Overview
The New York State Workers' Compensation Law (WCL) §226 authorizes the Board to penalize insurance carriers who fail to file proof of coverage (POC) transactions in a timely manner. (Subject Number 046-1802)
Untimely POC filings disrupt the administration of the DBL, resulting in unnecessary costs being incurred by all stakeholders. Late POC filings:
- Delay payment of benefits to claimants.
- Trigger an issuance of inquiries and penalties to employers and carriers.
- Prompt investigations by the Board.
Accordingly, POC penalties were created by statute to encourage insurance carriers to file proof of coverage submissions timely and correctly.
While the legislation permits the Board to issue penalties for every transaction, the Board initially will only penalize for a limited set of transactions. The balance of transactions will not be penalized but will be monitored to determine if they should be included as penalties at a later date. The Board will implement this legislation for DB POC transactions received on or after April 1, 2026.
Transactions
The Board will be measuring carrier performance quarterly on the timeliness of Add Policy (new) and Cancellation transactions filed as of April 1, 2026. The definition of "late" depends on the transaction type, which can be determined using the following table:
| Transaction type | Timely filing | Transaction late and penalized |
|---|---|---|
| Add new policy | Received no later than 30 days after effective date of new policy | Received beyond 40 days after effective date off new policy |
| Cancel for non-payment of premium | Received at least 10 days prior to date of cancellation | Received after date of cancellation |
Add policy: The Board will not measure the timeliness of an Add Policy filing where the policy is active and has already been reported prior to that transaction date. This will allow for a change to an insured or the addition of another insured to an existing policy.
Cancellation: The Board will only measure cancellations submitted as non-payment of premium. All statutory reporting rules apply. The Board will not be measuring other reasons for cancellation such as no employees, out of business, or "other" (which is often used for coverage placed elsewhere).
Note: The Board is only measuring carrier proof of coverage data transactions. Plan coverage and self-insured coverage that is manually reported will be excluded from the performance measurement.
Additional information on transactions can be found using the IC Inquiry Application.
Carrier Performance
As of April 1st, 2026, the Board will evaluate Disability Benefits carrier performance each quarter. The Board will calculate the performance of the carrier during the quarter by taking the total number of the measured transactions and calculating the percentage of those transactions that were timely filed.
Disability Benefits Carriers who do not meet an 85% timely performance rate will be penalized for untimely filings of Add Policy transactions and Cancellation transactions for non-payment of premium.
When the performance rate meets 85%, or greater, carriers will not be subject to any POC penalties. If the quarterly performance is 85%, or less, all measured transactions that are filed late will be penalized.
Quarterly Performance results can be viewed through the Board's IC Inquiry Application.
Penalties
WCL § 226 of the Disability Benefits Law allows for the imposition of a penalty up to $100 for every 10-day period a POC transaction (filing) is late. As per Subject No. 046-1802 the current penalty amount assessed will be $50 for each 10-calendar day period that a transaction is late.
A penalty notice (CC-420) will be issued mid-month following each quarter and will include instructions for payment. Payment is due within 30 days of receipt, unless the transaction is appealed.
| Quarter | Dates | Approximate CC-420 Date |
|---|---|---|
| Quarter 1 | January 1 - March 31 | April 15th |
| Quarter 2 | April 1 - June 30 | July 15th |
| Quarter 3 | July 1 - September 30 | October 15th |
| Quarter 4 | October 1 - December 31 | January 15th |
Appeal a Penalty
Appeals must be filed within 30 days from the date of the penalty notice (CC-420) using the online IC Inquiry Application. Once the appeal deadline has passed, all appeals will be reviewed in the order received. The amount of time it will take to complete the review process depends on the volume of appeals received in the quarter. A letter of decision will be mailed to the Primary Penalty Contact for any unpaid penalties or remaining balances .
Contact
POCPenalty@wcb.ny.gov - Questions regarding carrier proof of coverage penalties
WCPOCSupport@wcb.ny.gov - Workers' compensation proof of coverage (POC) transaction support
DBPOCSupport@wcb.ny.gov - Disability benefits proof of coverage (POC) transaction support