Insurers are required to submit all policy transaction data (policies, endorsements, cancellations and reinstatements) relevant to California workers’ compensation insurance coverage to the WCIRB. The policy data is subject to audit validations to ensure compliance with the provisions of the California Workers’ Compensation Uniform Statistical Reporting Plan—1995 (USRP) and the California Workers’ Compensation Experience Rating Plan—1995 (ERP).
New or renewal policy data must be submitted to the WCIRB no later than thirty (30) days subsequent to the inception date of the policy. Endorsements and cancellations or reinstatements must be submitted to the WCIRB no later than thirty (30) days after the transaction issue date. See the USRP, Part 2, Policy Reporting Requirements, Section 1, General Instructions, Rules 1-3.
The WCIRB reviews the policy transaction data to ensure the data is submitted timely and accurately. Policies are audited to ensure compliance with the use of approved coverage forms and that all language required by California law is included on the policy on an approved form. In addition, the WCIRB uses policy information to compile a record of workers’ compensation insurance coverage for all California insured employers.
Data submitters are required to report policy data electronically via the Compensation Data Exchange (CDX) web-based service. Policy data reported electronically must be submitted in accordance with the USRP and specifications set forth in the Workers Compensation Insurance Organizations’ (WCIO) Workers Compensation Policy Reporting Specifications (WCPOLS) as applicable in California.
Insurers may use the web-based Policy Entry and Edit Package (PEEP) on the CDX website to create, edit and/or validate policy data before submitting it electronically to the WCIRB. Links to these services appear in the Resources section below.
Prior to submitting production files, each insurer, or their authorized third-party entity (TPE), must submit test files for approval by the WCIRB. Please review the guidelines on the Electronic Policy Submission Test Requirements page and then email [email protected] to arrange the testing.
Until approved for electronic policy submission, insurers or their TPE shall submit to the WCIRB electronic versions (digital images or PDFs) of policy, endorsement, cancellation and reinstatement documents provided to policyholders for processing and in accordance with the timing requirements of the USRP. In accordance with the WCIRB Policy Data Quality Program (PDQP), documents submitted to the WCIRB will be subject to a $25 processing fee per document and testing for electronic submissions must be completed within the program standards. See the PDQP, Section III, Policy Reporting Electronic Submissions.
To ensure the timeliness and accuracy of policy data, the WCIRB targets the most effective methods for maintaining high standards of data quality while minimizing the manual touchpoints associated with the data exchange process. This approach includes both policy data validation through preprocessing and audit edits and policy data monitoring using the set of metrics in the PDQP.