Indemnity Data Reporting: Conditional Reporting Basics
When it comes to Indemnity data reporting, some fields are required, and others are conditional. A field is conditional when it is only required to be populated when another field is present or reported with certain codes within the file.
When reviewing the
File Results screen in the
Indemnity Data Collection tool, you may notice some edits are invoked for one data element but initiate an error because of another data element. Our File Level and Quarter End edits will flag these issues within your submitted data . The data element(s) may fail for the category and result in an assessment if not corrected by the end of the due quarter.
Although the
Indemnity Data Collection tool does display edits received from the quality of your data, proactively understanding how the fields work together and initiating checks in your source system can help to reduce the edits and potential assessments.
Familiarizing yourself with the data elements listed in Part 6 of the
Indemnity Data Call Reporting Guidebook is a great way to not only understand how to report the individual elements, but also to understand:
- The associated elements expected to be reported when specific conditions are present for the claim
- Specific requirements that can assist you with placing reporting triggers in your system
- Applicability and exceptions by state
Policy—Expansion of Email Address (Address Record—Record Type 03)
Please refer to the POC State Guide or the Policy and Proof of Coverage Reporting Guidebook to see the state-specific requirements on email address reporting
In 2023, the Workers Compensation Insurance Organization (WCIO) EDI Committee adjusted the Policy Data WCPOLS specification to allow for the expansion of the Email Address on the Address Record—Record Type 03. WCPOLS now allows for up to 67 bytes to be used to report an Email Address.
The first 42 bytes of an Email Address are reported in positions 225—266 of the Address Record. If the Email Address is longer than 42 bytes, then you can use the new “Email Address—Continued” field in positions 162—186, which provides an additional 25 bytes.
NCCI has completed a project to be able to collect all 67 bytes from both fields and to provide the full Email Address through Proof of Coverage (POC) in the International Association of Industrial Accident Boards and Commissions (IAIABC) 3.0 format. Currently, we provide the IAIABC 3.0 POC format to the following states: Alabama, Connecticut, Hawaii, Idaho, Kansas, Maine, Montana, Oklahoma, and Utah.
Unit Statistical Data—Reporting per Capita Class Codes
Did you know that domestic workers such as housekeepers and chauffeurs are classified under special class codes called per capita codes? Learn about the various codes and exposure amounts.
Common per Capita Codes
0908: Domestic Workers—Residences—Part-Time
0913: Domestic Workers—Residences—Full-Time
A per capita classification uses the number of workers, rather than payroll, to measure exposure.
Per Capita Exposure Amounts
Per capita exposure is “nonstandard” exposure. This means that a measurement other than payroll is used for the exposure amount. The exposure amount is rounded to the nearest tenth, and there is an assumed decimal point between positions 75 and 76 in the WCSTAT record layout.
Per Capita Exposure Reporting
Report each per capita exposure in multiples of 10 for full-term policies. The decimal point before the last position is assumed and not reported. For example, one per capita exposure translates to an exposure amount of 10; two per capita exposures translate to an exposure amount of 20, etc. on a full-term policy.
For more information on per capita class codes, refer to:
- Rules for determining premium of domestic workers—residences in NCCI’s
Basic Manual
- Part 4-H-3, Per Capita Classification Codes for Domestic Workers, in NCCI’s
Unit Statistical Reporting Guidebook
Suspect per Capita Payroll Example
Suspect per capita exposure can result in validation edits. Often, this has to do with incorrect decimal placement. In the example below, a 1 was reported for the exposure in Class Code 0908.
The carrier researched the issue after receiving a validation edit in
Unit Data Collection (UDC). It was discovered that there was one domestic worker employed under a full-term policy.
Corrections were submitted to revise the exposure amount to
10, which correctly reflects one domestic worker on a full-term policy.
Experience Rating (ER) Split Data Reporting
Are you familiar with NCCI’s template for electronically reporting Experience Rating (ER) Split Data?
ER Split Data is reported when:
- A client leaves a PEO arrangement covered under a master policy and the PEO’s data provider reports to NCCI the client’s data that was developed during the employee leasing arrangement
- A client is covered in Nevada under a PEO master policy, and the PEO’s data provider reports the client’s data following the reporting of the Unit Statistical Data for the PEO’s policy
- Changes in ownership interest affect the use of an entity’s experience in future experience rating modification, and NCCI requests individual exposure and claim data from the data provider
The template is a Microsoft Excel spreadsheet that can be downloaded and does not require a user ID or password. This spreadsheet provides a convenient way for you to enter the audited exposure and loss information for these types of employers and then have an electronic file automatically created for submission to NCCI using
Data Transfer via the Internet.
Available on the Data Reporting page/Experience Rating Split Data category, the template includes a guide that provides general instructions for use. The template allows entry of up to 10 separate ER Split Data reports, and each report can have up to 1,000 rows.
Benefits of using the template:
- Up-front editing
- No resubmissions
- No subsequent reporting
- Quicker processing
To learn more, check out these two webinars:
Refer to NCCI’s
Experience Rating (ER) Split Data Reporting Guide for the conditions, requirements, and examples for reporting ER Split Data.
