Policy and Proof of Coverage Data

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The WCRIBMA collects policy data from all carriers licensed to sell workers' compensation insurance in Massachusetts. Policy data are the coverage information from the documents included and attached to a workers' compensation policy. Policy data are used in the following products and services:

Online Proof of Coverage (POC) information used by the Massachusetts Department of Industrial Accidents
Tracking Receipt of Unit Statistical Data
Distribution of Experience Rating
Federal Proof of Coverage Service
Administration of Assigned Risk Pool
Actuarial Analysis
Workers' Compensation Analyst Tool (WCAT)

Reporting Guidelines

The Massachusetts Workers’ Compensation and Employers Liability Insurance Manual is to be used in conjunction with the Experience Rating Plan Manual, the Retrospective Rating Plan Manual, and the Massachusetts Workers' Compensation Policy Data Reporting Guide Effective 05/01/2017 for assistance with reporting policy data.

Transactions Accepted

Transaction Type Code	Transaction Description
01	New Policy
02	Renewal Policy
03	Endorsements other than annual rerate having record layouts in WCPOLS and issued subsequent to the policy
04	Annual Rerate Endorsement
05	Cancellation/Reinstatement
06	Policy Replacement Due to Key Field Change
08	Policy Replacement Due to Rating Change
10	Policy Replacement Due to Non-Rating Change
14	Policy Replacement Due to Miscellaneous Change/Non-Key Field Change
15	Policy Replacement Due to Add/Delete State Change
16	Coverage Notice/Binder
17	Noncompliance of Policy Terms and Conditions

Submission Requirements

All policy data must be submitted to WCRIBMA electronically. Options for creating a policy data submission file include electronic files and online entry.

Electronic files - When reporting policy data using electronic files, data must be formatted using the standard WCPOLS record layouts. All electronic file submissions must include a transmittal record. The WCPOLS record layouts, submission file requirements and transmittal record layout are found in the WCIO Data Specifications Manualtronic files must be submitted via the Compensation Data Exchange (CDX).

Before submitting electronic files, data reporters must pass electronic submission certification testing. Electronic Submission Testing Requirements.
Information relating to CDX is available on the CDX website (www.cdxworkcomp.org). Additional information is also available in WCRIBMA Circular Letter #1943.
Questions relating to CDX should be addressed to WCRIBMA Technical Suppport (WCRIBMA-TechSupport@wcribma.org).

Online entry – Currently, two submission options are available for online entry of policy data:

Manage Policy - A web based application accessible through the SOSA Area of WCRIBMA’s website. Manage Policy submits policy data directly into the WCRIBMA’s system.
PEEP - A web based application accessible through the CDX website, www.cdxworkcomp.org. PEEP creates an electronic file that must be submitted via CDX.
- Information relating to PEEP is available on the CDX website. Questions relating to PEEP should be addressed to Qiming Zhang at 617-646-7566 (or qzhang@wcribma.org).

Submission Processing - Overview

Overview of electronic and online policy file processing.

Data Reporter Sends a File via:	After Initial Submission	CDX Status/Action	WCRIBMA Processing	CDX Status/Action	Manage Pol Status/Action
Manage Policy	Submission displays in View Submitted Manage Policy Submissions in Manage Policy	N/A	If file is received on a business day, by 5:00 PM Eastern, WCRIBMA processes submitted file within 1 hour. Otherwise, WCRIBMA processes file the next business day.	N/A	Rejected* Update submission Status to ‘Rejected’ Create Error Report(s) Accepted Update Submission Status Update individual transaction statuses Create Policy Error Reports
CDX	CDX Processes Submitted File	Rejected - CDX Notifies Sender		Rejected - Update CDX ETR Status to 'Recipient Rejected'	Rejected Update Submission Status to ‘Rejected’ Create Error Report(s)
CDX	CDX Processes Submitted File	Accepted - CDX Sends file to WCRIBMA	Accepted - If file is received on a business day, by 5:00 PM Eastern, WCRIBMA processes submitted file within 1 hour. Otherwise, WCRIBMA processes file the next business day.	Accepted - Update CDX ETR Status to 'Recipient Accepted'	Accepted Update Submission Status Update individual transaction statuses Create Policy Error Reports

*Some submission rejections do not result in a Submission Reject report. In such instances, if the reason is not in SOSA Error Reports or is not on CDX, contact WCRIBMA Technical Support (WCRIBMA-TechSupport@wcribma.org).

Policy Data Editing

All policy data submissions received at the WCRIBMA are subject to editing to evaluate the reported data for timeliness, accuracy, completeness, and reasonability. Some edits fail as the result of errors in data submission, while others are the result of atypical circumstances. Some edits allow the acceptance of policies with warnings or errors. Other edits call for the rejection of a submission or a transaction within a submission. Failed edits generally require the resubmission of corrected data. In some situations, for example atypical data, explanations may be approved.

Policy Edits

Edit Notification

Data reporters are made aware of failed edits for a submission or policy via:

Error Reports
Manage Policy
Data reporters are expected to monitor submission and transaction status via Manage Policy and Error Reports. Refer to the Manage Policy User Guide and the Error Reports User Guide.

Email Notice from WCRIBMA (as needed)
Email notifications from WCRIBMA will be sent to Data Reporters, as needed, for situations that are not handled by the Error Reports product.

Edit Explanations

Data reporters may send edit explanations to explain atypical data. All explanations must adequately explain the reason for the edit failure and are subject to WCRIBMA approval.

If an "Explain" link is displayed with the edit, explanations should be sent by using the Explanation Capture System. Refer to the Explanation Capture System User Guide.

If an "Explain" link is not provided with the edit, explanations can be sent via email (DataOperations@wcribma.org).

Note that explanations for rejection edits, generally, are not acceptable.