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Subject Number 046-395 Carrier Performance Standard For Waiving Proof of Coverage Penalties Reduced From 90 Percent to 85 Percent For 2010

Board Bulletins and Subject Numbers

January 12, 2010

To:  Workers' Compensation Carriers and the New York State Insurance Fund

In Subject Number 046-365, dated October 5, 2009, the Board established a 2010 performance standard of 90 percent for timely filing of Proof of Coverage (POC). Those workers' compensation carriers meeting or exceeding this rate in any quarter of 2010 would have their POC penalties waived for that quarter.

Given that carriers have begun to implement process changes related to POC and in a further spirit of cooperation, the Board will reduce the carrier performance standard to 85 percent for 2010. Moreover, the Board will also delete two rewrite/reissue IAIABC transaction codes (00-50-01 and 00-50-80) from the performance standard as the Board recognizes these represent replacement filings which should be on file with the Board. In the second half of 2010, the Board will determine the standard for 2011, which will be announced via a subject number.

A significant number of expired policies continue to remain open on the Board's Insurance Compliance 2 (IC2) system. As a result, the Board cannot process non-compliance actions against employers who no longer have a workers' compensation policy. Therefore, the Board reserves the right to close these open, expired policy terms approximately 75 days after the policy expiration date if they have not been accurately renewed, non-renewed or cancelled by a carrier. This action will be considered a failure to file and will be penalized with a penalty start date 41 days after policy expiration date. The Board will use a transaction code of 00-41-CE (WCB Closed Term-No Filing Received) when processing these actions, which will be included in the carrier's performance standard. However, the first subsequent renewal, cancellation, or reinstatement transaction submitted after the Board's action to the policy will not be penalized or considered in the performance standard. Please note that a reinstatement transaction following the Board's action is not required to process a subsequent renewal or cancellation.

To help carriers analyze their policies on the IC2 system, a new "WC Policy Report" feature is now available on the Board's Insurance Compliance Inquiry web application. The WC Policy Report contains a list of open and closed policy terms in the Board's POC database and is available in PDF and Excel formats. Carriers should carefully review those open policies where policy terms have expired, or will expire in the near future, so that they can process the appropriate transaction as soon as possible.

If you have any questions, please contact the Bureau of Compliance, Data Administration Unit at:

Robert E. Beloten