Benefit from using the ER Split Data reporting template for submitting data for former professional employer organization (PEO) clients or ownership changes.
The template 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.
Download the
ER Split Data Reporting Template (Excel).
Keep these points in mind when using the template:
- State applicability and required data elements are defined in Part 2-B—Applicable States of the
Experience Rating (ER) Split Data Reporting Guide.
- The first tab is for data input, and the second tab is the User’s Guide with entry instructions.
- Each file you create can contain up to 10 separate ER Split Data reports. Each report can contain up to 1,000 rows for exposure and loss data.
- The created file includes the record layouts as defined in the
Experience Rating (ER) Split Data Reporting Guide.
- Before initial submission, you must be granted access to submit ER Split Data files. Contact NCCI’s Customer Service Department for additional information.
Report ER Split Data 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
For more information, contact our Customer Service Center at 800-NCCI-123 (800-622-4123).
