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As a POC service provider NCCI’s approach is to provide guidance to carriers on proof of coverage reporting guidelines. This guide is not intended to provide carrier notice to insured filing requirements.
All information provided in this guide is subject to change and dependent on notification from the state. Please refer to the applicable Workers Compensation Statutes or Rules for additional information.
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| NCCI POC Service Start Date |
September 1, 2002 |
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POC Contact Information |
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Texas Department of Insurance, Division of Workers Compensation
PO Box 12050
Austin, TX 78711-2050
Contact Name: Martha Luevano
Tel:
512-804-4858
Email:
martha.luevano@tdi.texas.gov
Web:
www.tdi.texas.gov
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| How NCCI Provides POC Data to State |
Proof of Coverage Inquiry
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POC Timeliness Reporting Requirements |
| Transaction Received Date |
NCCI’s received date is used to determine timeliness on POC transactions accepted by the state.
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| Policies |
Must be filed within 10 days after the Policy Effective Date or endorsement and annually thereafter no later than 10 days after the anniversary date of coverage.
POC Notices may be submitted if the policy will not be issued within 10 days after the Policy Effective Date. This does not eliminate the need to submit the policy.
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| Cancellations |
Due at least 10 days prior to the cancellation effective date if the cancellation is for reasons of non-payment, fraud, in obtaining coverage, misrepresentation of the amount of payroll for premium calculation, increased hazard caused by the insured, or failure to comply with reasonable loss control recommendations.
Cancellation due within 10 days after effective date if insured obtains coverage from another insurance carrier.
For all other reasons, cancellations are due at least 30 days prior to the cancellation effective date.
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| Reinstatements |
Due within 30 days after the Reinstatement Effective Date.
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| Nonrenewals |
Texas is a continuous coverage state. Nonrenewals are required and must be reported at least 30 days prior to the effective date of the Nonrenewal cancellation.
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POC Data Reporting Requirements |
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Address Reporting—No Physical Location:
- When there is no physical location in the state, Texas will accept Employer Names linked to:
- Address Type 2—Location of Operations with an Out-of-State Address reported with State Code Link 42
- Texas will not accept Employer Names linked to Address Type 6—No Physical Location
State Processing Exceptions:
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POC Penalties & Appeals |
| POC Fines |
A late coverage filing is an administrative violation not to exceed $25,000 per day per occurrence. Each day of noncompliance constitutes a separate violation.
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| Appeals |
All appeals regarding compliance actions will be dealt with by the Enforcement Section of the Division of Workers Compensation.
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Disclaimer:
This guide is comprised of materials and information which are proprietary to NCCI and are protected by United States and international copyright and other intellectual property laws.
This guide is provided solely as a reference tool to be used for the limited purpose of providing information to carriers regarding the reporting of proof of coverage information in various states. The information in this guide shall not be construed or interpreted as providing of legal or any other advice as to the cancellation, renewal or nonrenewal of an insurance policy or contract. Use of this guide for any purpose other than as set forth herein is strictly prohibited.
The guide is furnished “As Is” and includes information available at the time of publication only. NCCI makes no representations or warranties of any kind relating to this guide, and expressly disclaims any and all express, statutory, or implied warranties including the implied warranty of merchantability and fitness for a particular purpose. Additionally, you assume responsibility for the use of, and for any and all results, conclusions, analyses, or decisions developed, derived or obtained as a result of this guide and NCCI does not endorse, approve, or otherwise acquiesce in your actions, results, analyses, or decisions, nor shall NCCI have any liability thereto.
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