This guide is intended to help insurers and their authorized third party entities (data submitters) through the steps required to become approved for electronic policy data reporting.
Prior to electronic policy submission testing, data submitters must review and complete all pretesting requirements (see the Getting Started Guide and Checklist for Electronic Policy Submission Testing page). The testing process verifies that the data submitter can submit policy transactions electronically in accordance with the Workers Compensation Insurance Organizations’ (WCIO) Workers Compensation Policy Reporting Specifications (WCPOLS) and the California Workers' Compensation Uniform Statistical Reporting Plan—1995 (USRP) and the data is reflective of the policy documents provided to the policyholder. The WCIRB will not begin testing until all pretesting requirements have been completed.
In accordance to the WCIRB Policy Data Quality Program, all data submitters must complete testing 180 days from the Testing Commencement Date.
The Testing Commencement Date is based on the earlier of:
If the data submitter is unable to complete testing within 180 days, the insurers may be subject to the remedial actions.
Step 1: Policy validation by preprocessing testing. This step involves basic edit errors and validations to ensure that the submitted data meets the specification requirements. This step is done in tandem with Step 2 below.
Step 2: Hard copy comparison testing occurs by transaction type and is organized into two phases (Exhibit 1):
As part of testing, the data submitter must provide examples of the scenarios listed in Exhibit 2 along with the matching hard copy transaction for comparison. (Testing is based on transactions that the data submitter intends to use. However, should the data submitter wish to submit transactions that were not sampled during initial testing, the data submitter will need to alert the WCIRB and complete testing for those specific transactions.) While not required, the data submitter is strongly encouraged to use production transactions for testing purposes. If production data is unavailable for a specific testing scenario, fictitious data may be used.
Testing Phases | Estimated Timeframe |
Policies, Cancellations/Reinstatements and General Limiting & Restricting Endorsements (if applicable) | 45–60 days |
Change Endorsements | 45 days |
Phase | Transaction Types Included | Number of Examples2 |
1. Policies & Cancellations/ Reinstatements |
|
|
General Limiting & Restricting Endorsements | Based on an insurer’s filed forms & will be tested, if applicable | At least one example of each scenario |
2. Change Endorsements |
|
At least two examples of each change endorsement scenario in Exhibit 2 |
Transaction Type | Area of Testing | Scenario |
Policy
|
Names | Personal name reporting |
Commercial name reporting | ||
DBA reporting | ||
Multiple names | ||
Address (if applicable) | Foreign | |
C/O Address | ||
Experience Modification | At inception | |
Midterm | ||
Not applicable | ||
Variable Text | PEO policy related endorsement scenarios, if applicable | |
Group Coverage policy, if applicable | ||
USL&H policy, if applicable | ||
Fixed or Extended Term policy with ARE/Renewal Certificate, if applicable | ||
Cancellation and Reinstatement (TC05) | Cancellation and Reinstatement Sequencing | Including Cancellation & Reinstatement transaction issued same day, if applicable |
Change Endorsements
|
Name Changes | Add a name at inception |
Add a name at midterm | ||
Delete a name at midterm | ||
Change the named insured | ||
Class Code | Add a class code | |
Delete a class code | ||
Experience Modification | Add an experience modification at inception | |
Add an experience modification at midterm | ||
Delete an experience modification | ||
Address | Change the mailing address | |
Add a location | ||
Delete a location | ||
Forms | Add a form | |
Delete a form | ||
State (if applicable) | Add California | |
Delete California | ||
Variable Text Record | Change variable text on D records | |
Group | Change group status, if applicable |
1 Digital versions of hard copy documents will be collected via Box.com
2 Number of examples requested during testing is based on the insurer’s filed forms and expected book of business. The WCIRB may request additional examples if determined necessary.