Basics of Unit Statistical Data Reporting

Transcription

1 NCCI S Basics of Unit Statistical Data Reporting January 26 29, 2016 Palm Beach County Convention Center West Palm Beach, FL

2

3 Basics of Unit Statistical Data Reporting Presented by: Richard Saltzman and Jackie Ganthier Objective By the end of this session, you will understand the basic requirements of unit statistical reporting using the Statistical Plan and Unit Statistical Reporting Guidebook. 2 1

4 Agenda Loss and Expense Exposure Header/Policy Editing, Validation, and Quality Interaction URC Introduction General Requirements Resources 3 Introduction 2

5 NCCI s Stat Agent Role Data Collection Validation Edit 5 NCCI s Advisory Role Prepares rate recommendations Analyzes industry trends NCCI Assists in pricing proposed legislation Provides a variety of products and services 6 3

6 What Is Unit Statistical Data? Unit Statistical data is the audited exposure, premium, and Unit loss Statistical information data is for the a audited exposure, policy. premium, and loss information for a Required to policy. be submitted for all NCCI states covered on each policy. 7 Unit Statistical Data Life Cycle Correction Report Submissions (as needed) Workers Compensation Policy Unit Report Control System Validation Tests Front End Editing Data Uses Experience Rating, Class Ratemaking, and Products and Services Actuarial Analysis Report Preparation Policy System, Claim System, and Audit Unit Report Submissions: 1st and Subsequents (2nd 10th Reports) Pre Edit Submissions 8 4

7 Statistical Plan Part 1 General Rules Part 7 Pension Tables 9 Unit Statistical Reporting Guidebook Introduction Part 5 Loss and Expense Information and Examples 10 5

8 Unit Statistical Reporting Guidebook Part 7 State Specific Information and Examples Part 12 Edit and Validation Matrices 11 Unit Statistical Reporting Guidebook Part 13 DCA Access Online Part 14 Unit Statistical Data Reporting (Workflow) Part 15 Summary of Examples 12 6

9 Recommended Unit Data Reporting Workflow Carrier Identify expected unit reports (1st and subsequent reports) Review URC Expected Reports and DCA Access Online Create unit reports Update source system Pre edit the data Are corrections needed? Y N Submit unit reports 13 Recommended Unit Data Reporting Workflow NCCI Edit the Reports Update source system Did the unit reports reject? Y N Unit reports are accepted and loaded to database Are corrections needed? N Data is available for use 14 7

10 Introduction Review Questions Statistical Reporting Rules Unit Life Cycle starts with what? Audited Exposure, Premium, and Losses Summary of Examples located in Experience Ratings Possible Answers Claims Unit Statistical Data Unit Statistical Tools NCCI Statistical Plan Single State Policy Unit Statistical Resources WC Policy Submission Results Report Uses Unit Statistical Data Unit Statistical Reporting Guidebook 15 Blueprint Loss and Expense Exposure Header/Policy Editing, Validation, and Quality URC Resources Introduction General Requirements 16 8

11 General Requirements Types of Unit Reports 1st Reports Subsequents Corrections Replacements 18 9

12 Unit Report Valuation and Due Dates Report Level Valuation (month after PED*) Due by (month after PED) 1st 18th 20th 2nd 30th 32nd 3rd 42nd 44th 4th 54th 56th 5th 66th 68th 6th 78th 80th 7th 90th 92nd 8th 102nd 104th 9th 114th 116th 10th 126th 128th *Policy Effective Date 19 Record Types Header (01) Name (02) Address (03) Exposure (04) Loss (05) Unit Total (06) Submission Control (09) 20 10

13 Correction Reports Revise data previously reported Report appropriate correction type code Increment correction sequence number Update Type Previous/ Revised Add/Change /Delete 21 When to Report Corrections 1 2 Unit previously reported with error(s) 3 4 Subrogation Recovery/ Second Injury Fund reimbursement 5 6 Claim determined to be noncompensable Part of Body Code (previously unclassified) was determined Final audit completed Claim determined to be fraudulent 22 11

14 When Not to Report Corrections Loss Development Injury Type Development 23 Corrections Correction Type Code Correction Type Code H E L T M A Description Header Correction (1st reports only) Exposure Correction (1st reports only) Loss Correction Total Correction Correction to Multiple Record Types Loss Correction Due to Aggravated Inequity Unit Statistical Reporting Guidebook(USRG): Part 1 C

15 Corrections 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 2 25 Key Fields Matches 1st Unit Report to Policy Carrier Code Policy Number Policy Effective Date Exposure State 26 13

16 Carrier Code Policy Number Policy Effective Date Exposure State Report Number Linking Fields Links individual records within a unit Links subsequent and correction reports Correction Sequence Number 27 General Review Questions Unit Valued at 18 Months No Corrections Reports Key Fields Match Key Field Correction Report Reason Possible Answers Data Reported in Error Claim Number Policy and 1st Unit Report Loss Development Policy Number 1st Unit Reports 28 14

17 Blueprint Loss and Expense Exposure Header/Policy Editing, Validation, and Quality URC Resources Introduction General Requirements 29 Unit Report Control (URC) 15

18 URC State Applicability All Units Are Included in URC Alabama Hawaii Maryland Oregon Alaska Idaho Mississippi Rhode Island Arizona Illinois Missouri South Carolina Arkansas Indiana Montana South Dakota Colorado Iowa Nebraska Tennessee Connecticut Kansas Nevada Texas District of Columbia Kentucky New Hampshire Utah Florida Louisiana New Mexico Virginia Georgia Maine Oklahoma West Virginia 31 URC State Applicability Only Interstate Rate Units Are Included in URC Massachusetts Minnesota New York 32 16

19 URC State Applicability Data Providers That Elect to Report Directly to NCCI North Carolina Wisconsin 33 URC State Applicability Not Included in URC California Delaware Michigan New Jersey North Dakota Ohio Pennsylvania Puerto Rico Washington Wyoming 34 17

20 Program Requirements 1st Reports Policy data establishes the expectation of a 1st report Policy data fields used are: Carrier Code Policy Number Policy Effective Date State with at least $1 on State Premium Record 35 Program Requirements Subsequent Reports Open and reopened claims establish the expectation of a subsequent report Unit Statistical data fields used are: Carrier Code Policy Number Policy Effective Date Exposure State Claim Status 36 18

21 URC Does Not Expect Units When State is written on an if any basis, and No exposure develops Policy is cancelled flat 37 URC via DCA Access Online View and update capability of the current status of URC records by state View of unit reports expected, received, and/or overdue at each report level View status of policy and/or state URC records Active or inactive 38 19

22 Deactivating URC Records URC records may be deactivated when: Policy has expired AND Unit has not been received Methods for deactivating a URC record: Policy transactions Flat cancellation or delete state OR Use DCA Access Online to deactivate state(s) in URC 39 URC Key Field Changes Updating Key Fields on a URC Record: Policy transactions Submit a key field change transaction to the policy OR Use DCA Access Online to change the key fields in URC 40 20

23 URC Extended Term Policies Policy With Endorsement Report based on each policy period indicated on the endorsement Policy Without Endorsement Shorter policy period first Subsequent terms in increments of 12 months 41 Extended Term Policy Example ABC Contracting Company does not have any endorsements on the policy. Policy Effective Date = 1/1/13 Policy Expiration Date = 9/1/14 How many units are reported? How should the policy period(s) be reported? a. 1 unit; Policy Period 1/1/13 9/1/14 b. 2 units; Policy Period 1/1/13 1/1/14 and 1/1/14 9/1/14 c. 2 units; Policy Period 1/1/13 9/1/13 and 9/1/13 9/1/

24 Available URC Reports URC Monthly Expected Report URC Monthly Overdue Available in CSV, PDF, Microsoft Excel formats Sent to Unit Data Contact on file Refer to Data Reports Guide at ncci.com for more information. 43 URC Review Questions Expectation of Subsequent Reports URC Does NOT Expect Units for Interstate Rated States in URC Monitors Timely Submission of Unit Reports Possible Answers URC Report Claim Number MA, MN, NY Flat Cancelled Policies URC Program Open/Reopened Claims 44 22

25 Header/ Policy Information Loss and Expense Exposure Header/Policy Editing, Validation, and Quality URC Introduction General Requirements Resources 45 Header/Policy Information 23

26 Header Components Record Number Policy Number Policy Condition Indicators Replacement Report Indicator Carrier Code Policy Type Codes Risk ID Report Number Deductible Type Codes State Effective Date Correction Sequence Number Deductible Percent Administration Number Policy Effective Date Deductible Amount Per Claim/Accident FEIN Exposure State Deductible Amount Aggregate Employee Leasing (TX Only) 47 Policy Type Code Type of Coverage Type of Plan Type of Nonstandard Provisions Standard Workers Compensation Policy (01) Alternative Workers Compensation Coverage (02) Group Policy (03) (TX only) Voluntary (01) Assigned Risk (02) Nonstandard Does Not Apply (01) Excess Policy (05) (WV only) Individuals Excluded (08) Voluntary Coverage (09) 48 24

27 Link Data and Header Key Fields Link Unit to Policy Links correction reports and subsequents to prior report levels Coverage Provider ID (NCCI Carrier Code) Policy Number Policy Effective Date Exposure State Report Number Correction Sequence Number Link Unit to Unit 49 Summary of Examples Header Header Corrections to Key Fields Header Corrections to Non Key Fields Replacement Reports 50 25

28 Header Key Field Corrections Only allowed on 1st reports All Header fields must be reported, including fields unchanged NCCI Carrier Code Policy Number Policy Effective Date 51 Header Key Field Correction Example Error: Policy numbers do not match (Unit and Policy) Corrective Action: Policy number on unit should have been WC Previous Fields Policy Number: WC12345 Policy Effective Date: 1/1/07 Carrier Code: Revised Fields Policy Number: WC Policy Effective Date: 1/1/07 Carrier Code: Correction Sequence Number: 1 Correction Type Code: H (Header) USRG Example: Part 3 B

29 Header Corrections for Non-Key Fields Used to correct all fields excluding Carrier Code, Policy Number, and Policy Effective Date Corrections only allowed on 1st reports Cannot correct Report Number and Report Sequence Number All Header fields must be reported, including fields that remain unchanged 53 Replacement Reports Use the following to correct a Data Grade 5 on original 1st unit report: Replacement Report Code R Original Administration Number of the report being replaced Key and linking fields must be consistent with the report being replaced All Exposure and Loss Records from original 1st report, including corrected data Cannot be used for subsequent or correction reports 54 27

30 Replacement Reports Example Error: Interstate-Rated Policy Indicator reported as blank (Data Grade 5) Corrective Action: Interstate-Rated Policy Indicator on unit should have been Y (Yes) Original 1st Report Fields Carrier Code: Policy Number: WC54321 Policy Effective Date: 1/1/13 Exposure State: 09 (FL) Report Number: 1 Interstate Rated Policy Indicator: Blank USRG Example: Part 3 C Replacement Report Fields Carrier Code: Policy Number: WC54321 Policy Effective Date: 1/1/13 Exposure State: 09 (FL) Report Number: 1 Replacement Report Code: R Original Administration Number: 14191C9967 Interstate Rated Policy Indicator: Y (Yes) 55 Header Review Questions Header Key Field Corrections Replacement Reports Header Corrections Require Included in Policy Type Code Reporting Example of Header Non Key Field Correction Possible Answers Update Policy Type Code Claim Number All Fields to Be Reported Correct a 1st Unit Report DG 5 Type of Plan Codes Only Allowed on 1st Reports 56 28

31 Blueprint Loss and Expense Exposure Header/Policy Editing, Validation, and Quality URC Resources Introduction General Requirements 57 Exposure Information 29

32 Exposure Record Components Exposure Act/ Coverage Code Premium Amount Record Type Split Period Code Classification or Statistical Code Experience Modification Effective Date Update Type Rating Tier Identification Code (TX) Exposure Amount Rate Effective Date Experience Modification Factor Manual Rate 59 Exposure Matching Fields Prevent Duplicate Exposure Records Match Exposure Corrections to 1st Report Class Code or Statistical Code Exposure Act/Exposure Coverage Code Experience Modification Effective Date Rate Effective Date Manual Rate Premium Amount Applies only to MA, MI, NC, NY, and TX 60 30

33 Summary of Examples Exposure Balance to Minimum Premium Carrier Independently Filed Premium Credit/Debit Programs Carrier Subclassification Programs Coal Mine Experience Company Use Only Codes Deductible Programs Estimated to Final Audit Experience Modification Factor Exposure Corrections Increased Limits of Employers Liability No Exposure Developed Multistate Policy No Exposure Developed Single State Policy Per Capita Classification Codes for Domestic Workers Ratable Class Code With Nonratable Element Rate Effective Date Split Policy Periods Three Year Fixed Rate Policy USL&HW Act 61 Exposure Matching Fields Duplicate exposure on original 1st reports will reject if: Exposure matching data elements are not reported correctly More than one Exposure Record submitted with the same matching fields 62 31

34 Exposure Corrections If the 1st unit report rejects due to duplicate Exposure Records: Correct the invalid matching data elements AND/OR Delete one of the Exposure Records 63 Exposure Corrections If the correction rejects due to unmatched or duplicate Exposure Records: Correct the invalid matching data on the Correction Record or original 1st unit report OR Delete the duplicate Exposure Record on the Correction Record or 1st unit report 64 32

35 Exposure Corrections Example Error: Exposure Amount of $23,850 for Class Code 8810 reported incorrectly Corrective Action: Exposure Amount on unit should have been $32,850 Previous Fields Update Type Code: P Classification Code: 8810 Exposure Amount: $23,850 Manual Rate: 0.37 Premium Amount: $88 USRG Example: Part 4 B Revised Fields Update Type Code: R Classification Code: 8810 Exposure Amount: $32,850 Manual Rate: 0.37 Premium Amount: $122 Correction Sequence Number: 1 Correction Type Code: E (Exposure) 65 Premium Amount Premium obtained by payroll exposure: Report under appropriate classification code Premium = (Exposure x Rate) 100 Round to whole dollar amount 66 33

36 Estimated Audit Code Estimated Report as Y Submit correction after audit is completed Not Estimated Report as N Contains final exposure 67 Premium Amount Premium adjustments: Report under appropriate statistical code Premium = flat charge that does not vary by exposure Do not report exposures or rates 68 34

37 Statistical Codes Identify premium credit and debit adjustments: Deductible Programs Schedule Rating Programs Other NCCI-Filed Programs Carrier Independently Filed Credit/Debit Programs 69 Deductible and Schedule Rating Stat Code Premium Program Premium Adjustment 9663 Deductible Credit Placement Not Subject to Experience Rating NCCI Program Yes Carrier Program Yes 9664 Deductible Credit Subject to Experience Rating Yes Yes 9657 Deductible Credit Not Part of Standard Premium No Yes 9887 Schedule Rating Credit Not Subject to Experience Rating Yes Yes 9889 Schedule Rating Debit Not Subject to Experience Rating Yes Yes 9750 WV Only Schedule Rating Credit Not Part of Standard Premium No Yes 9751 WV only Schedule Rating Debit Not Part of Standard Premium No Yes 70 35

38 NCCI-Filed Premium Programs Statistical Code Premium Program Adjustment Placement 9841 Drug Free Workplace Premium Credit 9843 Managed Care Premium Credit 9880 Workplace Safety Premium Credit Subject to Experience Rating Subject to Experience Rating Not Subject to Experience Rating 9851 Small New Employer Credit Premium Credit Not Subject to Experience Rating 71 Carrier Independent Programs Other Than Deductible and Schedule Rating Statistical Code Premium Program Adjustment Placement 9721 Independent Carrier Filing Premium Credit Subject to Experience Rating 9722 Independent Carrier Filing Premium Credit Not Subject to Experience Rating 9723 Independent Carrier Filing Premium Debit Subject to Experience Rating 9724 Independent Carrier Filing Premium Debit Not Subject to Experience Rating 9655 Independent Carrier Filing Premium Credit Not Part of Standard Premium 9656 Independent Carrier Filing Premium Debit Not Part of Standard Premium 72 36

39 Carrier Independently Filed Program Example Carrier independently filed and approved Workplace Safety program Premium credit not subject to experience rating Reported with Statistical Code 9722 (Independent Carrier Filing Premium Credit Not Subject to Experience Rating Modification) Class Code Exposure Record Fields Exposure Amount Rate Premium 5551 $360, $68, $0 0 $ Exposure Review Questions Statistical Codes Identify Prevents Duplicate Exposures Reporting Estimated Exposures Independent Carrier Filing Premium Adjustment Program Possible Answers Statistical Code 9722 Deductible Programs Estimated Audit Code Y Exposure Matching Fields Type of Plan Codes Premium Adjustments (+/ ) 74 37

40 Blueprint Loss and Expense Exposure Header/Policy Editing, Validation, and Quality URC Resources Introduction General Requirements 75 Loss Information 38

41 Loss Record Components Record Type Claim Number Incurred Indemnity Incurred ALAE* Update Type Accident Date Paid Indemnity Paid ALAE* Number of Claims Deductible Reimbursement Claimant s Attorney Fees Employer s Attorney Fees Fraudulent Claim Code Loss Act/Coverage Code Incurred Medical Loss Conditions Class Code Paid Medical Injury Descriptions Injury Type Catastrophe Number Vocational Rehab Indicator MCO Type Code Jurisdiction State Lump Sum Indicator *Allocated Loss Adjustment Expense 77 Loss Matching Fields Single Claim Claim Number Accident Date Loss Condition Code: Act (TX only PED 10/1/08 12/31/14) Loss Condition Code: Type of Claim (TX only PED 10/1/08 12/31/14) Loss Condition Code: Type of Claim (MD and VA only PED 10/1/08 and Subsequent) 78 39

42 General Incurred Loss Information Losses are reported gross Full value of the claim All paid indemnity and medical Indemnity and medical reserves Incurred loss 79 Indemnity Losses Claim Reserves Compensation Benefits Claimant Attorney Fees (also in Claimant Attorney Incurred Fee field) Vocational Rehabilitation Employer Liability Losses (including ALAE) Awards Penalties for Delays in Compensation Payments Expenses Benefiting the Claimant 80 40

43 Medical Losses Claim Reserves Doctor and Hospital Payments Physical Rehabilitation Impartial Examinations Clinical Medical Other Medical Items Transportation Expenses, etc. Bonuses or Return to Work Incentives Expenses Benefiting the Claimant 81 Subsequent Reports Provides updated data on claims associated with a policy as of the last valuation (report level) Contains only loss data Open, Reopen, and Newly Arising Claims Nine subsequent reports (2nd through 10th) 82 41

44 Summary of Examples Claims Accident Date Fraudulent Claims Noncompensable to Compensable Claim Development Adding Claims Injury Description Code Second Injury Funds Catastrophe Number Claim Number Correction at Multiple Report Levels Claim With WC and EL Benefits Coal Mine Experience Deleting Claims Part of Body Unknown Part of Body Loss Development Loss Development Loss Matching Fields Noncompensable Claims State Act to USL&HW Claim Development Subrogation Recovery Claims Supplemental Disease 83 Adding Newly Arising Claims Newly arising claims Report newly arising claims at the next unit report level Not previously reported due to error Report correction report(s) to add claims when erroneously not previously reported Claims are added using a revised record only (Update Type Code R ) Do not report a previous record (Update Type Code P ) 84 42

45 Adding Newly Arising Claims Example Issue: New arising claim develops after the 1st report Action: Report the new claim on the 2nd report using a revised record 1st Unit Report Fields 2nd Unit Report Fields Policy Number: WC Carrier Code: Policy Effective Date: 1/1/08 Report Number: 1 USRG Example: Part 5 D Update Type Code: R Policy Number: WC Carrier Code: Policy Effective Date: 1/1/08 Report Number: 2 Claim Number: Accident Date: 1/15/08 85 Adding Newly Arising Claim Example Loss Record Fields Report Number 2 Update Type Claim Number Accident Date R /15/08 USRG Example: Part 5 D 86 43

46 Deleting Claims When to delete claims: Claim has been erroneously reported Loss matching fields are incorrect Report the Claim Number and Accident Date previously reported Do not change any other data elements Only report the Update Type Code P ; do not report a revised record 87 Deleting Claims Example Error: Claim erroneously reported on a 1st unit report Corrective Action: Submit a correction to delete the claim from the unit Original 1st Report Fields Exposure State: 09 (FL) Claim Number: Accident Date: 6/1/07 Correction to 1st Report Fields Update Type Code: P Exposure State: 09 (FL) Claim Number: Accident Date: 6/1/07 Correction Sequence Number: 1 Correction Type Code: L (Loss) USRG Example: Part 5 E 88 44

47 Deleting Claim Example Loss Record Fields Report Number 1 Correction Seq. No. 1 Corr. Type L Update Type Claim Number Accident Date P /15/08 USRG Example: Part 5 E 89 Injury Description Codes Six-digit field composed of three components: Part of Body What got injured? Nature of Injury What was the result? Cause of Injury What caused it? Foot Burn Fire 90 45

48 Part of Body Code Assignment Identifies the specific part of body affected by the injury Most significant contributor to the claim at time of unit valuation If the specific part of body cannot be identified, then code according to the applicable value for multiple body parts Multiple Upper Extremities = Part of Body Code Part of Body Unknown When the specific part of body affected by the injury cannot be determined at the 1st unit report, Part of Body Code 65 must be reported When the part of body is identified after the 1st report, corrections are required for all units going back to the first report level 92 46

49 Changes in the Part of Body (Loss Development) May change due to normal loss development Should be reported on next subsequent report Do not submit a correction report to reflect changes 93 Part of Body Loss Development Example Issue: Part of body changed due to loss development Action: Report appropriate part of body on 2nd Report 1st Report Fields Claim Number: Injury Description Codes Part of Body: 40 (Multiple Trunk) Nature of Injury: 49 (Sprain or Tear) Cause of Injury: 31 (Fall, Slip, or Trip, NOC) 2nd Report Fields Claim Number: Injury Description Codes Part of Body: 42 (Lower Back) Nature of Injury: 49 (Sprain or Tear) Cause of Injury: 31 (Fall, Slip, or Trip, NOC) USRG Example: Part 5 G

50 Subrogation Reductions to the paid and incurred loss amounts due to: Subrogation Recovery from a third party with a legal liability to the claim Net Incurred Loss = Gross Incurred Loss (Amount Recovered Recovery Expenses) Anticipated subrogation applies in Oregon 95 Second Injury Funds Reductions to the paid and incurred loss amounts due to: Second Injury Fund Carrier submits eligible claim for reimbursement from state Second Injury Fund Net Incurred Loss = Gross Incurred Loss Reimbursement Amount Carrier anticipates reimbursement from Special Fund Applies in states with Second Injury Fund 96 48

51 State Act and USL&HW Act Benefits Policies with coverage for State Act and USL&HW benefits Losses for both coverages are reported as one claim Loss Condition Act Code is reported as of valuation date Only State Act benefits Act Code 01 (State Act) Only USL&HW Act benefits Act Code 02 (USL&HW Act) Both State and USL&HW Act Benefits Act Code 02 Act Code may change due to loss development 97 State Act and USL&HW Act Benefits Example Painting company policy provides both State and USL&H benefits Exposure Record Fields Act Code Class Code Exposure Premium $100,000 $8, $20,000 $3,720 Painter sustained injury on pier, received State Act benefits Loss Record Fields Class Incurred Incurred Act Code Code Indemnity Medical $10,000 $15,

52 Loss Review Questions Subsequent Reports Subrogation Vocational Rehabilitation Medical Loss Part of Body indicates Possible Answers Includes payments to Hospitals and Doctors Significant contributor to Claim Cost Reported in Indemnity Loss Claim Reimbursement Type of Plan Codes Provide updates on Open/Reopened Claims 99 Submission Methods Data Transfer via the Internet Submit DCA Access Online For access, contact Customer Service or Customer Administrator

53 Blueprint Loss and Expense Exposure Header/Policy Editing, Validation, and Quality URC Resources Introduction General Requirements 101 Editing, Validation, and Data Quality 51

54 NCCI s Approach to Data Quality Rules and Requirements Front End Edits Validation Tests Comprehensive Edits Cross Data Comparisons Compliance Programs Data Tools 103 Data Quality Guidebook Part 1: Overview and Cross Data Type Comparisons Part 2: Data Quality Compliance Programs NCCI s Data Quality Approach Program Applicability by Data Type Overview of Data Types and Uses Data Quality Best Practices Workflows Cross Data Type Comparisons Compliance Programs (6)

55 Data Editing and Validation Editing Occurs before data is loaded to database. Front end quality checks to confirm accuracy, validity, and completeness. Occurs after data is loaded to database. Identifies patterns and data anomalies over time. Validation 105 Pre-Editing Unit Pre Edit Service Submit Data File Unit Pre Edit Tool Correct source system Correct and resubmit from tool Not required, but HIGHLY recommended!

56 Available Unit Reports Unit Certification Submission Results Report Unit Daily Submission Results Report Unit Pre-Edit Service Submission Results Report Unit Pre-Edit Tool Submission Results Report Unit Submission Results Report Unit Monthly Outstanding Error Report Unit Notification Tracking Report Refer to Data Reports Guide at ncci.com for more information. 107 Data Grade Descriptions Data Grade Type Description Transaction Reject Priority/ Critical Error Priority Error Entire transaction rejected. Must be corrected and resubmitted within 120 days. Data element reported incorrectly and contains an error. Captured on database but not used in NCCI s core services. Data element reported incorrectly and contains an error. Captured on database and used in NCCI s core services

57 Data Grade Descriptions Data Grade Type Description Default Error Suspect Informational A default value has been applied prior to processing. Data element may have been submitted incorrectly and may contain an error. An optional or not applicable data element was reported incorrectly and is in error. 109 Unit Compliance Programs Data Quality Incentive Program Incentive Programs Carrier Data Quality Report Program (Report Card) Escalation Programs Regulator Exception Program Data Quality Remediation Program

58 Blueprint Loss and Expense Exposure Header/Policy Editing, Validation, and Quality URC Introduction General Requirements Resources 111 Resources

59 Resources Keep updated on changes affecting your reporting Provides you with action oriented information 113 Resources Monitor data reporting timeliness and quality performance Summarized data Manage your data reporting more efficiently by targeting areas in need of improvement Data is refreshed on a daily basis Track your Report Card performance results

60 Resources Data Transfer via the Internet (DTVI): Send and receive data files Files remain in DTVI mailbox for eight calendar days DCA Access Online: Unit Pre Edit Tool Unit Extract Production Data Unit Report Control Notifications 115 Resources

61 Resources 117 Resources

62 Resources 119 Recap Identify expected unit reports (1st and subsequent reports) Submission Results Reports Carrier Review URC Expected Reports and DCA Access Online Create unit reports Statistical Plan & USRG DTVI DCA Access Online Pre edit the data Monthly URC Reports Are corrections needed? Unit Pre Edit Tool Unit Pre Edit Service Submit unit reports URC Program

63 Recap Edit the Unit Reports Data Grade 9 NCCI Did the unit reports reject? Unit reports are accepted and loaded to database Data Grade 5 Included in NCCI Products and Services Are corrections needed? Data is available for use Edit Matrix Statistical Plan Rules 121 Question and Answer Session Thanks for your participation! 61

64

65 Supplemental Information

66

67 Presenter Biographies Richard Saltzman has more than 30 years of experience in the insurance industry, including 20 years of insurance company experience. Richard works in Data Services, and his responsibilities include data reporting compliance projects, industry communications, and NCCI s data reporting manuals. Jacqueline Ganthier has worked at NCCI for 18 years and is a senior data analyst in the Data Services Department within NCCI s Data Resources Division. Jacqueline has held positions in Customer Operations and Data Resources, including as a customer service analyst, operational lead of the Bureau Compliance Statistical Service, and New York Policy Services. She was also responsible for carrier certification. Presently, her responsibilities include product support, data reporting compliance and external training, and focusing on NCCI s Webinars on Demand modules. Jacqueline also contributes as a technical writer to NCCI s data reporting communications and guidebooks. Jacqueline holds a bachelor of science degree in business management from Florida Atlantic University.