NEW ORK WORKERS COMPENSATION - Nycirb
NEW YORKWORKERS COMPENSATIONSTATISTICAL PLAN2013 EDITIONNew York CompensationInsurance Rating Board733 Third AvenueNew York, New York 10017(212) 697‐3535 2013 New York Compensation Insurance Rating BoardThe pages herein may include copyright material of the National Council on Compensation InsuranceCopyright (1980, et seq.), used with its permission.
NEW YORK WORKERS COMPENSATION STATISTICAL PLAN1st ReprintEffective January 1, 2018TOC—1TABLE OF CONTENTSTABLE OF CONTENTSINTRODUCTIONScope and Effective Date of the PlanOrganization of the Plan I.General 19.20.21.II.PagesReporting of Statistics . R – 1Preparation and Completion of Unit Statistical Reports . R – 1Submission Control Record. R – 1Auditing of Statistics Prior to Submission . R – 1Correction of Errors. R – 1Filing Requirements . R – 1Multi-state Policies . R – 2Uncollectible Premiums . R – 2a. Audited Policies . R – 2b. Policies on Which a Final Audit is Not Possible. R – 2Reinsurance . R – 2National Defense Projects . R – 2Radiation Exposure – Nuclear Regulatory Commission Projects . R – 2Radiation Exposure – Other Than Nuclear Regulatory Commission Projects . R – 2Coverage for Domestic Workers . R – 2a. On Standard One–Year Workers Compensation Policies . R – 2b. On Three–Year Workers Compensation Policies. R – 3c. Statutory WC Coverage Under Personal Liability Policies . R – 3Excess Coverage for Medical Payments – Ex-Medical Policies . R – 3Date of Valuation and Filing . R – 4Late Filing Penalties . R – 4Classification Code. R – 4Multiple Year Policies Other than Three-Year Fixed Rate . R – 5Three-Year Fixed Rate Policies. R – 5a. Date of Valuation and Filing . R – 5b. Subsequent Reports . R – 5Whole Dollar Amounts Required . R – 5Application of Manual Rules . R – 5Header Data / Policy Information1.2.3.4.5.6.7.8.9.10.Report Number . R – 6Correction Sequence Number. R – 6Correction Type. R – 6Replacement Report Code . R – 6Carrier Code . R – 6Policy Number. R – 7Policy Effective Date. R – 7Policy Expiration Date . R – 7Exposure State . R – 7State Effective Date . R – 7
TOC—2NEW YORK WORKERS COMPENSATION STATISTICAL PLANTABLE OF CONTENTSEffective January 1, 20181st ReprintTable of Contents (Contd.)Pages11.12.13.14.15.16.17.18.19.20.Risk ID Number . R – 7Insured Name . R – 8Insured Address . R – 8Federal Employer Identification Number (FEIN) . R – 8Policy Conditions . R – 8Policy Type ID . R – 8a. Type of Coverage . R – 9b. Type of Plan. R – 9c. Type of Non-Standard Provisions . R – 9Deductible Type . R – 9a. Type of Deductible . R – 9b. Type of Plan. R – 9Deductible Percent . R – 10Deductible Amount Per Claim / Accident . R – 10Deductible Amount Aggregate . R – 10III. Exposure / Premium Information1.2.3.4.5.6.Experience Modification Effective Date. R – 11Rate Effective Date . R – 11Update Type . R – 11Exposure Coverage Code . R – 11Classification Code . R – 11Exposure Amount . R – 11a. Payroll Classification Codes . R – 11b. Other Than Payroll Classification Codes. R – 12 c. Per Location . R – 12 d. Volunteer Firefighters . R – 12 e. Volunteer Ambulance Workers . R – 13 f.No Exposure Developed . R – 137. Manual Rate . R – 13a. Flat Increase or Decrease on an Outstanding Policy . R – 13b. Anniversary Rating Date Differing From the Policy Effective Date . R – 138. Split Period Code . R – 139. Premium Amount . R – 14a. Extension of Exposure . R – 14b. Flat Charges . R – 1410. Premium Amount Subject to Experience Modification Factor . R – 14a. Extension of Exposure . R – 14b. Other Than Extension of Exposure. R – 1411. Total Subject Premium Amount . R – 1512. Experience Modification Factor . R – 1513. Premium NOT Subject to Experience Modification Factor . R – 1614. Exposure – Payroll Total . R – 1715. Total Standard Premium Amount . R – 1816. Premium Discount Amount . R – 1817. Expense Constant Amount . R – 1818. Catastrophe Provision for Terrorism. R – 1819. Catastrophe Provision for Natural Disasters and Catastrophic Industrial Accidents . R – 1820. New York Workers Compensation Security Fund Surcharge . R – 18
NEW YORK WORKERS COMPENSATION STATISTICAL PLAN1st ReprintEffective January 1, 2018TOC—3TABLE OF CONTENTSTable of Contents (Contd.)IV. Loss Information1.2.3.4.5.6.7.8.9.10.11.12.13.14. 15.16.17.18.19.20.21.22.23.24.25.PagesReporting of Losses . R – 19Update Type . R – 19Claim Number . R – 19Accident Date . R – 19Incurred Losses. R – 20a. Incurred Indemnity Amount . R – 20b. Incurred Medical Amount . R – 21Expenses Excluded From Losses . R – 22Expenses Included in Losses . R – 22Fraudulent Claims . R – 23a. Reporting Fully Fraudulent Claims . R – 23b. Reporting Partially Fraudulent Claims . R – 23Recoveries – Subrogation, Third-Party Cases, Special Funds . R – 24Lump-Sum Claims. R – 25Paid Losses . R – 26a. Paid Indemnity Amount . R – 26b. Paid Medical Amount. R – 26Allocated Loss Adjustment Expense (ALAE) Paid Amount . R – 26Classification Code. R – 27Injury Type . R – 27a. Death . R – 27b. Permanent Total Disability. R – 27c. Permanent Partial Disability – Scheduled Loss of Use . R – 28d. Permanent Partial Disability – Non Scheduled . R – 28e. Temporary Injury . R – 28f. Medical Only . R – 28g. Contract Medical . R – 29h. Aggregate Trust Fund . R – 29Claim Status . R – 29BLoss Condition Code . R – 29Ba. Act . R – 30b. Type of Loss . R – 30c. Type of Recovery . R – 30d. Type of Claim . R – 31e. Type of Settlement . R – 31Jurisdiction State . R – 32Catastrophe Number . R – 32Managed Care Organization Type. R – 32Injury Description Code . R – 32New York State Workers’ Compensation Board Case Number . R – 32Claimant’s Weekly Wage . R – 33Claimant Attorney Fees Incurred . R – 33Employer Attorney Fees Incurred . R – 33Totals . R – 33
TOC—4NEW YORK WORKERS COMPENSATION STATISTICAL PLANTABLE OF CONTENTSEffective January 1, 20181st ReprintTable of Contents (Contd.)V.Subsequent Reports and Corrections1.2.3.4.5.6.7.PagesSubsequent Reports. R – 34a. Reporting Conditions . R – 34b. Revaluation of Losses . R – 34Correction Reports . R – 34Method of Reporting . R – 35a. Header Information . R – 35b. Exposure Information . R – 35c. Loss Information . R – 35d. Totals . R – 36Link Data . R – 36Replacement Reports . R – 36Procedure for Correction of Claims After Subsequent Reports Have Been Filed . R – 36Manage USR (MUSR) . R – 36VI. Unit Statistical Report CodesA.Codes Common to Premium and Losses . R – 371. Report Number and Valuation Date . R – 372. Correction Type . R – 373. Exposure State . R – 374. Policy Conditions . R – 375. Policy Type . R – 386. Deductible Type. R – 38B.Exposure Codes . R – 391. Update Type. R – 392. Exposure Coverage . R – 393. Premium Codes . R – 39a. Subject to Experience Modification Factor (Above Line “A”) . R – 39b. Not Subject to Experience Modification Factor (Lines “D”, “E” or “F”) . R – 40c. Not Subject to Experience Modification Factors andNot included in Standard Premium (Lines “H”, “I”, or “J”) . R – 40C.Loss Information Codes1. Injury Type . R – 412. Claim Status . R – 41A3. Loss Conditions . R – 424. Managed Care Organization Type . R – 425. Fraudulent Claim Codes . R – 426. Injury Description Codes . R – 42 INDEX . i – vii
NEW YORK WORKERS COMPENSATION STATISTICAL PLAN1st ReprintEffective January 1, 2018INTRODUCTIONScope and Effective Date of The PlanThe New York Workers Compensation Statistical Plan (Plan) is applicable for the reporting of New York data on directbusiness written for Workers Compensation, Voluntary Compensation and Employers Liability insurance. Acting under thedirection of the Superintendent of Financial Services, and pursuant to Article 23 of the New York Insurance Law, eachcarrier's experience must be submitted to the New York Compensation Insurance Rating Board (NYCIRB) in accordancewith all of the requirements specified in the Plan.This Plan is applicable on a mandatory basis for the reporting of data for all policies effective January 1, 2013 and thereafter, unless specifically noted otherwise.Organization of The PlanThe New York Statistical Plan is organized according to the following major parts:I.II.Header Data/Policy InformationIII.Exposure/Premium InformationIV.Loss InformationV.VI. General RulesSubsequent Reports and CorrectionsCodes
NEW YORKWORKERS COMPENSATIONSTATISTICAL PLAN2013 EDITIONNew York CompensationInsurance Rating Board733 Third AvenueNew York, New York 10017(212) 697‐3535PART IGENERAL RULES
NEW YORK WORKERS COMPENSATION STATISTICAL PLANOriginal PrintingEffective January 1, 2013R—1PART IPART I—GENERAL RULES1. Reporting of StatisticsCarriers or their authorized data providers may use any method they choose for the internal recording of statistical datasubmitted to the NYCIRB. This includes any type of format convenient to the carrier’s statistical and accountingprocedures and codes other than those set forth in the Plan, provided that the required data elements are submitted tothe NYCIRB in accordance with the rules and timeframes specified in this Plan.2. Preparation and Completion of Unit Statistical ReportsSummarized exposure, premium and loss data for each workers compensation policy is required under Item 6 below.Electronic format is the exclusive means of submitting this data to NYCIRB. For information regarding electronicreporting, refer to the Workers Compensation Statistical Reporting Specifications (WCSTAT) in the WCIO DataSpecifications Manual at www.wcio.org.3. Submission Control RecordA submission of statistical data must be accompanied by a submission control record as specified in the WCIO DataSpecifications Manual, General Section, at www.wcio.org.4. Auditing of Statistics Prior to SubmissionThe carrier must audit the statistics being reported prior to their submission to NYCIRB to detect any errors.Examples of such errors are: errors in the assignment of statistical codes; errors in the assignment of claims to policiesand/or class codes; errors in dollar amounts being reported. If audited information is not available prior to thesubmission of statistics, the carrier must identify and report the estimated exposure and premium until the auditedinformation becomes available.5. Correction of ErrorsCarriers are expected to correct any and all errors found in their data. Errors impact the quality and accuracy ofratemaking and experience rating and must be corrected to prevent delays in releasing these products. Refer to Part Vfor detailed instructions.6. Filing RequirementsExposure, premium and loss data must be filed for every workers compensation and employers liability policyproviding coverage in New York, including New York coverage on interstate policies and coverage provided underany voluntary compensation endorsement.Statistical reports are also required for any policies with New York exposure that are written on an “If Any” basis anddo not develop exposure, provided that the policy was not cancelled flat. Refer to Part III, Item 6.g.If more than one risk is written on a single policy, as provided in either Section 32 of the Volunteer Firefighters'Benefit Law or Section 32 of the Volunteer Ambulance Workers' Law, separate statistical reports must be submittedfor each risk included within the policy.Statistical data is not required for the following types of policies: Employers liability insurance on residence and farm employees in conjunction with other liability insuranceWorkers compensation on domestics provided in conjunction with homeowners insurancePolicies providing coverage under the National Defense Projects Rating Plan or Nuclear Regulatory Commissionprojects (See Items 10 and 11, respectively)Policies providing excess coverage other than excess medical
R—2NEW YORK WORKERS COMPENSATION STATISTICAL PLANPART IEffective January 1, 2013Original Printing7. Multi-State PoliciesStatistical reports must be filed for each state of a multi-state policy. A report must be filed for each state on a policywith estimated exposure, including those for which no exposure was developed.Statistical reports for New York coverage on a multi-state policy must be filed with the NYCIRB and also with theNational Council on Compensation Insurance (NCCI).8. Uncollectible Premiumsa. Audited PoliciesReport all earned premiums for those policies on which an audit has been conducted and the earned premium isknown, even if the premium is uncollectible. Likewise, report the corresponding exposure and loss data.b. Policies on Which a Final Audit Is Not PossibleReport the estimated earned premium and exposure corresponding to the term of coverage for those policies onwhich a final audit is not possible and the audited earned premium and exposure is not known. Likewise, report theloss data for the corresponding term of coverage.9. ReinsuranceStatistics are to be reported only for direct business. Do not submit unit statistical reports for workers compensationassumed policies (e.g., exclude premiums received from, or losses paid to, other carriers on account of reinsuranceassumed by the carrier). Do not submit unit report statistics for workers compensation ceded policies (e.g., reductionsshould not be made for premiums ceded to, or for losses recovered from, other carriers due to ceded reinsurance).10. National Defense ProjectsPremium and loss data for policies written under the National Defense Projects Rating Plan shall not be reported onunit statistical reports. Instead, "Exhibit I-Computation of Earned Premium", form NDPRP-I, must be filed with theNYCIRB at the
business written for Workers Compensation, Voluntary Compensation and Employers Liability insurance. Acting under the direction of the Superintendent of Financial Services, and pursuant to Article 23 of the New York Insurance Law, each carrier's experience must be submitted to the New York Compensation Insurance Rating Board (NYCIRB) in accordance
The Workers' Compensation Act was enacted in 1915 to protect workers and outline the responsibilities of stakeholders in Pennsylvania's workers' compensation system. Today, more than 100 years later, the Depart - ment of Labor & Industry's Bureau of Workers' Compensation, the Workers' Compensation Appeal Board and
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You must file the DWC Form-005 if you do not have workers compensation insurance, or you have terminated your workers compensation insurance coverage. However, if your only employees are exempt from coverage under the Texas Workers Compensation Act (for example, certain domestic workers, and certain farm and ranch workers) you do not have to file.
a Workers' Compensation Claim for Compensation, which your Workers' Compensation attorney can assist you in filing. Can survivor benefits be denied or reduced? The same rules that make an employee eligible for Workers' Compensation benefits, apply in the case of a work-related injury that results in death. First, the employer must .
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purposes of workers' compensation insurance. Myth: I am a small employer with minimal revenue, so I will have my employees secure their own workers' compensation policy in order to save money. Reality: A business cannot require their employees to obtain their own workers' compensation insurance poli-cy. The cost of the workers' compen-
CE-200APPLY (2/2009) - 1 - New York State Workers' Compensation Board Application for Certificate of Attestation of Exemption from New York State Workers’ Compensation and/or Disability Benefits Insurance Coverage. For NYS workers’ compensation exemption, this applicati
Cambridge IGCSE and O Level Accounting 1.4 The statement of financial position The accounting equation may be shown in the form of a statement of financial posi
