 2015related bodies corporatehas t he same meaning a s in section 129 of t he Act----

3002THE SOUTH AUSTRALIAN GOVERNMENT GAZETTETermMeaningrelevant legislationThe relevant legislation includes:1 August 2017 the ActRegulationsthe WHS Actthe WHS Regu lations the RTWCAany other legislation of either the State or Com monwealth pa rliam ents thatmay directly or ind irectly affect the safety of w orkers in the se lf-insuredemployer's w orkplace or the management or administration of w orkerscompensation claimsRTWCAthe Return To Work Corp oration of South Austra lia Act 1994Return To WorkS Athe Return to Work Corporation of South Australiaself-insured feehas the same meaning as in sectio n 146 of the ActSchedule 3Schedule 3 to the RegulationsSchemethe Retu rn to Work Schemeself-insured employeran employe r or group of employers reg istered by Return ToWorkSA as a self-insuredemployer pursuant to section129 of the ActStandardsInjury Manage m ent Standards for Se lf-insured Employers and WHS Standards forSelf- insured Emp loyersTotal equityshareholder funds (Equity)Total liabilit iescu rrent liabil ities plus non-current liabilitiesTotal tangible assetstota l current and non-cu rrent assets less intangible assetst ransferred liabi lityliabi lities of the se lf-insured employer unde r section 64(2) and 64(3) of the Act.WHS Actthe Work Hea lth and Safety Act 2012 (SA)WHS employerregistration feet he f ee payab le under t he Sout h Austral ia W ork Hea lt h and Saf ety Act 2012workerhas the same meaning as in sectio n 4 of t he Actw ork injuryhas the same meaning as in sectio n 4 of t he Act--

1 August 2017THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE3003PREAMBLENote: Terms in italics are defined in the Glossary.A.The purpose ofthis CodeThe purpose of the Code is to:B. constitute a code of conduct for self-insured employers that each self-insured employer must complywith as a condition of its registration pursuant to section ng(s)(d) of the Act; and ensure all self-insured employers are aware of the ongoing obligations of registration as a self-insuredemployer; and express those terms and cond itions to which registrat ion of all self-insured employers are subject to asdetermined by Return ToWorkSA under section 129(5)(a)(iii) of the Act (but not those terms andconditions that have been determined by ReturnToWorkSA to be applicable to an ind ividual selfinsured employer.)Board Policy on Self-insuranceThe Board's Policy on self-insurance is published on the ReturnToWorkSA website. An employerconsidering an app lication for registration as a self-insured employer or as a member of a group of selfinsured employers should be familiar with the Board Pol icy.Through the Policy on Self-insurance and the Code, the Board recognises,(1)The Act contains provision for self-insured employer status as an integral part of t he Scheme.(2)The financia l securit y of the Scheme is viewed as a relevant matter in the administration andcontinuation of self-insured employer registrations.(3)Self-insured employer status should only be made ava ilab le to fit and proper employers, capable ofachieving and mainta ining t he required level of performance as described in the Code andcompliance with the requirements of the Act.(4)Self-insured employer status should only be made ava ilab le to employers who can satisfy the Boardas to t heir ability to continue to meet all obligations of registration as a self-insured employer, andthat the granting of self-insured employer status is consistent with:(5)(a)the best interests of the Compensation Fund (not applicable to applications fo r renewal of aregistration as a self-insured employer); and(b)the achievement of t he objects and functions specified in the RTWCA and t he Act.All self-insured employers are required to maintain compl iance with the Code throug hout the periodof registration. Failure to comply may resu lt in a potential revocation or reduct ion of a registrationas a self-insu red employer, conditions being placed on the self-insured emp1oyerregistration, orrefusal to renew a self-insured employer registration.

3004C.THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE1 August 2017InconsistenciesThe Code and the relevant legislation operate concurrently.Whe re there is an inconsistency betw een the Code and a provision of t he relevant leg islatio n, t he relevantleg islat ion w ill prevai l.

1 August 2017THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE3005CHAPTER 11.Obligations of a self-insured employer1.1 .ApplicationThis chapter applies t o employers registe red as self-insured employers under section 129 of the Act.1.2.Obligations of a self-insured employerReg istrati o n as a self-insured employer is subject t o,1.3 .a)comp liance with the requ ire ment s of t he Actb)such other terms and condit ions as ReturnToWorkSA determines from t ime t o t ime or as arep rescribed by t he Regulationsc)a condit io n that a self-insured employer or a group of self-insured employers w ill comply w it h anycode of conduct determined by ReturnToWorkSA f rom t ime to time and pub lished in t heGazette; andd)any other te rm s and cond itions determined by ReturnToWorkSA t o be app lica ble to anindividual self-insured employer or a group of self-insured employers.Exercise of delegated powers and discretionsAt all t imes, a self-insured employer must have avai lable an emp loyee (o r employees) authorised toexercise delegated powers and d iscretions pursua nt to s 134 of the Act. These powers and discretionscannot be further de legated to any person or to a n unrelated body corporate .1.4.1.5 .Self-insured employer feea)Pursuant t o section 146 of the Act, a self-insured employer fee is payable by a self-insuredemployer.b)The fee for a ll self-insured employers is subject to an annual review by t he Board. The outcomeof any review is applied from the commencement of the follo wi ng financia l year (1 July eachfina ncia l year).Financial distressFinancial stability a nd the ab ility to contin ue to meet the financial obligations of self-insu rance areessential t o the maintenance of a self- insu ra nce re g istrat io n. Therefore, a self-insured employer mustnotify ReturnToWorkSA immediately if it is in, or reasonably expects to be in, financial distress.a)For the purposes of th is clause, a self-insured employer is in financia l d istress if it :(i)is in liqu idation or p ro visiona l liquidat io n o r unde r administration(ii)has a contro ller (as defined in the Corporatio ns Act 2001) o r analogous pe rson appo intedto it or any of its property or if any steps are take n for such an appointment(iii)is taken under section 459F(1) ofthe Corporations Act 2001 to have fai led to com p ly w itha statut ory demand

3006THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE1 August 2017(iv)is unable to pay, or stops or suspends or th reatens to stop or suspend payment of, itsdebts(v)an application or orde r, other than an appl ication contested in good faith w hich is stayed,dismissed or w ithd rawn w ithin 4 days, is made, or a resolution is passed, for its windingup or notice is given of an intention to ma ke such an appl ication o r propose such aresolut ion other than a so lvent reconstruction or amalgamationi(vi)is otherwise inso lvent(vii)enters into a compromise or arrangement w ith, or an assignment for t he benefit of, anyof its members or creditorsi or(viii) suffers an event analogous to any of the events described in th is clause.1.6.1.7.Actuarial reportsa)A self-insured employer must submit an actuaria l report w it hin three mont hs of t he end of t heself-insured employer's financial year.b)The actuarial report must be prepared by an actuary, fo llow ing Return ToWorkSA 's actuarialguidelines for self-insured employers, as publ is hed on the ReturnToWorkSA Website.Guaranteesa)A self-insured employer must provide a financial guarantee determ ined in accordance w ithb)Schedule 3·The financia l guarantee must be:c)(i)an unconditiona l undertaking to pay money on demand(ii)a continuing guarantee(iii)provided by a financial institution that is not related to the self-insured employer and thathas a Standard & Poor's credit rating not less than A . ReturnToWorkSA will, accept aguarantee from an institution that has an A or A- rating provided t hat the guaranteefrom that institution in respect of any one self-insured employer does not e xceed 2millioni and(iv)prov ided by a financial institution that is subject to prudential regu latio n by theAustral ian Prudential Regulation Authority (APRA), unless ReturnToWorkSA decidesotherw ise.A self-insured employer may request ReturnToWorkSA to accept other fo rms of secu rit y, whichprovide a comparable leve l of security. ReturnToWorkSA will have t he sole d iscretion as towhethe r to accept such a lternative forms of security.1.8.Excess of loss insurancea)A Self-insured employer must obtain and maintain an excess of loss insurance policy andproduce evidence of its existence, to the satisfaction of ReturnToWorkSA.b)Such excess of loss insurance must satisfy the following:(i)not less than oomillion on the sum insured,

1 August 2017c)THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE(ii)a deductible of not less than 5oo,ooo per event or series of related events, and(iii)if the self-insured employer elects to include a stop loss excess or an aggregate excess,such stop loss or aggregate excess must not be less than the higher of:(A)three t imes the ind ividua l event excess, or(B)Ten percent above the average incurred claim cost for the threeimmediately prior years.3007The excess of loss policy must not be contingent on the so lvency of the self-insured employer, agroup of self-insured employers or member of a group of self-insured employers.1.9.Annual reportsa)1.10.A Self-insured employer must:(i)Provide audited annua l financial statements no later than five months after the expiry ofthe self-insured employer's financia l year.(ii)notify ReturnToWorkSA in the event of any change to the position of:(A)Ch ief Executive Officer of the self-insured employer, or(B)any officer or officers, who has responsibi lity for t he compliance of t he employerwith the requi rements of the WHS Act and inj ury management systems.Schedule 3 of the RegulationsA self-insured employer must comply with any po licies or requirements notified by ReturnToWorkSAfrom time to t ime in relat ion to the application of Schedule 3, including but not limited to the currentversion of the Se lf-Insured Employer EDI Technical Specification published on the ReturnToWorkSAwebsite.1.11.Provision of dataa)A self-insured employer wil l have compl ied w ith these obligations if it establishes and maintainsa consistent and regular pattern of data provision. For these purposes, a 'consistent andregu lar pattern' will be:(i)data provided within the reporting period of 14 days or such other time as approved orstipulated by ReturnToWorkSA;(ii)no more than two missed or fa iled/rejected data transmissions in any six-month period;(iii)no occu rrences of two or more consecutive missed or fa iled/rejected transmissions;(iv)all errors at batch and line levels reso lved within one month;(v)all coding queries resolved within one month;(vi)when the self-insured employer changes its claims database, it should discuss thearrangements for data transmissions during the period of system transition w ithReturnToWorkSA, to ensure any resulting lapse in data transmission does not exceed onemonth, or where delays are beyond the control of the self-insured employer, such otherperiod as agreed between ReturnToWorkSA and the self-insured employer;

3008THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE(vii)1 August 2017when ReturnToWorkSA changes the data requirements, the self-insured employer meetsthose new data requirements within t hree months of being notified of those changes;and(viii) when an employer is first granted reg istration as a self-insured employer, an operationa land comp liant claims database must be implemented with transmissions commencingwithin three months after the first grant of registration.1.12.Notification of lump sum paymentsa)W ithout limitation, lump sum payments will ordinarily include:(i)b)redemptions of future:(A)income maintenance; or(B)costs pursuant to section 33 of the Act;(ii)econom ic loss compensation payments pursuant to section 56 of t he Act;(iii)non-economic loss compensation payments pursuant to section 58 of the Act;(iv)a commutation paid under section 59 of t he Act in respect of weekly payments arisingfrom the death of a worker; and(v)a lump sum payment to a spouse, or dependant of a deceased worker under section 6 ofthe Act.Notificat ion(i)A self-insured employer must, w ithin 4 days of making a payment:(A)on a lump sum to a worker; or(B)any addition or alteration to a determination in paragraph (A),complete and fo rward to ReturnToWorkSA a notification ofthat lump sumdetermination, addition, or alteration.(ii)The notification must be in such form as ReturnToWorkSA may approve from time totime.(iii )The notification must be accompanied by a copy ofthe determination.(iv)The follow ing information must also accompany the notification:(A)for any redemption, a copy of the redemption agreement and SAET orders(B)for any income maintenance redemption, t he amount of weekly incomemaintenance redeemed and t he cu rrent rate of notional weekly earnings(C)a copy of the most recent determination of weekly payment entitlements statingthe section 49(2) amount(D)for a non-economic loss compensation payment, the determinations statingpercentage of injury upon which the calculation is based

1 August 20171.13.THE SOUTH AUSTRALIAN GOVERNMENT GAZETTE(E)for economic loss compensation payments, the determination wh ich identifies allfactors specified by section 56 (4) demonstrating how the lump sum wasca lcu lated; and(F)for recoveries aga inst a third party wrongdoer unde r section 66 of the Act, a copyof t he deed of release stating the amount of damages reta ined by t he worker andthe rate of payments t he worker will be taken to be receiving under section 49 (3)of t he Act.3009Application ofthe Statement of Service StandardsIn applying the statement of service standards, the employer or self-insured employer will :1.14.a)ensure procedu res are in place which describe how t he self-insured employer will meet therequi rements of the statement of service standardsb)ensure that all providers of relevant services engaged by the self-insured employer meet therequi re ments of the statement of service standardsc)provide to ReturnToWorkSA within 30 days of receipt a copy of any investigation reportprovided to it by the State Ombudsman; andd)any investigation report provided by the Ombudsman and provided to ReturnToWorkSA mustbe accompanied by written details of any corrective actions undertaken or being underta ken bythe self-insured employer to address any substantiated compla int.Employer's duty to provide suitable employment and notice of termination of employmenta)A self-insured employer must ensure compliance with sections 8 andb)Self-insured employers, as large and diverse businesses, in the main will be able to create20of the Act.opportunities to provide su itable employment to inju red workers. Situations will however arisewhere self-insured employers may not be able to achieve th is.c)A self-insured employer must on informing a worker of an inability to provide suita bleemployment, also not ify ReturnToWo

Corporation from time to time and published in the Gazette. NOTICE PURSUANT to subsection 129(5) (d) of the Act, I hereby give notice that the attached document is the Code of Conduct for Self-Insured Employers determined by the Corporation and published in the South Australian Government Gazette. The Code of

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