Experience Rating (ER) Split Data Reporting Guide

Posted Date: June 28, 2018

Report your ER Split Data electronically for professional employer organization (PEO) clients or ownership changes, and improve the timeliness and quality of the data.

Use the Experience Rating (ER) Split Data Reporting Guide (PDF) to obtain:

  • Reporting requirements
  • State applicability
  • Record layout and field definitions
  • Editing information

The electronic reporting method provides an alternative to the hard copy submission of the following forms:

  • Workers Compensation Experience Rating for Former Clients of Labor Contractors (NC2745, FL1372, and VA1271)
  • Workers Compensation Experience Rating for Client Companies of Employee Leasing Arrangements (NV-361)
  • Request for Separate Experience Data resulting from ownership rulings

Reporting ER Split Data electronically helps ensure data quality standards and improves the timeliness of the reported data.

Access Data Reporting Resources:

Additional Resources Available:

  • Electronic Transmission User’s Guide provides information for submitting electronic data files to NCCI and receiving reports for ER Split Data and is available in NCCI’s Manuals Library

Report ER Split Data When:

  • Clients terminate their agreements with a PEO and were covered under the PEO master policy
  • Employers sell a portion of their operations, or a subset of locations, and an ERM-14 Form was submitted to NCCI

For Experience Rating purposes, ER Split Data is the audited exposure, premium, and loss information for these types of employers.

NCCI Contact Information:

  • Phone: 800-NCCI-123 (800-622-4123), Option 6
  • Web: From ncci.com, click Contact Us, then click Customer Service Center to access the online form
  • Email for data reporting questions: data@ncci.com
  • Email for Products and Services: customer_service@ncci.com