The WCIRB Policy Data Quality Program (PDQP) uses a set of key performance indicators as well as reconciliation activities to identify potential systemic data reporting deficiencies in policy data reported to the WCIRB. This program, together with a variety of other approaches the WCIRB uses to ensure that timely, complete and accurate policy data is submitted, aligns with the WCIRB’s objective of targeting the most effective methods for maintaining high standards of data quality while minimizing the manual touchpoints associated with the data exchange process.
Quarterly PDQP reports are released to insurer participants comparing their results against the acceptable thresholds and statewide benchmarks for each metric. Insurers that do not meet specific performance standards are required to take corrective action and may be assessed fines.
Each insurer, or their authorized third-party entity (TPE), must complete electronic policy submission testing in accordance with the PDQP prior to submitting policy transactions electronically. All incoming policy data goes through the WCIRB’s pre-processing edits to ensure compliance with Workers Compensation Policy Reporting Specifications (WCPOLS). For California specific data reporting requirements, refer to the WCIRB Data Reporting Handbook.
Data accuracy is monitored in two parts. The first part, Accuracy of Electronic Reporting, measures the accuracy and completeness of an insurer’s electronically submitted policy data. The second part, Data Quality Metrics, measures the timeliness and completeness of an insurer’s policy data reporting along with responsiveness in providing the WCIRB with accurate data.
Accuracy of Electronic Reporting validates whether the policy data submitted electronically to the WCIRB matches the hard copy policy documents provided to the policyholder. The WCIRB selects a random sample of policy transactions from a participating insurer’s recently submitted electronic submissions and reconciles the following data elements against corresponding hard copy policy documents:
Data Quality Metrics uses key performance indicators to assess the timeliness, accuracy and completeness of a participating insurer’s incoming policy data. A summary of these data quality metrics is provided in the chart below:
|Data Quality Metric||Program|
|Submission Timeliness – Policies||Measures an insurer’s volume of new and renewal policies, annual rating endorsements, and renewal certificates / renewal agreements received by the WCIRB more than 30 days after policy inception|
|Submission Timeliness – Cancellations and
|Measures an insurer’s volume of cancellations and reinstatements received by the WCIRB more than 30 days after issuance|
|Responsiveness to Policy Work Items||Measures an insurer’s volume of policy work items that remain unresolved more than 60 days after issuance of the inquiry|
|Unmatched Policy Transactions – Cancellations and
|Measures an insurer’s volume of cancellations and reinstatements that are not matched to policies within 60 days of receipt by the WCIRB|
|Unmatched USRs||Measures an insurer’s volume of unit statistical reports that are not matched to WCIRB policies within 60 days of receipt by the WCIRB|
|Experience Modification Reporting Success – Policy Transactions||Measures an insurer’s volume of initial policies with incorrect or missing experience modifications 60 days after receipt of initial policy|
|Forms Compliance||Identifies an insurer's policies reported with unapproved forms and/or policies not endorsed with provisions required by California law using approved forms (advisory only)|
If you have any questions regarding PDQP, please contact Data Quality Assurance at [email protected].