Experience Rating / RULE 2

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A. ELIGIBILITY

All employers with New York exposure during the experience period are eligible for participation in the experience rating plan.

B. RATING EFFECTIVE DATE

  1. The Rating Effective Date appears on a risk’s experience rating worksheet. It is the earliest date that a specific modification is applied to a policy.  To determine modification application, refer to Rule 4 Section (D) of this Plan.

    The Rating Board establishes the rating effective date. In most cases, a risk’s rating effective date is the same as its policy effective date.

    Note: Wrap-up policies are not used to determine rating effective dates. Refer to Rule 5 Section (A)(4) of this Plan for information on wrap-up policies.

  2. The rating effective date may differ from a risk’s Policy Effective Date for reasons including, but not limited to:

    1. Short-term policies
    2. Cancellations
    3. Gaps in coverage
    4. Changes in ownership or combinability status
    5. Multiple policy effective dates
    6. A policy that is longer than one year and 16 days
    7. Late receipt of current policy information by the Rating Board.

  3. To determine a risk’s rating effective date, the Rating Board will apply the Rating Effective Date Determination Table in conjunction with a review of the most recent full-term policies and unit statistical data. For purposes of this Rule, a full-term policy is considered to be written for 12 months and is not cancelled prior to its expiration date.

    Rating Effective Date Determination Table

    If the risk is…

    Then the rating effective date is…
    A single policy risk, or a multiple policy risk with all policies having the same effective date The effective month and day of the most recent full-term policy in effect and each policy thereafter unless the date is changed due to a reason listed above.
    A multiple policy risk with policies having different effective dates The effective month and day of the most recent full-term policy in effect with the largest amount of estimated standard premium.

  4. Rating Effective Date Examples

    The rating effective date is the earliest date that a specific modification is applied to a policy.

    Example 1:

    Assume that a risk has a current policy effective January 1, and all previous policies have also been effective on January 1 since the risk was in business:

    Since all policies have had January 1 effective dates, the rating effective date is January 1.

    Example 2:

    Assume that after several years, the policy effective date changes.

    Policy Rating Effective Date
    01/01/18 – 01/01/19 01/01/18
    01/01/19 – 06/01/19 01/01/19
    06/01/19 – 06/01/20 01/01/19 (applicable from 06/01/19 to 01/01/20)
    01/01/20 (applicable from 01/01/20 to 06/01/20)
    06/01/20 – 01/01/21 06/01/20

    Since the next full-term policy after the change in effective date is 06/01/19-06/01/20, experience ratings will be issued with rating effective dates of 01/01/18, 01/01/19 and 01/01/20.  Upon expiration of the 06/01/19-06/01/20 policy, a new rating effective date of 06/01/20 will apply.

    Example 3:

    Assume that after several years, the policy effective date changes, and then changes again.

    Policy Period Rating Effective Date
    01/01/18 – 01/01/19 01/01/18
    01/01/19 – 05/01/19 01/01/19
    05/01/19 – 05/01/20 01/01/19 (applicable from 05/01/19 to 01/01/20)
    01/01/20 (applicable from 01/01/20 to 05/01/20)
    05/01/20 – 05/01/21 05/01/20
    01/01/21 – 01/01/22 05/01/20 (applicable from 01/01/21 to 05/01/21)
    05/01/21 (applicable from 05/01/21 to 01/01/22)
    01/01/22 – 01/01/23 01/01/22

    Since the next full-term policy after the first change in effective date is 05/01/19-05/01/20, experience ratings will be issued with rating effective dates of 01/01/18, 01/01/19 and 01/01/20. Upon expiration of the 05/01/19-05/01/20 policy, a new rating effective date of 05/01/20 will apply. The 05/01 rating effective date will remain until after expiration of the 01/01/21-01/01/22 policy. A new rating effective date will become effective 01/01/22.

C. ELEMENTS OF THE EXPERIENCE RATING FORMULA AND WORKSHEET

Effective as of 11/01/2022 Effective as of 10/01/2022
  1. Expected Loss Rate

    The Expected Loss Rate (“ELR”) is a factor reflecting the amount of expected losses per unit of exposure for experience rating purposes for each classification. The ELR is applied to each $100 of payroll for payroll-based classifications and to exposure for non-payroll-based classifications) for a classification.

    ELRs are listed in Table I – Expected Loss Rates of this Plan.

  2. Expected Losses

    The Expected Losses for each payroll-based classification are determined by multiplying the ELR by payroll divided by 100. For non-payroll classifications, the classification’s exposure is multiplied by the ELR. The result is rounded to the nearest whole number.  Within the experience rating calculation, the expected losses represent the benchmark level of losses expected for all employers in the state within a particular classification.

    Note: In determining the modification for risks subject to the New York Payroll Limitation Law, expected losses are based on limited payrolls.

  3. Primary/Excess Split Point Value

    The dollar value which splits a loss into its primary and excess portions is known as the primary/excess split point. This value varies by size of risk in terms of expected losses and can be found in Table II – Primary/Excess Split Points of this Plan.

  4. Discount Ratio

    The Discount Ratio (“D-Ratio”) is a factor applied to the expected losses for each classification and Split Point to determine Expected Primary Losses.

    Discount ratios by classification and Split Point are listed in Table III – D-Ratios of this Plan.

  5. Expected Primary Losses

    A risk’s Expected Primary Losses for each classification are determined by multiplying the Expected Losses for the classification by the classification D-Ratio for the risk’s Split Point. The result is rounded to the nearest whole number.

  6. Expected Excess Losses

    A risk’s Expected Excess Losses for each classification are the difference between the classification’s Expected Losses and Expected Primary Losses.

  7. Actual Incurred Losses

    For purposes of experience rating, Actual Incurred Losses are the loss amounts reported according to the Statistical Plan. Actual Incurred Losses include both paid amounts and carrier established reserves on each claim.

  8. Actual Primary Losses

    Actual Primary Losses are the portion of the actual incurred losses that are used in the experience rating calculation. For each actual incurred loss, the amount up to the primary/excess split point value is considered primary.

  9. Losses Employed in a Rating

    To reduce the effect of unusual or catastrophic occurrences on the modification, certain loss limitations apply.
    1. For each claim, losses considered in the determination of the modification are limited to the Split Point applicable to the individual risk. Actual excess losses (the portion of the loss that exceeds the Primary/Excess Split Point) are not used in the calculation of the modification.

      Example 1:

      Assume a risk has a Primary/Excess Split Point of $10,000. A claim is reported with a loss amount of $85,000 and appears at full value on the modification worksheet. In the determination of the modification, the loss amount will be limited to $10,000. This limitation applies to all claims that exceed $10,000 for this risk.

      Example 2:

      Assume a risk has a Primary/Excess Split Point of $20,000. A claim is reported with a loss amount of $185,000 and appears at full value on the modification worksheet. In the determination of the modification, the loss amount will be limited to $20,000. This limitation applies to all claims that exceed $20,000 for this risk.

      Example 3:

      Assume a risk has a Primary/Excess Split Point of $100,000. A claim is reported with a loss amount of $85,000 and appears at full value on the modification worksheet. In the determination of the modification, the loss amount will not be limited because the claim value is less than the Primary/Excess Split Point for this risk.

    2. Except as noted in item (c) below, for an occurrence involving two or more claims, the two largest losses are used in experience rating with each claim value limited to the Split Point applicable to the individual risk.

      Example 4:

      Company A, which has a Primary / Excess Split Point of $20,000, has three claims from a single occurrence:

      ClaimActual IncurredSplit PointActual Primary
      1$275,000$20,000$20,000
      2$42,000$20,000$20,000
      3$5,000$20,000$0
      Total$322,000 $40,000

      Claims 1 and 2 have the two largest reported loss amounts from this single occurrence and will be used in the calculation of the modification. Claim 3 is not used in the calculation.

      In addition, Claims 1 and 2 exceed the Split Point. Accordingly, the actual primary portion of each is the Split Point amount of $20,000.

      Example 5:

      Company A, which has a Primary / Excess Split Point of $20,000, has four claims from a single occurrence:

      ClaimActual IncurredSplit PointActual Primary
      1$119,000$20,000$20,000
      2$15,000$20,000$15,000
      3$5,000$20,000$0
      4$4,000$20,000$0
      Total$143,000 $35,000

      Claims 1 and 2 have the two largest reported loss amounts from this single occurrence and are used in the calculation of the modification. Claims 3 and 4 are not used in the calculation.

      In addition, Claim 1 exceeds the Split Point, and accordingly, its actual primary portion is the Split Point amount of $20,000. Claim 2 does not exceed the Split Point, therefore the actual primary portion of each is the actual reported loss amount.

      Example 6:

      As a comparison, if each loss in Example 5 above was a result of four separate occurrences, all losses would be limited individually and used in the calculation as follows:

      LossActual IncurredSplit PointActual Primary
      1$119,000$20,000$20,000
      2$15,000$20,000$15,000
      3$5,000$20,000$5,000
      4$4,000$20,000$4,000
      Total$143,000 $44,000

      Example 7:

      Company A, which has a Primary / Excess Split Point of $20,000, has four claims from a single occurrence (labeled losses 1 through 4), and two additional claims from two separate occurrences (labeled losses 5 and 6):

      OccurrenceLossActual IncurredSplit PointActual Primary
      A1$119,000$20,000$20,000
      A2$15,000$20,000$15,000
      A3$5,000$20,000$0
      A4$4,000$20,000$0
      B5$40,000$20,000$20,000
      C6$2,000$20,000$2,000
       Total$185,000 $57,000

      Claims 1 and 2 have the two largest reported loss amounts from the single occurrence and are used in the calculation of the modification.  Claims 3 and 4 are part of the same occurrence and are not used in the calculation.

      In addition, Claim 1 exceeds the Split Point, therefore its actual primary portion is the Split Point amount of $20,000.  Claim 2 does not exceed the Split Point, therefore the actual primary portion of each is the actual reported loss amount.  

      Claims 5 and 6 are included because each comes from an individual, separate occurrence. Claim 5 exceeds the Split Point, and its actual primary portion is the Split Point amount of $20,000. Claim 6 does not exceed the Split Point, and its actual primary portion is the actual reported loss amount.

    3. Claims that are directly attributable to the COVID-19 pandemic and reported with Catastrophe 12, are not subject to item (b) above.

  10. Table of Classifications with Non-Ratable Elements

    The following Non-Ratable Element Codes are not subject to experience rating:

    Classification
    Code    		Non-Ratable
    Element Code
    47710771
    74057445
    74317453

  11. Prior Formula Modification

    The Prior Formula Modification is defined as the modification or merit rating factor resulting from the application of the experience rating plan rules and formula, which was in effect until September 30, 2022 (“Prior Rules and Formula”), to the data during the experience period as defined under this Plan.

    For risks that were previously rated under the interstate rating plan administered by the National Council on Compensation Insurance (“NCCI”), the Prior Formula Modification is the modification resulting from the application of the Prior Rules and Formula to New York data during the experience period.

  12. Number of Claims

    The Number of Claims refers to the number of indemnity and medical claims incurred by the insured during the experience period. Claims are defined as those which had a medical and/or indemnity incurred loss amount.

    For occurrences involving two or more claims, the number of claims from each such occurrence is limited to two.

D. EXPERIENCE RATING FORMULA

  1. The experience rating modification formula is used to determine the modification for all risks.
    Experience Rating Modification = Actual Primary Losses + Expected Excess Losses
    Expected Losses

    Note: If total expected losses are below $100, Expected Losses in the above formula will be assigned a minimum value of $100 and Expected Excess Losses will be derived using the minimum value of $100 for Expected Losses. The derivation of Expected Primary Losses will not be affected by the minimum expected loss amount.

  2. Capped Debit Modification

    Modification factors determined by the formula in Section (D)(1) of this Rule are subject to a capping methodology as follows:

    1. If the number of claims for the risk during the experience period is 1, the modification cannot exceed 1.12

    2. If the number of claims for the risk during the experience period is 2, the modification cannot exceed 1.40

    3. If the number of claims for the risk during the experience period is 3, the modification cannot exceed 1.75

    4. If the number of claims for the risk during the experience period is 4 or more, the modification cap is determined by the following formula:

      Capped Debit Modification = 2 + 0.000003 x Expected Losses

  3. United States Longshore and Harbor Workers’ (“USL&HW”) Act Coverage

    Experience ratings containing classifications where the rates include coverage under the USL&HW Act are calculated using the formula described in Section (D)(1) of this Rule.

    Classifications subject to the USL&HW Act, but not followed by the letter “F” in the Table of Expected Loss Rates and Discount Ratios, have their expected losses determined by applying the USL&HW Act percentage, found on Table I – Expected Loss Rates, to the expected loss rate (ELR) for such classifications.

  4. Transitional Modification Factor

    A transitional modification factor may apply to risks with rating effective dates from October 1, 2022 through September 30, 2023. Specifically, if the modification resulting from the formula described above exceeds the Prior Formula Modification by more than 0.3, a transitional modification will be promulgated equal to the Prior Formula Modification + 0.3.

E. EXPERIENCE TO BE USED IN A RATING

  1. Experience Period

    The experience period represents the total amount of past exposure and loss data used in an experience rating.  The calculation of a risk’s modification must include all eligible experience that occurred during the experience period.

    1. A risk’s rating effective date determines its experience period.  Experience for each of a risk’s policies is included if the policy effective date is:

      1. Not less than 21 months before the rating effective date; and
      2. Not more than 57 months before the rating effective date.

    2. A risk’s experience period cannot contain more than 45 months of data.  The 45-month limitation is a maximum period of time between the expiration date of the most recent policy and the effective date of the oldest policy.  While the experience period may not exceed 45 months, a modification may be produced with less than 12 months of data.  The amount of data included in a risk’s experience period may be impacted for reasons including, but not limited to:

      1. Short-term policies
      2. Cancellations
      3. Gaps in coverage
      4. Changes in ownership or combinability status
      5. Rating effective date changes
      6. Multiple policy effective dates
      7. Policies longer than one year and 16 days
      8. Wrap-up policies

    3. If both the recent and oldest policies fit within the experience period, and the inclusion of both polices would exceed 45 months, the oldest policy is not used.

    4. Based on a risk’s rating effective date:

      1. A risk’s most current data, excluding 4th through 10th reports, is used to calculate modifications. Refer to the Statistical Plan for valuation date information.

      2. An individual policy’s 1st, 2nd, and 3rd report data may be used in more than three modifications. However, the policy must be eligible for inclusion according to Section (E)(1)(a)(b) and (c) of this Rule.

  2. Experience Period Reference Table

    The following table provides an illustration of the policies that need to be included in the experience for a respective rating effective date and can be used as a reference.

    EXPERIENCE PERIOD REFERENCE TABLE
     
    Rating
    Effective Date    		 Oldest Policy
    Effective Date    		 Most Recent
    Policy
    Effective Date    		   Rating
    Effective Date    		 Oldest Policy
    Effective Date    		 Most Recent
    Policy
    Effective Date
    01/01/23 04/01/18 04/01/21   01/01/24 04/01/19 04/01/22
    02/01/23 05/01/18 05/01/21 02/01/24 05/01/19 05/01/22
    03/01/23 06/01/18 06/01/21 03/01/24 06/01/19 06/01/22
    04/01/23 07/01/18 07/01/21 04/01/24 07/01/19 07/01/22
    05/01/23 08/01/18 08/01/21 05/01/24 08/01/19 08/01/22
    06/01/23 09/01/18 09/01/21 06/01/24 09/01/19 09/01/22
    07/01/23 10/01/18 10/01/21 07/01/24 10/01/19 10/01/22
    08/01/23 11/01/18 11/01/21 08/01/24 11/01/19 11/01/22
    09/01/23 12/01/18 12/01/21 09/01/24 12/01/19 12/01/22
    10/01/23 01/01/19 01/01/22 10/01/24 01/01/20 01/01/23
    11/01/23 02/01/19 02/01/22 11/01/24 02/01/20 02/01/23
    12/01/23 03/01/19 03/01/22 12/01/24 03/01/20 03/01/23
     
    01/01/25 04/01/20 04/01/23 01/01/26 04/01/21 04/01/24
    02/01/25 05/01/20 05/01/23 02/01/26 05/01/21 05/01/24
    03/01/25 06/01/20 06/01/23 03/01/26 06/01/21 06/01/24
    04/01/25 07/01/20 07/01/23 04/01/26 07/01/21 07/01/24
    05/01/25 08/01/20 08/01/23 05/01/26 08/01/21 08/01/24
    06/01/25 09/01/20 09/01/23 06/01/26 09/01/21 09/01/24
    07/01/25 10/01/20 10/01/23 07/01/26 10/01/21 10/01/24
    08/01/25 11/01/20 11/01/23 08/01/26 11/01/21 11/01/24
    09/01/25 12/01/20 12/01/23 09/01/26 12/01/21 12/01/24
    10/01/25 01/01/21 01/01/24 10/01/26 01/01/22 01/01/25
    11/01/25 02/01/21 02/01/24 11/01/26 02/01/22 02/01/25
    12/01/25 03/01/21 03/01/24 12/01/26 03/01/22 03/01/25
     
    01/01/27 04/01/22 04/01/25 01/01/28 04/01/23 04/01/26
    02/01/27 05/01/22 05/01/25 02/01/28 05/01/23 05/01/26
    03/01/27 06/01/22 06/01/25 03/01/28 06/01/23 06/01/26
    04/01/27 07/01/22 07/01/25 04/01/28 07/01/23 07/01/26
    05/01/27 08/01/22 08/01/25 05/01/28 08/01/23 08/01/26
    06/01/27 09/01/22 09/01/25 06/01/28 09/01/23 09/01/26
    07/01/27 10/01/22 10/01/25 07/01/28 10/01/23 10/01/26
    08/01/27 11/01/22 11/01/25 08/01/28 11/01/23 11/01/26
    09/01/27 12/01/22 12/01/25 09/01/28 12/01/23 12/01/26
    10/01/27 01/01/23 01/01/26 10/01/28 01/01/24 01/01/27
    11/01/27 02/01/23 02/01/26 11/01/28 02/01/24 02/01/27
    12/01/27 03/01/23 03/01/26 12/01/28 03/01/24 03/01/27
     
    01/01/29 04/01/24 04/01/27 01/01/30 04/01/25 04/01/28
    02/01/29 05/01/24 05/01/27 02/01/30 05/01/25 05/01/28
    03/01/29 06/01/24 06/01/27 03/01/30 06/01/25 06/01/28
    04/01/29 07/01/24 07/01/27 04/01/30 07/01/25 07/01/28
    05/01/29 08/01/24 08/01/27 05/01/30 08/01/25 08/01/28
    06/01/29 09/01/24 09/01/27 06/01/30 09/01/25 09/01/28
    07/01/29 10/01/24 10/01/27 07/01/30 10/01/25 10/01/28
    08/01/29 11/01/24 11/01/27 08/01/30 11/01/25 11/01/28
    09/01/29 12/01/24 12/01/27 09/01/30 12/01/25 12/01/28
    10/01/29 01/01/25 01/01/28 10/01/30 01/01/26 01/01/29
    11/01/29 02/01/25 02/01/28 11/01/30 02/01/26 02/01/29
    12/01/29 03/01/25 03/01/28 12/01/30 03/01/26 03/01/29

     

  3. Experience Period Examples

    For the examples below, consider the following scenario:

    A risk’s rating effective date determines its experience period. The experience period contains policies with effective dates ranging from 21 to 57 months before the rating effective date, not exceeding 45 months of data.

    To determine the maximum 45-month time period included in the experience period, refer to the Experience Period Reference Table or apply the following procedure:

    1. List the modification effective date      1/1/23
    2. Add 3 months to the date in (a)          4/1/23
    3. Subtract 2 years from the date in (b)   4/1/21
    4. Subtract 3 years from the date in (c)   4/1/18

    The maximum experience period of a 1/1/23 modification includes policies with effective dates on or after 4/1/18, through policies with effective dates on or before 4/1/21.

    The examples below clarify the experience period used in a rating that has policy periods with varying lengths.

    Example 1:

    Assume a 1/1/23 rating effective date.

    Policy Period Months of Data
    06/01/18 – 01/01/19 7
    01/01/19 – 01/01/20 12
    01/01/20 – 01/01/21 12
    01/01/21 – 01/01/22 12

    The 1/1/23 rating includes 43 months of data. This is within the 45-month period under this rule. The oldest policy period (6/1/18-1/1/19) is not more than 57 months before the rating effective date.

    Example 2:

    Assume a 7/1/23 rating effective date.

    Policy Period Months of Data
    10/01/18 – 07/01/19 9
    07/01/19 – 07/01/20 12
    07/01/20 – 10/15/20 3.5
    10/15/20 – 07/01/21 8.5 month coverage gap –
    no data to be included
    07/01/21 – 07/01/22 12

    The 7/1/23 rating includes 36.5 months of data, excluding the 8.5-month gap in coverage. This is within the 45 - month period as provided under this rule. The oldest policy period (10/1/18-7/1/19) is not more than 57 months before the rating effective date.

    Example 3:

    Assume a 7/1/23 rating effective date.

    Policy Period Months of Data
    02/01/19 – 12/01/19 10
    12/01/19 – 07/01/20 7-month coverage gap –
    no data to be included
    07/01/20 – 07/01/21 12
    07/01/21 – 07/01/22 12

    The 7/1/23 rating includes 34 months of data, excluding the 7-month gap in coverage. This is within the 45-month period as provided under this Rule. The oldest policy period (2/1/19-12/1/19) is only 53 months before the rating effective date and does not exceed the 57-month limit.

    Example 4:

    Assume a 7/1/23 rating effective date.

    Policy Period Months of Data
    07/01/19 – 07/01/20 12
    07/01/20 – 07/01/21 12
    07/01/21 – 10/01/21 3-month coverage gap –
    no data to be included
    10/01/21 – 07/01/22 9

    The 7/1/23 rating includes 33 months of data within an experience period of 36 months. The data effective 10/1/21 is used.

    Example 5:

    Assume a 7/1/23 rating effective date.

    Policy Period Months of Data
    07/01/19 – 07/01/20 10
    07/01/20 – 07/01/21 12
    07/01/21 – 07/01/22 12
    10/01/21 – 10/01/22 12 – newly acquired
    subsidiary with a different
    policy date

    In this example, the 7/1/21-7/1/22 policy overlaps with the 10/1/21-10/1/22 subsidiary policy. The 7/1/23 rating includes 36 months of data for the principal entity and 12 months of data for the subsidiary entity. Because two policies overlap for nine months, the 39-month experience period is within the 45-month limit.

    Example 6:

    Assume a 7/1/23 rating effective date.

    Policy Period Months of Data
    12/01/18 – 07/01/19 7
    07/01/19 – 07/01/20 12
    07/01/20 – 07/01/21 12
    07/01/21 – 09/01/21 2
    09/01/21 – 07/01/22 10

    The experience period includes the 12/1/18 policy and the 9/1/21 policy. In this example, the 7/1/23 rating includes 43 months of data

    Example 7:

    Assume a 7/1/23 rating effective date.

    Policy Period Months of Data
    11/01/18 – 11/01/19 12
    11/01/19 – 09/01/20 10
    09/01/20 – 07/01/21 10-month coverage gap –
    no data to be included
    07/01/21 – 10/01/21 3
    10/01/21 – 07/01/22 9

    The 7/1/23 rating includes 34 months of data, excluding the 10-month gap in coverage. This is within the 45-month period. The most recent policy period (10/1/21-7/1/22) is not less than 21 months before the rating effective date.

    Example 8:

    Assume a 9/1/23 rating effective date.

    Policy Period Months of Data
    11/01/18 – 11/01/19 12
    11/01/19 – 11/01/20 12
    11/01/20 – 09/01/21 10
    09/01/21 – 09/01/22 12

    In this example, there is a total of 46 months of data. Since this exceeds the 45-month period and the oldest data is more than 57 months before the rating effective date, the 11/1/18-11/1/19 policy is not used. As a result, the experience period is 34 months.

    Example 9:

    Assume a 1/1/23 rating effective date with combinable entities A and B,

    Entity A Entity B
    Policy Date Months of Data Policy Date Months of Data
    01/01/19 – 01/01/20 12 03/01/19 – 03/01/20 12
    01/01/20 – 01/01/21 12 03/01/20 – 03/01/21 12
    01/01/21 – 01/01/22 12 03/01/21 – 03/01/22 12
    Total 36 Total 36

    The experience period for a 1/1/23 rating effective date can include policies with effective dates on or between 4/1/18 and 4/1/21. Entity A and Entity B each have 36 months of experience.  This particular risk’s experience period begins 1/1/19 and ends 3/1/22, totaling 39 months of experience, even though 33 of the 39 months are overlapping. Each entity’s separate experience, as well as the total experience of the risk, fits within the 45-month maximum experience period.

  4. Self-Insurer Data

    1. Experience of self-insured risks may be included in an experience rating upon written request to the Operations Department of the Rating Board.

    2. Payroll and loss data must be submitted to the Rating Board on Form ERM-6.  The ERM-6 Form is available on the Rating Board’s website at www.nycirb.org. The ERM-6 Form must be signed by either the risk, self-insurer or authorized third party administrator (“TPA”). The data is subject to verification by the entity submitting the data for inclusion in an experience rating, as well as by the Rating Board.

    3. The carrier requesting the data inclusion must be the risk’s insurer during the time for which the modification including the self-insured data would apply.

    4. For multiple insurer risks, agreement from only one of the risk’s insurers, during the time for which the modification would apply, is required.

  5. Discontinued Operations

    An entity may discontinue all or part of its operations.

    If an entity discontinues… Then the future experience ratings will include…
    All of its operations and reestablishes them at a later date The applicable data developed prior to the discontinuation.
    Parts of its operations The applicable data developed both prior to the discontinuation and for the remaining operations.

     

  6. Insolvent Carriers

    1. Experience ratings may be promulgated by the Rating Board using data reported by those insolvent carriers that continue providing sufficient complete levels of unit statistical reports for experience rating purposes.

    2. When an insolvent carrier is unable to submit unit statistical reports for the policies it has written, experience ratings will be issued by the Rating Board if the experience required for rating purposes is submitted by the liquidator, an authorized Managing General Agent (MGA) or TPA, or by the employer using an ERM-6 Form. The data from an ERM-6 will be included in the determination of the rating upon receipt of authorization from the risk’s carrier during the time for which the modification including the data submitted on an ERM-6 would apply.

    3. Data obtained from insolvent carriers that has been submitted later than the customary due date schedule for unit statistical reports, or insolvent carrier data obtained from third party sources, will be utilized in calculating experience ratings to the extent that the submitted data impacts the current and, if applicable, up to two preceding experience ratings. Refer to Rule 4 Section (B)(2)(a) of this Plan.

    4. When absolutely no insolvent carrier unit statistical report data can be obtained, the following steps will be taken:

      1. If a first report (exposure record) is unobtainable, an experience rating will be calculated without the policy that is missing the first report.
      2. If a subsequent report(s) is missing, and the prior report(s) has been submitted to the Rating Board, experience ratings will be calculated using the prior report(s) data.
      3. If an experience rating cannot be issued due to multiple years with missing data from an insolvent carrier, the last authorized rating factor will continue to apply.