Proof of Coverage Workers’ Compensation Reporting Requirements

The law (WCL § 54[5-a] permits the Board to issue penalties for every failure to timely file with the Board proof of a policy issuance, amendment, endorsement, reinstatement, non- renewal or cancellation. However, the untimely filings that will be initially penalized, as referenced in Subject Number 046-304, and WCIC 2010 # 1 are as follows:

This change results in removing transactions that were included in the performance standard but not directly penalizable, and also removes the penalizable reinstatement transactions.

All other untimely transactions will not be penalized at the current time. For a complete listing of all transactions New York State accepts, please review the International Association of Industrial Accident Boards and Commissions (IAIABC) Event Table.

Not at the current time. However, transactions that are not currently penalized will be monitored to determine if they should be included as penalties at a later date.

Not at the current time. However, transactions that are not currently penalized will be monitored to determine if they should be included as penalties at a later date.

Not at the current time. However, transactions that are not currently penalized will be monitored to determine if they should be included as penalties at a later date.

Yes, you will receive a penalty if the renewal transaction is not filed within the required number of days.

Not at the current time. However, transactions that are not currently penalized will be monitored to determine if they should be included as penalties at a later date.

The penalty amount for workers' compensation carriers is $50 for each 10 day period that a transaction is late, which is ten percent of the maximum $500 penalty authorized by the Legislature.

Penalty notices are issued shortly after the end of each calendar quarter.

The penalty is calculated based on calendar days.

The start date of the penalty period for workers' compensation carriers will be the effective date of the transaction or the effective date of the legislation (October 19, 2008), whichever is later.

Within thirty days of the date of the notice of penalty, submit requests for re-determination review along with an explanation of any relevant facts and circumstances. Appeals should be submitted to pocpenalty@wcb.ny.gov via hard copy or on line using the IC Inquiry application. Appeal instructions are included with the penalty letters.

Carriers must be registered for Insurance Compliance Inquiry in order to obtain a detailed transaction report, summary report and to file their appeal on line.

The Board will continue to monitor POC filings (transactions) not listed in the subject number. Carriers will receive notice that additional filings are subject to penalty via a new Subject Number prior to assessment.

If you have any questions, please contact the Monitoring and Compliance unit at: pocpenalty@wcb.ny.gov

IAIABC Proof of Coverage data is completed by the submission of information in two parts identified as the 'Insured' and 'Employer' record descriptions.

The Insured record contains information about the type of POC transaction being sent (e.g. Binder, New, Renew, Rewrite/Reissue, Cancel, Change), the effective date of the transaction, the insurer (e.g. carrier, issuing office and agent), the insured (the named policyholder on the policy), and other identifying policy information. It may or may not be followed by one or more Employer records.

The Employer record(s) identifies the employer(s) affected by the transaction submitted. Depending on the transaction type, Employer records need to be submitted for each legal entity (i.e. employer) location either covered on the Policy or affected by the transaction being submitted. The employer's FEIN and UI Number (UIER in NY State – this is the Unemployment Insurance Employer Registration number assigned by the NYS Dept. of Labor) name, and address are also submitted in this area.

No. The cancellation must be received at the Board (via the third-party vendor) at least 10 days prior to the cancellation date for non-payment of premium or 30 days for any other reason. Carriers should consider this factor if submitting data through a vendor in order to meet timely filing requirements.

Yes! Carriers should notify the Board of a cancellation as soon as possible in case the Board rejects the transaction (for reasons unrelated to timely filing) and you are required to re-file the cancellation. You will also have to review, and perhaps extend, the policy cancellation date to ensure the re-filed cancellation is timely filed with the Board and the employer. Therefore, the earlier the original cancellation is submitted, the earlier you can re-file if the Board rejects the original cancellation, thus reducing or eliminating the need to extend the policy cancellation date.

Yes.

Renewals with or without a change in carrier/insurer assignment within a carrier group may be submitted.

Payroll information should be reported for the policy period.

Yes, FEIN is mandatory information for both insured and employer endorsements reported to the WCB. If there are multiple employers that represent different, unique entities covered under the policy, each entity must have its own FEIN reported in order for us to properly record coverage information. When the same FEIN is used to report more than one employer endorsement those employers added (with the same FEIN) will be treated as locations. For more information see IAIABC websiteopens external website.

Yes, this is a mandatory requirement. For more information see IAIABC websiteopens external website.

The Federal Employer Identification Number (FEIN) is a 9-digit number assigned by the Federal Government to identify a specific employer. In the case of a sole proprietor who does not have a FEIN, their Social Security number must be provided in place of the FEIN.

Yes, acknowledgment files will be generated for transactions submitted in EDI flat files. Transactions submitted through the internet application are immediately accepted or rejected.

The NYS WCB will accept jurisdiction information for New York State only.

Yes. The New York State Legislature amended Workers' Compensation (WCL) §54 and §226 in 2008 to authorize the Workers' Compensation Board to penalize workers' compensation carriers, disability benefits carriers, the State Insurance Fund and group self-insured trusts for failure to timely file proof of coverage (POC) transactions.

For more information see Workers Compensation Insurance Carrier Bulletin WCIC-2010 #1

If the rewrite (re-assignment of risk to different insurer within group) occurs on a renewed term, submit a Renewal transaction. The Rewrite/Reissue transaction is used when the prior policy was cancelled for cause and later reconciled. The carrier rewrites the policy for the original term using a new policy number. The WCB's web application does not support this transaction. The carrier must submit a cancellation for the prior term and submit a new policy for the rewritten term.

Yes, they are accepted and processed as new or renewal policy transactions.