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Data Quality Compliance Programs

The WCRIBMA has a number of data collection mechanisms including, policy and proof of coverage data, unit statistical report (USR) data and aggregate financial (AF) call data. By imposing fines for data errors and late reporting, these programs, in effect, transfer a portion of the data correction costs to those companies responsible for the errors. There are five data quality programs. These are:

  1. Policy Data Quality Incentive Program (PDQIP)
  2. Unit Statistical Data Quality Incentive Program (USDQIP)
  3. Aggregate Financial Call Acknowledgment Process
  4. Aggregate Financial Data Quality Incentive Program (AFDQIP)
  5. Examinations and Reconciliations

Programs Summaries

A summary of each Data Quality Compliance Program is listed below.

See the following Circular Letters for historical background on Data Quality Compliance implementation and changes:

Circular Letter # Issue Date Title
2336 06/29/2018 Unit Statistical Reporting Data Quality Incentive Program
2318 06/30/2017 Policy Data Quality Incentive Program
2317 06/30/2017 Unit Statistical Reporting Data Quality Incentive Program
2304 12/30/2016 Policy Data Quality Incentive Program
2303 12/30/2016 Unit Statistical Reporting Data Quality Incentive Program
2290 07/01/2016 Policy Data Quality Incentive Program (PDQIP)
2289 07/01/2016 Data Quality Incentive Program for USR Data Reporting (USDQIP)
2274 12/30/2015 Policy Data Quality Incentive Program (PDQIP)
2260 06/30/2015 Policy Data Quality Incentive Program (PDQIP)
2250 12/30/2014 Policy Data Quality Incentive Program
2224 08/30/2013 Revisions to the Massachusetts Workers' Compensation Statistical Plan
2220 07/24/2013 Policy Data Quality Incentive Program
2168 01/18/2011 Revisions to Parts I & II of the Massachusetts Workers' Compensation Statistical Plan.
2101 10/01/2008 Revisions to the Massachusetts Workers' Compensation Statistical Plan - Part I
2083 02/20/2008 Revisions to the Massachusetts Workers' Compensation Statistical Plan - Part I
2064 07/30/2007 Revisions to the Massachusetts Workers' Compensation Statistical Plan - Part II - Section V, Data Quality Incentive Program
1956 06/15/2004 Revisions to Part I of the Massachusetts Workers' Compensation Statistical Plan
1939 12/22/2003 Revisions to the Massachusetts Workers' Compensation Statistical Plan
1909 01/17/2003 Revisions to the Massachusetts Workers' Compensation Statistical Plan
1851 08/04/2000 Data Quality Incentive Programs

Policy Data Quality Incentive Program (PDQIP)

Fines associated with Policy and Proof of Coverage Data will be imposed for the following situations:

    Timeliness Fines

    For residual market policies, policy data records with transaction type codes of 02 or 05 are subject to timeliness fines. For voluntary policies, policy data records with transaction type codes 01, 02 or 05 are subject to timeliness fines. For transaction type code 01 (New Policy) and 02 (Renewal Policy), timeliness fines are incurred when the data is accepted into the  WCRIBMA's system beyond 30 calendar days of the policy effective date. For transaction type code 05 (Cancellation/Reinstatement), timeliness fines are incurred when the data is accepted into the WCRIBMA's system beyond 30 days of the transaction issue date.

    Data Quality Fines

    A finable data quality edit is not corrected and/or adequately explained by the due date.

Unit Statistical Data Quality Incentive Program (USDQIP)

Fines associated with Unit Statistical Reports (USRs) will be imposed for the following situations:

    Timeliness Fines

    Missing policies – a USR was submitted and rejected because no corresponding Policy and Proof of Coverage Data is in the WCRIBMA system, and the policy still has not been submitted or the USR is still not in an accepted status before the 21st month from the policy effective date.

    Delinquent USR – a USR is expected as a consequence of Policy and Proof of Coverage Data reporting, but it is not submitted before the 21st month from the policy effective date.

    Rejected Correction Report – a USR correction report remains in rejected status for 3 months, following the last day of the month in which the unit was rejected.

    *Data reporters have access to due, delinquent and rejected unit statistical data via the Manage USR Unit Statistical Tracking System (USTS) found within the SOSA area of the WCRIBMA website.

    Data Quality Fines

    A finable data quality edit is not corrected and/or adequately explained by the due date.

Aggregate Financial Call Acknowledgement Form Process

Fines associated with the Aggregate Financial Call Acknowledgement Form will be imposed for the following situations:

    Timeliness Fines

    A completed form is not submitted by the due date.

    Inappropriate Signatory Fines

    Forms that are submitted without the signature of a company officer or a company actuary who is a member of the Casualty Actuarial Society and/or a member in good standing of the American Academy of Actuaries will incur a fine. Additional fines will begin to accrue if a corrected form is not submitted by the due date.

Aggregate Financial Data Quality Incentive Program (AFDQIP)

Fines associated with the Aggregate Financial Calls will be imposed for the following situations:

    Timeliness Fines

    Data calls are not submitted by their respective due dates.

    Data Quality Fines

    Basic Edit Failures – Per Occurrence Fine - a call is submitted with a basic edit failure.

    Basic Edit Failures – Timeliness Fine - a basic edit failure is not corrected by due date.

    Actuarial Edit Failures – Timeliness Fine - an actuarial edit is not corrected and/or adequately explained by the due date.

Examinations and Reconciliations

Fines associated with Examination and Reconciliations will be imposed for the following situation:

    Timeliness Fines

    A Triennial AUP findings report is not submitted by the due date.


Disciplinary Fine

Disciplinary fines are in addition to the Data Quality Compliance Program fines described above.

Sample of reasons for Disciplinary Fines:

  1. In a filing the WCRIBMA must adjust, correct or make allowances for inaccuracies in the data supplied by a carrier or carrier group.
  2. Unsuitable data for use in a WCRIBMA filing.
  3. Unresponsive to requests for overdue calls.
  4. Unresponsive to requests or unsatisfactorily responses to attempts to resolve data anomalies.
  5. Uncooperative with WCRIBMA and/or auditing firms in connection with Targeted AUP.
  6. Noncompliance with triennial examination.
  7. Missing, rejected or filtered data excluded from data reconciliation process.
  8. At the direction of the Commissioner due to unreliable, incomplete, untimely or otherwise defective aggregate financial data that materially impacts a filing submitted to the Commissioner.

Invoicing

On the first of every month, invoices are emailed to data contacts on file. Changes to contacts must be reported to Data Operations Department via email (DataOperations@wcribma.org).


Appeals

If the carrier or carrier group (carrier) is subject to a fine, which in the opinion of the carrier is inappropriate, the carrier may submit a written appeal to the Data Operations Department via email (DataOperations@wcribma.org) or to the following address:

Data Operations Department
WCRIBMA
101 Arch Street, 5th Floor
Boston, MA 02110

Appeals must be received within twenty (20) business days from the invoice date in order to be considered.

The WCRIBMA’s decision may be appealed to the Commissioner of Insurance. An appeal to the Commissioner must be filed within thirty (30) days of receipt of the WCRIBMA’s decision.

Resources

Statistical Plan

Policy and Proof of Coverage Data

Unit Statistical Data

Aggregate Financial Data

The Workers' Compensation Rating and Inspection Bureau of Massachusetts
101 Arch Street, 5th Floor
Boston, MA 02110