Data Tips
Data Tips provide you with information on best reporting practices. Do you have an idea for a tip? Please email it to
thedataconnection@ncci.com.
Indemnity and Medical Guidebook Updates
Did you know the 2022
Indemnity Data Call Reporting Guidebook updates were released on June 22, 2022? Be sure to check out the Change Tracking Guide. The updates included language updates to improve the accuracy and completeness of the information, reorganizing and adding references for information that is now available in the recently transformed
Electronic Transmission User’s Guide.
Did you know the 2022
Medical Data Call Reporting Guidebook was released on September 14, 2022? Check out the Change Tracking Guide for full details.
Indemnity Data Reporting Reminder
During our reasonability review of the Indemnity data, we determined that three highly conditional fields (Disability/Loss of Earnings Capacity Percentage, Pre-Existing Disability Percentage and Temporary Disability Benefits Extinguishment Code) are being under populated.
Here is some additional information on these fields:
Disability/Loss of Earnings Capacity (LOEC) Percentage
There are 28 jurisdictions (including federal) where permanent partial disability (PPD) benefits are based upon additional factors beyond just the Impairment Percentage as set by the claimant’s physician post-maximum medical improvement. In these jurisdictions either a Disability or LOEC Percentage is determined for use in the calculation of benefits. When this has occurred, the final percentage used in the calculation of the PPD benefits is to be reported in the Disability/LOEC Percentage field, on a whole-body basis. Thus the final number of weeks of PPD benefits should be the Disability/LOEC Percentage multiplied by the maximum number of weeks to determine the length of PPD benefits.
Pre-Existing Disability Percentage
Likewise in the instance where a claimant’s PPD benefits are shortened due to a previous injury, the percent used in the calculation should be reported in the Pre-Existing Disability percentage field. Thus the final number of weeks of PPD benefits would be determined by calculating the percent of PPD benefits the claimant is entitled to; the Impairment Percentage (converted to a whole-body basis) minus the Pre-Existing Disability Percentage (also on a whole-body basis). Then that percentage would be multiplied by the maximum number of weeks.
Temporary Disability Benefit Extinguishment Code
The Temporary Disability Benefit Extinguishment Code should be reported as zero (0) if Temporary Partial Disability (TPD) or Temporary Total Disability (TTD) benefits are being paid. When TPD or TTD benefits cease to be paid, then the Temporary Disability Benefit Extinguishment Code would be populated with whichever of the six code values best corresponds to the reason for termination of temporary benefits. Be aware that Code 6 (Other) is not to be used for ongoing TPD or TTD benefits. This code is to be used when temporary benefits have been terminated, but not for one of the code values (1–5) with a defined reason.
Policy—What Is the Industry Code?
The Industry Code data element in policy reporting is the North American Industry Classification System (NAICS) code. This code correlates to the classification of a business as it relates to the United States business economy. The NAICS codes replaced the Standard Industrial Classification (SIC) system in 1997. You can find the most current NAICS code listing at
www.census.gov/naics.
Effective in Fourth Quarter 2022, NCCI and NCCI POC states will no longer accept the SIC codes. Refer to the
Policy and Proof of Coverage Reporting Guidebook, Proof of Coverage section, specifically the POC Data Element Requirements Chart for individual state reporting requirements. This information is also available in the
POC State Guide.
Refer to Circular
POLS-2022-02—Policy—Industry Code Reporting Requirements for details.
Deductible Reporting—Three Report Records—Header, Exposure, and Loss
When a policyholder selects a deductible program as part of their workers compensation coverage, the information about the deductible will be reported to NCCI on Policy Data and Unit Statistical Data.
For policy, the information is reported for each state with a deductible program on the Deductible Endorsement Record—Record Type Code 43.
For Unit Statistical Data, reporting accurate deductible information is important, since this information may impact the experience rating modification, in which gross and net deductible programs are treated differently. In applicable states, a net deductible program uses deductible reimbursements to reduce incurred losses (in the experience rating calculation) up to the deductible amount on the policy.
Deductible information is reported on three related unit statistical records—the Header Record, Exposure Record, and Loss Record:
- The Header Record identifies the type of deductible, the associated deductible plan, and the deductible amount
- The Exposure Record includes the program’s premium credit, if applicable
- The Loss Record contains the deductible reimbursement amount, if applicable
The two key resources to understand how to report these three records are the
Statistical Plan for Workers Compensation and Employers Liability Insurance and the
Unit Statistical Reporting Guidebook (USRG).
Below is a sample of the NCCI Small Deductible Programs State Guide (from
USRG’s Part 8), which specifies information required for each record under the NCCl-filed small deductible programs.
For the latest educational opportunity on reporting deductible data, register for the
Data Now Program 2023—Deductible Data Reporting session.
