For more than 40 years, NCCI has been a Proof of Coverage (POC) service provider, allowing states to verify that employers have workers compensation coverage in their state. During the last several months, updates have occurred in states where NCCI provides this service. Here’s a quick summary of the changes:
New POC Forms
- The Colorado Department of Labor and Employment Division of Workers’ Compensation now requires Form WC95—Request for Insurer Information prior to reporting workers compensation coverage.
- The Kentucky Department of Workers’ Claims (DWC) and the New York Workers’ Compensation Board updated their authorization forms (opt-in forms) to authorize NCCI to provide POC services.
Recent POC Data Format Transitions
- The Kansas Department of Labor and the Oklahoma Workers’ Compensation Commission transitioned from the NCCI Daily POC format to the IAIABC 3.0 XML format. For additional information, refer to Circulars FYI-POC-KS-2018-01 and POC-OK-2019-01.
- The Maine Workers’ Compensation Board transitioned from the IAIABC POC 2.1 format to the IAIABC 3.0 format. For additional information, refer to Circular FYI-POC-ME-2018-01.
As a POC service provider, NCCI provides guidance to carriers on POC reporting guidelines in the
Proof of Coverage (POC) State Guide. Changes to the individual state pages are announced through the Change Tracking Guide in the
POC State Guide available on
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A workers compensation policy may include a deductible program. Deductibles are categorized as either gross or net programs. State rules and regulations determine whether the deductible program is gross or net or whether both types of programs are available. When a policyholder selects a deductible, the appropriate deductible endorsement is attached to the policy.
For unit statistical reporting, deductible program reporting is required for both small and large deductible programs for the following three unit statistical (WCSTAT) records.
Type of Deductible|
|Identifies whether the program applies to Medical-Only Losses, Indemnity-Only Losses, or Medical and Indemnity Losses|
Type of Plan|
|Identifies the deductible plan basis, such as Per Claim, Per Accident, or Per Policy (Aggregate)|
Deductible Amount Per Claim/Accident|
|Includes the actual policy deductible amount (e.g., $5,000)|
Deductible statistical codes identify where the credit applies in the overall premium calculation. The deductible premium credit is reported to the appropriate statistical code, as follows:
- Code 9664—Deductible Reporting—Subject to Experience Modification Factor
- Code 9663—Deductible Reporting—Not Subject to Experience Modification Factor
- Code 9657—Deductible Reporting—Not Part of Standard Premium
Losses are reported differently based on whether the program is gross or net, as follows:
Gross Deductible Programs—The full value of the Incurred Indemnity and Incurred Medical amounts are reported. The Deductible Reimbursement Amount is reported as zero (0).
Net Deductible Programs—The full value of the Incurred Indemnity and Incurred Medical amounts are reported. The Deductible Reimbursement Amount is reported subject to the policy deductible, loss amount, and upper limit as defined by the net deductible program rules.
For unit statistical deductible reporting, the key resources are NCCI’s
Statistical Plan and the
Unit Statistical Reporting Guidebook, Part 8—Deductible Programs.
Did you know that NCCI’s preferred reported code for a Provider Identification Number is the National Provider Identification Number, when applicable? This reporting preference was made to ensure preciseness of the Medical Data Call.
For additional information, refer to Circular MED-2019-01, released on March 5, 2019.