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WCIRB Connect - Access Options for Third Party Entities

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WCIRB Connect - Access Options for Third Party Entities

June 30, 2021

WCIRB Connect® is a powerful tool that provides online access to information and data for insurers, agents and brokers, and other authorized users. If you are a Workers’ Compensation Insurance Rating Bureau of California (WCIRB) member that uses third party entities (TPE) – including third party administrators, managing general agents (MGAs), data submitters and fee audit companies – to act on your behalf for purposes of data submissions, premium auditing and communicating with the WCIRB, you can authorize your TPE to access experience rating worksheets (ratesheets), inspection reports, experience modifications (X-Mods) and other policyholder information as well as policy and unit statistical report (USR) information for your policyholders through WCIRB Connect.

To authorize access, insurers must complete Form 902, Third Party Entity Registration and execute a Consent to Use Third Party Entity and Agreement to Indemnify for each TPE. Once the agreement is in place and any necessary system testing is complete, the WCIRB will accept certain types of information and data, including policy forms, USRs, aggregate financial information, medical transaction data and related correspondence from TPEs. In addition – pursuant to the applicable authorization – the WCIRB will release certain information and data to authorized TPEs, communicate with TPEs and facilitate access to WCIRB Connect.

WCIRB Connect TPE Options

Regardless of which configuration option the insurer selects for its TPEs, all TPE accounts include access to basic policyholder information such as the following:

  • X-Mods, including eligibility and X-Mod history information
  • Comprehensive Risk Summary® (CRS) Report showing 10 years of X-Mod history, WCIRB assigned classifications, primary name and address and other basic policyholder information summarized in a downloadable report (Visit the CRS Report page to learn how to acquire the required policyholder authorization to access a CRS report.)
  • Unlimited subscriptions to X-Mod Direct® email alert

In addition to this basic policyholder information, insurers may choose to grant access to additional information for their TPEs by selecting from one of the three different TPE access options.

  1. Restricted – Policyholder Search
    TPEs with this access level may view basic policyholder information and may also view all of the ratesheets and inspection reports for the insurer’s policyholders. This information is commonly required by TPEs, including MGAs, and those involved in the production or review of premium audits.
  2. Restricted – Submitter
    TPEs with this access level may view the basic policyholder information listed above and may also view the insurer’s policy and USR data provided that the TPE submitted either the policy or USR data and that the TPE is identified as the submitter on the Electronic Transmission Record (ETR) accompanying the policy or USR data file.
  3. Restricted ‒ Business Segment Identifier (BSI)
    TPEs with this access level may view the basic policyholder information listed above as well as the insurer’s policy and USR data specifically assigned to them through the BSI field on an insurer’s electronic data file submission(s).
  4. Unrestricted – Insurer Level
    TPEs with this access level may view the same screens, reports and information that the insurer is able to view, for all of the insurer’s policyholders. In other words, the TPE will have access to all of the insurer’s data regardless of whether the TPE submits or receives such data.

The exhibit below summarizes each of the TPE options available in the WCIRB Connect. Click here to view a PDF version.



Connect tool / access Restricted:
Policyholder Search
Restricted:
Submitter
Restricted:
BSI
Unrestricted:
Insurer-Level
Search for any policyholder by name, FEIN or BN
View X-Mod information for any policyholder
View ratesheets that my insurer can view without authorization Limited by submission Limited by BSI assignment
Subscribe to X-Mod Direct
View WCIRB assigned classifications for any policyholder
View inspection reports that my insurer can view without authorization Limited by submission Limited by BSI assignment
Request a CRS Report, showing information such as the X-Mod information, assigned classifications and names on current policies for a risk
Authorize for ratesheets, inspection reports or the CRS Not available Not available Not available Not available
View detailed policy and USR information for my insurer's policies Not available Limited by submission Limited by BSI assignment
Submit/Approve Change in Ownership requests Not available Not available Not available
View and respond to work items in the Work Queue Not available Limited by submission Limited by BSI assignment
Search for policy audit and USR audit letters sent to my insurer Not available Limited by submission Limited by BSI assignment
View lists of outstanding X-Mods in Manage X-Mod Reporting Not available Limited by submission Limited by BSI assignment
Track reporting trends in Data Quality Edits Not available Limited by submission Limited by BSI assignment
View live USR lists in Manage USR Timeliness Not available Not available Not available
Coverage research for claims adjusters in pursuit of an open claim Not available Not available Not available Not available
Search for group level reports sent to my insurer Not available Not available Not available
Access Submission Manager, including SHRs, SHR-PETs, file names, submitter info, header info and a list of policy numbers in WCPOLS files Not available Limited by submission Insurer selects either "ALL access" or "NO access" for the TPE

WCIRB Connect Third Party Configuration Options

To learn more about using third parties, see the Using Third Parties page on the WCIRB website. If you are a third party data submitter, an MGA, a fee auditor or another TPE and would like to access WCIRB Connect, contact the WCIRB member you provide services for and discuss WCIRB Connect access. Only WCIRB members may request TPE access to WCIRB Connect.