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Revision History |
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Type |
Effective Date |
Circular |
Notes |
| Part 3F1c, 3F4c | 07/01/2023 | C-23-4 | NCCI Items B-1447 & E-1410 - Revisions to Manual Rules Related to the Inclusion of COVID-19 Claims in Experience and Merit Rating and Manual Rules Related to the COVID-19 Pandemic - Paid Furloughed Employees and Final Premium Reporting |
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Part 3F4c
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03/01/2020 |
Correction to North Carolina Workers Compensation Statistical Plan Manual Rules Related to the COVID-19 (Coronavirus) Pandemic |
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Part 3F1, 3F4c |
03/01/2020 |
NCCI Item B-1443 – Revisions to NCCI Manual Rules Related to the COVID-19 (Coronavirus) Pandemic – Removal of Expiration Date |
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Part 3F1, 3F4c |
03/01/2020 |
Revisions to North Carolina Basic Manual Rules Related to the COVID-19 (Coronavirus) Pandemic |
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Parts 3F1, 6I3f |
01/01/2017 |
NCCI Item B-1429 - Establishment of Audit Noncompliance Charge | |
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Revision |
05/01/2017 |
NCCI Item B-1430 - Elimination of Anniversary Rating Date (ARD) | |
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Revision |
6/24/2014 |
Rule Changes - Workers Compensation | |
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Original |
4/1/2014 |
2014 North Carolina Workers Compensation Statistical Plan Manual | |
The effective date of the applicable experience modification that is required for all exposures. If the risk is not currently experience rated, the policy effective date must be used. If the experience modification changes during the policy period then the effective date of the modification which applies to the reported exposure(s), subject to the rules of the Experience Rating Plan Manual, must be reported. The date must be within the policy period.
Policies Effective Prior to May 1, 2017:
This date reflects the rate effective date that corresponds to the class code and its associated rate, exposure and premium. If the rate changes during the policy period, report the rate effective date that applies to the reported class code, rate, exposure and premium.
Policies Effective On or after May 1, 2017:
The Rate Effective Date is no longer applicable. If the Rate Effective Date is reported, it must equal the policy effective date.
The alpha code that identifies the exposure activity. Refer to Part 6 - Coding Values for the appropriate Update Type codes.
The numeric code that identifies the type of exposure coverage for each classification code. Refer to Part 6 - Coding Values for specific Exposure Act/Exposure Coverage codes.
The classification code assigned to the employer pursuant to the rules of the Basic Manual for Workers Compensation and Employers Liability Insurance.
Exposures are required for all classification codes. The exposure reported shall be the audited exposure corresponding to the charged premium amount.
Audited or Estimated Exposure
If the final audit has been completed by the USR valuation date, the Estimated Audit Code field should contain the value "N" when the unit is submitted to the Bureau.
If the final audit has not been completed by the USR valuation date, the Estimated Audit Code field should contain the value "Y" when the unit is submitted to the Bureau. Without further request from the Bureau, a correction to the USR must be submitted updating the value to "N" as soon as audited payrolls are available.
Audit Noncompliance Charge
If the final audit has not been completed by the USR valuation date due to the insured being uncooperative with the audit; the Estimated Audit Code filed must contain the value “U” when the unit is submitted to the Bureau. Statistical Code 9757 - Audit Noncompliance Charge may be reported when conditions have been met to apply the audit noncompliance charge as outlined in the Basic Manual. Without further request from the Bureau, the USR must be replaced by a correction report as soon as audited payrolls are available.
Note:
When the exposure reported on the 1st report includes Statistical Code 9757 - Audit Noncompliance Charge, the Estimated Audit Code must be reported as “U”.
If, at any time, a final audit is successfully completed, a correction must be submitted to remove statistical code 9757 and update the value of the Estimated Audit Code to “N”.
COVID-19
COVID-19 final premium rule is not applicable for new and renewal policies with effective dates on and after 12:01 a.m. on July 1, 2023.
COVID-19 final premium rule is applicable for new, renewal, and in-force policies effective March 1, 2020 through June 30, 2023.
If final premium based on audited exposure cannot be reported due to federal, state, and/or local emergency orders, laws, or regulations issued due to the COVID-19 (coronavirus) pandemic which impact an employer’s staffing or business operations, report the applicable exposure and premium in the class code(s) and the Estimated Audit Code as an “N.”
When a policy is issued with “NC” listed in item 3A and upon audit it is determined that North Carolina exposure did not develop, a first level unit report must be submitted with Statistical Code 1111. Statistical Code 1111 must be reported with no corresponding exposure, corresponding rate, premium amounts or losses. Units reported for policies with no exposure should not contain any classification codes.
Minimum premium units should not be considered the same as no exposure units. When no exposure develops under a minimum premium policy, a unit must be submitted with Statistical Code 1111 and include the balance to minimum premium Statistical Code 0990. The balance to minimum premium is the additional premium required to bring the total policy standard premium up to the minimum premium amount. When exposure develops (payroll greater than 0) and the premium is less than or equal to the minimum premium, the appropriate class code(s) for the employer must be reported with the corresponding rates, premium and statistical codes including Statistical Code 0990 (balance to minimum premium stat code). Refer to Part 3-F.2-Exposure Information for instructions regarding the reporting of No Exposure Units.
Class codes that have an exposure base other than payroll:
Per Capita Classifications - The number of employee(s) based on the duration of coverage for one-year intervals. Per Capita exposures should not be added to the total standard exposure.
Other Miscellaneous Exposures - Refer to Part 1 - Rules and Definitions.
Paid Furloughed Employee
Statistical Code 0012 - Paid Furloughed Employees and its associated rules are not applicable for new and renewal policies with effective dates on and after 12:01 a.m. on July 1, 2023.
Statistical Code 0012 - Paid Furloughed Employees and its associated rules are applicable for new, renewal, and in-force policies effective March 1, 2020 through June 30, 2023.
Paid furloughed employees means employees who continue to receive payments during a temporary layoff or an involuntary leave and are not performing any work duties for an employer. Payments by an employer or any public governmental entity to paid furloughed employees as a result of federal, state, and/or local emergency orders, laws or regulations, issued due to the COVID-19 (coronavirus) pandemic which impact an employer’s staffing or business operations must be reported to Statistical Code 0012—Paid Furloughed Employees. Such payments do not include any appropriated funds or loans received by an employer as authorized by any law or regulation, or public governmental entity, that are used by an employer specifically to retain or hire working employees.
Code 0012 may be used as a statistical code to report the payments only; or it may be used as a classification code to report the payments with a zero rate and zero premium.
Payments reported to Code 0012 are excluded from premium and experience rating calculations only if the employer keeps separate, accurate, and verifiable records.
Submit the applicable carrier rate (charge per unit of exposure) for each classification code.
The numeric code used to indicate a change in manual/charged rates or modification factors during the life of a policy. For policies with no change in manual/charged rates or modification factors, zero-fill. For policies with changes in manual/charged rates or modification factors, report 0 for the first period,1 for the second period, 2 for the third period, etc., through 9.
If the anniversary rating date is different than the policy effective date, the exposure, rate and corresponding premium must be split.
Contact the Bureau for questions regarding the reporting of the Split Period Code when processing corrections which are adding or deleting splits.
The premium by classification is determined by:
Payroll - The premium obtained by extension of payroll or other exposure at the applicable carrier rate should be reported for the appropriate classification code. Report whole dollars only.
Flat Charges or Credits - This premium does not vary by payroll and should be reported for the appropriate statistical code.
The premium credit or debit amount per classification that is subject to experience modification.
The sum of premium amounts subject to experience modification prior to the application of the modification factor.
The numeric value that identifies the experience modification of the insured. If a change in experience modification occurs after the policy effective date, the exposures, manual rate and corresponding premium must be reported. The effective date of the mid-term change in experience modification shall be reported in the Mod Effective Date field.
The classification codes, corresponding exposures, rates (if applicable) and premium amounts for those classifications that are not subject to experience modification.
The sum of all payroll and exposure amounts included in standard exposure.
The sum of all premium dollars both subject to modification and not subject to modification which are to be included in standard premium.
The premium adjustment resulting from the application of the premium discount plan.
The premium adjustment resulting from the application of the expense constant.
The determination of whether or not an employer falls under the minimum premium criteria is made by comparing the premium obtained by extension of payroll plus the expense constant to the highest minimum premium shown for the carrier's filed rates for the classifications on the policy. When the premium, including the expense constant, is less than the policy minimum premium, the additional premium necessary to balance to the minimum premium shall be reported. The amount reported under the statistical code should not include expense constants. Expense constants are reported separately.
If the minimum premium applies to a multi-state policy, the additional premium required to bring the total employer standard premium up to the minimum premium shall be allocated to the state with the highest minimum premium.
The amount of premium credit or debit associated with a statistical code that is not part of standard premium. Refer to Part 6 - Coding Values for a list of Premium Amount Not Subject to Standard Premium (Non-standard) statistical codes.
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