1. EXPERIENCE MODIFICATION EFFECTIVE DATE

Report the experience modification date, YYMMDD, only when different from the policy effective date. If the experience modification changes in accordance with New York Experience Rating Plan Manual rules, report the effective date of the experience modification that applies to the reported class codes, exposures and premium.

Note: For the first split (split 0), the experience modification effective date must be equal to, or Prior to, the policy effective date. For subsequent splits (splits 1….), the experience modification effective date must be after the policy effective date, but prior to the policy expiration date.

2. RATE EFFECTIVE DATE

Report the rate effective date, YYMMDD, only when different from the policy effective date. If the rate changes in accordance with manual rules, report the effective date that applies to the reported class codes, exposures and premiums.

Note: The rate effective date must be prior to, or equal to, the effective date of the first split period.

3. UPDATE TYPE

Report the 1-letter code that identifies the activity of the exposure data.

Code Description
R Original first reports and revised data on correction reports
P Previously reported data (used only on correction reports)

Refer to Part V of this Plan for further instructions.

4. EXPOSURE COVERAGE CODE

Report the exposure coverage for each class on the policy.

CodeDescription
00For use with Statistical Codes
01State Act or Federal Act Excluding USL&HW and Federal Mine Health and Safety Act
02USL&HW coverage on “F” and Non “F” Classifications

5. CLASSIFICATION CODE

Report the 4-digit code corresponding to the classification assigned to the employer according to the rules of the New York Workers’ Compensation and Employers’ Liability Manual or the statistical code defined by the Rating Board.

Refer to Part (I)(18) of this Plan for additional instructions.

6. EXPOSURE AMOUNT

  1. Payroll Classification Codes

    1. Payroll exposures are required for all classifications except those specifically indicated as exceptions in this section.

      Payrolls must be appropriately separated as of the effective date of the change whenever there is a change in experience modification.

      The exposure on the 1st report must be the audited exposure corresponding to the charged premium amount.  When a final audit has not been made at the time of filing a statistical report, submit the estimated exposures and mark the Estimated Audit Indicator field in the Policy Conditions field with the symbol “Y.” When the exposure reported on the 1st report is based on estimated exposure, because the employer has not responded to the request for audited data and has been deemed uncooperative, submit the estimated exposures and mark the Estimated Audit Indicator field in the Policy Conditions field with the symbol “U.”  A correction of the estimated exposure must be submitted with a revised statistical report as soon as the audited payrolls are available.

    2. For eligible construction classifications subject to the Payroll Limitation Law, report the limited payroll amounts, if any, as determined in accordance with the Law.

      Refer to Rule V (G) of the New York Workers’ Compensation Employers’ Liability Manual for detailed information regarding the Payroll Limitation Law.

    3. For other classifications eligible for payroll limitation, report the limited payroll amounts, if any, as determined in accordance with the New York Workers’ Compensation Employers’ Liability Manual.

    Refer to Rule V (F) of the New York Workers’ Compensation Employers’ Liability Manual for detailed information regarding payroll limitation.

  2. Other Than Payroll Classification Codes

    An employee covered under a per capita classification for a period of one year must be reported as an exposure of 10. For coverage less than one year, the exposure reported must be that fraction part of a year, expressed to the nearest tenth (with an implied decimal point), for which the coverage is in effect. Refer to the following table:

    Individual Durations of Coverage Between Fraction of Year To Be Reported As
    0 days to 17 days 0 year 00
    18 days to 1 month 23 days .1 year 01
    1 month 24 days to less than 3 months .2 year 02
    3 months to 4 months 5 days .3 year 03
    4 months 6 days to 5 months 11 days .4 year 04
    5 months 12 days to 6 months 17 days .5 year 05
    6 months 18 days to 7 months 23 days .6 year 06
    7 months 24 days to less than 9 months .7 year 07
    9 months to 10 months 5 days .8 year 08
    10 months 6 days to 11 months 11 days .9 year 09
    11 months 12 days to one year 16 days 1.0 year 10

    Example: An employee covered for six months (.5 of a year) shall be reported as an exposure of 05. Exposure shall be governed by the duration of coverage and not by the number of days worked.

  3. Per Location

    The exposure under Classification Code 9027 (“Building Operation – Dwelling or Combined Dwelling and Commercial Occupancy Not More than One Story Used for Commercial Purposes”) must be reported in accordance with the rules specified above for Per Capita classifications, treating one location year as an exposure of 10.

  4. Volunteer Firefighters

    The population of the “home area” must be reported under Classification Code 7711 (“Firefighters – Volunteer & Drivers”) in the exposure field and the corresponding premium shall be reported in the premium field.

    Where there are separate charges for servicing other areas under contract, the statistical report must show as separate items the following:

      1. The number of contracts for servicing other “home areas” must be shown in the exposure field and the total of the charges must be shown in the premium column. It is not necessary to list each such charge separately.

      2. For each “outside area,” report the population in the exposure column and the corresponding premium in the premium field. For these items, report 1.00 in the manual rate field.  Where only a proportionate share of the total premium for the “outside area” is paid because the “outside area” is covered by more than one contract, report in the manual rate field the ratio of the contract for the “home area” to the contract price for all areas servicing such “outside area.”

    Example: If the contract price for the “home area” is 25% of the total contract price for all areas, show .25 in the manual rate field.

    Note: WCSTAT requires the reporting of three positions after the decimal point. Therefore, in the above example, the 25% to be reported in the manual rate field must be reported as 0000250, with an implied decimal point before the “2”.

    Note: Do not include the population reported in the exposure field in the Exposure – Payroll Total.

  5. Volunteer Ambulance Workers

    The number of ambulances or first response vehicles servicing the ambulance district must be reported under Classification Code 7370 (“Ambulance Operation – Volunteer Ambulance Service Company”) in the exposure field and the corresponding premium shall be reported in the premium field. The exposure must be reported in accordance with the rules specified above for Per Capita classifications, treating one ambulance year as an exposure of 1.0.

  6. No Exposure developed (1st Report)

    Report no exposure developed/no payroll by using Statistical Code 1111 for the entire policy period and zero-fill the exposure field.

7. MANUAL RATE

Report the carrier’s authorized rate corresponding to each classification code.

In the case of split rates due to a flat increase or decrease on an outstanding policy, either:

  1. Report the additional premium resulting from a flat increase under Statistical Code 0998 (“Outstanding Rate Increase”). Report the premium credit resulting from a flat decrease under Statistical Code 0994 (“Outstanding Rate Decrease”), or

  2. The exposure, authorized rate and corresponding premium may be split. The inception date of each period covered must be shown in the “Rate Effective Date” field.

8. SPLIT PERIOD CODE

Report the single digit code when indicating changes in authorized rates or experience modifications during a policy period.  Valid values are “0” – “9” where “0” is reported for the first effective period, “1” is reported for the second effective period, and so on up to a ninth effective period (if applicable). This field is zero-filled for policies with no changes in rates or experience modification.

9. PREMIUM AMOUNT

Premium by classification code may be obtained in two ways:

  1. Extension of Exposure

    The premium obtained by extension of payroll or other exposure at the carrier’s authorized rate must be reported under the appropriate classification codes.

  2. Flat charges

    The premium obtained by flat charges does not vary by exposure and must be reported under the appropriate statistical codes.

10. PREMIUM AMOUNT SUBJECT TO EXPERIENCE MODIFICATION FACTOR

Report the premium by classification as determined by:

  1. Extension of Exposure

    Report the premium obtained by the extension of payroll or other exposure bases at the applicable manual rate corresponding to the appropriate classification code.

  2. Other Than Extension

    Report premium that does not vary by exposure separately under the appropriate statistical code as follows:

    1. Construction Employment Territory Differential Premium

      Report the premium resulting from the application of territory differentials for construction employers subject to Rule VI (J) of the New York Workers’ Compensation and Employers’ Liability Manual.

      1. Statistical Code 9126 – Territory 1 Differential Premium – Counties of the Bronx, Kings, New York, Queens and Richmond

      2. Statistical Code 9127 – Territory 2 Differential Premium – Counties of Dutchess, Nassau, Orange, Putnam, Rockland, Suffolk and Westchester

      3. Statistical Code 9128 – Territory 3 Differential Premium – All Other Counties

      Note: Exposures are not applicable to these codes.

    2. Drug-Free Workplace Premium Credits

      Report the premium credit amount under Statistical Code 9841 “Drug Free Workplace Credit – Subject to Experience Rating” for policies written in conjunction with a carrier filed Drug-Free Workplace Program, when the program has been filed subject to experience rating.

    3. Employers’ Liability Increased Limits

      Refer to Part VI of this Plan for the appropriate statistical codes to report the premium charged for providing increased limits for coverage under Part II of the Workers’ Compensation and Employers’ Liability Insurance Policy for employees not subject to the New York State Workers’ Compensation Law. In those cases where the calculated charge is less than any minimum charge for the selected limits, the additional premium required to balance to such minimum charge must be reported under Statistical Code 9848 “Minimum Premium Including Liability.”

    4. Deductible Programs

      1. Report the premium credit for the New York small deductible program under Statistical Code 9664 “Deductible Prem Cred – Prior to Experience Rating.”

      2. Report the premium credit for carrier deductible programs under Statistical Code 9664 “Deductible Prem Credit – Prior to Experience Rating” when filed to be applicable prior to the application of the experience modification.

    5. No Exposure/Premium Developed

      Zero-fill the premium field under Code 1111, when no New York exposure develops on the policy.

    6. Premium for the Extension of Employers’ Liability Coverage to Additional Interests Under a Volunteer Ambulance Workers’ Benefit Law (VAWBL) or Volunteer Firefighters’ Benefit Law (VFBL) Policy.

      Report the premium charged for this additional coverage under Statistical Code 9851 “Extension of Employers’ Liability – Volunteer Ambulance” for VAWBL policies endorsed by WC 31 06 13 “New York Volunteer Ambulance Workers’ Benefit Law Extension of Employers’ Liability Insurance Endorsement”, and under Statistical Code 9850 “Employers’ Liability Extension” for VFBL policies endorsed by WC 31 06 07 A “New York Volunteer Firefighters’ Benefit Law Extension of Employers’ Liability Insurance Endorsement”.

    7. Rate Deviations

      Not applicable in New York to policies effective October 1, 2008 and subsequent.

    8. Repatriation Expense Premium

      Report the premium charged for repatriation expense on policies endorsed by WC 31 06 17 B “New York Foreign Voluntary Compensation and Employers’ Liability Coverage Endorsement” under Statistical Code 9606 “Repatriation Expense Premium Charge.”

    9. Waiver of Subrogation Premium

      Report the premium charged for waiver of subrogation on policies endorsed by WC 00 03 13 “Waiver of Our Right to Recover from Others Endorsement” under Statistical Code 0930 “Waiver of Subrogation.”

11. TOTAL SUBJECT PREMIUM AMOUNT

Report the total premium amount subject to experience modification. This is the sum of classification code and statistical premium that is subject to experience rating.

12. EXPERIENCE MODIFICATION FACTOR

Report the experience modification factor used to develop the charged premium.

Example: A .95 experience modification factor must be reported as 0950. There is an implied decimal between the first and second digit in this field.

If a change in experience modification occurs subsequent to the inception date of the policy, then the exposures, carrier approved rates and corresponding premiums must be split and reported separately with the corresponding mod factor and mod effective date.

Note: Zero-fill for policies not subject to experience modification and for policies subject to Merit Rating. Refer to Item (13)(f) of this Part for instructions on reporting Merit Rating credit and debit premium.

13. PREMIUM NOT SUBJECT TO EXPERIENCE MODIFICATION FACTOR

Report the classification codes and corresponding exposures, rates (if applicable) and premium amounts separately for classifications not subject to experience modification.

  1. Atomic Energy Radiation Exposure

    Refer to Part (I), and Items (12) and (13) of this Plan.

  2. Construction Classification Premium Adjustment Program Premium Credit

    Report the premium credit amount resulting from this program under Statistical Code 9046 “Premium Adjustment Credit Factor.”

  3. Drug-Free Workplace Premium Credit

    Report the premium credit amount under Statistical Code 9846 “Drug-Free Workplace Credit – Not Subject to Experience Rating” for policies written in conjunction with a carrier filed Drug-Free Workplace Program, when filed not subject to experience rating.

  4. Deductible Programs

    Report the premium credit amount for carrier filed and approved deductible programs under Statistical Code 9663 “Deductible Prem. Credit After Experience Rating” when filed not subject to experience rating.

  5. Managed Care/Preferred Provider Organization Premium Credit

    Report the premium credit amount under Statistical Code 9874 “Managed Care/PPO Prem Credit – Not Subject to Experience Rating” for policies written in conjunction with a carrier filed and approved Managed Care or Preferred Provider Organization program.

  6. Merit Rating Premium Amount

    Report the premium amount resulting from the application of New York Merit Rating factors as follows:

    Merit Rating Factor Code
    .92 9885
    1.00 9884
    1.04 9896
    1.08 9886

    Note: Zero-fill the premium amount when Code 9884 applies.

  7. Minimum Premium Policies

    1. Other than Maritime or FELA

      The additional premium necessary to bring the total standard premium up to the minimum premium must be reported separately from the classification code(s) manual premium and the expense constant.  The Balance to Minimum Premium must be report under Statistical Code 0990 “Minimum Premium Balance.” The amount reported under this statistical code should not include the expense constant.

      Note: If the minimum premium applies to a multi-state policy, the additional premium required to bring the total risk standard premium up to the minimum premium must be reported to the state with the highest minimum premium.

    2. Maritime or FELA

      Report the additional premium required to equal the separate minimum premiums under Statistical Code 9849 “Minimum Premium Including FELA or Admiralty” when manual premium is developed under Maritime or FELA classifications and where such premium together with any Maritime or FELA increased limits charge is less than any Maritime or FELA minimum premiums.

  8. Non-Ratable Premium Elements

    Report the exposures, manual rates and premium amounts under the associated statistical codes listed in Part (VI) of this Plan for classification codes containing non-ratable elements.

    Note: Report the same exposure under the non-ratable codes as reported for the companion ratable classification codes.

  9. Rate Deviations

    Not applicable in New York to policies effective October 1, 2008 and subsequent.

  10. Schedule Rating Premium Amount

    For policies that include Schedule Rating credits or debits, report the premium credit amount under Statistical Code 9887 “Schedule Rating Credit” and the premium debit amount under Statistical Code 9889 “Schedule Rating Debit”.

  11. Short Rate Penalty Premium

    Report the additional premium resulting from the application of the Short Rate Cancelation Rule Rule IX (C)(3)(f) in the New York Workers’ Compensation and Employers’ Liability Manual) under Statistical Code 0931 “Short Rate Penalty – Not Subject to Experience

  12. Workplace Safety and Loss Consultation Premium Surcharge

    Report the premium surcharge amount as a result of the New York Compulsory Workplace Safety and Loss Consultation Program under Statistical Code 9747 “Workplace Safety – Loss Consultation Premium Surcharge.”

  13. Workplace Safety and Loss Prevention Incentive Program (WSLPIP) Premium Credit Amounts

    1. Drug and Alcohol Prevention Program

      Report the premium credit amount under Statistical Code 9753 “Drug & Alcohol Prevention Program Premium Credit – WSLPIP” for policies written in conjunction with New York’s Drug and Alcohol Prevention Program.

    2. Return-To-Work Program

      Report the premium credit amount under Statistical Code 9743 (“Return to Work Program Premium Credit – WSLPIP”) for policies written in conjunction with New York’s Return-To-Work Program.

    3. Safety Incentive Program

      Report the premium credit amount under Statistical Code 9748 (“Safety Incentive Program Premium Credit – WSLPIP”) for policies written in conjunction with New York’s Safety Incentive Program.

  14. Safe Patient Handling Act Program Premium Credit

    Report the premium credit amount under Statistical Code 9651 (“Safe Patient Handling Program Premium Credit”) for policies eligible for the Safe Patient Handling Act Program Premium Credit.

14. TOTAL PAYROLL EXPOSURE

Report the sum of all payroll exposures. Do not include exposures reported for the non-ratable codes.

Note: Total payroll exposure is only required on first reports and corrections to first reports.

15. TOTAL STANDARD PREMIUM AMOUNT

Report the total premium amount charged for the policy, excluding any approved expense constants, premium discounts, terrorism and catastrophe charges, New York Security Fund surcharges and any New York assessments.

Note: The total standard premium amount is only required on first reports and corrections to first reports.

16. PREMIUM DISCOUNT AMOUNT

Report the premium amount resulting from the application of approved premium discount plans under Statistical Code 0063 (stock company or Type A) or Statistical Code 0064 (non-stock company or Type B). Do not include the premium discount amount in the total standard premium.

17. EXPENSE CONSTANT AMOUNT

The premium amount resulting from the application of an approved expense constant must be reported under Statistical Code 0900 (“Expense Constant”) and must be reported separately from the classification code(s) manual premium and any Balance to Minimum premium. Do not include the expense constant amount in the total standard premium.

Note: The expense constant on a multi-state policy must be allocated to the state with the highest applicable expense constant. If two or more states included on the policy have the same highest expense constant, the expense constant must be reported for the state developing the largest amount of standard premium.

18. CATASTROPHE PROVISION FOR TERRORISM

Report the premium amount charged for terrorism under Statistical Code 9740 (“Catastrophe Provision – Terrorism Premium Charge”.)

Note: Do not include the terrorism amount in the total standard premium.

19. CATASTROPHE PROVISION FOR NATURAL DISASTERS AND CATASTROPHIC INDUSTRIAL ACCIDENTS

Report the premium amount charged for natural disasters and catastrophic industrial accidents under Statistical Code 9741 (“Catastrophe Provision – Terrorism Premium Charge”.)

Note: Do not include the catastrophe amount in the total standard premium.

20. NEW YORK WORKERS’ COMPENSATION SECURITY FUND SURCHARGE

Report the surcharge amount under Statistical Code 9749 (“New York WC Security Fund Surcharge”) when the policy is subject to the Security Fund Surcharge.

Note: Do not include the Security Fund surcharge amount in the total standard premium.