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Federal Coverages & NichePrograms—Policy Rules &Reporting RequirementsPresented by:Julie Gonzalez and Shani Oulton bjectiveTo provide an overview of Niche and Federaltype programs, and discuss data reportingrequirements across multiple data types. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.21
Agenda Overview of Data Types and Data UsageNiche ProgramsFederal Coverages Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.3Data TypesPolicy Data Proof ofCoverage URC Program PremiumTrends ExposureTrendsFinancialCall Data StatewidePremiumLevelIndications IndustryResults Copyright 2015 National Council on Compensation Insurance, Inc. All Rights on IndividualRisk Rating ClassRates/LossCosts LegislativeAnalysis LegislativeAnalysis ResearchMedicalCall Data LegislativeAnalysis Research42
Niche Programs 014 Data Educational ProgramWhat Is a Niche Market? Subset of the market on which a specificinsurance product is focused Defines the insurance product features aimed atsatisfying: Specific needs Cost Production quality Demographics Small market segment Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.63
Topics Voluntary CompensationEmployers Liability InsuranceWrap-Up ProgramsRetrospectively Rated PoliciesExcess PoliciesMinimum Premium PolicyCatastrophe Provisions Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved. Anniversary Rating DateUncooperative AuditRatable and Nonratable GroupsSupplemental DiseasesLump Sum/SettlementsMedicare Secondary PayerMissouri MesotheliomaWest Virginia Deliberate IntentCoverage7Voluntary CompensationBasic Manual Rule 2-ICoverage for workers not required under statute—optional coverageBenefits equivalent to statutory benefitsSeparate payroll records must be maintainedWC000311A—Voluntary Compensation and Employers Liability Coverage Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.84
Foreign Voluntary CompensationCoverage for employeeswho are hired within theUnited States, but traveland work outside of theUnited StatesEmployees in a specificcountry for a designatedmaximum number ofconsecutive daysOptional additionalcoverage for repatriationexpensesBasic ManualRule 2-I (CT and FL Exceptions) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.9Reporting Voluntary CompensationPolicy and Unit ReportFinancial Call Type of Nonstandard ID—Code09—Voluntary Coverage Classification Code Do not report repatriationcoverage charge Exposure and loss amount Repatriation losses andexpenses Premium for VoluntaryCompensation (includingForeign VoluntaryCompensation) insurance Premium for additional(optional) repatriation coverageCircular DR-2013-03 Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.105
Employers Liability InsuranceCoverages Workers Compensation and Employers Liability Employers Liability Without Workers Compensation Stop Gap Coverage—Monopolistic Funds E/L Increased LimitsReporting Statistical Codes Corresponding to E/L Increased Limits Statistical Code 9139—Flat Charge for Employers Liability/Voluntary Compensation Type of Claim W/C and E/L E/L onlyBasic Manual Rule 3-A-14Statistical Plan Preface—A–1 Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.11Wrap-Up Construction ProjectsBasic Manual Rule 3-A-23Owner/General ContractorElectricianSteel Framers Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved. Policies are issued by onecarrier to two or morelegal entities Classifications assigned toeach separate legal entitybased on operations Designated WorkplaceExclusion Endorsement(WC 00 03 02) Owner ControlledInsurance Program (OCIP)or Contractor ControlledInsurance Program (CCIP)Plumbers126
Wrap-Up Projects Reporting Policy Wrap-Up/Owner Controlled InsuranceProgram (OCIP) Code 1Unit Report Separate unit reports (exposure/losses)by contractor Deductible program typeLoss reimbursement for net deductibleprogram Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.13Wrap-Up Projects ReportingFinancial Call Master Wrap-Up Policy that covers multiple years must bereported as separate policies with individual effective dates foreach of the annual components. For Wrap-Up Policies Not Written Under a Deductible Program: For Wrap-Up Policies Written Under a Large Deductible Program: Include experience (premiums, losses, and expenses) of allassociated owner/contractor and subcontractors in all Calls.Experience of all associated owner/contractor andsubcontractors must follow the rules for including/excludingDeductible Policies—Large.For Wrap-Up Policies Written Under a Deductible Program—OtherThan Large: Experience of all associated owner/contractor andsubcontractors must follow the rules for including/excludingDeductible Policies—Other Than Large. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.147
Wrap-Up Policy Example5 Year Wrap-UpProgram2010–2015Wrap-Up PolicyPolicy # Wrapup110/1/10–10/1/11Wrap-Up PolicyPolicy # Wrapup210/1/11–10/1/12 Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.Wrap-Up PolicyPolicy # Wrapup310/1/12–10/1/13Wrap-Up PolicyPolicy # Wrapup410/1/13–10/1/14Wrap-Up PolicyPolicy # Wrapup510/1/14–10/1/1515Wrap-Up Policy—Unit ReportsWrap-Up PolicyBob’s PlumbingPolicy # Wrapup1B10/1/10–5/1/11Payroll/LossBob’s PlumbingPolicy # ABC1/1/10–1/1/11Payroll/LossManny’s SteelPolicy # Wrapup1C12/1/10–10/1/11Payroll/LossManny’s SteelPolicy # GHI1/1/10–1/1/11Payroll/LossJulie’s WiringPolicy # Wrapup1D1/1/11–5/1/11Payroll/LossJulie’s WiringPolicy # MNO1/1/11–1/1/12Payroll/LossRichard’s ConcretePolicy # Wrapup1E6/1/11–10/1/11Payroll/LossRichard’s ConcretePolicy # XYZ1/1/11–1/1/12Payroll/LossPolicy # Wrapup110/1/10–10/1/11 Deductibleprogram type Reimbursement(Net Programs) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.168
Wrap-Up Policy—Financial CallsWrap-Up PolicyPolicy # Wrapup110/1/10–10/1/11SmallDeductiblePolicy Report all premium,loss, and expense inPolicy Year 2010LargeDeductiblePolicy Exclude allpremium, loss, andexpense from PolicyYear/CAY Calls Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.17Retrospectively Rated PoliciesAdjusts premium on lossesincurred during the policytermPremium reflects actualexperience of the insuredLosses incurred during thepolicy establishes cost ofinsurance, includingprovisions for premiumexpenses and taxes Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.Includes Loss SensitiveRating Plan (LSRP)189
Retrospectively Rated Policies Policy Retrospective Rating Code 5 Unit Reports Retrospective Rated Policy Indicator Y Premium Adjustments—do not report Financial Retrospective Rating Plan Adjustments Net—in Company standard and DSR—out Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.19Excess PoliciesOffered to qualified self-insured employers;coverage for losses above a set amountTarget markets—contractors, oil fieldservice industry, and maritime operationsOften combined with claims administrationand safety and loss programs Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.2010
Excess Policy Reporting Policy and unit report Statistical Plan Part 1.R.—Excess Policies Not Reportable West Virginia exception—Deliberate IntentCoverageFinancial Call If reported in NAIC Page 14, Line 16 (WC Line)reconciliation Then, report only on Calls #1 and #1A, and as areconciliation item in the Reconciliation Call #8 Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.21Minimum Premium PolicyBasic Manual Rule 3-A-16: If Any Coverage—Potential ExposureSubcontractors, Trucking IndustryExempt Employers Needing Certificateof Insurance Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.2211
Minimum Premium Policy Policy Reporting Multistate policy State Premium Record—at least 1 Exposure RecordUnit Reporting Statistical Code 1111Balance to Minimum PremiumExpense constantLoss with corresponding exposure Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.23Pick the AnswerQuestionsAnswersCovers One Job LocationEmployers LiabilityFor Potential ExposureExcess PoliciesIncreased LimitsWrap-Up PolicyCoverage Not RequiredMinimum Premium PolicyAbove WorkersCompensation CoverageVoluntary Compensation Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.2412
Catastrophe ProvisionsBasic Manual Rule 3-A-24: Catastrophe (other than Certified Acts of Terrorism) TerrorismMiscellaneous ValuesReporting 9741—Catastrophe Provisions for Catastrophe (otherthan Certified Acts of Terrorism) 9740—Catastrophe Provisions for TerrorismExposure, Rate and/or Premium Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.25Anniversary Rating DateBasic Manual Rule 3-A-2: Effective month and day of policy in effectunless a different date has been established Industry approachReporting Policy State Premium RecordUnit Report – Rate Effective Date andModification Effective Date Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.2613
Oklahoma and Tennessee Law-Only Filings Premium adjustment for outstanding policies Circulars OK-2014-01 TN-2014-01 and TN-2014-04Three methods to apply the ratingadjustments Directly to the rates Total manual premium Split period method Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.27Uncooperative Audit or Audit Noncompliance Part five of the policy contains audit provisions The right of the carrier to examine and auditall policyholder records If the employer is uncooperative and thecarrier is unable to verify the necessary data In some states, the carrier can apply anoncompliance charge Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.2814
Uncooperative Audit orAudit NoncomplianceState-specific endorsements: If insured refuses to cooperate in completing afinal audit, must pay additional funds not toexceed several times the most recent estimatedannual premium Separate charge if applicable from class codemanual premium Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.29Uncooperative Audit or Audit NoncomplianceStateEndorsementStatistical CodeCOWC 05 04 049757(not part of standard premium)Audit Noncompliance Charge—Amount notspecified (carrier must file with DOI for approval)MTWC 25 04 019757(not part of standard premium)Audit Noncompliance Charge—Amount notspecified (carrier must file with DOI for approval)FLWC 09 04 079757*(not part of standard premium)*FLJUA OnlyAudit Noncompliance Charge—Not to exceedthree times most recent estimated annualpremiumMOWC 24 06 04 A9757(not part of standard premium)Audit Noncompliance Charge—Equal toestimated annual premiumSCNoneNoMay increase payroll up to a maximum of threetimes the estimated payroll for purposes ofdetermining the final premiumNCNoneNoMay increase payroll up to a maximum of threetimes the estimated payroll for purposes ofdetermining the final premiumGAWC 10 04 02NoMay utilize a payroll amount of three times theestimated payroll for purposes of determiningfinal premium Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.Basic Manual3015
Ratable/Nonratable GroupsBasic Manual Rule 3-A-17 (Non-ratableElement): Class codes designated with an “N” have correspondingstatistical codes (non-ratable element) Non-ratable element is a supplementary loading in themanual rate for a classification Adjusts for the classification’s potential for occupationaldisease/catastrophic losses Premium for a non-ratable element is not subject toexperience rating or retrospective rating FL Example: Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.31Non-Ratable ElementsStatistical Codes for Non-Ratable Portion ofClass Code Rate Report Exposure, Rate, and Premium Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.3216
Supplemental Disease ExposuresBasic Manual Rule 3-A-7 (Disease Loading): Supplemental disease loading may be addedIncidental Foundry, Asbestos, Abrasive, Sandblasting,Atomic Energy Radiation, Silicosis Not subject to experience rating or retrospective ratingFL Example: Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.33Supplemental Disease Exposures Statistical Codes for Supplemental DiseaseReport Exposure, Rate, Premium and Loss 0059—Abrasive or Sandblasting 0065—Incidental Foundries—Steel 0066—Incidental Foundries—Non-Ferrous Metals 0067—Incidental Foundries—Iron 0133—Supplemental Disease Experience—inConnection With Asbestos Exposure 0179—Disease Experience—Supplemental 9985—Atomic Energy—Radiation Exposure NOC Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.3417
Lump Sum/Settlements Unit Report Lump-Sum Settlement—Y/N IndicatorDiscounted/CommutativeClaim StatusAllocated between Medical and IndemnityDetailed Claim Information Lump Sum Amount Paid Benefits Covered by Lump Sum CodeFinancial Call Allocated between Medical and Indemnity If subdivision is unknown or unspecified, use casevalues at the time of settlement to determineproration Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.35Medicare Secondary Payer (MSP) Claimant receives benefits under a WC policy andmay be entitled to Medicare benefits in the future Medicare is not responsible for paying claimsassociated with a WC injury first—also referred to ascoordination of benefits Workers compensation pays first, and the secondarypayer is MedicareReporting: Medical loss reported includes “set-aside” tocover future medical costs, management fees MSP service provider fees are ALAE/DCCE Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.3618
Missouri Mesothelioma Additional benefits provided for mesotheliomaunder Missouri statutes Insured may elect to exclude additionalbenefits for mesothelioma, which eliminatesexclusive remedy provisions Endorsements (WC 23 03 02 or WC 23 03 03) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.37Missouri MesotheliomaDR-2014-01 Policy Reporting Endorsement Record Type 7 Unit Reporting Charge for Additional Mesothelioma Benefits—Independent Carrier Filing Statistical CodeFinancial Call Reporting Net Earned Premium Include the premium for Additional MesotheliomaBenefits Company Standard Premium and DSR Level Premium Exclude premium for Additional Mesothelioma Benefits Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.3819
West Virginia Deliberate Intent Coverage Endorsement (WC 47 03 01A) Code 9614—exposure Provided via WC/EL policy endorsement or “excess”policy Flat Premium—Report “1” for exposure, “0” for rate, and “Flat Charge” forpremium No Premium—Report “1” for exposure, “0” for rate, and“0” for premiumType of Nonstandard ID Code 05—Excess PolicyExposure Act Code 07—Excess Benefits CoverageReport corresponding losses under Code 9614Loss Condition Code—Type of Claim 05—Excess BenefitsFinancial Call #8—Enter as “Reason for Difference” ifincluded on company’s NAIC Annual Statement Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.39Considerations Is the policy reportable on line 16 of the NAICAnnual Statement Exhibit of Premiums andLosses? What is the policy term? Does the policy include optional coverage(s) forrisk(s) outside the scope of the basic policy? Is the program administered by NCCI?Does the policy cover the entire exposure and/oris the insurer directly responsible for all losses?What is the nature of any independently filedcarrier program(s)? Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.4020
Considerations What is the exposure state? Can the final charged premium be determinedat first audit? What is the benefit (jurisdiction) state?What is the location of the exposure?How is the manual premium determined foreach class?What Act determines the level of benefits thatmay be paid? Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.41Considerations Is the final claim payment the result of asettlement? If so, is there a reasonable allocation of thesettlement between indemnity and medical? Does the medical portion of the settlement includean amount for a Medicare Set-Aside arrangement? If an injured worker is receiving wage loss benefitspursuant to a claim, is the employer or the carrierpaying the benefits? If the employer is paying the wage loss benefits,what is the level of the benefits and the durationof the payments? Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.4221
Federal Coverages 2014 Data Educational ProgramState vs. Federal Workers Compensation Workers compensation laws protect people whoare injured on the job Designed to ensure that injured employees areprovided with fixed monetary awards,eliminating the need for litigation State statutes establish this framework for mostemployment Federal statutes are limited to federal employeesor workers employed in some aspects ofinterstate commerce Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.4422
Topics Federal Employers Liability ActAdmiralty LawUSL&HW Act and ExtensionsTexas Classes for Oil and Gas IndustryDefense Base ActFederal Mine Safety and Health ActNational Defense Projects Rating PlanAtomic Energy Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.45Federal Employers Liability Act (FELA)Basic Manual Rule 3-A-4: Railroads engaged in interstate commerce areliable for injuries to, employees if the railroadshave been negligent Not intended to be awarded automatically This Act is the sole and exclusive remedy for aninjury to a worker employed by a railroad Added to the Standard Policy by attachingEndorsement (WC 00 01 04 A) FELA is not available in the residual market whereNCCI is the Plan AdministratorRequires the injured railroader to prove that therailroad was “legally negligent,” at least in part, incausing the injury Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.4623
FELA CoverageFELAProgram IStandard WorkersCompensation andEmployers LiabilityPolicyWC 00 00 00B Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.FederalEmployers’Liability ActCoverageEndorsementWC 00 01 04 A47FELA Coverage WithVoluntary CompensationFELAProgram IIStandard WorkersCompensation andEmployers LiabilityPolicyWC 00 00 00B Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.FederalEmployers’Liability ActCoverageEndorsementWC 00 01 04 AVoluntaryCompensation andEmployers LiabilityCoverageEndorsementWC 00 03 11 A4824
FELA Coverage With VoluntaryCompensation and Longshore and HarborWorkers’ CompensationFederalEmployers’Liability ActCoverageEndorsementWC 00 01 04 AFELAProgram IIUSL ActStandard WorkersCompensation andEmployers LiabilityPolicyWC 00 00 00BVoluntaryCompensation andEmployers LiabilityCoverageEndorsementWC 00 03 11 ALongshore andHarbor Workers’Compensation ActCoverageEndorsementWC 00 01 06A Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.49Admiralty Law(Merchant Marine/Jones Act)Basic Manual Rule 3-A-4: Employee benefits—similar to workers compensation formasters and members of crews Provides seamen with the same protection from employernegligence as FELA provides railroad workers State Act Workers Compensation plans DO NOT covervessel crew Employees can bring action against their employer fornegligence Transportation Wage Maintenance and Cure (TWMC)coverage may be available Added to the Standard Policy by attaching Endorsement(WC 00 02 01 A) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.5025
Maritime CoverageMaritimeProgram IStandard WorkersCompensation andEmployers LiabilityPolicyWC 00 00 00B Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.Maritime CoverageEndorsementWC 00 02 01A51Maritime Coverage With VoluntaryCompensationMaritime CoverageEndorsementWC 00 02 01AMaritimeProgram IIStandard WorkersCompensation andEmployers LiabilityPolicyWC 00 00 00B Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.VoluntaryCompensationMaritime CoverageEndorsementWC 00 02 035226
Maritime Coverage With Voluntary Compensationand Longshore and Harbor Workers’ CompensationMaritime CoverageEndorsementWC 00 02 01AMaritimeProgram IIUSL ActStandard WorkersCompensation andEmployers LiabilityPolicyWC 00 00 00BVoluntaryCompensationMaritime CoverageEndorsementWC 00 02 03Longshore andHarbor Workers’Compensation ActCoverageEndorsementWC 00 01 06A Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.53SummaryFELAAdmiralty Interstate Railroad Employees Program I or Program II Endorsement WC 00 01 04 A Master/Crew Members Program I or Program II Endorsement WC 00 02 01 A (TWMC) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.5427
Admiralty Law/FELA Reporting Policy and Unit Report Program I and II—01 for Exposure Act Code and LossConditions Act Code Program II—USL Act 02 for Exposure Act Code 01 or 02 for Loss Conditions Act Code, depending onbenefits Do not report additional premium for TransportationMaintenance Wages Cure (TMWC)Financial Call Maritime and FELA classes—Not reportable Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.55QuizRailroad workers engaged in interstatecommerce need coverage. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.5628
Quizprovides seamen withthe same protection from employer negligenceas FELA. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.57QuizFELA and/or Admiralty coverage are added tothe standard WC Policy by . Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.5829
United States Longshore and HarborWorkers Compensation Act (USL&HW)Basic Manual Rule 3-A-4: A federal WC law that applies to workers inmaritime employments—including longshore,harborworkers, shipbuilders, ship breakers, andship repairers It does not apply to masters or crews of vesselsCompensation benefits to workers for anemployment-related injury or disease occurringon the navigable waters of the United States oradjoining shore side areas Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.59Status and Situs Status is an occupational concept thatdetermines if the “work performed” or“duty” is considered maritime employment Situs is a geographical concept thatdetermines if the “place” of injury isconsidered an area used by an employerfor maritime work Added to the Standard Policy by attachingEndorsement (WC 00 01 06A) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.6030
Status and SitusStatus Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.COVEREDSitus61USL&HW Extensions Defense Base ActNonappropriated Funds EndorsementOuter Continental Shelf Lands Act Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.6231
Defense Base Act Covers workers engaged in employmenton overseas defense bases or undercontract with the US government Added to the Standard Policy by attachingEndorsement (WC 00 01 01A) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.63Outer Continental Shelf Lands Act Extends benefits when an injury occurs whilework is conducted on the Outer ContinentalShelf for the purpose of exploring, developing,removing, or transporting natural resourcesby pipeline Added to the Standard Policy by attachingEndorsement (WC 00 01 09B) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.6432
Nonappropriated FundInstrumentalities Act Covers morale, welfare, and recreation workerson US military installations in continental UniteStates and overseas Added to the Standard Policy by attachingEndorsement (WC 00 01 08A) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.65SummaryUSL&HWUSL&HWExtensions Navigable waters of the United States Endorsement WC 00 01 06 A Defense Base Act Endorsement WC 00 01 01 A Nonappropriated Funds EndorsementWC 00 01 08 A Outer Continental Shelf Lands Act EndorsmentWC 00 01 09 B Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.6633
Premium Federal ExposureBasic Manual Rule 3-A-4Classifications, loss costs, or rates subject toadmiralty law, FELA, and USL&HW Act F-Classification codes and Admiralty/FELAclassifications that include USL&HW Act benefits Non-F-Classification codes and Admiralty/FELAclassifications that do not include USL&HW Actbenefits Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.67USL&HW ExampleFound on the NCCI advisory loss cost and/orrate pages in NCCI’s Basic ManualExample using Florida rates effective 01/01/14:ClassificationPayrollRate6872F 75,00018.36n/a18.36 13,7705403 75,00011.962.2126.43 19,823 Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.LHWCA Factor Adjusted RatePremium6834
Federal and State Act Concurrent BenefitsReporting Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.69USL&HW and Extensions Policy and Unit Report F-Classes (e.g. 9077F) Industrial class where rate is increased byUSL&HW factor Exposure Act 02 Loss Condition Act 02 or 01 depending onbenefits Jurisdiction State 00 Financial Call F-Classes—Not reportable F-Loaded Classes—Reportable Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.7035
Texas Classes for Oil, Gas, or otherMinerals Over WaterExperience Rating Plan Classifications for oil, gas, or other minerals onor over waterStatistical PlanPart 6—Coding ValuesOil, Gas, or other Minerals Over Water Coverage G. Exposure Act/Exposure Coverage Codes State Act (Code 05)USL&HW (Code 08)K-1. Act—Loss Condition Codes State Act (Code 05)USL&HW (Code 08) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.71Federal Coverage Service for USL&HW USL&HW and its extensions coverage Exposure Record—Record Type 05 USLH&W F-Class (refer to Policy and Proof ofCoverage Reporting Guidebook for listingOr Exposure Act Code 02 Endorsement Identification Record—Record Type 07(must include one or more of the federal USL&HWendorsement numbers) Daily electronic file to US Department of LaborState Premium Record—Record Type 04 (one ormore NCCI states on policy) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.7236
Defense Base Act (DBA) Monoline CoverageReporting Service Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.73Federal Coverage Service for DBADaily electronic file to US Department of Labor Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.7437
Quizis a federal coverage that providesworkers compensation and employers liabilityto shipbuilders, ship repairers, and shipbreakers. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.75QuizDaily electronic files are sent to the USDepartment of Labor for reportedexcess policies. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.7638
QuizThe industry in Texas hasfederal codes for work done over water. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.77QuizUSL&HW has extensionsavailable through endorsement. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.7839
Federal Mine Safety and Health Act(Coal Mine Disease)Basic Manual Rule 3-A-12:Disease coverage provided for risks subjectto the ActAdvisory loss costs/rates and anyunderlying state law coverage for diseaseare shown separately on the state pagesIn states where there are no coal mines, thestate pages will not include information forthis coverageAvailable by endorsement (WC 00 01 02 A) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.79Federal Mine Safety and Health Act(Coal Mine Disease)Coal worker’s pneumoconiosis (black lung) is a lung disease thatresults from breathing in coal dust over a long period of time.Refer to US DOL for complete bla
Presenter Biographies Julie Gonzalez, AIDM, has been employed at NCCI since 1992.As a data consultant and
