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Policy and Proof of Coverage Data

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,  the Massachusetts Workers’ Compensation Policy Data Reporting Guide 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 Manual. Electronic files must be submitted via the ACCCT Compensation Data Exchange (CDX).

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 ACCCT website, www.accct.org. PEEP creates an electronic file that must be submitted via CDX.

    • Information relating to PEEP is available on the ACCCT website. Questions relating to PEEP should be addressed to Deborah Dohl at 617-646-7538 (or ddohl@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 WCRIBMA processes submitted file within 2 business days N/A Rejected*
  • Update submission Status to ‘Rejected’
  • Create ‘Submission Rejected Report’


Accepted
  • Update Submission Status to ‘Accepted’
  • Update individual transaction statuses to ‘Accepted’ or ‘Rejected’
  • 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 ‘Submission Rejected Report’
Accepted - CDX Sends file to WCRIBMA Accepted -WCRIBMA processes submitted file within 2 business days Accepted - Update CDX ETR Status to 'Recipient Accepted' Accepted
  • Update Submission Status to ‘Accepted’
  • Update individual transaction statuses to ‘Accepted’ or ‘Rejected’
  • Create Policy Error Reports

*Some submission rejections do not result in a Submission Reject report on Manage Policy. In such instances, if the reason 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:

  • 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.

Resources

Manuals - Rates - Rating Values

Policy Edits

Massachusetts Workers' Compensation Policy Data Reporting Guide

Masssachusetts Workers' Compensation Policy Data Reporting Guide Effective 05/01/2017

Manage Policy User Guide

Error Reports User Guide

Explanation Capture System User Guide

Data Quality Compliance Programs

Electronic Submission Testing Requirements

WCIO Workers Compensation Data Specifications Manual

ACCCT Compensation Data Exchange (CDX) 

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