State Fund s Guide to Complete Submissions for Workers Compensation Insurance

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1 State Fund s Guide to Complete Submissions for Workers Compensation Insurance Entering and Attaching Loss Runs State Fund s pricing system uses the employer s currently valued loss data (among other factors) to accurately determine the estimated premium. Losses also provide us with an accurate assessment of the applicant s operations and safety practices. The losses must be entered in the PriceNow Loss Input Screen and valid loss runs must be attached to the PriceNow submission in order to be considered complete. In order to properly enter loss data into PriceNow, you must separate the loss amounts for Indemnity Claims and Medical-Only Claims, and enter them in the appropriate fields. The loss runs must be on the carrier s letterhead. Loss Run Valuation Dates For submissions sent on or before April 30, 2016, loss runs should be valued within 90 days of the submission date. For submissions sent on or after May 1, 2016, loss runs must be valued within 100 days of the effective date. Steps 3 5 in PriceNow for Entering and Attaching Loss Runs Step 3 (Loss Info): Once you have entered the necessary loss data into PriceNow (State Fund requires four years of loss data on all submissions), click Continue at the bottom of the page. A Glossary of Loss Terms for Step 3 is available on page 3 for your reference. Step 4 (Tier Price): Based upon the data you have entered thus far, this screen will display the estimated Tier assignment and estimated price (range) for your submission. If you have entered incomplete or inaccurate data, the Tier assignment and price (range) that are displayed on this page may be incorrect. Click Continue at the bottom of the page. Step 5 (Additional Info): This screen requires you to provide additional details and answer questions about the employer. At the bottom of this screen, you are required to attach (upload) the loss runs for that submission. You are also able to upload other documents that are relevant to the underwriting or pre-qualification process. Below is a visual guide that begins at Step 3 and ends at Step 5 of the PriceNow submission process for entering and attaching loss runs. 1

2 Step 3 (Loss Info) Once you have entered the necessary loss data into PriceNow (State Fund requires four years of loss data on all submissions), click Continue at the bottom of the page. Explanation of loss data entry requirements Enter total claim count for all Indemnity Claims ( Lost time claims i.e., claims that have indemnity & medical costs). (Do not include $0 value claims) Enter total claim count for all Medical Only Claims (i.e., claims that have no indemnity costs). (Do not include $0 value claims) Enter total paid & reserved amounts (of medical, indemnity & expense) for all Indemnity Claims (i.e., claims that have indemn. & med costs). (No Med Only) Enter total paid amounts (of medical, indemnity & expense) for all Indemnity Claims (i.e., claims that have indemn. & med costs). (No Med Only) Enter total paid & reserved amounts (of medical & expense) for all Medical Only Claims (i.e., claims that have no indemnity costs). Enter total paid amounts (of medical & expense) for all Medical Only Claims (i.e., claims that have no indemnity costs). Data entry not required. This field auto calculates, and equals the grand total of all claims costs (Indemnity & Medical Only Claims combined). Data entry not required. This field auto calculates, and equals the grand total of only paid claims costs (Indemnity & Medical Only Claims combined). See Glossary of Loss Terms on next page for more information 2

3 Terms # of Indemnity Incurred Claims Definitions The total claim count for all Indemnity Claims (not including claims with $0 value). The Indemnity claim type refers to claims which have indemnity (wage loss, non-medical) benefit payments or reserves, in addition to medical payments or reserves, and expenses. This claim type is also sometimes referred to as a Disability Claim or Lost-Time Claim. The total claim count for all Medical-Only Claims (not including claims with $0 value). # of Medical-Only Incurred Claims The Medical-Only claim type refers to claims that involve minor, non-litigated injuries, with no compensable time lost from work. This claim type is also referred to as a Non-Disability Claim. These claims do not have any indemnity costs paid or reserved on them. First Aid Claims should be included in this claim count, if they have a loss amount. Indemnity Incurred Loss Indemnity Loss Paid Medical Only Incurred Loss Medical Only Loss Paid Evaluation Date Indemnity Incurred The sum of all loss amounts for all Indemnity Claims (Lost-Time). Include the total value (all paid & reserved amounts) for all portions of the Indemnity Claims (i.e., medical, indemnity & expense). The sum of only paid loss amounts for all Indemnity Claims (Lost-time). Include only the paid amounts for all portions of the Indemnity Claims (i.e., medical, indemnity, and expense). The sum of all loss amounts for all Medical-Only Claims. Include the total value (all paid and reserved amounts) for all Medical-Only Claims (i.e., medical & expense amounts). The sum of only paid loss amounts for all Medical-Only Claims. Include only the paid amounts of all Medical-Only Claims (i.e., medical & expense amounts). The valuation date of the loss data (not necessarily the same as the loss run report date). Refers to claims that include payments or reserves for lost wages (i.e., indemnity, disability, or losttime benefits) and medical costs, as well as, expenses. Refers to the sum of paid costs plus reserves plus expenses. 3

4 Step 4 (Tier Price) Based upon the data you have entered thus far, this screen will display the estimated Tier assignment and estimated price (range) for your submission. If you have entered incomplete or inaccurate data, the Tier assignment and price (range) that are displayed on this page may be incorrect. Click Continue at the bottom of the page. Price Indication 4

5 Step 5 (Additional Info) This screen requires you to provide additional details and answer questions about the employer. At the bottom of this screen, you are required to attach (upload) the loss runs for that submission. You are also able to upload other documents that are relevant to the underwriting or pre-qualification process. Bottom of page 5