WCSTAT (Unit) File Submission and Processing

Transcription

1 WCSTAT (Unit) File Submission and Processing January 15 18, 2019 Palm Beach County Convention Center West Palm Beach, FL Your Source for Data Quality

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3 WCSTAT (Unit) File Submission and Processing Presented by: Randy Bloom and Sylva Ghazarian Objectives Provide an understanding of the electronic reporting process from building the file through updating your data. Data Excellence! 2 1

4 Agenda Identify Expected Unit Reports Resources for Unit Report Submission Unit Report Components Pre Editing Electronic File Submissions and Submission Editing Data Quality Editing Reporting Unit Data Unit Data Collection Tool 3 Submission and Editing Flow Identify expected unit reports (1st and subsequent reports) Review URC Expected Reports and Unit Data Collection Carrier Create unit report file Update source system Pre edit the data Are corrections needed? Yes No Submit unit report file 4 2

5 Submission Methods 5 Identifying Expected Unit Reports 3

6 Filing Requirement Unit Statistical Plan Part 1 General Rules F. Filing Requirement Exposure, premium, and loss data must be filed for every policy governed under the scope of this plan. 7 Unit Statistical Data Definition Summarized audited exposure, premium, and loss information for a policy Unit Statistical Data Reported separately for each exposure state on the policy Reported in accordance with the Statistical Plan 8 4

7 Types of Unit Reports 1st Unit Report Contains audited exposure, premium, and loss information. Subsequent Unit Report (2nd 10th) Contains loss information for open, reopened, and newly arising claims. 9 Types of Unit Reports (cont d) Correction Unit Report Revises data reported in error or as a result of other changes that require corrections. Corrections can be submitted for data on any report level or on a previously submitted correction unit report. Replacement Unit Report Replaces an original 1st report that has a priority/critical error (Data Grade 5). 10 5

8 Unit Report Due Dates First Reports Losses included in the first reporting of a given policy must be valued as of 18 months after the month in which the policy became effective and filed no later than two months after the respective valuation date. Subsequent reporting of loss data (2nd 10th) Must be valued 12 months after the valuation date of the preceding report. Each report level must be filed no later than two months after the respective valuation date. 11 Unit Report Control (URC) 1st Report Open Policy Unit Report Control (URC) 2nd Report Closed 3rd Report Not Expected 12 6

9 Unit Report Control (URC) 13 Reports URC Expected Reports Identifies a list of policies for which NCCI expects to receive first and subsequent unit reports URC Overdue Reports This report includes cumulative information on first and subsequent unit reports that are overdue up to 36 months from the due date. Unit reports are overdue when they have either not been submitted or were rejected (Data Grade 9) after their due month 14 7

10 Reports Reports URC Identifies Expected the specific Unit Reports Statistical Data that is Identifies a list of policies expected, received and overdue for which NCCI expects to URC Overdue Reports This report includes cumulative information on receive first and subsequent first subsequent unit reports that are overdue up to 36 months from the due date. Unit are overdue when they have either not been submitted were rejected (Data unit reports Grade 9) after their due month 15 Reports URC Expected Reports Identifies the specific Unit Statistical Data that is expected, received and overdue URC Overdue Reports This report includes cumulative information on first and subsequent unit reports that are overdue up to 36 months from the due date. Unit reports are overdue when they have either not been submitted or were rejected (Data Grade 9) after their due month 16 8

11 Resources for Unit Report Submission Manuals Electronic Reporting Requirements Unit Reporting Rules WCIO Workers Compensation Data Specifications Manual Statistical Plan Manual Electronic Transmission User s Guide Unit Statistical Reporting Guidebook 18 9

12 Electronic Transmission User s Guide Overview Provides the necessary requirements for preparing and submitting test and production files to ensure that all connections, data files, and systems are functioning and processing correctly Provides setup and testing requirements for certification Includes the naming convention for all data files that you submit to NCCI and are distributed to you 19 Electronic Transmission User s Guide 20 10

13 Electronic Transmission User s Guide 21 WCIO Overview Workers Compensation Insurance Organizations (WCIO) WCIO Workers Compensation Data Specifications Manual provides standards for data reporting Defines Field Formatting Record Layout With Data Element Definitions WCSTAT for Unit Statistical data Applicable Data Collection Organizations (DCOs) 22 11

14 WCIO Data Specifications 23 WC Statistical Plan Overview NCCI s Statistical Plan for Workers Compensation and Employers Liability Insurance provides rules and requirements for reporting Unit Statistical data for NCCI states and Indiana Provides detailed reporting instructions for each data element Includes general data quality guidelines for quality data Provides information that allows you to code your internal systems for submitting consistently accurate unit reports to NCCI and other statistical rating organizations 24 12

15 Statistical Plan Manual 25 Unit Statistical Plan vs. WCIO Statistical Plan and Unit Statistical Reporting Guidebook Provides rules and requirements including record and report types for reporting Unit Statistical data for all NCCI states and NCCI State exceptions. WCIO Workers Compensation Data Specifications Manual Provides standard formats and specifications, including record layouts, for the electronic transmission of Unit Statistical data

16 WCIO Specifications Layout 27 Statistical Plan Data Elements Statistical Plan 2008 Edition Part 2 Header/Policy Information Effective 01 Sep :00:01 E. Carrier Code Report the numeric code assigned to the data provider (insurer) by NCCI. This numeric code must remain the same throughout the life of the policy, unless a correction has been submitted to revise the carrier Code previously reported. Effective 01 Sep :00:01 F. Policy Number Report the alphanumeric code that uniquely identifies the policy under which the experience occurred, excluding blanks, punctuation marks, and special characters. This number must be identical to the number set forth on the policy information page. The complete policy number, including prefixes or suffixes, if used, must remain the same throughout the life of the policy unless a correction report has been submitted to revise the policy number 28 14

17 WCIO Specifications Layout Example of different types of field requirements from WCIO manual: WCPOLS 29 Statistical Plan 30 15

18 WCIO Specifications Layout 31 Statistical Plan 32 16

19 Unit Report Components Electronic Unit Statistical Data: What Makes Up a Unit Report Unit Report Composed of a record or series of records Records Collec on of related data elements Data Elements Items of data that convey information about the policy, exposures, and losses. This data may be submitted as codes and values

20 Record Types 1 Header 2 Name 3 Address 4 Exposure 5 Loss 6 Total 9 File Control 35 Link Data and Key Fields Link Data Elements reported consistently within each record to link all records of a single transaction A subset of link data reported consistently across all transactions 36 18

21 Link Data and Key Fields Links individual records within a unit report Coverage Provider ID (NCCI Carrier Code) Policy Number Policy Effective Date Exposure State Key Fields Link Data Report Number Correction Sequence Number 37 Link Data and Key Field Example DATA ELEMENT Carrier Policy Number Exposure State Policy Effective Date Report # FORMAT 5 Digit Numeric Up to 18 A/N* 2 Digit Numeric 6 Digit Numeric 1 Digit Numeric VALUE NCCI Insurance Company UNITRPTEXAMPLEZ1 Alabama January 01, Correction Sequence # 1 Digit Numeric 0 *A/N Alphanumeric 38 19

22 Link Data and Key Field Example DATA ELEMENT Carrier Policy Number Exposure State Policy Effective Date Report # FORMAT 5 Digit Numeric Up to 18 A/N* 2 Digit Numeric YYMMDD 1 Digit Numeric VALUE NCCI Insurance Company UNITRPTEXAMPLEZ1 Alabama January 01, Correction Sequence # 1 Digit Numeric 0 *A/N Alphanumeric 39 Link Data and Key Field Example DATA ELEMENT Carrier Policy Number FORMAT 5 Digit Numeric Up to 18 A/N* REPORTED VALUE UNITRPTEXAMPLEZ1 Exposure State 2 Digit Numeric 01 Policy Effective Date Report # YYMMDD 1 Digit Numeric Correction Sequence # 1 Digit Numeric 0 *A/N Alphanumeric 40 20

23 Record Type Components Header information: The header information on the unit is based on the policy information The key fields (Policy Number, Policy Effective Date, and Carrier Code) must match the policy information previously reported to NCCI, either on the policy or a prior report level Exposure information: The exposure information includes individual classification payroll, rates, and premium Loss information: Loss amounts and coding values must be valued 18 months after the Policy Effective Date Losses requiring subsequent reports must be valued one year after the prior valuation 41 Original Reports Requirements Unit Report Type Header Record (1) Name Record (2) Address Record (3) Exposure Record (4) Loss Record (5) Total Record (6) Original Reports: 1st Reports Must have only 1 Must have only 1 Optional Must have at least 1 Required when there is a loss(es) Optional 1st Replacement Reports Must have only 1 Must have only 1 Optional Must have at least 1 Required when there is a loss(es) Optional Subsequent Reports Must have only 1 Must have only 1 Optional None allowed Must have at least 1 Optional Unit Statistical Reporting Guidebook: Part 1 B

24 Assumed Decimal Exposure 43 Reporting Fields With Assumed Decimals Exposure Amount Decimal between Positions 75 and Manual Rate Decimal between Positions 89 and 90 Experience Mod Factor Decimal between Positions 51 and

25 WCIO Unit Stat Format Unit Example 45 WCIO Unit Stat Format Unit Example 46 23

26 WCIO Unit Stat Format Unit Example 47 Link Data Carrier Code Policy Number Exposure state Policy Effective Date Report Number Correction Sequence Number 48 24

27 Record Types Header Record Name Record Address Record Exposure Record Loss Record Total Record 49 Extract Data Feature 50 25

28 Extract File 51 Pre Editing 26

29 Pre Editing In House Pre Edit Service Pre Edit Tool 53 Pre Editing In House Pre Edit Service Submit data Pre Edit via ncci.com Service Receive Pre Edit Submission Results Report Pre Edit Tool 54 27

30 Pre Editing Pre Edit Tool In House Pre Edit Service Submit data Submit data Pre Edit via ncci.com via ncci.com Service Receive submitting Pre Edit to production Submission Results Report Receive Pre Edit Pre Edit Submission Tool Results Online correction of unit data prior to Report 55 File Naming Conventions Inbound File Type Naming Convention Pre Edit Service File Unitpru.**.txt Pre Edit Tool pred250e.**.txt **Accommodates up to 18 additional characters 56 28

31 Electronic File Submissions and Submission Editing Electronic Certification Testing What does the certification process test? Ensures all connections, files, and systems are functioning and processing correctly Who has to get certified? All new data providers Data providers that changed their data reporting system For general certification requirements, refer to the Electronic Transmission User s Guide Electronic Transmission User s Guide: Part 4 F

32 Electronic File Submissions Web based tool for reporting data Data Transfer via the Internet (DTVI) Retrieve your submitted and received data files Notification when data is received and processed Files retained for eight calendar days Data Provider Profile Form Electronic Transmission User s Guide: Part 2 59 DTVI 60 30

33 Electronic File Submissions Secure FTP (File Transfer Protocol) Automates your file transmissions Defines directories to retrieve and store files Sets up a transmission schedule Electronic Transmission User s Guide: Part 2 61 File Naming Conventions Inbound File Type Naming Convention Production File unit25e*.txt Certification File unit25e*.tst *Accommodates up to 30 additional characters 62 31

34 DTVI File Names Inbound Files Unique date and time stamp before the file extension in the stored file name yyyymmdd_hhmmssnnn Inbound File Name unit25e*.txt Stored File Name unit25e*_ _ txt 63 File Tracking Feature Data Transfer Via the Internet

35 NCCI Unit Data Reporting Workflow Submission Editing Did the file reject? No Edit the unit reports Yes Update source system NCCI Did the unit reports reject? No Unit reports are accepted and loaded to database Are corrections needed? No Data is available for use Yes Yes 65 Submission Edits Invalid File Name Unauthorized User Invalid Data File does not follow standard naming convention User does not have access to submit the data Data submitted with invalid characters or the file is empty Out of Balance 80% Duplicate Units Invalid Encryption Key File Control record counts do not match NCCI counts 80% or more of the units match data already on NCCI s database PGP encryption key does not match NCCI key 66 33

36 Out of Balance One unit report submitted with eight records, but the File Control Record lists two units submitted with nine records. Detail Record Count Total Unit Reports Submitted Total 67 Data Quality Editing 34

37 Unit Statistical Editing Front end quality checks Validity Accuracy Completeness Two different versions of the matrix are found in the Unit Statistical Reporting Guidebook All Edits in Production Future Enhancements 69 Unit Edit Matrix 70 35

38 Description Provides results of individual file submissions and displays units that were rejected or accepted with errors. Description Includes information on all unit reports that were submitted the prior day and remain rejected or in error. Unit reports with rejects and/or errors that were corrected are not included on this report. Data Reports Unit Submission Results Report Frequency/Naming Convention Upon Submission UnitSubmissionResultsReport_xxxxxxx.csv Unit Daily Submission Results Report Frequency/Naming Convention Daily UnitDailySubmissionResultsReport_xxxxxxx.csv 71 User Generated Reports Reject and Edit Report This report identifies rejects and errors resulting from customized criteria selected via the Data Reports feature. URC Expected/Overdue Reports Identifies the specific Unit Statistical Data that is expected and overdue

39 Correction of Errors Data providers are expected to correct all errors found in their data. All priority errors that impact the accuracy of ratemaking and/or experience rating must be corrected immediately to prevent delays in the release of these products. Statistical Plan Manual: Part 1 E 73 Reporting Unit Data 37

40 Unit Report Type Correction Reports: Header Record (Correction Type H) Exposure Record (Correction Type E) Loss Record (Correction Type L) Multiple Record (Correction Type M) Total Record (Correction Type T) Loss Record Corrections Due to Aggravated Inequity (Correction Type A) (FL Only) Correction Reports Requirements Header Record (1) Must have only 1 Must have only 1 Must have only 1 Must have only 1 Must have only 1 Must have only 1 Name Record (2) Optional Must have only 1 Must have only 1 Must have only 1 Must have only 1 Must have only 1 75 Address Record (3) None Allowed None Allowed None Allowed None Allowed None Allowed None Allowed Exposure Record (4) None Allowed Required None Allowed Required when correcting exposure(s) None Allowed None Allowed Loss Record (5) None Allowed None Allowed Required Required when correcting loss(es) None Allowed Required Total Record (6) None Allowed Optional Optional Optional Must have only 1 Optional Unit Statistical Reporting Guidebook: Part 1 B 2 Correction Sequence Number Number of Corrections Field Value First 9 sequential correction reports 1 through 9 Next 26 sequential correction reports A through Z Beyond 35 sequential correction reports Z Unit Statistical Reporting Guidebook: Part 1 C

41 Header Corrections 1st reports only Use Correction Type Code H or M Report all Header Record fields Updatable key fields Carrier Code, Policy Number, Policy Effective Date Use Previously Reported fields to correct key fields Exposure State is not updatable need to report a new unit Other link data fields are not updateable (Report Number, Correction Sequence Number) Contact NCCI Customer Service if you need to change 77 Exposure Corrections 1st Reports Only Use Correction Type Code E or M Report Correction Sequence Number 78 39

42 Exposure Matching Fields Match Exposure Corrections to 1st Report Prevents Duplicate Exposure Records Class Code or Statistical Code Exposure Act/Exposure Coverage Code Experience Modification Effective Date Rate Effective Date 79 Loss Corrections Use Correction Type Code L All report levels A for Aggravated Inequity Claims (Florida only) Use Correction Type Code M 1st reports only Report Correction Sequence Number 80 40

43 Loss Matching Fields Match losses on subsequent and correction reports to losses on prior reports Claim Number Accident Date 81 Update Type Code Identifies how each Exposure and Loss Record will be processed Two methods: Previous and Revised (P and R) Add, Change, and Delete (A, C, D) Statistical Plan: Part 6 Unit Statistical Reporting Guidebook: Part 1 E 82 41

44 Unit Data Collection Tool Allows you to: Unit Data Collection (UDC) View, submit, and correct your company s Unit Statistical data Update your Unit Report Control (URC) statuses 84 42

45 Unit Data Collection Unit Data Collection also includes: Unit Pre Edit Tool Allows you to submit your Unit Statistical data file to pre edit and update it online before submitting the data to production Notifications Allows you to view and respond to Unit Notifications issued to your company Extract Production Data Allows you to extract your Unit Statistical data in the WCSTAT format to assist you with creating subsequent reports, archiving, or researching Carrier Information Provides specific details about your company s group, branch, contact, and buyout/runoff information Data Reports Allows you to retrieve NCCI generated reports and request customized reports 85 Unit Data Collection Unit Data Collection also includes: Unit Pre Edit Tool Allows you to submit your Unit Statistical data file to pre edit and update it online before submitting the data to production Notifications Allows you to view and respond to Unit Notifications issued to your company Extract Production Data Allows you to extract your Unit Statistical data in the WCSTAT format to assist you with creating subsequent reports, archiving, or researching Carrier Information Provides specific details about your company s group, branch, contact, and buyout/runoff information Data Reports Allows you to retrieve NCCI generated reports and request customized reports 86 43

46 Unit Data Collection All unit report types can be entered and submitted through Unit Data Collection Update Type Code A/C/D Units submitted through Unit Data Collection generate a WCSTAT data file that is sent to the carrier via Data Transfer via the Internet Return file name = udcunit_ txt Changes made online should be made in the carrier s system to ensure synchronization of data between NCCI and the carrier 87 44

47 Supplemental Information

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49 Presenter Biographies Randy Bloom has worked at NCCI for 33 years, currently in the Data Collection Department of the Data Resources Division. His primary role is as Third Party Data Steward, Infrastructure Support, Unit Production Support and Financial Data Support, which entails assisting coworkers with NCCI infrastructure setup, Unit Data Collection system issues, and Financial Data Collection issues, as well as coordinating the creation, implementation, and testing of Unit Data Collection and unit edit enhancements and fixes. During his tenure at NCCI, Randy has also held positions in Customer Operations, Human Resources, Finance, Marketing, and Underwriting Support. Sylva Ghazarian has worked at NCCI for 25 years and is currently with the Data Operations Department of NCCI s Data Resources Division. Sylva s primary role is unit production lead, and her responsibilities include resolving unit system issues as well as coordinating the creation, implementation, and testing of unit edit enhancements and fixes. During her tenure at NCCI, Sylva has held positions in Residual Markets, Customer Operations, and Data Resources.