Part 1 - Rules and Definitions

Revision History
Type	Effective Date	Circular	Notes
Revision	2/7/2022	N/A	Part 1-B Language Revision
Original	4/1/2014	C-14-2	2014 North Carolina Workers Compensation Statistical Plan Manual

A. General Rules

A unit statistical report (USR or unit) must be submitted for every Workers Compensation and Employers Liability policy written by a member of the North Carolina Rate Bureau.
USR’s are not required for policies providing coverage under the National Defense Projects Rating Plan.
USR’s are not required for Employers Liability Insurance on residence and farm employees provided in conjunction with other liability insurance or workers compensation on domestic workers provided in conjunction with Homeowners Insurance.
A separate USR must be reported for each policy written with estimated exposure or written on an "if any" basis, including those on which no exposure has developed, provided that the policy was not cancelled effective the same day on which it was written. (This type of cancellation may also be referred to as a “flat” cancel.)
The USR must conform to the rules found in the Basic Manual for Workers Compensation and Employers Liability Insurance, Experience Rating Plan Manual, Retrospective Rating Plan Manual and other guides and manuals distributed by or on behalf of the NCRB. Nothing in this Statistical Plan should be construed to supersede any rules or procedures set forth in the above mentioned manuals or guides.
Data submissions must follow the specifications outlined in the WCSTAT section of the Workers Compensation Insurance Organizations (WCIO) Data Specifications Manual. This manual is available on the WCIO website: www.wcio.org.
All USR’s required by this Plan shall be submitted electronically to either the North Carolina Rate Bureau or the National Council on Compensation Insurance, Inc. (NCCI). Data Providers submitting units to NCCI should be aware that USR’s are validated by NCCI and NCRB.

B. Validity and Editing of the Unit Statistical Report

When a USR is received, it is edited for accuracy and validity based on the following criteria:

The USR reflects coverage and benefits afforded under North Carolina statutes.
The statistical codes and other reported elements must conform to this Statistical Plan.
Each field is consistently coded with all other related fields.

Once the edit process is completed, the USR will exist in the Manage Data web application with a status of Accepted, Accepted with Warnings (AWW) or Rejected. The status of the unit is defined as follows:

Accepted units have been validated via the Bureau edit process and require no further action from the data provider.
Accepted with Warning units have been validated via the Bureau edit process and have produce done or more warnings.
Rejected units have been validated via the Bureau edit process but one or more errors have been detected.

Errors detected during the editing process must be promptly corrected or reconciled. NCRB uses policy information to manage and process USRs.

Example:

Reject Edit 000085 “Matching policy not found” is generated when a USR is submitted and the matching policy is not accepted in the Bureau database. When this edit occurs, one or more of the following actions are required:

The carrier should not resubmit the rejected USR if the policy is being submitted for the USR.
If the unit has been reported in error:

A purge request must be submitted to NCRB if you report USR data to NCRB.
A purge request must be submitted to NCCI if you report USR data to NCCI.
Once a policy has been accepted, the system will automatically process the rejected unit and the edit process will be completed. The additional processing will result in the USR being accepted or rejected.

C. Date of Valuation and Filing

Losses included in the first report of a unit shall be valued during the eighteenth month after the effective date of the policy and the report shall be submitted no later than twenty months after the effective date of the policy. Second through tenth reports are valued every twelfth month after the valuation of the first report. The table shown below displays the correct valuation and reporting dates.

VALUATION AND FILING DATES TABLE

Effective Month	Valuation Month 18 months after policy effective month	Reporting Month 20 months after policy effective
January	July	September
February	August	October
March	September	November
April	October	December
May	November	January
June	December	February
July	January	March
August	February	April
September	March	May
October	April	June
November	May	July
December	June	August

NOTE: When a unit is not received as of the expected valuation date, the unit may become delinquent. Delinquent units are subject to fines. Refer to Part 8-Fine System for Late Unit Reports for information concerning fines. For instructions regarding the submission of USR’s for policies covering more than one year, refer to Part 1-Rules and Definitions items D and E.

D. One - Year Policies

A policy issued for a period of one year or a period not longer than one year and sixteen days is treated as a one-year policy.

Example:

A policy issued with an effective date of January 8, 2013 and expiration date of January 24, 2014 is considered a one-year policy. The USR would reflect a policy period of January 8, 2013 to January 24, 2014.

E. Multiple Year Policies - Other than Three-Year Fixed Rate

Multiple year policies other than three-year fixed rate policies are considered separate policies for USR data reporting purposes. Reports for each unit of twelve months or less must be submitted at the time all other reports on policies with the same effective date are being submitted. Losses must be valued during the eighteenth month after the effective date of each unit of experience and at annual periods thereafter.

Examples:

The reports on a three-year policy effective July 1, 2010 shall be submitted with the regular reports on policies effective in July 2010, July 2011 and July 2012. Losses shall be valued January 2012, January 2013 and January 2014, respectively.
The reports on a policy covering the period July 1, 2010 to January 1, 2013, with the last six months considered as a unit, shall be submitted with the regular reports on policies effective in July 2010, July 2011 and July 2012. Losses shall be valued January 2012, January 2013 and January 2014, respectively.
A policy issued with an effective date of January 8, 2013 and expiration date of January 31, 2014 would not be considered a one-year policy. In this case, the first reported USR would reflect a policy period of January 8, 2013 to January 8, 2014. At the next valuation date, a second USR would be reported for the policy period of January 8, 2014 to January 31, 2014.

F. Three-Year Fixed Rate Policies

Reports for Three-Year Fixed Rate Policies shall be first reported as of the 42nd month after the month in which the policy became effective and the reports shall be submitted no later than 44 months after the month in which the policy became effective.

These reports shall be specifically identified as three-year fixed rate policy experience. See Part 2 - Header/Policy Information for additional details on policy identification data.

G. Uncollectible Premiums

For policies on which an audit has been conducted and the earned premium is known, but uncollectible, report all earned premiums with corresponding exposures and losses.

H. Reinsurance

Only policies written on a direct basis should be included in the USR reporting. No deductions shall be made for, or as a result of, reinsurance ceded. Premiums and losses arising from reinsurance assumed by the reporting carrier shall be excluded from the experience.

I. National Defense Projects

Do not report the experience of policies written under the National Defense Projects Rating Plan to the North Carolina Rate Bureau.

J. Radiation Exposure

Experience in connection with either construction or operation work performed for or under the direction of the Nuclear Regulatory Commission or any government agency shall be reported under Statistical Code 9984.

When the following operations are not performed for or under the direction of any government agency, the experience in connection with radiation exposure must be reported under Statistical Code 9985:

Research
Manufacturing
Handling
Transporting
Use of Radioactive Material
Exposure to Radioactive Material

The payroll reported for radiation exposures shall not be added to payrolls shown for other manual classifications in determining the employer payroll total. Radiation losses for employers where a supplemental loading has been applied shall be assigned to Statistical Code 9985. If no supplemental radiation loading has been applied, then radiation losses shall be assigned to the appropriate classification code. However, any radiation loss whether reported under Statistical Code 9985 or a classification code must be identified as an occupational disease loss and the Type of Loss must be set accordingly.

K. Excess Policies

Experience in connection with excess policies must be excluded from the experience reported under this Stat Plan.

L. Deductible Programs

Deductible programs are available as an optional feature of the insurance policy. The premium credit amount associated with the deductible program is reported either prior to the application of the experience mod (Statistical Code 9664) or after the application of the experience mod (Statistical Code 9663).

When a deductible program applies, all losses are to be reported on a gross basis prior to the application of the deductible.