WCSTAT (Unit) Data File Submission and Processing€¦ · NCCI’s 2018 Data Educational Program January 30 –February 2, 2018 Palm Beach County Convention Center West Palm Beach,

NCCI’s 2018 Data Educational ProgramJanuary 30–February 2, 2018

Palm Beach County Convention CenterWest Palm Beach, FL

The Path to Data Excellence

WCSTAT (Unit) DataFile Submission and

Processing

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© Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved.

WCSTAT (Unit) Data File Submission and Processing

Presented by:Bob Vaughan and Lisa Combes


NCCI’s 2018 Data Educational Program

Objectives

Provide an understanding of the electronic reporting process from building the file through updating your data.

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Data Excellence!

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Agenda

Submission and Editing Overview

Electronic Submission Requirements

Submission Methods

Submission Editing

Data Quality Editing

Reporting and Updating Unit Data

Unit Data Collection Tool

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Submission and Editing Overview

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Submission and Editing FlowIdentify expected

unit reports (1st and subsequent reports)

Are corrections needed?

Submit unit

reports

Review URC Expected Reports and Unit Data Collection

Create unit reports

Pre‐edit the data

Update source system

No

Carrier

Yes

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Recommended Unit Data Reporting Workflow

Did the unit reports reject?

Are corrections needed?

Data is available for use

Unit reports are accepted and

loaded to database

Yes

No

Edit the reports

No

NCCINCCI

Yes

Update source system

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4


Electronic Submission Requirements



Manuals

Unit Reporting Rules

Statistical Plan Manual

Unit Statistical Reporting Guidebook

Electronic Reporting

Requirements

Electronic Transmission User’s Guide

WCIO Workers Compensation Data

Specifications Manual

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5



Unit Report―Composed of a record or series of records

Records―Collec on of related data elements

Data Elements―Items of data that convey information about the policy, exposures, and losses. This data may be submitted as codes and values.

Electronic Unit Statistical Data

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Record Types

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Header1

Address3

Loss5

File Control9

Name2

Exposure4

Total6

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WCIO Overview

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WCIO Workers Compensation Data Specifications Manual provides standards for data reporting

Defines Field Formatting

Applicable Data Collection Organizations (DCOs) Record Layout With Data Element Definitions

WCSTAT for Unit Statistical data

Workers Compensation Insurance Organizations(WCIO)



WCIO Specifications Layout

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Example of different types of field requirements from WCIO manual: WCPOLS

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Statistical Plan

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Numeric Fields

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Reporting Fields With Assumed Decimals

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0 0 0 0 0 0 0 0 1 . 0

Manual Rate—Decimal between Positions 89 and 90

Experience Mod Factor—Decimal between Positions 51 and 52

Exposure Amount—Decimal between Positions 75 and 76



Link Data and Key Fields

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Coverage Provider ID (NCCI Carrier Code)

Policy Number

Policy Effective Date

Exposure State

Report Number

Correction Sequence Number

Links individual records within a unit report

Key

Fields

Link Data

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Unit Report Control (URC)

1st Report“Open”

Unit Report Control (URC)

Policy

3rd ReportNot

Expected

2nd Report“Closed”

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Original Reports Requirements

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Unit Report Type

Header Record (1)

Name Record (2)

Address Record (3)

Exposure Record (4)

Loss Record (5)

Total Record (6)

Original Reports:

1st Reports Must have only 1

Must have only 1

Optional Must have at least 1

Required when there is a loss(es)

Optional

1st Replacement Reports

Must have only 1

Must have only 1

Optional Must have at least 1

Required when there is a loss(es)

Optional

Subsequent Reports

Must have only 1

Musthave only 1

Optional None allowed

Must have at least 1

Optional

Unit Statistical Reporting Guidebook: Part 1‐B‐2

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Submission Methods



Submission Methods

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Unit Submission

Electronic File

Unit Data Collection

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Electronic File Submissions

Data Transfer via the Internet (DTVI)(Secure Mailbox)

Web‐based tool for reporting data

Receive your submission results reports and data files

Email notification is sent to submitter when data is received

Files retained for eight calendar days

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Electronic Transmission User’s Guide: Part 2



Electronic File Submissions

Secure FTP (File Transfer Protocol) Automates your file transmissions

Define directories to retrieve and store files

Set up a transmission schedule

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Electronic Transmission User’s Guide: Part 2

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Electronic Certification Testing

What does the certification process test?

Ensures all connections, files, and systems are functioning and processing correctly

Who has to get certified?

All new data providers

Data providers who changed their data reporting system

For general certification requirements, refer to the Electronic Transmission User’s Guide

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Electronic Transmission User’s Guide: Part 4‐F‐5



File Naming Conventions

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Inbound File Type Naming Convention

Production File unit25e*.txt

Certification File unit25e*.tst

*Accommodates up to 30 additional characters

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DTVI File Names

Inbound Files—Unique date and time stamp before the file extension in the stored file name

yyyymmdd_hhmmssnnn

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Inbound File Name Stored File Name

unit25e*.txt unit25e*_20160128_141055123.txt


Submission Editing

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Pre‐Editing

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In‐House

Pre‐Edit Service

Pre‐Edit Tool



Pre‐Edit Tool/Service

Pre‐Edit Tool Submit data via ncci.com Online correction of unit data prior to submitting to

production Receive Pre‐Edit Submission Results Report

Pre‐Edit Service Submit data via ncci.com Receive Pre‐Edit Submission Results Report

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File Naming Conventions

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Inbound File Type Naming Convention

Pre‐Edit Service File unitpru**.txt

Pre‐Edit Tool pred250e.**.txt

**Accommodates up to 18 additional characters



Submission Edits

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File does not follow standard naming conventionInvalid File Name

User does not have access to submit the dataUnauthorized

User

Data submitted with invalid characters or the file is emptyInvalid Data

File Control record counts do not match NCCI countsOut of Balance

80% or more of the units match data already on NCCI’s database80% Duplicate

Units

PGP encryption key does not match NCCI keyInvalid

Encryption Key

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Data Quality Editing



Unit Statistical Editing

Front‐end quality checks Validity

Accuracy

Completeness

Two different versions of the matrix are found in the Unit Statistical Reporting Guidebook

All Edits in Production

Future Enhancements

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Unit Edit Matrix

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Data Reports

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Unit Submission Results Report

Description Frequency/Naming Convention

Provides results of individual file submissions and displays units that were rejected or accepted with errors.

Upon SubmissionUnitSubmissionResultsReport_xxxxxxx.cvs

Unit Daily Submission Results Report

Description Frequency/Naming Convention

Includes information on all unit reports that were submitted the prior day and remain rejected or in error. Unit reports with rejects and/or errors that were corrected are not included on this report.

DailyUnitDailySubmissionResultsReport_xxxxxxx.cvs

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Data Reports Feature

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File Tracking Feature

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Reporting and Updating Unit Data



Reporting Unit Data

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Correction Reports

Updating Header Record

Update Type Code

Updating Exposure Record

Updating Loss Record

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Correction Reports Requirements

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Unit Report Type

Header Record

(1)

Name Record

(2)

Address Record

(3)

Exposure Record

(4)

Loss Record

(5)

Total Record

(6)Correction Reports:Header Record(Correction Type H)

Must have only 1

Optional None Allowed

None Allowed

None Allowed

None Allowed

Exposure Record(Correction Type E)

Must have only 1

Must have only 1

None Allowed

Required None Allowed

Optional

Loss Record(Correction Type L)

Must have only 1

Must have only 1

None Allowed

None Allowed

Required Optional

Multiple Record(Correction Type M)

Must have only 1

Must have only 1

None Allowed

Required when correcting exposure(s)

Required when correcting loss(es)

Optional

Total Record(Correction Type T)

Must have only 1

Must have only 1

None Allowed

None Allowed

None Allowed

Must have only 1

Loss Record Corrections Due to Aggravated Inequity(Correction Type A) (FL Only)

Must have only 1

Must have only 1

None Allowed

None Allowed

Required Optional

Unit Statistical Reporting Guidebook: Part 1‐B‐2



Correction Sequence Number

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Number of Corrections Field Value

First 9 sequential correction reports 1 through 9

Next 26 sequential correction reports A through Z

Beyond 35 sequential correction reports Z

Unit Statistical Reporting Guidebook: Part 1‐C‐2

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Updating Unit Data

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Correction Reports

Header Record

Update Type Code

Exposure Record

Loss Record



Header Corrections 1st reports only Use Correction Type Code “H” or “M”

Report all Header Record fields Updateable key fields—Carrier Code, Policy Number, Policy Effective Date

Use “Previously Reported” fields to correct key fields

Exposure State is not updateable—need to report a new unit

Other link data fields are not updateable (Report Number, Correction Sequence Number)

Contact NCCI Customer Service if you need to change

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Header Correction for Key Fields Example

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Updating Policy Number

Unit Statistical Reporting Guidebook Example: Part 3‐B



Header Correction for Key Fields Example

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Updating Policy Number

Pol NbrWC123456

Prev Pol NbrWC12345

Carrier Cd99990

Prev Carrier Cd00000

Corr Seq Nbr1

Pol Eff Dt01/01/07

Prev Pol Eff Dt000000

Unit Statistical Reporting Guidebook Example: Part 3‐B

Corr Type CdH

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Updating Unit Data

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Correction Reports


Update Type Code





Update Type Code

Identifies how each Exposure and Loss Record will be processed

Two methods:

Previous and Revised (P and R)

Add, Change, and Delete (A, C, D)

48

Statistical Plan: Part 6

Unit Statistical Reporting Guidebook: Part 1‐E

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Update Type Code Reporting

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Update Type Code Records Required

R or A Original 1st Reports Adding Exposure Class Code Adding Claims • One record is required

P and Ror

D and A

Updating or Correcting Exposure and/or Loss Information• One record for the previous data (P or D)

— Must match previously submitted data (including matching fields)• One record for the changed and unchanged data (R or A)

P or D Deleting Exposure and/or Loss Information• One record is required• Matching data elements must match previously submitted data• To delete an entire report—all records get “P’s” or “D’s”

C Correcting Exposure/Loss Information (cannot be used to update matching fields)• One record is required• Updated information including the same matching fields



Updating Unit Data

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Correction Reports


Update Type Code



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Exposure Corrections

1st Reports Only

Use Correction Type Code “E” or “M”

Report Correction Sequence Number

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Exposure Matching Fields

Match Exposure Corrections to 1st Report

Prevent Duplicate Exposure Records

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Class Code or Statistical Code

Exposure Act/Exposure Coverage Code

Experience Modification Effective Date

Rate Effective Date

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Unmatched Exposure Records

Exposure Record on correction report:

Exposure Record (“P,” “C,” or “D”) does not have a corresponding Exposure Record (“A,” “C,” or “R” on the database)

Based on the exposure matching fields

Unit report will reject

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Unmatched Exposure Corrective Actions

When the correction rejects due to unmatched Exposure Records, then correct the invalid matching data:

On the correction reportor

On the original 1st unit report

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Unmatched Exposure Corrections Example

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Original 1st Report

Pol Nbr: WC12345 Carrier Cd: 99990 Pol Eff Dt: 01/01/15 Rpt Nbr: 1 Corr Seq Nbr: 0 Corr Type Cd: Exp St: 09

Update Type

Exp Act

Class Cd

Exposure Amt Rate

Premium Amt Experience Mod

Mod Eff Dt

Rate Eff Dt

Split Period

R 01 8810 100,000 1.63 1,630 1.00 01/01/15 01/01/15 0




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Original 1st Report

Pol Nbr: WC12345 Carrier Cd: 99990 Pol Eff Dt: 01/01/15 Rpt Nbr: 1 Corr Seq Nbr: 0 Corr Type Cd: Exp St: 09

Update Type

Exp Act

Class Cd

Exposure Amt Rate


Mod Eff Dt

Rate Eff Dt

Split Period

R 01 8810 100,000 1.63 1,630 1.00 01/01/15 01/01/15 0

Rpt Nbr: 1

Update TypeR

Corr Seq Nbr: 0

Exp Act01

Class Cd8810

Mod Eff Dt01/01/15

Rate Eff Dt01/01/15

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Exposure Correction Report—Updating Exposure Classification Code

Pol Nbr: WC12345 Carrier Cd: 99990 Pol Eff Dt: 01/01/15 Rpt Nbr: 1 Corr Seq Nbr: 1 Corr Type Cd: E Exp St: 09

Update Type

Exp Act

Class Cd

Exposure Amt Rate


Mod Eff Dt

Rate Eff Dt

Split Period

P 01 8742 100,000 1.63 1,630 1.00 01/01/15 01/01/15 0 R 01 8742 100,000 1.63 1,630 1.00 01/01/15 01/01/15 0

Class code on previous record does not match 1st report.Class code on previous record does not match 1st report.




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Update Type

Exp Act

Class Cd

Exposure Amt Rate


Mod Eff Dt

Rate Eff Dt

Split Period

P 01 8742 100,000 1.63 1,630 1.00 01/01/15 01/01/15 0 R 01 8742 100,000 1.63 1,630 1.00 01/01/15 01/01/15 0

Rpt Nbr: 1

Update Type

P

Corr Seq Nbr: 1

Exp Act01

Class Cd

8742

Mod Eff Dt01/01/15

Rate Eff Dt01/01/15

Corr Type Cd: E

Update Type

R

Exp Act01

Class Cd

8742

Mod Eff Dt01/01/15

Rate Eff Dt01/01/15

Class code on previous record does not match 1st report.Class code on previous record does not match 1st report.

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Update Type

Exp Act

Class Cd

Exposure Amt Rate


Mod Eff Dt

Rate Eff Dt

Split Period

P 01 8810 100,000 1.63 1,630 1.00 01/01/15 01/01/15 0 R 01 8742 100,000 1.63 1,630 1.00 01/01/15 01/01/15 0




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Update Type

Exp Act

Class Cd

Exposure Amt Rate


Mod Eff Dt

Rate Eff Dt

Split Period

P 01 8810 100,000 1.63 1,630 1.00 01/01/15 01/01/15 0 R 01 8742 100,000 1.63 1,630 1.00 01/01/15 01/01/15 0

Rpt Nbr: 1

Update TypeP

Corr Seq Nbr: 1

Exp Act01

Class Cd8810

Mod Eff Dt01/01/15

Rate Eff Dt01/01/15

Corr Type Cd: E

Update TypeR

Exp Act01

Class Cd8742

Mod Eff Dt01/01/15

Rate Eff Dt01/01/15

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Updating Unit Data

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Correction Reports


Update Type Code





Loss Corrections

Use Correction Type Code “L”—All report levels

“A”—for Aggravated Inequity Claims (Florida only)

Use Correction Type Code “M”—1st reports only

Report Correction Sequence Number

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Loss Matching Fields

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Claim Number

Accident Date

Match losses on subsequent and correction reports to losses on prior reports



Duplicate Loss Records

Loss Record on subsequent or correction report:

Loss Record (“R” or “A”) does not have a corresponding Loss Record (“P” or “D”)

and

Has the same matching fields on another Loss Record in the same correction report or previously submitted unit report

Unit report will reject

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Duplicate Loss Corrective Actions

When the correction report rejects due to duplicate Loss Records:

Correct the invalid matching data on the correction record or previously reported data

or

Add a Previous Record to match the previously reported data

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Pol Nbr: W123456 Carrier Cd: 99990 Pol Eff Dt: 01/01/08 Rpt Nbr: 1 Corr Seq Nbr: 0 Corr Type Cd: Exp St: 10

Update Type Claim Nbr Accident Dt

Nbr of Claims

Class Code

Injury Type

Claim Status Cat Nbr Jurisdiction St

R 25768 07/11/08 1 8810 09 0 0 10

Incurred Indemnity

Paid Indemnity

Incurred Medical

Paid Medical

Paid ALAE

Deductible Reimbursement

Emp Attny Fees Incurred

Clmt Attny Fees Incurred

35,000 15,000 25,000 20,000 100 00 00 00

Loss Conditions Code (type of): Injury Description

Code:

Act Loss Recovery Claim Settlement Part Nature Cause Voc Rehab Lump- Sum Fraud Claim

01 01 01 01 00 36 40 18 N N 00

Loss Example

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Original 1st Report

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Nbr of Claims

Class Code

Injury Type


R 25768 07/11/08 1 8810 09 0 0 10

Incurred Indemnity

Paid Indemnity

Incurred Medical

Paid Medical

Paid ALAE




35,000 15,000 25,000 20,000 100 00 00 00


Code:


01 01 01 01 00 36 40 18 N N 00

Loss Example

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Original 1st Report

Rpt Nbr: 1

Update TypeR

Corr Seq Nbr: 0

Claim Nbr25768

Accident Dt07/11/08





Nbr of Claims

Class Code

Injury Type


R 25768 07/11/08 1 8810 09 0 0 10

Incurred Indemnity

Paid Indemnity

Incurred Medical

Paid Medical

Paid ALAE




35,000 25,000 40,000 25,000 100 00 00 00


Code:


01 01 01 01 00 36 40 18 N N 00

Loss Example

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Subsequent Report—Updating Claim Information

Missing previous record on subsequent report.Missing previous record on subsequent report.

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Nbr of Claims

Class Code

Injury Type


R 25768 07/11/08 1 8810 09 0 0 10

Incurred Indemnity

Paid Indemnity

Incurred Medical

Paid Medical

Paid ALAE




35,000 25,000 40,000 25,000 100 00 00 00


Code:


01 01 01 01 00 36 40 18 N N 00

Loss Example

69


Rpt Nbr: 2

Update TypeR

Corr Seq Nbr: 0

Claim Nbr25768

Accident Dt07/11/08

Missing previous record on subsequent report.Missing previous record on subsequent report.





Nbr of Claims

Class Code

Injury Type


P 25768 07/11/08 1 8810 09 0 0 10

Incurred Indemnity

Paid Indemnity

Incurred Medical

Paid Medical

Paid ALAE




35,000 15,000 25,000 20,000 100 00 00 00


Code:

Act Loss Recovery Claim Settlement Part Nature Cause Voc Rehab Lump-Sum Fraud Claim

01 01 01 01 00 36 40 18 N N 00


Nbr of Claims

Class Code

Injury Type


R 25768 07/11/08 1 8810 09 0 0 10

Incurred Indemnity

Paid Indemnity

Incurred Medical

Paid Medical

Paid ALAE




35,000 25,000 40,000 25,000 100 0 0 0


Code:


01 01 01 01 00 36 40 18 N N 00

Loss Example

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Nbr of Claims

Class Code

Injury Type


P 25768 07/11/08 1 8810 09 0 0 10

Incurred Indemnity

Paid Indemnity

Incurred Medical

Paid Medical

Paid ALAE




35,000 15,000 25,000 20,000 100 00 00 00


Code:


01 01 01 01 00 36 40 18 N N 00


Nbr of Claims

Class Code

Injury Type


R 25768 07/11/08 1 8810 09 0 0 10

Incurred Indemnity

Paid Indemnity

Incurred Medical

Paid Medical

Paid ALAE




35,000 25,000 40,000 25,000 100 0 0 0


Code:


01 01 01 01 00 36 40 18 N N 00

Loss Example

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Rpt Nbr: 2

Update TypeP

Corr Seq Nbr: 0

Claim Nbr25768

Accident Dt07/11/08

Update TypeR

Claim Nbr25768

Accident Date 07/11/08


Unit Data Collection Tool

37




All unit report types can be entered and submitted through Unit Data Collection

Update Type Code A/C/D

Changes made online should be made in the carrier’s system to ensure synchronization of data between NCCI and the carrier

Units submitted through Unit Data Collectiongenerate a WCSTAT data file that is sent to the carrier via Data Transfer via the Internet

Return file name = udcunit_1234567.txt

Extract Data feature can be used to create subsequent reports

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NCCI’s 2018 Data Educational Program74

Supplemental Information

Presenter Biographies

Bob Vaughan, AIDM, has worked at NCCI for 20 years. He is a consultant in the Data Services Department in NCCI’s Data Resources Division. Bob participates in many projects related to NCCI’s data tools and serves as coordinator for the Data Collection Procedures (DCP) Subcommittee. Bob is also responsible for data reporting communications and manuals. He is actively involved in industry committees focused on data reporting.

Lisa Combes has worked at NCCI for 15 years and is a senior data analyst in the Data Services Department in the Data Resources Division. Lisa supports NCCI’s data providers by developing industry communications, data reporting manuals, and customer training materials. She is also responsible for researching and resolving escalated customer inquiries.

Lisa’s prior positions at NCCI include systems support manager for Residual Markets; underwriting analyst, quality technical analyst, and senior business analyst in the Assigned Risk Department; and senior technical business analyst in Residual Market Plan Administration.

Lisa has 31 years of experience in the insurance industry, including personal lines and as a general liability underwriter. She is a graduate of Gateway Technical Institute.

Documents

WCSTAT (Unit) Data File Submission and Processing€¦ · NCCI’s 2018 Data Educational Program January 30 –February 2, 2018 Palm Beach County Convention Center West Palm Beach,