Carriers or their authorized data providers may use any method they choose for the internal recording of statistical data submitted to the Rating Board. This includes any type of format convenient to the carrier’s statistical and accounting procedures and codes other than those set forth in the Plan, provided that the required data elements are submitted to the Rating Board in accordance with the rules and timeframes specified in this Plan.
Summarized exposure, premium and loss data for each workers’ compensation policy is required under Item 7 below. Electronic format is the exclusive means of submitting this data to Rating Board. For information regarding electronic reporting, refer to the Workers’ Compensation Statistical Reporting Specifications (WCSTAT) in the WCIO Data Specifications Manual at www.wcio.org.
Manage Data is an online Rating Board product that allows member carriers to:
- Create, view and correct unit statistical reports
- Provide responses to Accepted with Warning errors utilizing the Communicator application as described below
- Prepare WCSTAT files for submission to the Rating Board via Compensation Data Exchange (“CDX”) or the WCSTAT Upload tool
- View Error Reports
- Manage the timely submission of data through the Manage Data Unit Stat Search
Manage Data is updated each evening to include each day’s WCSTAT submissions, thereby creating a complete and current database. Manage Data includes a Unit Statistical portal for real time processing of data.
- Communicator Application:
The Rating Board Communicator application, located within Manage Data, allows carriers to directly submit their responses to the Rating Board for Original and Correction Unit Statistical Reports. Explanations may only be entered for USRs with “Accepted with Warnings” status. Explanations will be tracked within Manage Data.
USRs in “Accepted with Warning” status will have one of the following status indicators:
Status Description Unanswered Carrier has neither provided an explanation nor submitted a correction. Under DCO Review The Rating Board is in the process of reviewing the carrier’s explanations. Response Accepted The USR status changes from “Accepted with Warnings” to “Resolved.” The error will be closed, and Fine Tracking will be stopped. Response Rejected The error will not be closed because the explanation is not satisfactory. Carrier will be required to provide additional details. Error Resolved via Correction Carrier provided a Unit Statistical correction to resolve the error. Communicator will automatically close out the Unit Statistical Error.
A submission of statistical data must be accompanied by a submission control record as specified in the WCIO Data Specifications Manual, General Section, at www.wcio.org.
The carrier must validate the statistics being reported prior to their submission to the Rating Board to detect any errors. Examples of such errors are:
- errors in the assignment of statistical codes;
- errors in assignment of claims to policies and/or classification codes; and
- errors in dollar amounts being reported.
For purposes of reporting exposure and premium data, if audited information is not available prior to the submission of statistics, the carrier must identify and report the estimated exposure and premium until the audited information becomes available.
Carriers are expected to correct any and all errors found in their data. Errors impact the quality and accuracy of ratemaking and experience rating and must be corrected to prevent delays in releasing these products. Refer to Part (V) of this Plan for detailed instructions.
Exposure, premium and loss data must be filed for every workers’ compensation and employers’ liability policy coverage in New York, including New York coverage on interstate policies and coverage provided under any voluntary compensation endorsement.
Statistical reports are also required for any policies with New York exposure that are written on an “If Any” basis and do not develop exposure, provided that the policy was not canceled flat. Refer to Part III, Item (6)(f) of this Plan.
If more than one risk is written on a single policy, as provided in either Section 32 of the New York Volunteer Firefighters’ Benefit Law or Section 32 of the New York Volunteer Ambulance Workers’ Benefit Law, separate statistical reports must be submitted for each risk included within the policy.
Statistical data is not required for the following types of policies:
- Employers’ liability insurance on residence and farm employees in conjunction with other liability insurance
- Workers’ compensation on domestics provided in conjunction with homeowners’ insurance
- Policies providing coverage under the National Defense Projects Rating Plan or Nuclear Regulatory commission projects (See Items (11) and (12) of this Part below, respectively)
- Policies providing excess coverage other than excess medical.
Statistical reports must be filed for each state of a multi-state policy. A report must be filed for each state on a policy with estimated exposure, including those for which no exposure was developed.
For policies with effective date on or before December 31, 2020 statistical reports for New York coverage on a multi-state policy must be filed with the Rating Board, and if applicable, with the National Council on Compensation Insurance (“NCCI”).
For policies with effective date on or after January 1, 2021, statistical reports for New York coverage on a multi-state policy must be filed with the Rating Board, and are no longer required to be reported to NCCI.
- Audited Policies
Report all earned premiums for those policies on which an audit has been conducted and the earned premium is known, even if the premium is uncollectible. Likewise, report the corresponding exposure and loss data.
- Policies on Which a Final Audit is Not Possible
Report the estimated earned premium and exposure corresponding to the term of coverage for those policies on which a final audit is not possible and the audited earned premium and exposure is not known. Likewise, report the loss data for the corresponding term of coverage.
Statistics are to be reported only for direct business. Do not submit unit statistical reports for workers’ compensation assumed policies (e.g., exclude premiums received from, or losses paid to, other carriers on account of reinsurance assumed by the carrier). Do not submit unit report statistics for workers’ compensation ceded policies (e.g., reductions should not be made for premiums ceded to, or for losses recovered from, other carriers due to ceded reinsurance).
Premium and loss data for policies written under the National Defense Projects Rating Plan shall not be reported on unit statistical reports. Instead, “Exhibit I-Computation of Earned Premium, form NDPRP-I, must be filed with the Rating Board at the same time this form is submitted to the employer in accordance with the rules of the National Defense Projects Rating Plan. Such filing shall include only New York experience and must not include experience of any other state which may be included on the policy. Refer to the “Forms” section on the Rating Board’s website, www.nycirb.org, for a copy of form NDPRP-I.
Premiums and losses for policies covering Nuclear Regulatory Commission projects under the direction of any government agency must not be reported under this Plan.
The New York Workers’ Compensation and Employers’ Liability Manual provides that a supplemental rate may be applied to operations involving research, manufacture, handling, transportation and use of, or exposure to, radioactive material, where such operations are not performed for, or under the direction of, any government agency. The additional premium resulting from this supplemental rate and radiation losses on risks where the supplemental loss cost has been applied, must be reported under Code 9985 “Atomic Energy – Radiation Exposure NOC.”
- On Standard One-Year Workers’ Compensation Policies
Premium and loss data must be submitted on unit statistical reports in accordance with Part III, Items (6)(b) through (6)(f) of this Plan.
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On Three-Year Workers’ Compensation Policies
- Three-Year Fixed Rate Policies
For three-year fixed rate policies written in accordance with Rule X “Three-Year Fixed Rate Policy Option” of the New York Workers’ Compensation and Employers’ Liability Manual, report the premiums and loss data on these policies in accordance with Item (20) below.
- Other Three-Year Policies
For three-year policies that are not fixed rate policies written in accordance with Rule III (C)(3) of the New York Workers’ Compensation and Employers’ Liability Manual, report the premiums and loss data in accordance with Item (19) below.
- Three-Year Fixed Rate Policies
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Statutory Workers’ Compensation Coverage Afforded Under Personal Liability Policies
- Experience to be Reported
Whenever workers’ compensation and employers’ liability coverage for domestic workers is required by the New York State Workers’ Compensation Law and afforded by endorsement under a personal liability policy, statistical reports must be filed in accordance with the preceding sections of this Plan. Premium and loss data must be reported only for workers’ compensation and related employers’ liability coverage and must not include any other liability coverage afforded under the personal liability policy.
-
Time of Reporting
- If the personal liability policy is written for a three-year period, it shall be considered for reporting purposes as three consecutive annual policies having the same policy number, and three reports shall be filed at annual intervals.
- If the workers’ compensation and employers’ liability coverage is endorsed on an outstanding personal liability policy, the time for reporting experience for such coverage must be determined on the basis of the policy effective date, not the endorsement date.
- Experience to be Reported
15. EXCLUDING MEDICAL AND EXCESS COVERAGE FOR MEDICAL PAYMENTS (PER CLAIM OR PER ACCIDENT BASIS) – EXCLUDING MEDICAL POLICIES
- Any medical loss on a policy that is written on an Excluding Medical basis and includes endorsement WC 31 03 10 “New York Medical Benefits Reimbursement Endorsement” should not be reported.
- The experience under this coverage shall be reported in the same manner as the experience for the basic coverage provided by the policy. The instructions contained in this Plan are applicable to the reporting of such excess coverage. Excluding Medical policies that are written without excess coverage for medical payments must be coded with the following Policy Type ID codes:
Types of Coverage 09 Type of Plan 01 Type of Non-Standard Provisions 06
Losses included in the first reporting of a given policy must be valued as of (18) months after the month in which the policy became effective. Subsequent reporting of loss data (2nd - 10th) must be valued (12) months after the valuation of the preceding report. Each report level must be filed with the Rating Board no later than two (2) months after the respective valuation date. Fines will be assessed in accordance with Part I (17) of this Plan on the first day of the fine month.
The table shown below displays the valuation date, filing month, and fine month for all submissions by report level:
Report Level | Valuation Date | Filing Month | Fine Month |
1st | 18th month | 20th month | 23rd month |
2nd | 30th month | 32nd month | 35th month |
3rd | 42nd month | 44th month | 47th month |
4th | 54th month | 56th month | 59th month |
5th | 66th month | 68th month | 71st month |
6th | 78th month | 80th month | 83rd month |
7th | 90th month | 92nd month | 95th month |
8th | 102nd month | 104th month | 107th month |
9th | 114th month | 116th month | 119th month |
10th | 126th month | 128th month | 131st month |
Examples of Valuation and Filing Dates for First Reports | |||
Effective Month of the Policy | Valuation Month (18 Months after the policy effective month) | Filing Month (20 months after policy effective month) | Fine Month (23 months after policy effective month) |
January | July | September | December |
February | August | October | January |
March | September | November | February |
April | October | December | March |
May | November | January | April |
June | December | February | May |
July | January | March | June |
August | February | April | July |
September | March | May | August |
October | April | June | September |
November | May | July | October |
December | June | August | November |
The Timeliness and Data Quality Fine Program applies to all Unit Statistical Reports received on or after January 1, 2023.
- First and Subsequent Unit Statistical Reports (other than Correction Reports)
The Rating Board will fine carriers if the Unit Statistical Report is:
- received by the Rating Board on or after the Fine Month as indicated in Part I (16) of this Plan; or
- received or remains in “Failed” or “Accepted with Warnings” status on or after the Fine Month as indicated in Part I (16) of this Plan.
The fine amount is $100 per Unit Statistical Report per month from the Fine Month until the month in which the USR is received and accepted by the Rating Board and all associated failures or warnings have been resolved.If the Unit Statistical Report is not received and not accepted by the Rating Board two months after the assigned fine month as indicated in Part I (16), the carrier will be charged $200 per Unit Statistical Report per month.
Examples:
Example 1:
- A Policy is effective in January 2023.
- A USR is due in September 2024 but is late.
- The carrier is notified that the USR is late in October of 2024.
- The Fine Month is December of 2024.
- The USR is not submitted by November of 2024.
- A fine of $100 applies and appears on the December invoice.
- The USR is not submitted in December of 2024.
- An additional fine of $100 applies and appears on the January invoice, for a total of $200 for this USR.
- The USR is submitted in January 2025 and is in “Accepted” status.
- No additional fines apply for this USR.
Example 2:
- A Policy is effective in January 2023.
- A USR is due in September 2024 and is received in September by the Rating Board in “Failed” or “Accepted with Warning” status.
- The carrier is promptly notified that the USR is in “Failed” or “Accepted with Warning” status.
- The Fine Month is December of 2024.
- No USR replacement, correction, or explanation is submitted by November of 2024.
- A fine of $100 applies and appears on the December invoice.
- No USR replacement, correction, or explanation is submitted by December of 2024.
- An additional fine of $100 applies and appears on the January invoice, for a total of $200 for this USR.
- A correction or an acceptable explanation is submitted in January 2025. The status of the USR is changed to “Accepted”.
- No additional fines apply for this USR.
Correction Reports
All correction types as indicated in Part II (3) of this Plan will be included in the Data Quality Fine Program. Correction submissions are subject to a fine of $100 per unit if not in “Accepted” status within 60 days of received date, and an additional $200 for each 30-day period in which the unit is not in “Accepted” status.
Example 3:
- A USR Correction is submitted on May 15.
- The Correction is received with an “Accepted with Warnings” status.
- The carrier has 60 days from received date of the USR to resolve the warning. Therefore, the due date for addressing this warning, either by correction or an acceptable explanation, is July 14.
- An explanation is submitted by the carrier on July 12.
- The Rating Board reviews the explanation on July 19.
- The Rating Board rejects the explanation.
- The carrier will be assessed a fine of $100 on July 15, which will be reflected on the August invoice.
- The next due date for an explanation/correction is 30 days after the original explanation/correction due date, on August 13.
Example 4:
- A USR Correction is submitted on May 15.
- The Correction is received with an “Accepted with Warnings” status.
- The carrier has 60 days from received date of the USR to resolve the warning. Therefore, the due date for addressing this warning, either by correction or an acceptable explanation, is July 14.
- An explanation is submitted by the carrier on July 12.
- The Rating Board reviews the explanation on July 19.
- The Rating Board accepts the explanation.
- The carrier will not be assessed a fine because the acceptable explanation was submitted in a timely manner.
Example 5:
- A USR Correction is submitted on May 15.
- The Correction is received with an “Accepted with Warnings” status.
- The carrier has 60 days from received date of the USR to resolve the warning. Therefore, the due date for addressing this warning, either by correction or an acceptable explanation, is July 14.
- An explanation is submitted by the carrier on July 17.
- The carrier will be assessed a fine of $100 on July 15, which will be reflected on the August invoice.
- The Rating Board reviews the explanation on July 19.
- The Rating Board accepts the explanation.
- No additional fines apply for this USR.
Maximum Fine Amount
The total annual fines levied in accordance with items (a)(ii) and (b) of this section for an individual carrier group may be subject to a maximum amount to be determined by the Rating Board.
Report the employer’s classification codes determined in accordance with the rules of the New York Workers’ Compensation and Employers’ Liability Manual.
No claim may be assigned to any classification unless exposure has also been reported for that classification. For losses, report the classification code under which the injured worker’s payroll is assigned even if, at the time of the injury, the worker may have been involved in an activity that could be classified differently.
Multiple year policies other than three-year fixed rate must be considered as separate policies for USR reporting purposes, and reports for each unit of (12) months or less shall be filed at the time all other USR reports on policies with the same effective date are being filed. If, however, a policy written for a period that is more than one year, but not more than one year and sixteen days, such policy must be treated as a one-year policy for reporting purposes. The USR reports for such policy must be filed at the time all other USR reports on policies with the same effective date are being filed. Losses must be valued 18 months after the effective date of each unit of experience, and at annual periods thereafter.
Examples:
The statistical reports on a three-year policy effective July 1, 2021 must be filed at the same time as other reports on policies effective in July 2021, July 2022 and July 2023. Losses shall be valued January 2023, January 2024 and January 2025, respectively.
The statistical reports on a policy covering the period July 1, 2022 to January 1, 2025, with the first six months considered as a unit, must be filed with other reports on policies effective in July 2022, January 2023 and January 2024. Losses shall be valued January 2024, July 2024 and July 2025, respectively.
The statistical reports on a policy covering the period July 1, 2022 to January 2025, with the last six months considered as a unit, must be filed with the other reports on policies effective in July 2022, July 2023 and July 2024. Losses shall be valued January 2024, January 2025 and January 2026, respectively.
Note: A policy issued for a period not longer than one year and 16 days is treated as a one-year policy.
The complete three-year experience incurred under the policy must be reported as one complete policy.
- Date of Valuation and Filing
Losses included in the reporting of a given policy must be valued as of 42 months after the inception month of the policy, and the statistical reports must be filed not later than 44 months after the effective month of the policy. These statistical reports must be specifically identified as three-year fixed rate policy experience by placing a “Y” in the Three-Year Fixed Rate indicator of the “Policy Conditions” field.
- Subsequent Reports
Second and third statistical reports must be filed 12 and 24 months, respectively, after filing the original statistical report. Fourth and subsequent reports are not required for three-year fixed rate policies.