Effective Policy Reporting for POC

Transcription

1 Effective Policy Reporting for POC January 15 18, 2019 Palm Beach County Convention Center West Palm Beach, FL Your Source for Data Quality

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3 Effective Policy Reporting for POC Presented by: Cristina Granados and Jorge Acevedo Objective Increase your knowledge of effective Policy data reporting Ensure that your Proof of Coverage (POC) data is successfully submitted 2 1

4 Agenda Policy and POC Resources Policy Editing and POC Impact Reporting Names and Addresses Proof of Coverage Process Changes Adding & Deleting Employers Quiz 3 Policy and POC Resources 2

5 Policy and Proof of Coverage Reporting Guidebook Reporting Data Element Requirements Chart by Record and by Transaction 5 Policy and Proof of Coverage Reporting Guidebook POC Data Reports Section 6 3

6 Policy Pre Edit Service Allows carriers to submit a policy data file for preediting prior to production submission Data Transfer via the Internet Edit results are provided through the Policy Pre Edit Service Submission Results Report 7 Policy Data Collection (PDC) 8 4

7 PDC Employer State View 9 Policy Data Collection Coverage Notice Binder 10 5

8 Data Reports POC Transaction Report 11 Data Manager Dashboard Timeliness State Coverage 12 6

9 Data Manager Dashboard Quality POC Reject Rates 13 POC State Guide 14 7

10 POC State Guide 15 POC State Guide State Contacts State Exceptions Reporting Requirements Penalties Appeals Process State Filing Requirements 16 8

11 POC State Guide 17 Workers Compensation Coverage Verification (WCCV) Public Web Service 18 9

12 WCCV 19 Policy Editing and POC Impact 10

13 Policy Data Header Name WCPOLS Address State Premium Exposure Endorsement 21 NCCI Policy Editing and POC Impacts Data Grades 7, 6 and 4 Data Grades 8 and 9 NCCI Errors Rejected Data Available for POC* Not Available for POC *May be rejected by POC state when received 22 11

14 POC Impact of Policy Edits Edits can cause rejected POC transactions. Potential POC impacts for employer: Not in Compliance Stop Work Order May Be Subject to Compliance Fines Potential POC impacts for carrier: Timeliness Fines 23 Data Grade 9 Entire transaction reject Examples include: Missing all State Premium Records Prior Policy Number no match Policy Expiration Date Change policy is in nonrenewed state Duplicate transaction All names and addresses linked together with at least 10 names and 10 addresses reported Transaction is available for 90 days in the Policy Data Collection tool for correction 24 12

15 Data Grade 9 POC Impact Transaction not available for POC or any other NCCI use Correct and resubmit in same day to minimize POC impact Note: Received date of transaction is the date the transaction is accepted. 25 Data Grade 8 Single record reject: Name Address State Premium Exposure Endorsement The rejected record is viewable for eight days in the Policy Data Collection tool for informational purposes only. Must be corrected with a subsequent transaction 26 13

16 Data Grade 8 POC Impact If the record had previously been sent and accepted: Rejected Name or Address Record Will generate Delete Employer POC transaction Rejected State Premium Record Will generate Delete Jurisdiction POC transaction Correct and resubmit the same day to minimize POC impact 27 Data Grade 7 POC Critical Error HELD records Name Records Unlinked name Address Records Unlinked address An employer is a linked name and address. Unlinked names and addresses are not sent to any state

17 Data Grade 7 POC Critical Error Name Records Missing/invalid FEIN Missing Unemployment Identification Number Hawaii, Maine, and Rhode Island only Address Records Missing/invalid Industry Code Florida, Kansas, Kentucky, Maine, Montana, Oklahoma, Oregon, and Tennessee 29 Data Grade 7 (cont d) POC Critical Error Combination Name and Address Records All names and addresses reported with the same Name Link Identifier (five names/three addresses minimum) 30 15

18 Data Grade 7 Monthly Outstanding Report 31 Data Grade 6 POC Error Type of Plan ID Code Reason State Was Added Code Assignment Date Number of Employees 32 16

19 Data Grade 4 Priority Error Employee Leasing Policy Type Code PEO/Client Company Code Producer Name Class Code Legal Nature of Entity 33 Policy Errors and POC Impact IAIABC POC Reject & Error Reports Data Grade 7 Data Grade

20 Reporting Names and Addresses Name Standardization Rules For Policies Effective 01/01/2017 and later: NCCI does not split names For Policies Effective 12/31/2016 and earlier: NCCI will split names Both sets of rules are addressed in the Policy and Proof of Coverage Reporting Guidebook 36 18

21 Reporting Names Example: Policy Effective 2019 What you report: NLI CSN Name PCED PCXD Take on Me Incorporated and Jump Incorporated dba Sweet Dreams Consulting *The names being used in this presentation are not real and are being used for illustrative purposes only. Any resemblance to any person, living or dead or any company is purely coincidental. 37 Reporting Names What NCCI loads: Flag NLI CSN Name NED NXD PCED PCXD N Take on Me Inc & Jump Inc dba Sweet Dreams Consulting 01/01/19 Name Standardization will still use abbreviations and other rules, but name splitting is no longer performed

22 Reporting Names Example: Policy Effective 2016 What you report: NLI CSN Name PCED PCXD Take on Me Incorporated and Jump Inc dba Sweet Dreams Consulting Reporting Names What NCCI loads: Flag NLI CSN SNN Name NED NXD PCED PCXD N Take on Me Inc 01/01/16 N Jump Inc 01/01/16 N Sweet Dreams Consulting dba 01/01/16 Each split name is assigned a unique Split Name Number. This is an internal two digit code to prevent duplicate name errors

23 Reporting Names Best Practice: Report one name per record when each part of the name has different FEINs 41 Linking Fields NLCI CSN SCL 42 21

24 Name Link Identifier Located on Name and Address Records Primary Insured is always 001 For each additional employer, increase the Name Link Identifier by 1 (e.g., 002) Name Link Identifier must be the same for the name and address to be linked 43 Name Link Counter Identifier Located on Name and Address Records Accommodates policies with more than 999 unique employers If there are more than 999 names on the policy, report 00 in this field for the first 999 names Increase this field by 1 for the next 999 names If 999 or fewer names are being reported, this field should be reported as

25 Continuation Sequence Number Located on the Name Record only Primary Insured Name is always 001 Identifies each name of an employer with multiple names Only report 002 or greater when the employer has multiple names 45 State Code Link Located on the Address Record only Does not apply to primary insured but can be reported Does not apply unless reporting an out of state address State Code Link is required on every Address Type 6 record 46 23

26 Reporting Multiple DBAs What if you had to report two different DBAs for the same insured? Jump Inc & Take on Me Inc dba Sweet Dreams Consulting Jump Inc & Take on Me Inc dba Flashdance Accounting How would you report this? It depends on where they operate. 47 Reporting Names If all are operating at the same locations You should report: NLI CSN Name PCED PCXD Jump Inc Take on Me Inc dba Sweet Dreams Consulting dba Flashdance Accounting

27 Reporting Names If each is operating at different locations You should report: NLI CSN Name PCED PCXD Jump Inc Take on Me Inc dba Sweet Dreams Consulting Jump Inc Take on Me Inc dba Flashdance Accounting Name Effective Date Name Effective Date is set the first time a unique name is reported on the policy It is always the Policy Effective Date on establishing transactions Set by the Policy Change Effective Date on subsequent transactions Will default to Policy Effective Date if a Policy Change Effective Date is not reported Date cannot be changed, it can only be reset by deleting all occurrences of the name from the policy, then reporting the name back in a subsequent transaction 50 25

28 Address Reporting Employer records are created from: Address Type 1 (Mailing Address) Address Type 2 (Physical Location of Operations) Address Type 6 (No Specific Location in Jurisdiction) Data Grade 8 Record Reject: Address Type 2 records if they are duplicates of Address Type 1 51 Duplicate Employers Will any of these records be rejected? NLI Type Address SCL PCED PCXD Main Street, Boca Raton FL Main Street, Boca Raton FL Main Street, Boca Raton FL

29 Address Effective Date Address Effective Date is based on the Standardized Address. Example: Three addresses reported with different Policy Change Effective Dates 1 Main Street, Boca Raton, FL Main Str., Boca Raton, FL Main St., Boca Raton, FL Standardizes to: 1 Main St, Boca Raton, FL All will receive the same Address Effective Date. 53 Address Effective Date Address Type 6 standardizes based only on the State Code Link. This means that every Address Type 6 record for a state has the same Address Effective Date on the policy. The Address Effective Date is set the first time the address is reported on the policy. Cannot be changed Can only be reset by deleting every occurrence of that address from the policy 54 27

30 Names and Addresses: Broken Linking Pitfalls of Broken Links NLI CSN Name Address Take on On Me Inc 2 Main St Jump Inc 5 South St Macarena Inc 11 North St One Sweet Day Inc 17 East St Waterfalls Inc 23 West St Cannonball Inc 31 First Ave 56 28

31 Hazard of Broken Links Take on Me Inc 2 Main St One Sweet Day Inc 17 East St Take on Me Inc 2 Jump Inc 5 South St Main St Waterfalls Inc 23 West St Macarena Inc 11 North St Cannonball Inc 31 First Ave 57 Hazard of Broken Links Take on One Me Sweet Inc 11 Day Inc 2 Take on Take Me Inc 2 on Me Inc 17 North St One Main Sweet St Day Inc 17 Main St East St East St Take on Me Inc 23 West Take on St Me Inc 5 One Sweet Day Inc 23 South St West St Waterfalls Take on Me Inc 2 Waterfalls Inc 11 Jump Inc 2 Main St Inc 23 West Jump Inc 5 South St North St Main St St Jump Inc 17 East St Waterfalls Jump Inc 11 North St Waterfalls Inc 5 Inc 31 South First Cannonball St Inc 5 Ave South St Jump Inc 31 Macarena Macarena First Inc 11 Ave Inc 5 South Cannonball Inc 31 Macarena North Inc 2 St Main St First Ave Macarena Inc 17 St East Cannonball Inc 2 Main St St 58 29

32 Another Pitfall Changing NLI from one transaction to another can lead to unexpected results. Best Practice: Report the same NLI throughout the life of the policy for each employer. 59 Changing NLI Pitfall NLI CSN Name PCED PCXD London Calling LLC Mister Roboto Inc NLI Type Street City ST SCL PCED PCXD Club St Boca Raton FL Box St Miami FL

33 Changing NLI Pitfall NLI CSN Name PCED PCXD London Calling LLC Mister Roboto Inc Mister Roboto Inc NLI Type Street City ST SCL PCED PCXD Club St Boca Raton FL Box St Miami Jar Rd Atlanta Changing NLI Pitfall NLI CSN Name PCED PCXD London Calling LLC Cruel Summer Inc Jessie s Girl Corp Mister Roboto Inc Mister Roboto Inc

34 Changing NLI Pitfall NLI Type Street City ST SCL PCED PCXD Club St Boca Raton FL Cup Cr Tampa Box St Miami Jar Rd Atlanta Policy Change Transaction Processing 1. Formally deleted records 2. Current records including additions 3. Informally deleted records 64 32

35 Changing NLI Pitfall NLI CSN Name PCED PCXD London Calling LLC Cruel Summer Inc Jessie s Girl Corp Mister Roboto Inc Mister Roboto Inc Changing NLI Pitfall NLI Type Street City ST SCL PCED PCXD Club St Boca Raton FL Cup Cr Tampa Box St Miami Jar Rd Atlanta

36 Changing NLI Pitfall Employers deleted: Mister Roboto Inc, 1 Box St, Miami Mister Roboto Inc, 8 Jar Rd, Atlanta 67 Best Practice Report the same linking fields for names and addresses throughout the life of the policy

37 Proof of Coverage Process WCPOL Transactions Header (01) Endorse ID (07) Name (02) New Policy Transaction (Code 01) Exposure (05) Address (03) State Premium (04) 70 35

38 POC Records Policy Level Information Primary Insured Information Employer Information 71 PC1 Elements Carrier Trans Type Demographics Agent PC1 Policy Number Policy Eff. Date Primary Insured 72 36

39 PC2 Elements PEO Client Code Name and Address Name Type Legal Nature PC2 UI Nbr Nbr of Emps Industry Code 73 Carrier Policy Source System POC Process NCCI Database IAIABC NCCI Daily Proof of Coverage Inquiry IAIABC POC Reports IAIABC ACK Files 74 37

40 Establishing Coverage What You Report Setting the Stage What NCCI Loads What POC Creates What the State Provides 76 38

41 Establishing Transaction Billie Jean Inc. needs workers compensation coverage A new policy is written The additional employer covered on the policy will be Love Shack Inc. Both shops are located in Florida The policy will go into effect on January 1, What You Report Bacon & Bagels, Inc. New Policy PED: 01/01/19 NLI CSN Name PCED PCXD Billie Jean Inc Love Shack Inc NLI SCL Address Address Type PCED PCXD Maple St Syrup St Code A/D State PCED PCXD 09 Florida

42 What NCCI Loads Bacon & Bagels, Inc. New Policy PED: 01/01/19 Flag NLI CSN Name NED NXD PCED PCXD N Billie Jean Inc 01/01/19 N Love Shack Inc 01/01/19 Flag NLI SCL Address AED AXD PCED PCXD N Maple St 01/01/19 N Syrup St 01/01/19 Flag State ST Eff Dt ST Exp Dt PCED PCXD N 09 01/01/19 79 What the POC Process Creates Billie Jean Inc. PED: 01/01/19 Rec Type Name Address Triplicate Code Trans Set Eff Dt PC1 Billie Jean Inc 1 Maple St 00/10/01 01/01/19 PC2 Billie Jean Inc 1 Maple St PC2 Love Shack Inc 10 Syrup St ACK CODE TA TA TA 80 40

43 Changing Coverage Employer Change Transaction Insured reports a name change to the primary name The name changes from: Billie Jean Inc. to Unbelievable Deli, Inc. Change takes effect on July 1,

44 What You Report Billie Jean Inc. Full Policy Replacement to Change Primary Name PED: 01/01/19 NLI CSN Name PCED PCXD Unbelievable Deli Inc Love Shack Inc NLI SCL Address Address Type PCED PCXD Maple St Syrup St What NCCI Loads Billie Jean Inc. Full Policy Replacement to Change Primary Name PED: 01/01/19 Flag NLI CSN Name NED NXD PCED PCXD N Unbelievable Deli inc 07/01/19 07/01/19 N Love Shack Inc 01/01/19 Y Billie Jean Inc 01/01/19 07/01/19 Y Love Shack Inc 01/01/19 Flag NLI SCL Address AED AXD PCED PCXD N Maple St 01/01/19 N Syrup St 01/01/19 Y Maple St 01/01/19 Y Syrup St 01/01/

45 What the POC Process Generates Billie Jean Inc. Changing Primary Name PED: 01/01/19 Rec Type Name Address Triplicate Trans Set Eff Dt PC1 Unbelievable Deli Inc 1 Maple St 00/32/84 07/01/19 PC1 Unbelievable Deli Inc 1 Maple St 00/31/54 07/01/19 PC2 Unbelievable Deli Inc 1 Maple St PC1 Unbelievable Deli Inc 1 Maple St 00/33/56 07/01/19 PC2 Billie Jean Inc 1 Maple St ACK CODE TA TA TA TA TA 85 Corrections 43

46 Correcting Establishing Transaction Correcting a New Policy or Renewal the same day it is accepted by NCCI may lead to additional rejected POC transactions. Example: New policy with two employers Policy needs to be reported or it will be late Employers reported without FEINs (zeros) 87 Thriller, Corporation. New Policy PED: 01/01/19 What You Report NLI CSN Name FEIN PCED PCXD Thriller Corp Celebration Repair NLI SCL Address PCED PCXD Main St South St

47 Thriller, Corporation. Changing FEINs PED: 01/01/19 What You Report NLI CSN Name FEIN PCED PCXD Thriller Corp Celebration Repair NLI SCL Address PCED PCXD Main St South St What NCCI Loads Flag NLI CSN Name FEIN NED NXD PCED PCXD N Thriller Corp /01/19 N Celebration Repair /01/19 Y Thriller Corp /01/19 Y Celebration Repair /01/19 Flag NLI SCL Address AED AXD PCED PCXD N Main St 01/01/19 N South St 01/01/19 Y Main St 01/01/19 Y South St 01/01/

48 What the POC Process Generates Thriller, Corporation. PED: 01/01/19 Rec Typ Name Address FEIN Triplicate Trans Set Eff Dt PC1 Thriller Corp 1 Main St /10/01 01/01/19 PC2 Thriller Corp 1 Main St PC2 Celebration Repair 10 South St PC1 Thriller Corp 1 Main St /32/76 01/01/19 PC1 Thriller Corp 1 Main St /32/76 01/01/19 91 What the POC Process Generates Rec Typ Name Address FEIN Triplicate Trans Set Eff Dt PC1 Thriller Corp 1 Main St /32/77 01/01/19 PC2 Thriller Corp 1 Main St PC1 Thriller Corp 1 Main St /32/77 01/01/19 PC2 Thriller Corp 1 Main St PC1 Thriller Corp 1 Main St /32/77 01/01/19 PC2 Celebration Repair 10 South St PC1 Thriller Corp 1 Main St /32/77 01/01/19 PC2 Celebration Repair 10 South St

49 What the POC Process Generates Thriller, Corporation. PED: 01/01/19 Rec Typ Name Address FEIN Triplicate Trans Set Eff Dt PC1 Thriller Corp 1 Main St /10/01 01/01/19 PC2 Thriller Corp 1 Main St PC2 Celebration Repair 10 South St PC1 Thriller Corp 1 Main St /32/76 01/01/19 PC1 Thriller Corp 1 Main St /32/76 01/01/19 ACK CODE TR TR TR TR TR 93 What the POC Process Generates Rec Typ Name Address FEIN Triplicate Trans Set Eff Dt PC1 Thriller Corp 1 Main St /32/77 01/01/19 PC2 Thriller Corp 1 Main St PC1 Thriller Corp 1 Main St /32/77 01/01/19 PC2 Thriller Corp 1 Main St PC1 Thriller Corp 1 Main St /32/77 01/01/19 PC2 Celebration Repair 10 South St PC1 Thriller Corp 1 Main St /32/77 01/01/19 PC2 Celebration Repair 10 South St ACK CODE TR TR TR TR TR TR TR TR 94 47

50 What the POC Process Generates Thriller, Corporation. PED: 01/01/19 Rec Typ Name Address FEIN Triplicate Trans Set Eff Dt PC1 Thriller Corp 1 Main St /10/01 01/01/19 PC2 Thriller Corp 1 Main St PC2 Celebration Repair 10 South St ACK CODE TR TR TR Wait for acknowledgement reject from state, then correct FEINs. Rec Typ Name Address FEIN Triplicate Trans Set Eff Dt PC1 Thriller Corp 1 Main St /10/01 01/01/19 PC2 Thriller Corp 1 Main St PC2 Celebration Repair 10 South St ACK CODE TA TA TA 95 Changes Adding and Deleting Employers 48

51 Add Employer Transaction Rules Transaction Set Type Effective Date = Later Date Reported Policy Change Effective Date Name record Address record Name Effective Date Address Effective Date State Effective Date 97 Add Employer Transaction Rules Edit Policy Change Effective Date DATE IS PRIOR TO THE NAME EFFECTIVE DATE Edit Policy Change Effective Date DATE IS PRIOR TO THE ADDRESS EFFECTIVE DATE When you see one of these two edits, the reported Policy Change Effective Date was not used in the change or addition

52 Add Employer Example Adding an Employer Change transaction PED: 01/01/19 NLI CSN Name FEIN PCED PCXD Whip It Corp Our House Inc NLI SCL Address PCED PCXD Main St South St Add Employer Example Adding an Employer Change transaction PED: 01/01/19 NLI CSN Name FEIN PCED PCXD Whip It Corp Our House Inc Rock the Casbah LLC NLI SCL Address PCED PCXD Main St South St North St

53 Delete Employer Transaction Rules Transaction Set Type Effective Date = Earlier Date Name Expiration Date Address Expiration Date State Expiration Date Generates a Delete Jurisdiction transaction 101 Delete Employer Example Deleting an Employer Change transaction PED: 01/01/19 NLI CSN Name FEIN PCED PCXD Whip It Corp Our House Inc Rock the Casbah LLC NLI SCL Address PCED PCXD Main St South St North St

54 Common Deleting Scenarios Formal Deletes delete date is reported carrier sets delete date Informal Deletes delete date is not reported NCCI sets delete date POC impacts Gaps in coverage Timeliness reporting fines 103 Two Common Ways to Cause an Informal Delete DG8 Record rejected Not reporting a Name/Address/State Premium record that was previously accepted by a POC state

55 Informal Delete Due to Data Grade 8 Dire Straits LLC Policy Effective January 1, 2019 January 1, 2020 Employees in Florida and South Carolina Dire Straits LLC is no longer doing business in South Carolina, effective July 1, 2019 Opened new location in Tennessee effective July 1, Informal Delete Due to Data Grade 8 Establishing Transaction: Dire Straits LLC PED: 01/01/19 Record State Add/Del PCED PCXD Florida South Carolina Record State Class Code Payroll PCED PCXD

56 Informal Delete Due to Data Grade 8 Dire Straits LLC Adding and Deleting States PED: 01/01/19 Record State Add/Del PCED PCXD Florida D South Carolina A Tennessee Record State Class Code Payroll PCED PCXD Where is the South Carolina exposure record? 107 How NCCI Processes an Informal Delete Flag State ST Eff Dt ST Exp Dt PCED PCXD N 09 01/01/19 N 41 07/01/19 07/01/19 Y 09 01/01/19 Y 39 01/01/19 01/01/

57 The Correction Correction will require two transactions: 1. Add record back 2. Formally delete record 109 Dire Straits LLC Adding State PED: 01/01/19 The Correction Part 1 Record State Add/Del PCED PCXD Florida Tennessee A South Carolina Record State Class Code Payroll PCED PCXD

58 Dire Straits LLC Deleting State PED: 01/01/19 The Correction Part 2 Record State Add/Del PCED PCXD Florida Tennessee D South Carolina Record State Class Code Payroll PCED PCXD Informal Delete Due to Not Reporting a Name Primary Insured: Shout, Inc. Additional Employer: Sweet Dreams Change Scenario: Sweet Dreams takes on a partner in business, and a name change is required Effective date of name change is July 1,

59 Shout, Inc. New Policy PED: 01/01/19 What You Report NLI CSN Name PCED PCXD Shout Inc Sweet Dreams NLI SCL Address PCED PCXD Jackson St Franklin Lane What You Report Shout, Inc. Full Policy Replacement Changing Name PED: 01/01/19 NLI CSN Name PCED PCXD Shout Inc Sweet Dreams Are Made of Cheese Inc NLI SCL Address PCED PCXD Jackson St Franklin Lane What happened to Sweet Dreams?

60 What You Report Shout, Inc. Full Policy Replacement Adding and Deleting Name PED: 01/01/19 NLI CSN Name PCED PCXD Shout Inc Sweet Dreams Sweet Dreams Are Made of Cheese Inc NLI SCL Address PCED PCXD Jackson St Franklin Lane Franklin Lane Informal Delete POC Transactions 00/33/56 Delete Employer With Location 00/33/87 Delete Employer Without Location 00/33/73 Delete Jurisdiction If the Transaction Set Type Effective Date = Policy Effective Date on the IAIABC POC Accepted Report, then correction is necessary if that was not the intent

61 IAIABC POC Coverage Provider Accepted Report 117 Quiz 59

62 QUIZ 1. What two fields need to be reported when deleting Names, Addresses, or States? 2. What is the difference between a Formal Delete and an Informal Delete? 119 QUIZ 3. What POC report will give you a clue if an Informal Delete has been created by your policy reporting? 4. If you realize that an employer has been added with the wrong effective date, how do you fix the gap in coverage created?

63 Supplemental Information

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65 Presenter Biographies Jorge Acevedo has been with NCCI since He is the Proof of Coverage lead data analyst on the Policy/Proof of Coverage Team in the Data Collection Department. Prior to joining Data Collection in 2007, he worked in the Experience Rating Department as an analyst. Jorge s professional background includes technical support for a major computer company and fraud detection for an Internet hosting company. Cristina Granados currently works on the Policy/Proof of Coverage Team in the Data Collection Department of NCCI s Data Resources Division; she has been with NCCI for 12 years. Cristina s primary responsibilities include supporting carriers with Policy and Proof of Coverage reporting inquiries and challenges. Cristina has held several positions in the Customer Operations and Data Divisions. Her experience includes analyzing and researching classifications/statistical codes, policy edits, Proof of Coverage issues, producing experience rating modifications and ownership rulings, and assisting with internal training. Cristina has a Doctorate in Medicine from University of Cartagena and a Master s degree in Business Administration from Florida Atlantic University.

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67 POLICY & POC ACRONYM REFERENCE SHEET Data Elements Reported on WCPOLS Carrier Generated NLI Name Link Identifier NLCI Name Link Counter Identifier CSN Continuation Sequence Number SCL State Code Link PED Policy Effective Date PXD Policy Expiration Date PCED Policy Change Effective Date PCXD Policy Change Expiration Date Data Elements NOT Reported in WCPOLS NCCI Generated NED Name Effective Date AED Address Effective Date NXD Name Expiration Date AXD Address Expiration Date SNN Split Name Number Codes Reported in Acknowledgment POC & State Generated PC1 IAIABC POC Insured Record PC2 IAIABC POC Employer Record TA Transaction Accepted TE Transaction Accepted with Errors TR Transaction Rejected Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved

68 IAIABC Triplicate History by POC Format Transaction Submission Code Transaction Triplicate POC 1.0 POC 2.1 POC 3.0 Notification of Coverage Assigned Risk Binder I X POC 1.0 Binder POC 2.1 Coverage Notice/Binder some/all Employer locations within Jurisdiction A X X X POC 3.0 POC Notice some or all employer locations within Jurisdiction POC 1.0 Binder Insured has no physical location in jurisdiction POC 2.1 Coverage Notice/Binder Insured has no Physical location within Jurisdiction POC 3.0 POC Notice without location(s) within Jurisdiction I X X X POC 1.0 Binder Named Employer(s) with no jurisdiction address POC 2.1 Coverage Notice/Binder Employers with No Physical Address, but Operating within the Jurisdiction POC 3.0 POC Notice with no physical locations within jurisdiction but operating within the Jurisdiction POC 1.0 New Policy POC 2.1 New Policy all/some employer locations with locations POC 3.0 New Policy some or all employer locations within Jurisdiction POC 1.0 New Policy Insured has not physical location in jurisdiction POC 2.1 New Policy Insured has no Physical Location within Jurisdiction POC 3.0 New Policy Without location(s) within Jurisdiction POC 1.0 New Policy Named Employer(s) with no jurisdiction address POC 2.1 New Policy Employers with No Physical Address, but Operating within the Jurisdiction POC 3.0 New Policy with no physical locations within the Jurisdiction but operating within the Jurisdiction POC 1.0 Renew Policy POC 2.1 Renewal all/some employer locations within Jurisdiction POC 3.0 Renewal some or all employer locations within Jurisdiction POC 1.0 Renew Policy Insured has no physical location in jurisdiction POC 2.1 Renewal Insured has no Physical location with Jurisdiction POC 3.0 Renewal without location(s) within Jurisdiction POC 1.0 Renew Policy Named Employer(s) with no jurisdiction address POC 2.1 Renewal Policy Employers with No Physical Address, but Operating within the Jurisdiction POC 3.0 Renewal Policy with no physical locations within the Jurisdiction but operating within the Jurisdiction EN/M X X X A X X X I X X X EN/M X X X A X X X I X X X EN/M X X X POC 1.0 Add Jurisdiction POC 2.1 Endorsement Notifying a New Jurisdiction when a New Location is added to Existing Policy POC 3.0 Endorsement notifying a new Jurisdiction when a location is added to existing policy POC 1.0 Add Jurisdiction with no State location POC 2.1 Endorsement Notifying a New Jurisdiction when a New Employer with No jurisdiction location is added to Existing Policy POC 3.0 Endorsement notifying a new Jurisdiction when an employer with no Jurisdiction location is added to existing policy POC 1.0 Add Jurisdiction Named Employer(s) with no jurisdiction address POC 2.1 Add New Employer Add (Employer Not in Jurisdiction) POC 3.0 Endorsement notifying a new Jurisdiction when an employer with no physical location but operating within the Jurisdiction is added to existing policy POC 1.0 Rewrite/Reissue Policy POC 2.1 Rewrite/Reissue Policy Employer Locations within Jurisdiction POC 3.0 Rewrite/Reissue Policy some or all employer locations within Jurisdiction A X X X I X X X EN/M X X X A X X X POC 1.0 Rewrite/Reissue Policy Insured has no physical location in Jurisdiction POC 2.1 Rewrite/Reissue Policy Insured has No Physical Location within Jurisdiction I X X X POC 3.0 Rewrite/Reissue Policy without location(s) within Jurisdiction POC 1.0 Rewrite/Reissue Policy Named Employer(s) with no jurisdiction address POC 2.1 Rewrite/Reissue Policy Employers with No Physical Address, but Operating within the Jurisdiction POC 3.0 Rewrite/Reissue Policy with no physical locations within the Jurisdiction but operating within the Jurisdiction EN/M X X X Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved 1

69 IAIABC Triplicate History by POC Format Transaction Submission Code Transaction Triplicate POC 1.0 POC 2.1 POC 3.0 Addition of Coverage POC 1.0 Add Location(s) POC 2.1 Add New Employer Add (Location in Jurisdiction) POC 3.0 Add Employer location within Jurisdiction POC 1.0 Add Employer(s) with no jurisdiction address POC 2.1 Add Employer Add (Employer not in Jurisdiction) POC 3.0 Add New Employer with no Physical Location within Jurisdiction POC 1.0 Include Corporate Officer/Partner/Sole Proprietor POC 2.1 Submitting Corporate Officer/Partner/Sole Proprietor Inclusion POC 3.0 Corporate Officer/Partner/Sole Proprietor Inclusion POC 1.0 Exclude Corporate Officer/Partner/Sole Proprietor POC 2.1 Submitting Corporate Officer/Partner/Sole Proprietor Exclusion POC 3.0 Corporate Officer/Partner/Sole Proprietor Exclusion Change of Existing of Coverage POC 1.0 Change Change Legal Status, Change Insured Name, Change Governing Class Code, Change Total Payroll, Change Insured Address, Change Telephone Number, Change Business Market, Change Wrap Up Indicator, Change Assignment Date POC 2.1 Change Insured Demographics Legal Status, Insured Name, Governing Class, Total Payroll, Insured Address, Telephone Number, Business Market, Wrap Up Indicator, Assignment Date, Employee Leasing Policy Identification, Minimum Premium Policy Indicator Change Insured Demographics Legal Status, Insured Name, Governing Class, Total Payroll, Insured Address, Telephone Number, Business Market, Wrap Up Indicator, Assignment Date, Employee Leading Policy Identification, Minimum Premium Policy Indicator, Losses Subject to Deductible Code, Basis of Deductible Calculation Code, Insured Sate Premium, PEO or Client Company Code, Reason State was Added to the Policy Code E/M X X X E/M X X X I X X X I X X X I X X I X Change Prior Policy Number PI X Add new Insured FEIN PI X POC 1.0 Change Erroneous Insured FEIN POC 2.1 Change Insured FEIN Change Insured FEIN PI PI X X X POC 1.0 Change Employer FEIN POC 2.1 Change Employer FEIN Employer Locations within Jurisdiction POC 3.0 Change Employer FEIN Employer locations within Jurisdiction PE X X X POC 1.0 Change Employer UI POC 2.1 Change Employer U/I Employer Locations within Jurisdiction POC 3.0 Change Employer UI Number employer locations within Jurisdiction PE X X X POC 1.0 Change Change Name all or any employer location, Change Address all or any Employer location, Change SIC Code (Employer level), Change # of Employees (Employer level) POC 2.1 Change Employer Demographics Employer Locations with Jurisdiction Name, Address, SIC Code, Number of Employees POC 3.0 Change Employer Demographics Employer location within Jurisdiction Name, Address, Industry Code, Number of Employees, Legal Status of Employer, Name Type Code, PEO or Client Company Code PE X X X POC 2.1 Change Employer Demographics Employer with No Jurisdiction Location Name, Address, SIC Code, Number of Employees POC 3.0 Change Employer Demographics Employer with no Jurisdiction location Name, Industry Code, Number of Employees, Legal Status of Employer, Name Type Code, PEO or Client Company Code POC 2.1 Change Employer U/I Number Employer with No Jurisdiction Location POC 3.0 Change Employer UI Number employer with no Jurisdiction location PE PE X X X X Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved 2

70 IAIABC Triplicate History by POC Format Transaction Submission Code Transaction Triplicate POC 1.0 POC 2.1 POC 3.0 POC 2.1 Change Employer FEIN Employer with No Jurisdiction Location POC 3.0 Change Employer FEIN employer with no physical location within Jurisdiction Change Policy Number Change Policy Number POC 1.0 Change Erroneous Effective Date POC 2.1 Correct Erroneous Policy Effective Date Change Policy Effective Date POC 1.0 Change Erroneous Expiration Date POC 2.1 Correct Erroneous Expiration Date Change Policy Expiration Date POC 1.0 Change Erroneous Carrier/Insurer FEIN POC 2.1 Change Carrier/Insurer FEIN Change Carrier/Insurer FEIN PE PI PI PI PI PI PI PI PI Deletion of Coverage POC 1.0 Delete location(s) POC 2.1 Delete Employer Locations within Jurisdiction E/M X X X POC 3.0 Endorsement, Delete Location POC 1.0 Delete Jurisdiction POC 2.1 Delete Jurisdiction No Longer Covered by Carrier/Insurer I X X X POC 3.0 Endorsement, Delete Jurisdiction POC 2.1 Delete Employer with No Jurisdiction Location POC 3.0 Delete Employer no Jurisdiction address E/M X X Cancellation/Nonrenewal of Coverage Policy Cancelled By Carrier/Insurer Failure to Comply with Terms of Audit I X Policy Cancelled By Carrier/Insurer Cancelled at Request of Finance Company I X Policy Cancelled By Carrier/Insurer Failure to Submit Payroll Information I X POC 1.0 Cancelled By Carrier/Insurer Non Payment POC 2.1 & POC 3.0 Policy Cancelled by Carrier/Insurer Non Payment I X X X POC 1.0 Cancelled By Carrier/Insurer Underwriting Reason POC 2.1 & POC 3.0 Policy Cancelled by Carrier/Insurer Underwriting Discretion I X X X X X X X X X X X X X X X X X POC 1.0 Cancelled by Carrier/Insurer Revocation of Voluntary Market Acceptance POC 2.1 & POC 3.0 Policy Cancelled by Carrier/Insurer Revocation of Voluntary Market Acceptance POC 1.0 Cancelled By Carrier/Insurer Failure to Pay Deductible POC 2.1 & POC 3.0 Policy Cancelled by Carrier/Insurer Failure to Pay Deductible I X X X I X X X POC 1.0 Cancelled by Carrier/Insurer Misrepresentation of Information on Application POC 2.1 & POC 3.0 Policy Cancelled by Carrier/Insurer Misrepresentation on Application POC 1.0 Cancelled By Carrier/Insurer Rewrite/Reissue POC 2.1 & POC 3.0 Policy Cancelled by Carrier/Insurer Rewrite/Reissue POC 1.0 Cancelled By Insured Reason Unknown POC 2.1 & POC 3.0 Policy Cancelled by Insured Reason Unknown POC 1.0 Cancelled By Insured Out of Business POC 2.1 & POC 3.0 Policy Cancelled by Insured Out of Business POC 1.0 Cancelled by Insured Coverage Placed Elsewhere POC 2.1 & POC 3.0 Policy Cancelled by Insured Coverage Placed Elsewhere POC 1.0 Cancelled By Insured Duplicate Coverage POC 2.1 & POC 3.0 Policy Cancelled by Insured Duplicate Coverage POC 2.1 & POC 3.0 Policy Cancelled by Insured Ownership Change I X X X I X X X I X X X I X X X I X X X I X X X I X X X POC 1.0 Cancelled By Insured Business Sold POC 2.1 Policy Cancelled by Insured Business Sold I X X POC 1.0 Cancelled by Insured No Employees/No Exposure/No Operations POC 2.1 & POC 3.0 Policy Cancelled By Insured No Employees/No Exposure/No Operations I X X X Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved 3

71 IAIABC Triplicate History by POC Format Transaction Submission Code Transaction Triplicate POC 1.0 Non Renewal of Policy By Insured Reason Unknown POC 2.1 & POC 3.0 Policy Non Renewed by Insured Reason Unknown I X X X POC 1.0 Non Renewal of Policy By Insured Out of Business POC 2.1 & POC 3.0 Policy Non Renewed by Insured Out of Business I X X X Policy Non Renewed by Carrier/Insurer Non Payment I X X POC 1.0 Non Renewal of Policy by Insured Coverage Placed Elsewhere POC 2.1 & POC 3.0 Policy Non Renewed by Insured Coverage Placed Elsewhere I X X X POC 1.0 Non Renewal of Policy by Insured Change of Ownership POC 2.1 & POC 3.0 Policy Non Renewed by Insured Change of Ownership POC 1.0 POC 2.1 POC 3.0 I X X X POC 1.0 Non Renewal of Policy By Insured Business Sold POC 2.1 Policy Non Renewed by Insured Business Sold I X X POC 1.0 Non Renewal of Policy by Insurer Underwriting Discretion POC 2.1 & POC 3.0 Policy Non Renewed by Carrier/Insurer Underwriting Discretion I X X X POC 1.0 Non Renewal of Policy by Insured No Employees/No Exposure/No Operations POC 2.1 & POC 3.0 Policy Non Renewed by Insured No Employees/No Exposure/No Operations Reinstatement of Coverage POC 1.0 Reinstate Policy POC 2.1 Carrier/Insurer Reinstate Policy I X X X I X X X Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved 4