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You are here: Home . wc . news . advisories . ad2002-07

Advisory 2002-07

Electronic Submission of Proof of Coverage (Commercial Carriers)

The Texas Workers' Compensation Commission (Commission) is requiring electronic filing of Proof of Coverage information by insurance companies (commercial insurance carriers) as part of its Business Process Improvement Project. Self-Insured Governmental Entities and Certified Self-Insureds are not affected by this change. The Commission has designated two data collection agents: The National Council on Compensation Insurance, Inc. (NCCI), and Insurance Services Office, Inc. (ISO), to submit Proof of Coverage information to the Commission in accordance with the Texas Labor Code 401.024(c), 402.042(b)(11) and 406.009 and Rule 110.1. (Contact information is provided in an attachment).

Effective September 1, 2002, all commercial insurance carriers licensed to write workers' compensation insurance in Texas are hereby required to submit proof of coverage information to one of the two Commission-designated data collection agents. The choice of agent is the carrier's. The method of communicating the Proof of Coverage information to the designated data collection agent is by agreement of the carrier and the designated data collection agent. Rule 110.1 identifies the specific filing requirements and timeframes for carriers to provide coverage information. Both designated data collection agents offer the option of receiving the Workers' Compensation Policy Reporting Specifications (WCPOLS) reports and extracting the International Association of Industrial Accident Boards and Commissions (IAIABC) Proof of Coverage data requirements for transmission to the Commission.

After August 31, 2002, the submission of the TWCC-20, TWCC-20A, and TWCC-205 via hard copy, fax or email will not be accepted by the Commission, unless a "Request for Coverage Information" letter was received prior to September 1, 2002, in which case the response to the letter must be sent to the Commission. It will not be necessary for a carrier to resubmit coverage information to the designated data collection agent if the information was submitted to and received by the Commission in hard copy format prior to September 1, 2002.

Filing Requirements: Submission of coverage information to one of the data collection agents constitutes providing coverage information to the Commission only if the submitted information is accurate and complete and includes all mandatory proof of coverage information contained in the attached State of Texas Profile. Transactions submitted to a designated data collection agent will be edited by the designated data collection agent using IAIABC standard Proof of Coverage edits and other edits agreed to by the designated data collection agent and the Commission. If the transaction does not pass these edits, the transaction will be rejected by the designated data collection agent and will not be forwarded to the Commission. If the Commission identifies problems with the information as submitted by the designated data collection agent that are attributable to the carrier, the transaction will be rejected and the Commission will directly notify the carrier to submit a corrected transaction to the data collection agent. The carrier is not considered to have "provided" the coverage information to the Commission and timeliness of filing continues to accrue until a transaction/transmission which meets the specifications of the Commission and the designated data collection agent is received and accepted by the designated data collection agent. The date received, or "date stamp", is the date that complete, acceptable information is received by the designated data collection agent.

Acknowledgement of Commission receipt will be sent to the submitting designated data collection agent. The designated data collection agent will forward this acknowledgment to the commercial carrier. The acknowledgment means that the information passed the edits applied by the designated data collection agent and has been received by the Commission.

This move to electronic filing of Proof of Coverage data is part of the Commission's Business Process Improvement Project. Data accuracy and completeness are essential objectives of this project. To complement this objective, commercial carriers submitting Proof of Coverage data to their selected designated data collection agent via Workers' Compensation Policy Reporting Specifications (WCPOLS) transactions must ensure that name and address linking is complete for all transactions. It is also critical that coverage information submitted with a claim first report of injury (EDI 148 transaction: Employer FEIN, DN-16; Policy Number, DN-28; and Policy Effective Date, DN29) exactly match these same elements submitted through the Proof of Coverage process for the associated coverage (policy).

Questions concerning this change in process should be directed to Robin Miksch, Chief, Records Processing, (512) 804-4372, robin.miksch@tdi.texas.gov.

Signed this 15 th day of May, 2002

Richard F. Reynolds, Executive Director

Attachments:

Texas State Profile
Designated Data Collection Agent Contact Information

Distribution:

TWCC Staff
Carrier Representatives
Forms Notification List
Public Information List
TWCC Website

Texas State

Required IAIABC Transactions

Texas will use all IAIABC Proof of Coverage transactions, except Binder transactions, as specified in the IAIABC Proof of Coverage Release 2 Implementation Guide. Binder transactions are not accepted in Texas.

Edits By Data Collection Agent

All IAIABC edits will be accomplished.
All Texas mandatory fields and appropriate conditional fields must be present.
WCPOLS transactions must contain all appropriate name and address records, including Name Link Codes, to identify all entities covered by the policy.

FIELD REQUIREMENTS (R/C/O, Required/Conditional/Optional)

Header Record Layout

ELEM #

LOCATION

LENGTH

GROUPING

FIELD NAME

TEXAS

DN001

1 - 3

3

Transaction

Transaction Set ID

R

DN098

4 - 28

25

Sender

Sender ID

-

9

Sender Fein

R

7

Filler

-

9

Sender Postal Code

R

DN099

29 - 53

25

Receiver

Receiver ID

-

9

Receiver Fein

R

7

Filler

-

9

Receiver Postal Code

R

DN100

54 - 61

8

Transmission

Date Transmission Sent

R

DN101

62 - 67

6

Time Transmission Sent

R

DN102

68 - 75

8

Original Transmission Date

C 1

DN103

76 - 81

6

Original Transmission Time

C 1

DN104

82 - 82

1

Test/Prod Indicator

R

DN105

83 - 87

5

Interchange Version ID

-

3

Transmission Type Code

R

2

Version Number

R

Trailer Record Layout

ELEM #

LOCATION

LENGTH

GROUPING

FIELD NAME

TEXAS

DN001

1 - 3

3

Transaction

Transaction Set ID

R

DN106

4 - 12

9

Detail Record Count

R

Insured Record Layout

ELEM #

LOCATION

LENGTH

GROUPING

FIELD NAME

TEXAS

DN001

1 - 3

3

Transaction

Transaction Set ID

R

DN107

4 - 12

9

Record Sequence Nbr

R

DN300

13 - 14

2

Transaction Set Purpose Code

R

DN302

15 - 22

8

Jurisdiction Designee Received Date

R

DN002

23 - 24

2

Transaction Set Type Code

R

DN303

25 - 26

2

Transaction Reason Code

R

DN304

27 - 34

8

Transaction Set Type Effective Date

R

DN006

35 - 43

9

Insurer

Insurer Fein

R

DN007

44 - 73

30

Insurer Name

R

DN305

74 - 103

30

Issuing Office Name

O

DN306

104 - 133

30

Issuing Office Address Line 1

O

DN307

134 - 163

30

Issuing Office Address Line 2

O

DN308

164 - 193

30

Issuing Office City

O

DN309

194 - 195

2

Issuing Office State

O

DN310

196 - 204

9

Issuing Office Postal Code

O

DN311

205 - 234

30

Agency

Issuing Agency Name

O

DN312

235 - 264

30

Issuing Agency City

O

DN313

265 - 266

2

Issuing Agency State

O

DN314

267 - 275

9

Insured

Insured Fein

R

DN017

276 - 365

90

Insured Name

R

DN315

366 - 395

30

Insured Address Line 1

R

DN316

396 - 425

30

Insured Address Line 2

C 2

DN317

426 - 455

30

Insured City

R

DN318

456 - 457

2

Insured State

R

DN319

458 - 466

9

Insured Postal Code

R

DN320

467 - 476

10

Insured Telephone Number

O

DN321

477 - 477

1

Business Market

R

DN322

478 - 478

1

Wrap-Up Indicator

R

DN323

479 - 480

2

Insured Legal Status

O

DN028

481 - 498

18

Policy

Policy Number

R

DN333

499 - 499

1

Employee Leasing Policy Identification

R

DN332

500-500

1

Minimum Premium Indicator

O

501 - 510

10

Filler

DN029

511 - 518

8

Policy Effective Date

R

DN030

519 - 526

8

Policy Expiration Date

R

DN324

527 - 544

18

Prior Policy Number

C 3

545 - 556

12

Filler

DN325

557 - 564

8

Assignment Date

O

DN004

565 - 566

2

Jurisdiction

Jurisdiction

R

DN326

567 - 570

4

Governing Class

O

DN327

571 - 581

11

Total Payroll

O

DN328

582 - 585

4

Employer Cnt

Number of Employers

R

Employer Record Layout

ELEM #

LOCATION

LENGTH

GROUPING

FIELD NAME

TEXAS

DN001

1 - 3

3

Employer Segment

Transaction Set ID

R

DN107

4 - 12

9

Record Sequence Nbr

R

DN016

13 - 21

9

Employer Fein

R

DN329

22 - 36

15

Employer UI Code

O

DN018

37 - 96

60

Employer Name

R

DN019

97 - 126

30

Employer Address Line 1

R

DN020

127 - 156

30

Employer Address Line 2

C 2

DN021

156 - 171

15

Employer City

R

DN022

172 - 173

2

Employer State

R

DN023

174 - 182

9

Employer Postal Code

R

DN025

183 - 188

6

Industry Code

O

DN330

189 - 194

6

Number of Employees

O

DN331

195 - 202

8

Employer Notification Date

C 4

POC Acknowledgment Record Layout

ELEM #

LOCATION

LENGTH

GROUPING

FIELD NAME

TEXAS

DN001

1 - 3

3

Detail Acknowledgment

Transaction Set ID

R

DN107

4 - 12

9

Record Sequence Nbr

R

DN108

13 - 20

8

Date Processed

R

DN109

21 - 26

6

Time Processed

R

DN006

27 - 35

9

Filler

-

DN014

36 - 44

9

Filler

-

DN008

45 - 53

9

Filler

-

DN110

54 - 56

3

Acknowledgment Transaction Set ID

R

DN111

57 - 58

2

Application Acknowledgment Code

R

DN026

59 - 83

25

Filler

-

DN015

84 - 108

25

Filler

-

DN005

109 - 133

25

Filler

-

DN002

134 - 135

2

Filler

-

DN003

136 - 143

8

Filler

-

DN112

144 - 146

3

Request Code (Purpose)

R

DN113

147 - 206

60

Free form text

-

DN114

207 - 208

2

Nbr of errors

R

Variable Segment
Occurs Number of Error Times

DN115

209 - 212

4

Error Code

Element Number

C 5

DN116

213 - 215

3

Element Error Number

C 5

DN117

216 - 217

2

Variable Segment Number

C 5

C 1 - Required on header record for AK1.
C 2 - The Address Line 2: R when information is provided in that field by the sender.
C 3 - Prior Policy Number: R only for renewal coverage. If there is no prior term (New Business policies), leave blank.
C 4 - Employer Notification Date: R for all cancellations and non-renewals.
C 5 - Used only when errors exist.

DESIGNATED DATA COLLECTION

The following data collection agents have been designated by the Texas Workers' Compensation Commission in accordance with 401.024(c), 402.042(b)(11) and 406.009 of the Texas Labor Code to collect Proof of Coverage data on behalf of the Commission.

National Council on Compensation Insurance, Inc. (NCCI)
Customer Service Center
901 Peninsula Corporate Circle
Boca Raton, Florida 33487
1-800-NCCI 123 (800-622-4123)
customer_service@ncci.com

Insurance Services Office, Inc. (ISO)
Attn: Customer Support
545 Washington Blvd
Jersey City, NJ 07310-1686
1-800-888-4476
ISOnet@iso.com



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