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Policy Validation: Preprocessing and Audit Edits

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Policy Validation: Preprocessing and Audit Edits

The WCIRB employs a variety of approaches toward ensuring that complete, accurate and timely policy data is submitted to the WCIRB in compliance with the requirements outlined in the Uniform Statistical Reporting Plan. Two of the primary approaches are the validation of policy transactions to identify the most critical data reporting errors and anomalies and the WCIRB Policy Data Quality Program (PDQP). These approaches, coupled with data reporting educational materials and active partnerships with insurer data reporters, align with the WCIRB’s objective of maintaining high standards of data quality while minimizing the manual touchpoints associated with the data exchange process. Read more about the WCIRB’s initiative to modernize the collection, auditing and dissemination of data here.

Policy validations or “edits” occur at two stages once data is received in WCIRB Connect®: preprocessing and audit edits. Lists of both sets of edits appear below.

Policy Preprocessing Edits

Preprocessing edits are applied at the point of initial receipt of the policy data submission into WCIRB Connect. These edits check for basic WCPOLS compliance. Policy transactions with data reporting deficiencies resulting in critical preprocessing edit failures are rejected and the submitter must correct the errors and resubmit the transactions.

Below is a link to the current list of preprocessing edits that are applied to all policy data submissions. Insurers and other data submitters should review this list to ensure that submissions are consistent with the indicated requirements.

Some of the preprocessing edits relate to the Electronic Transmittal Record, known as the ETR. This is the first record in any WCPOLS submission. To correct ETR errors, please refer to the WCIO's Electronic Transmittal Record Specifications (ETR) located on the WCIO website, Universal Electronic Transmittal section. If you use PEEP to create submission files, PEEP creates the ETR for you. If you are unsure how to modify the ETR in PEEP, please contact a WCIRB data submission analyst at [email protected].   

Policy Audit Edits

Audit edits are applied once a policy passes preprocessing validation and matches to a bureau file number in WCIRB Connect®. These edits are more complex than preprocessing edits and may be relational, comparing incoming policy data to prior WCIRB coverage records.

The policy audit process distinguishes between two types of edit failures, each of which is handled in a different way:

  1. Transactional errors may impact the completeness of the WCIRB’s permanent coverage records for California workers’ compensation or an insurer’s compliance with California regulations regarding approved forms and required language on policies.
  2. Data quality errors are anomalies that are monitored for systemic data quality issues potentially impacting coverage records or experience rating, but no individual responses or corrections are required.

Below is the list of policy audit edits: