Frequently Asked Questions

Assigned Risk - Pool Application

1. How much commission is paid?

   For servicing an Assigned Risk Pool (WWCIP) account, the producer receives the following commission:
   
   4% for the first $10,000
   1% for over $10,000

    

    

2. I want to switch producers. What do I have to do?
   To change producers, you must notify the servicing carrier, in writing, of the change.  The change will be made effective with the inception of the next renewal policy.
3. I want to switch servicing carriers. What can be done?
   A request for a change in servicing carrier will be approved only when a need for such action is proven. You should first try to resolve the dispute with the servicing carrier. If you are not satisfied with the response or have additional questions, contact the Assigned Risk Pool at 262-796-4592.
4. How is the effective date of coverage determined?
   Coverage will be bound at 12:01 A.M. on the day following receipt of a complete application by WCRB, or on such later day as may be requested. If the application is incomplete, the applicant and producer will be notified. They will have 15 calendar days from the date of notification to submit the needed forms or information to the Bureau. If the complete information is received within 15 days, the original receipt date will be honored. If the information is received between 15 and 30 calendar days, coverage will be bound as of 12:01 A.M. on the day following receipt. If the information is not received within 30 calendar days of notification, the entire application will be returned to the applicant (or producer if applicable).
5. What must be submitted with my application?
   • Payroll verification such as the employer's latest filed federal employer 940, 941 or 943 form; an equivalent federal or state required verifiable current payroll record; payroll information included in a certified profit and loss statement; notarized wage statements; W-2 and W-3 forms. An employer new in business without prior payroll shall provide a notarized statement explaining the lack of verifiable payroll records.
   • The annual/deposit premium. Electronic OAR applications must be paid via electronic check only. No exceptions. Hard copy applications can be paid via certified check, bank draft, money order, producer's check or premium finance check.
   • Various supplementary attachments may include but not limited to the WI Supplementary Non-Election Form; WI Supplementary Election of Coverage Form and the WI Supplementary Limited Other States Coverage Request.

   (See Forms)
6. What is the difference between the voluntary market and the Assigned Risk Pool?
   An employer insured through the Assigned Risk Pool is subject to the same rules, rates, classifications and experience rating as those employers insured in the voluntary market.  Premium discounts and dividends are not applicable. No surcharges are permitted on Assigned Risk Pool accounts.
7. Why do I have to pay the minimum premium every year when I get most of it back at the end of my policy term?
   The minimum premium is the lowest premium required in order to issue a worker's compensation policy and is subject to adjustment at final audit. The final audit is not completed until after the expiration date of the policy, and the unearned portion of the minimum premium cannot be returned until that time.
8. Do I have to have a producer in order to submit an application?
   You may submit the application and supplemental form directly with WCRB and do not need a producer of record.
9. I just provided my payroll information along with my application. Why is my new insurer auditing me?
   Due to the fluctuating payrolls of some businesses, even though payroll information has been submitted, the insurer may still want to do a preliminary audit. WWCIP has special audit requirements for certain business types and premium levels.
10. Is there a penalty for being taken out of the Assigned Risk Pool?
    No short rate cancellation penalties are assessed when an employer is removed from the Pool
11. How do I apply for Wisconsin Assigned Risk Plan coverage on-line?
    Become a WCRB Web site member by completing and submitting a Group Administrator Registration form.  After you become a member, go to MEMBER PRODUCTS, Online Assigned Risk-Pool Application:

    1. Create a new application, completing all sections.
    2. Submit the application.  WCRB will review the application             
    3. Receive e-mail notification from WCRB requesting payment.
    4. Make payment within 3 business days of the WCRB e-mail notification.  Payment can ONLY be made by electronic transfer of funds through the agency or insured’s bank account.
    5. Receive confirmation e-mail.  Coverage will become effective at 12:01 a.m. the day after the application was submitted or at 12:01 a.m. on the future date requested.
12. Can I submit my Online Assigned Risk-Pool Application electronically and then pay by hard-copy check?
    No, this is not allowed.  Payment can ONLY be made by electronic transfer of funds through the agency or insured’s bank account.
13. Can I print my Online Assigned Risk-Pool Application and mail it?
    No.  Applications must be submitted electronically.   
14. What are the international rules for making a payment on my Online Assigned Risk –Pool Application?
    Payments made through the online payment process have to be made from a dollar denominated domestic bank account.
15. Why do I need to provide my mailing address zip code when I make an electronic check payment?
    When you make a payment via the Online Assigned Risk-Pool Application product, you are accessing the US Bank system. US Bank uses the zip code that you entered on your application to authenticate you as a customer. If the zip codes do not match, then you are not allowed to continue with the payment.
16. Why do some of my older applications no longer appear on the "My Applications" screen?
    Applications are purged 30 days after the last WCRB input.

COVID 19

1. Has WCRB established a new unit statistical code for reporting certain payroll for COVID 19?
   Yes, Unit Statistical Code 0012 - Paid Furloughed Workers During A
   Governmental Emergency Order Impacting Employment
   
   Carriers may implement code 0012 as a class code in their operating system.
2. Who is considered a paid furloughed employee for WI worker’s compensation insurance purposes?
   By definition, a paid furloughed employee is one who is still being paid where they have been given a temporary layoff, an involuntary leave or another modification of normal working hours for a specified duration. This is for payments made by the employer during the paid furloughed time under the Governmental Emergency Order regardless of when it was earned.
3. Is paid furloughed time the same as idle time?
   No. Paid furloughed time is the time period where a state-wide emergency order has been issued by a public official and is for an extended period. The employee is not performing work duties for the employer.
   
   Idle time is “down” time when an employee is waiting for materials or products in order to perform their duties. The employee is still under the total direction and control of the employer
4. If a paid furloughed employee continues to be paid by their employer, is their payroll excluded from the employer’s worker’s compensation insurance premium?
   If an employer continues to pay furloughed employees their normal wages and the employer keeps separate, accurate and verifiable records, the payroll will not be included for the basis of premium.
5. How is the payroll to be split when an employee works part of a day and is furloughed part of the day?
   If the employee is performing work duties for any portion of the day, no division of payroll is acceptable.
6. What if an employer does not have documentation on the work that is furloughed versus the work that is actually being done?
   If accurate, verifiable payroll records are not maintained, 100% of the wages are assigned to the employee’s normal classification.
    
   WI Basic Manual Rule IV E.2.b.2. states: “Estimated or percentage allocation of payroll is not permitted.”
    
7. What if Code 0012 is used fraudulently by an employer to falsely lower WC premiums?
   Code 0012 can ONLY be used if an emergency order is issued by a governmental official. Code 0012 is defined as: Paid Furloughed Workers During A Governmental Emergency Order Impacting Employment. If a governmental emergency order is not in effect, code 0012 cannot be used. During a declared government emergency order, improper use of this code or the use of false or misleading documentation in support of reallocation of payroll to this code is a violation of the law and may subject the employer/owners to fines, penalties and/or imprisonment for fraud.
    
8. Is a $0.00 rate appropriate for code 0012?
   Yes. The WCRB believes there is no justification for charging premium based on payroll that creates no worker’s compensation exposure.
    
9. Is there an end date to when code 0012 can be used?
   Statistical code 0012 Paid Furloughed Workers During A Governmental Emergency Order Impacting Employment will be a permanent reporting code and will be implemented whenever an emergency order is in effect.
    
10. Is the term Governmental Emergency Order defined?
    Governmental Emergency Order means any order, decree, stipulation, or determination, promulgated or entered by any public official or governmental body representing the state in which a statewide emergency is declared.
     
11. Is the term public official defined?
    Public Official means someone who has authority to exercise the power of the state government and does so in his or her official capacity as an employee of the state government.
     
12. Should there be a waiting period before code 0012 can be used?
    No. The use of stat code 0012 is directly linked to an executive order made by a state official with the authority to do so.
13. What actions should we take in the following scenario?
    An employer has limited operations due to COVID-19. As a result, some employees are placed into new roles for the duration of the pandemic. What classifications could be assigned to these employees?
     
    The temporary interruption or suspension of normal business activities caused by COVID-19 may qualify as a change in operations for classification purposes.
     
    WI Basic Manual Rule IV states: 

    • • Changes in classification due to changes in an employer’s operations will be applied as of the date the change in operations occurred, 
    • • The reallocation of payroll among classifications on the policy is not considered a change or correction in classification(s). 

    The employer is responsible for maintaining separate payroll records. The payroll records must show the actual payroll, by classification, for individual employees.  The records must:

    1. Reflect actual time spent working within each job classification and an average hourly wage comparable to the wage rates for such employees within the employer’s industry.
    2. Actual payroll must be maintained. Estimated or percentage allocation of payroll is not permitted.
14. Does the definition of Paid Furloughed Employees in the filing extend to employees on leave under Federal leave programs such as FFCRA, EPSLA and EFMLEA?
    No. The Paid Furlough Employee filing applies only to voluntary salary, wages or payments made by employers to their employees who are not working. The federal programs noted above address required payments made to employees who are not working for a variety of reasons. Such Federal leave programs may involve reimbursements, tax saving and other incentives for employers who are required to make such payments to their employees.
     
15. Should the payroll allotted to stat code 0012 – Furloughed Workers During Emergency Governmental Orders Impacting Employment, be included in the basis for codes 9740 – Terrorism and 9741 – Catastrophe?
    No.  There is no rate or premium charge filed for stat code 0012.  Code 0012 is a stat code and does not affect the worker’s compensation insurance premium and should not be included in the calculation of the exposure total on a unit statistical report nor used in the calculation of terrorism or catastrophe charges.
     
16. Do we treat stat code 0012 as a classification code but with $0.00 rate with manual premium or does this become an adjustment later in the premium algorithm?
    Stat code 0012 is not a class code and should not be treated as a class code. The code can be reported on the policy but will not be included in any premium algorithm.
     
17. Will COVID-19 claims be included in my future experience rating modifications?
    Wisconsin procedures will be consistent with those previously applied to other Extraordinary Loss Event catastrophe codes.  Valid claims coded with catastrophe code 12 and reported to Wisconsin will be excluded from experience rating calculations for any employer(s) incurring one or more such claims.
     
    Wisconsin Experience Rating Plan Manual Section III.D.2. states:
     
    2. Losses
    The incurred losses in the experience period are those reported in accordance with the Wisconsin Worker’s Compensation Statistical Plan Manual. No loss can be excluded from the experience of a risk on the ground that the employer was not responsible for the accident that caused such loss.
     
    EXCEPTION:
    Losses reported with a Catastrophe number assigned as a result of an Extraordinary Loss Event are excluded from experience rating calculations. For a list of the catastrophe numbers see the Wisconsin Worker’s Compensation Statistical Plan Manual, Section III, Loss Information Codes.
     
18. Will COVID-19 data be included in ratemaking?
    WCRB Actuarial Subcommittee will meet in May to discuss the 2020 rate filing.
    
    The Subcommittee will meet again in November to begin discussion on the 2021 rate   The impact and treatment of claims reported under catastrophe code 12 will be discussed at this meeting.
     
19. How should the Exposure Act/Exposure Coverage code be reported?
    Code 0012 is filed as a stat code only in WI.  For WI the exposure coverage 00 is to be reported.
     
20. When reporting stat code 0012, will the WCRB be looking for a split audit at the effective date of stat code 0012 or is just the total reported?
    Split period codes are used to indicate a change in manual/charged rates or modification factors.  Since stat code 0012 has no rate or modification applied, there is no split reporting.  Report the total stat code 0012 payroll on the effective date of the policy on the unit statistical report.
21. Can code 0012 be used on unit statistical reports with an estimated audit indicator of Yes or Uncooperative?
    No, the payroll reported under 0012 is to be determined at FINAL audit only.  Estimated audits reporting unit statistical code 0012 will not be accepted.

Experience Rating

1. What is Experience Rating?
   Experience Rating is a method for tailoring the cost of worker’s compensation insurance to reflect the risks of an individual business. Using past loss experience (usually three years) to forecast or predict future worker’s compensation losses does this. It gives an employer the opportunity to have an impact on the final cost of his or her worker’s compensation insurance by controlling workplace hazards that can cause injuries to employees.
   
   In simple terms, the plan compares an employer’s experience with the experience that is expected for employers engaged in the same business. For example, if claim experience is better than what is expected, the employer will earn a "credit" experience rating modification, which will decrease the amount of premium paid. Conversely, if claim experience is worse than what is expected, the employer will earn a "debit" experience rating modification, which will increase the amount of premium paid.
2. What is meant by "tailoring the cost of worker’s compensation insurance?"
   Every business has been assigned to one or more classifications that place it in a group with other employers engaged in similar business operations. The "manual rate" for each classification is calculated based on the combined experience for that classification. The manual rate, or premium per unit of payroll, is simply the "average" cost for reflecting the "average" conditions of that group. The "average" cost includes the experience of both the more "risky" and less "risky" employers in that group, and does not recognize the individual employer’s success in controlling workplace hazards. Experience rating adjusts the "average" rate to reflect the safety of each employer’s business operations. The "average" rate is tailored through the credit or debit of the experience rating modification in proportion to how much better or worse a company’s experience is than the average for an employer’s group.
3. What are the eligibility requirements to be experience rated?
   A risk is eligible for intrastate experience rating when it develops a qualifying premium based on payrolls or other exposures reported in accordance with the Wisconsin Worker's Compensation Statistical Plan Manual (WI Statistical Plan Manual).  Qualifying premium is achieved when the payrolls or other exposures developed in the last year or last two years of the experience period produce, at current manual rates, a premium equal to at least twice the Experience Rating Eligibility amount shown in the WCRB Miscellaneous Values Table; or, when more than the latest two years of the experience period's exposures produce, at current manual rates, an average annual premium equal to at least the Experience Rating Eligibility amount.
4. What can be done to reduce an experience rating modification?
   Since an experience rating modification compares actual losses to the "average" or expected losses for each classification(s), an employer has a strong incentive to promote workplace safety programs and accident prevention. The experience rating system benefits those employers who have better than the "average" loss experience. Employers who promote and implement workplace safety programs and accident prevention procedures AND thereby reduce their worker’s compensation losses will realize the benefits of the experience rating system and lower their worker’s compensation costs.  Employers who do not promote and implement workplace safety programs AND thereby fail to reduce their worker’s compensation losses will increase their worker’s compensation costs.
5. How is an experience rating modification applied to a policy?
   An experience rating modification is applied to a worker's compensation policy as of the rating effective date established for an employer. When an experience rating modification is released, the employer can access the rating worksheet via a secure "FindMyMod" URL provided to employers in their experience rating modification access code letter.  The insurer can access the rating worksheet via the WCRB or the CDX Web site and is responsible for endorsing the policy to reflect the application of the experience rating modification.
6. How can I have a favorable loss ratio and a debit experience rating modification at the same time?
   Loss ratios are measures used by insurance companies to determine whether or not a risk meets their underwriting standards and profitability expectations.  Because the amount of premium paid does not factor into the experience rating modification calculation, a loss ratio has no effect on a experience rating modification.
7. Claim Number # # # # # # shows up on my rating as one amount; however, on my latest loss run, the reserve has been lowered. Why isn’t this change reflected in my experience rating modification?
   Because reserves can change daily, insurance companies have specific guidelines to follow regarding the reporting of claim information, and generally they report updated information only once a year.  When filing loss information with the WCRB, all claims within a specific policy period are valued eighteen months after the inception date of a policy, and every twelve months after that date for each open claim, for up to ten years.

   Policy Effective Month:	Valuation Month:
   January	July
   February	August
   March	September
   April	October
   May	November
   June	December
   July	January
   August	February
   September	March
   October	April
   November	May
   December	June

8. I have been told that by paying my own medical claims, I will save money through a decrease in my experience rating modification. Is this true?

   Not necessarily. A study performed by the Worker’s Compensation Division of the Department of Workforce Development concluded that it takes an employer at least six years to recoup any payments made out of pocket for medical claims. However, the belief that there would be significant savings remained. Since July 1, 1998, the experience rating formula has allowed for a seventy percent reduction for all claims that have only medical payments or reserves. This removed any perceived incentive for employers to pay their own medical claims.

9. Can an employer pay all or a portion of worker's compensation claims directly?
   The insurance company is the proper payee of all worker's compensation claims.  Agents, consultants, or insurers may not, without violating insurance statutes, advise employers to circumvent the worker's compensation system.
   
   The Office of the Commissioner of Insurance, along with the Worker's Compensation Division of the Department of Workforce Development, and the Wisconsin Compensation Rating Bureau, hold that consultants, agents, and insurance companies must not encourage, advise, or condone the direct payment by employers of any portion of medical and/or indemnity charges resulting from work injuries. All worker's compensation injury claims must be reported to the insurance company.
   
   The Wisconsin insurance statutes prohibiting this practice include s. 626.11, Rate standards; s. 626.12, Rating methods; s. 626.25, Use of rates; and s. 628.34, Unfair marketing practices, Wis. Stats.
   
   OCI will pursue information about the direct payment of medical/indemnity expenses through its complaint process and follow through with appropriate enforcement action.
   
   In addition, under s. 102.31(1)(b), Wis. Stats., a worker’s compensation insurance policy is construed to grant full coverage of all liability of the assured under the Worker’s Compensation Act. Finally, under DWD 80.02 (1)(b) of the Wisconsin Administrative Code, an employer’s insurance carrier has primary liability for unpaid medical treatment.
   
   Chapter 102.31 and DWD 80.02 also support this position by stating the policy shall be construed to grant full coverage and that an employer's insurance carrier has primary liability for unpaid medical treatment.
   
   Insurance companies must submit all proposed changes to the standard worker's compensation policy to the Wisconsin Compensation Rating Bureau for review and approval. The Rating Bureau is responsible for developing any revision in the policy language and submitting the revision for approval to the Insurance Commissioner.
10. What is the definition of a change in ownership, as it relates to experience rating?
    For the purposes of experience rating, a change in ownership includes any of the following:
    

    • Sale, transfer, or conveyance of all or a portion of an entity’s ownership interest.
    • Sale, transfer, or conveyance of an entity’s physical assets to another entity which takes over its operations.
    • Merger or consolidation of two or more entities.
    • Formation of a new entity subsequent to the dissolution or nonoperative capacity of an entity.
    • Voluntary or court-mandated establishment of a trustee or receiver, excluding a debtor in possession, a trustee under a revocable trust, or a franchiser.
11. What makes companies combinable for the same experience rating modification?
    Two or more companies are combinable only if:

    • The same person, group of persons, or corporation(s) owns more than fifty percent of each company, or
    • An entity owns a majority interest in another entity, which, in turn owns a majority interest in another entity. All entities are combinable for experience rating purposes, regardless of the number of entities.
12. If I own 100 percent of one company, and own another with my spouse, are the entities combinable for experience rating?
    Only if you own more than fifty percent of the entity you and your spouse own together. The marital property law does not come into consideration when determining combination of separate entities.
13. If I purchase another company, what happens to any experience rating modification?
    When a business is purchased, the experience earned by that business would continue to be applied to the new owner of that business, unless all of the following criteria are met:
    
    a. The change must be a material change such that the entire ownership interest after the change had no ownership interest before the change, or the collective ownership of all those having an interest in an entity both before and after the change amounts to either less than 1/3 ownership before the change, or less than 1/2 ownership AFTER the change.
    
    b. The material change in ownership is accompanied by a change in operations sufficient to result in a reclassification of the governing classification.
    
    c. The material change in ownership is accompanied by a change in the process and hazard of the operations.
    
    NOTE: Change in governing classification and change in process and hazard must be verified by a Bureau Inspection.
14. How do I notify the Bureau of a change in ownership?
    When an ownership change occurs, notification can be given in two ways. They are:
    
                  a. The filing of a Confidential Request for Information (ERM-14 form)
    
                  b. Submitting the information in narrative form on the insured’s letterhead, 
                      signed by a principal in the company.
15. Is it possible to have more than one experience rating modification factor on one worker’s compensation policy?
    There are a few reasons why there might be multiple experience rating modifications on a single policy, but the most common is when an employer changes their policy effective date. This might result in a revised Rating Effective Date. If you have questions regarding other reasons for change, please contact our office for assistance.
16. How is the effective date of an experience rating modification factor determined?
    The effective date of the published experience rating modification factor is governed by the Rating Effective Date on a given policy.
17. What is the definition of an Rating Effective Date?
    The Rating Effective Date is the effective month and day of the policy in effect, and each annual anniversary thereafter, unless the Wisconsin Compensation Rating Bureau has established a different date.
18. How is a Rating Effective Date (other than the normal policy effective date) determined, and how is it applied to a policy?

    If a policy is canceled and rewritten by the same or another insurer, all rules, classifications, and rates of the rewriting insurer which were in effect as of the rating effective date of the original policy shall apply to the rewritten policy until the next rating effective date, as established by the rating organization.
    
    a) The experience modification effective on the normal rating effective date will apply for the full term of:
     

    1. The policy commencing on that date, or
        
    2. Any other policy commencing up to three months after that date.
        

    For example, an experience modification effective 7-1-2022 will apply to the policy effective 7-1-2022 or to any policy with an effective date up to 10-1-2022.  No experience modification will apply for a period longer than 15 months. 
    
    b) If a policy commences more than three months after the normal rating effective date, the following procedure will apply:
     

    1. The current experience modification will apply to the new policy until the date the modification expires.
        
    2. A renewal experience modification will apply to the new policy until the date the policy expires.
        
    3. A renewal experience modification will apply annually thereafter as of the new normal rating effective date.  This will be the date twelve months after the effective date of the new policy.
        

    Example of b):
    
    Assume -
    Experience modification effective  7-1-2022 to 7-1-2023
    New policy commences   1-1-2023 to 1-1-2024
    
    The 7-1-2022 modification applies until 7-1-2023.  A new modification applies from 7-1-2023 until 1-1-2024.  The new normal rating date is 1-1-2024. 

19. Is there any protection in the experience rating system for a catastrophic loss?
    The experience rating formula takes into consideration that a catastrophic loss can happen, and has built in safeguards for that situation. Any time an employer has a single accident resulting in two or more claims, the highest loss value used in the calculation of the experience modification factor is "capped". The amount of the highest value is published with the annual rate revision.
20. What are the rules regarding the timing of the experience rating modification being endorsed?
    An insurance company must apply any reductions in an experience rating modification from the existing one back to the effective date of the experience rating modification. An insurance company can only apply an increase in the existing experience rating modification if they issue an endorsement within ninety days of the effective date of the experience rating modification. If the insurer does not endorse the policy within the first ninety days, any increase can only be applied as of the date the company issues the endorsement, unless the late endorsement is due to one of the following:
     

    1. Late issuance of an experience rating modification due to an employer who has failed to cooperate with audits or because of other faults attributable to the employer or agents of the employer.
        
    2. Retroactive reclassification of a risk.
        
    3. Changes in risk ownership.
21. I see a claim on my Experience Rating Worksheet that was reported as open, but I know it has closed. What is the rule about this situation?
    If, up to thirty days after the effective date of an experience modification, a claim closes at a significantly lower incurred loss value than was indicated on the latest unit statistical report, the WCRB may be notified.  After the WCRB verifies the closure date and the incurred value at closure, it will call for the issuance of a special corrected unit report if the closed claim value would result in a change in the experience modifier.  This report is not a required part of the normal filing sequence for unit statistical reports, and will be used only for revision of the experience modification.
22. If I am the carrier of record, can I view my experience modification worksheet electronically?
    Yes.  There are two options available.  One is through the WCRB Members area of our Web site using the Experience Rating Worksheet application.  The second option is through the Compensation Data Exchange (CDX) product which can be found on the CDX Web site.  In addition, we can send electronic rating worksheets to companies using the WCRATING format.  If you are interested in this method, please contact Miguel Garcia (miguel.garcia@wcrb.org).
23. My insured has been advised that they can lower their experience modification by continuing an injured employee’s wages and not reporting the indemnity loss to my insurance carrier. Is this practice acceptable?
    No, this is not an acceptable practice.  When full wages are continued in lieu of worker’s compensation, employers must still report the claim and insurance companies must reimburse employers an amount equal in value to the amount payable under ch. 102, Wis. Stats. (Wisconsin Worker's Compensation Act), and report this amount to the Wisconsin Compensation Rating Bureau for purposes of experience rating and ratemaking.
    
    Many insured employers pay continuing wages to injured employees while their employees are unable to work due to work-related injuries.  A number of worker’s compensation insurance companies for these employers have not been paying wage benefits, as required by ch. 102, Wis. Stats., and have not reported the amount that is payable for compensation to the Wisconsin Compensation Rating Bureau (WCRB).  These practices are contrary to Wisconsin’s worker’s compensation system since they jeopardize the safety incentive implied in the experience modification system, put other employers at a rating disadvantage, distort work-injury statistics and negatively impact ratemaking.
    
    Under ch. 102, Wis.Stats., employers are allowed to pay continued wages to injured employees.  This usually occurs while union-represented employees and/or employees of municipalities are temporarily disabled during the healing period.
    
    Section 102.31 (1) (b), Wis. Stats., provides that a contract for WC insurance coverage shall be construed to grant full coverage for all liability of the insured under ch. 102, Wis.Stats.
    
    The portion of continued wages that is worker’s compensation is the amount that is payable for compensation under ch. 102, Wis. Stats.  The Worker's Compensation Division of the Department of Workforce Development (DWD) has regulatory authority over this portion of the continued wages.  The excess amount paid is not considered worker’s compensation over which the DWD has no regulatory authority.
    
    Where full wages are continued in lieu of worker’s compensation, employers must still report the claim and insurance companies must reimburse employers an amount equal in value to the amount payable under ch. 102, Wis. Stats., and report this amount to the WCRB for purposes of experience rating and rate making.  Failure of insurance companies to take such action constitutes use of a deductible in worker's compensation policy rating that has not been filed by the WCRB nor approved by the Office of the Commissioner of Insurance (OCI) for use in Wisconsin.
    
    It is the position of the Office of the Commissioner of Insurance, Wisconsin Compensation Rating Bureau, and the Department of Workforce Development that in a situation where an insured employer pays continued wages to an injured worker, consultants, agents and insurance companies shall not encourage, advise or condone an insurance company's failure to reimburse an employer an amount equal in value to the amount of compensation payable under ch. 102, Wis. Stats., and not report the amount of compensation paid to the Wisconsin Compensation Rating Bureau for purposes of experience rating. Statutory authority that support this position include:
    
    • s. 626.11, Wis. Stats, Rate standards;
    
    • s. 626.12, Wis. Stats., Rating methods;
    
    • s. 626.25, Wis. Stats., Use of rates; and
    
    • s. 628.34, Wis. Stats., Unfair marketing practices.
    
    The standard worker's compensation insurance policy contains language that requires the insurance company to promptly pay benefits required by ch. 102, Wis. Stats. when due, and establishes a duty for an employer after an injury occurs to not voluntarily make payments, assume obligations or incur expenses.  An employer must comply with the policy provisions to obtain protection from the policy.  Since worker's compensation is a required coverage and all policies authorized for use in Wisconsin contain identical provisions about payments and required duties of the insured employer, it is improper for consultants, agents or insurance companies to permit employers to pay continued wages to injured employees without reimbursement by the insurance company and reporting of the compensation payments to the WCRB.
    
    It is improper for consultants, agents or insurance companies to encourage, condone, advise or permit an employer to reimburse an insurance company for wage benefits paid by the insurance company with the actual or implied intent to avoid reporting of the compensation payments to the WCRB.  It is also improper for insurance companies to avoid paying legitimate worker's compensation claims because of a request to do so by a consultant, agent or employer.
    
    If you know of anyone marketing this practice, the Office of the Commissioner of Insurance should be notified.

Financial Calls

1. What is WIFDRA?
   WIFDRA (Wisconsin Financial Data Reporting Application) is a financial call reporting tool. To assist our membership in the filing of annual Financial Call data, we have developed this Internet-based system to help prevent reporting errors, ensure quality data, enhance timeliness of reporting, provide immediate feedback of failed data quality checks, and eliminate costs associated with submitting data on hard copy.
2. What is the WIFDRA Designated Contact Form?
   This form is used to establish your company’s WIFDRA Contact Person when setting up a new carrier group user profile.  The WIFDRA application has a WIFDRA Group Administrator for each carrier group, and it is that person’s responsibility to keep the company user profiles current and accurate. If the Group Administrator is no longer with the company, then a new form needs to be filed with the WCRB as soon as possible.
3. Is there a User Guide available for WIFDRA?
   Yes, it is strongly recommended that you read through the entire User Guide as it outlines the application’s features, layout, and provides helpful hints on how to complete the Calls required by WCRB.  The User Guide link can be found in the upper right corner on any page in WIFDRA.
4. Is there a fining program for the WCRB Financial Calls?
   Yes.  A delinquent Acknowledgement Form or Financial Call is assessed a $50 per business day fine each day the Form/Call is delinquent.  The maximum fine will not exceed $5,000, per call, per licensed company, regardless of whether a carrier has elected to file their calls on a group basis.  Any carrier failing to comply, after notification of delinquency by the Bureau, will be referred to the Office of Commissioner of Insurance for further action.
5. My company holds a license to write worker's compensation in Wisconsin, but currently we do not write any WC business. What Financial Call reporting requirements apply to my company?
   Every insurance company licensed to write the business of worker's compensation insurance within the State of Wisconsin MUST complete and file the Acknowledgement Form.
   Financial Call Reporting Requirements:

   • All carriers with over $100k of CY earned premium for call year are required to report.
   • If a carrier drops below $100k of CY earned premium for a call year, they are required to continue report for that year plus three additional years.
   • After the 3 year additional reporting window, the carrier will be required to report each year until the open claim count is less than 10 and CY incurred loss is less than $100k.

   Once these conditions are met, the carrier is no longer required to report.

Fining

1. What types of fines are imposed by WCRB?
   One of the duties of WCRB is ensuring timely and accurate worker's compensation coverage and rating information for use by WCRB's customers. Fining the insurer for noncompliance is one of the tools used to accomplish this.
   
   WCRB fines insurers for the following:

   • Failure to resolve a Notice to Carrier within the allowable time
   • Late filing of a unit statistical report and/or failure to resolve a unit statistical report rejection
   • Filing an Estimated unit statistical report and failing to update with audited data within the allowable time

   
   Failure to resolve any of the above, in an accurate and timely manner, may result in a fine according to the following schedule:
    

   Notice/Fine	Amount
   First	None
   Second/first	$150.00
   Third/second	$250.00
   Fourth/third	$350.00
   Fifth/fourth	$500.00
   Sixth/fifth-and each subsequent	$500.00

   • Late filing of a policy:

   S.626.35, Wis. Stats. requires that an insurer file a copy of the insurance policy or other evidence of coverage not more than 60 days after the effective date of the policy. Failure to do so will result in $150 fine.

   • Late filing of financial call data

   Wisconsin financial call data is collected annually by WCRB and it is subject to the Financial Call Fining Program.  A delinquent Acknowledgement Form or Financial Call is assessed a $50 per business day fine each day the Form/Call is delinquent.  The maximum fine will not exceed $5,000, per call, per licensed company, regardless of whether a carrier has elected to file their calls on a group basis.  Any carrier failing to comply, after notification of delinquency by the Bureau, will be referred to the Office of Commissioner of Insurance for further action.
2. Why were we fined after we already answered the Notice to Carrier?
   The fine was levied because the Notice to Carrier was not completely and/or accurately responded to by the due date.
3. If I answer this Notice to Carrier, will you rescind the fine?
   Not generally. The Bureau’s responsibilities include the collection of timely and accurate information. Rescinding of fines could lead to lower standards becoming the norm, and ultimately damage the Wisconsin Worker’s Compensation System.
4. When unit stat reports are considered delinquent by WCRB, which reports are assessed timeliness fines?
   All unit stat reports (first reports, subsequent reports, and correction reports) filed with WCRB are tracked for both timeliness (delinquent) and accuracy, and become subject to our fining program if they are not resolved.  Fines are assessed on all unit stat reports in a rejected status if they are not successfully processed per the reporting schedule found in the WI Statistical Plan Manual and/or the date of the reject letter exceeds 60 days.  For additional information see General Circular 471, dated December 22, 2004.

Inspections/Classifications

1. How can I be sure I am classified correctly?
   The Bureau will inspect Wisconsin operations to determine the proper classification(s).   An inspection may be requested by the employer, the producer of record, the current carrier (insurer), or Bureau staff.  Please see the Forms section of our Web site to access the Inspection Request Form   Employers may also go to the Forms area to complete the WCRB Business Operations Report.  Once submitted, Bureau staff will review the information provided in the report and, if the detail in the report is sufficient, rule on the proper classifications which should apply to your operations.
2. What is an inspection?
   • An inspection is a comprehensive review of your business operations, which allows the WCRB to assign the appropriate classification code(s) applicable to your policy.  Estimated remuneration (i.e. payroll and other compensation) for your employees (at inception) and final remuneration (determined at final audit) are matched with the codes and used to calculate your insurance premium.
   • An inspection is not a payroll audit, which is a function performed by the insurance company. 
   • Although social security numbers and payroll estimates are not reviewed as part of an inspection, the inspector may request a listing of employees (by job title, department or type(s) of duties) to facilitate proper head counts and types of positions (including seasonal employees, temporarily vacant positions, etc.).
3. What is the inspection process?
   • A notification letter is sent to the insured to advise them of a pending inspection.
   • The agency of record, if applicable, is mailed a copy of the letter at the same time.
   • The appointment is scheduled and completed.
   • An inspection report is generated based on the information obtained from the site visit or correspondence with the insured.
   • If any classification or other changes are deemed necessary, a Notice to Carrier (NTC) is generated and the carrier processes changes to the policy.
   • The insured receives notification of any changes from the agency (or in the case of a pool policy, the carrier).
4. Why is my business being inspected?
   • Per S.626.09, Wis Stats., it is the Bureau’s responsibility to ensure employers are properly classified for Worker’s Compensation insurance purposes.
   • Inspections may be requested by the insured, agent, current carrier of record or by the WCRB internally for a variety of reasons. 
   • An inspection may be required for a newly formed business, when operations have changed, when an entity is added, when a location is added/removed and more.
   • Inspectors are not typically aware of specific reasons that resulted in an inspection request. 
5. Do I have to comply with the inspection request?
   • Yes. Your workers compensation policy affords the WCRB the authority to perform an inspection.  Please reference Part Six-Conditions, (A) Inspection of the standard Workers Compensation and Employers Liability Insurance Policy.
   • The inspector must continue to follow up until the inspection is completed.
6. A Bureau inspection resulted in a classification change. When is the change effective?
   
   Corrections in classifications which result in a decrease in premium, whether determined during the life of the policy or upon audit, shall be applied retroactively to the inception of the policy term and, if applicable, the experience rating modification will be recalculated.
   
   Corrections which result in an increase in premium shall be applied as follows: The effective date of a change for purposes of the time periods in a) and b) below is the date an insurer determines that it is necessary to effect a classification(s) change.
   
   a)  During the first 120 days of the coverage term, retroactively to the inception of the policy term and recalculation of the experience rating modification.
   
   b)  After the first 120 days of the policy term, corrections in classifications will not be effective until the next renewal policy.
   
   The date of a WCRB inspection supersedes the carrier date when determining the application of a change or correction in classification. WCRB will notify the carrier of the effective date of change.
   
    
7. Can I divide my employee’s payroll between classes?
   Some employees may perform duties directly related to more than one properly assigned classification. Payroll may be divided among the properly assigned classifications provided that:
   a. The classifications can be properly assigned to the employer according to the rules of the classification system, and
   b. The employer maintains proper payroll records, which shows the actual payroll by classification for that individual employee.
       1) Records must reflect actual time spent working within each job classification and an
           average hourly wage comparable to the wage rates for such employees within the
           employer's industry.
       2) Estimated or percentage allocation of payroll is not permitted. 
   
   This exception in no way abrogates the rules governing the Standard Exceptions or the "all inclusive" classes in the Basic Manual.
   
   Classes where an employee’s payroll cannot be divided are 7380, 8742, 8748, 8810 and 8871.
   
   Note: If payroll records do not show the actual payroll applicable to each classification, the entire payroll of the individual employee must be assigned to the highest rated classification that represents any part of his or her work.
    
8. What is the rate for class code ----?
   A rate for any Wisconsin class code can be obtained by using the Class Code Lookup feature of our Web site.

Miscellaneous

1. What is the nine point test for an independent contractor?
                                                        Employee Defined
   
                                 (Copied from Worker’s Compensation Act - R.04/2000)
   
   102.07 Employee defined. "Employee" as used in this chapter means:
   
   (8)(a)Except as provided in par. (b), every independent contractor is, for the purpose of this chapter, an employee of any employer under this chapter for whom he or she is performing service in the course of trade, business, profession, or occupation of such employer at the time of the injury.
   
   (b)An independent contractor is not an employee of an employer for whom the independent contractor performs work or services if the independent contractor meets all of the following conditions:
   
   [The following nine part test applies to independent contractors who are not statutory employees. It was created by Chapter 64, Laws of 1989, effective January 1, 1990.]

   1. Maintains a separate business with his or her own office, equipment, materials, and other facilities.
   2. Holds or has applied for a federal employer identification number with the federal internal revenue service or has filed business or self-employment income tax returns with the federal internal revenue service based on that work or service in the previous year. (The added language was taken from the unemployment insurance definition of independent contractors.)
   3. Operates under contracts to perform specific services or work for specific amounts of money and under which the independent contractor controls the means of performing the services or work.
   4. Incurs the main expenses related to the service or work that he or she performs under contract.
   5. Is responsible for the satisfactory completion of work or services that he or she contracts to perform and is liable for a failure to complete the work or service.
   6. Receives compensation for work or service performed under a contract on a commission or per job competitive bid basis and not on any other basis.
   7. May realize a profit or suffer a loss under contracts to perform work or service.
   8. Has continuing or recurring business liabilities or obligations.
   9. The success or failure of the independent contractor’s business depends on the relationship of business receipts to expenditures.

   (c) The department may not admit in evidence state or federal laws, regulations, documents granting operating authority, or licenses when determining whether an independent contractor meets the conditions specified in par. (b) 1. or 3.
   
   If you have any further questions, please contact the Wisconsin Department of Workforce Development (DWD) Worker's Comp Division.
2. I am a contractor and I hire an independent subcontractor. Why am I being charged a premium for them?
   Unless the independent contractor provides a certificate of insurance or evidence that they are not statutory employees, the carrier may collect premium on the "subcontractors" as they may be responsible for claim payment.  See question #1 above for a nine part test that applies to independent contractors who are not statutory employees.
3. Who is authorized to receive information on a specific employer?
   The current insurer and agent of record are permitted access to employer information.   Physicians, attorneys, and other interested third parties may be provided certain proprietary policy information upon completion of the "Information Release Authorization Form" (IRAF).
4. Who has to carry worker’s compensation insurance?
   Employers who employ three or more workers on a full or part-time basis.
   
   Employers who employ one or more workers on a full or part-time basis and who pay gross, combined wages of $500 or more in any calendar quarter for work done in Wisconsin must have insurance by the 10th day of the first month of the next calendar quarter.
   
   Farmers who employ six or more workers on any 20 days during a calendar year must have insurance 10 days after the 20th day of employment.
   
   If you have any further questions, please contact the Wisconsin Department of Workforce Development (DWD) Worker's Comp Division. DWD can also be contacted by phone at 608-266-1340.
5. How can I become a member of the WCRB?
   Chapter 626, Wis Stats., requires that all carriers writing worker’s compensation in Wisconsin be members of the WCRB.  The Office of the Commissioner of Insurance will not amend a carrier’s license to include worker’s compensation insurance without verifying membership. 
   
   To become a member, the carrier will need to print a copy of the WCRB By-laws found under the “About Us” link on the WCRB Web site home page.  An authorized representative of the carrier must sign the last page of the By-laws and return the entire copy to the WCRB, P.O. Box 3080, Milwaukee, WI 53201-3080 along with the initial membership fee of $500 payable to WCRB.  Requirements are outlined in the By-laws.
6. What manuals are approved for use in Wisconsin?
   • WI Basic Manual
   • WI Experience Rating Plan Manual
   • WI Statistical Plan Manual
   • NCCI's Retrospective Rating Plan Manual

Policy

1. Why do we have to cancel our policy if we are not renewing it?
   Once an insurer has issued a policy in Wisconsin, that insurer remains the insurer of record until the proper cancellation or nonrenewal notification is submitted, or the WCRB receives replacement coverage. Wisconsin is a continuous coverage state. Therefore, until proper statutory notice of cancellation or nonrenewal is received or a replacement policy issued, coverage continues indefinitely.
   
   Wisconsin Worker's Compensation Act states in section 102.31 (2) (a) "No party to a contract of insurance may cancel it within the contract period or terminate or not renew it upon the expiration date until a notice in writing is given to the other party fixing the proposed date of cancellation or declaring that the party intends to terminate or does not intend to renew the policy upon expiration. Except as provided in par. (b), when an insurance company does not renew a policy upon expiration, the nonrenewal is not effective until 60 days after the insurance company has given written notice of the nonrenewal to the insured employer and the department."
2. What is the rate for a class code?
   A rate for any Wisconsin class code can be obtained by using the Class Code Lookup feature of our Web site.
3. Are there any endorsements that must be included with every policy filed in Wisconsin?
   The following endorsements are required on all policies:

   • Wisconsin Law Endorsement 
   • Wisconsin Cancellation and Nonrenewal Endorsement 
   • Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement 
   • Catastrophe (Other Than Certified Acts Of Terrorism) Premium Endorsement 

   Terrorism and catastrophe coverage cannot be deleted from a worker’s compensation insurance policy.
4. What is the minimum premium?
   Minimum premium is the lowest premium that is required in order to provide insurance under a worker’s compensation policy. Minimum premium is not subject to an experience rating modification. The minimum premium for each classification can be found using the Class Code Lookup product on our Web site. For a policy with two or more classifications, apply the highest minimum premium for any classification on the policy, even if that classification is written on an if-any basis.
5. How is the minimum premium calculated at audit?
   The minimum premium is subject to adjustment at final audit. It is determined on the basis of those classifications developing premium as follows:
   

   • If one or more classifications develop premium, the minimum premium charged for the policy shall be the minimum premium of the one such classification with the highest minimum premium.
   • If the circumstances upon which the minimum premium was originally determined have changed during the policy period, the minimum premium shall be changed in the manner indicated and the audit shall be made accordingly.
   • In the event that the designated minimum premium is greater than 20% of the earned payroll, then the minimum premium shall be 20% of the earned payroll, but not less than the applicable expense constant. This amount is not subject to pro rata or short rate cancellation.
   • When more than one state is insured on the same policy, the highest minimum premium shall be charged even if that state is on an "if any" basis.
6. How is the final premium determined when the calculated premium is less than minimum premium or no payroll is developed?
   The final premium is 20% of the earned payroll, but not less than the applicable expense constant.  This amount is not subject to pro rata or short rate cancellation. See Rules - WI Basic Manual.
   
   In the event of mid-term cancellations, this rule only applies if it produces a lower minimum premium than would be produced under Rule X of the WI Basic Manual.
   
   The following examples may help illustrate how the rule and the exception work in tandem:
   
   (NOTE: In all examples, the applicable manual rate is $10.00, and the applicable minimum premium shown on the Policy Information Page is $900, which is the current maximum in Wisconsin.)
   
   The Final Audit develops $10,000 in earned payroll.  The final premium is 10,000 x $10.00 divided by 100 or $1,000 plus the expense constant of $220 for a total of $1,220.  Neither minimum premium rule applies, as the audited premium exceeds the minimum.
   
   The Final Audit develops $5,000 in earned payroll.  The calculated premium is 5,000 x $10.00 divided by 100 or $500 plus the expense constant of $220 for a total of $720, which is less than the minimum premium.  The Wisconsin Exception refers to 20% of earned payroll or .20 x $5,000 for a total of $1,000.   Since $1,000 is greater than the policy minimum shown of $900, the Wisconsin Exception does not apply, and the $900 Minimum is applicable under WI Basic Manual Rule VI. F.5
   
   The Final Audit develops $3,000 in earned payroll.  The calculated premium is 3,000 X $10.00 divided by 100 or $300 plus the expense constant for a total of $520.  The Wisconsin Exception calculation is 20% of $3,000 or $600, which is less than the $900 policy premium.  Therefore, the Exception applies and the minimum premium charged is $600.
   
   The Final Audit develops no earned payroll.  Since 20% of 0 is nothing, the Wisconsin Exception obviously applies, and since the minimum charge under the Exception is the Expense Constant, the actual minimum charged would currently be $220.
   
   The last example is, by far, the most common situation, as a number of risks, primarily contractors, often buy policies they are not required to purchase because they have no employees, solely to obtain a Certificate of Insurance.   Since there is no loss exposure in this situation, the Office of the Commissioner of Insurance believes that the Expense Constant is adequate payment to the carrier for issuing the policy.  Similar arguments are used for employers with very small payroll.
   
   Remember, in any of the above examples, if the policy is canceled mid-term, the Minimum Premium Rule applies only if it produces a lower premium than would be produced under Rule X.  See WI Basic Manual.
7. How is the minimum premium determined on a multi-state policy?
   When more than one state is covered on the same policy, the highest minimum premium shall be charged even if that state is on an "if any" basis.  See WI Basic Manual, Rule VI. F.5.d.
8. What is the process for developing, approving, and releasing the rate revision?
   The WCRB contracts with an outside vendor to develop the manual rates. The data used in the development of the rates is collected as soon as possible each year. Our Actuarial Subcommittee then reviews the rate revision. We release the manual rates to the membership, via circular, the same day that the Office of the Commissioner of Insurance approves them. Our goal is to release the rates in early July with an October 1 effective date.
9. What are the Limits of Liability under Part Two - Employers Liability - of a Standard Worker's Compensation and Employers Liability Policy?
   The standard Limits for Employers Liability are as follows:
   
                Bodily Injury by Accident
                $100,000 - each accident
   
                 Bodily Injury by Disease
                 $100,000 - each employee
   
                 Bodily Injury by Disease
                 $500,000 - policy limit
10. Can I increase the limits under Part Two - Employers Liability - of a Standard Worker's Compensation and Employers Liability Policy?
    The limits under Part Two may be increased, subject to the following:
    
              1.The limits of liability shall be the same for all states specified in Item 3.A. of the
                 Information Page.
    
              2.The additional premium for increased limits shall be determined by multiplying the
                 total premium by the percentage shown in the tables below.
     

    Table for Increased Limits - Effective 01-01-2013
    Limits of Liability (000 Omitted)	Percentage	Minimum Premium for Increased Limits
    $500/500/500	0.8%	$75.00
    1,000/1,000/1,000	1.1	120.00
    2,000/2,000/2,000	1.4	140.00
    3,000/3,000/3,000	1.6	160.00
    4,000/4,000/4,000	1.8	180.00
    5,000/5,000/5,000	2.0	200.00
    6,000/6,000/6,000	2.2	210.00
    7,000/7,000/7,000	2.4	220.00
    8,000/8,000/8,000	2.6	230.00
    9,000/9,000/9,000	2.8	240.00
    10,000/10,000/10,000	3.0	250.00

    
    Total Premium shall be included in Subject Premium. It shall not be less than the minimum premium shown in the tables.
11. How is premium determined for a worker's compensation policy in Wisconsin?
    The WI Premium Algorithm used to determine premium is on the Manuals page of our Web site.
12. What is the difference in coverage between a sole proprietor, partners, members of Limited Liability Companies (LLC), members of Limited Liability Partnerships (LLP), and executive officers?
    SOLE PROPRIETORS, PARTNERS, MEMBERS OF LLCS AND LLPS
    Sole proprietors, partners, members of LLCs and LLPs are not covered under a worker's compensation policy unless they elect the coverage. They may elect to be eligible for worker's compensation benefits by including endorsement WC 00 03 10 with their existing policy. Premium is determined by using the payroll for individuals/partners given in the most recent rate revision circular. This election may be withdrawn upon 30 days written notice to the insurance carrier and filing WC 00 03 08 (Partners/Officers and Others Exclusion) with WCRB.
    
    EXECUTIVE OFFICERS
    Not more than two officers of a corporation, having ten or fewer stockholders, may elect not to be covered by a worker's compensation insurance policy. The election may be made at any time during the policy period and the insurance policy shall be endorsed with a WC 00 03 08 naming each officer who has so elected. The election may not be reversed during the period of the policy.
13. How do I report policy information to the WCRB?
    Policy information can be reported to WCRB by either Manage Policy or by CDX.
    
    Manage Policy
    The Manage Policy product on the WCRB Web site provides members the ability to create and submit transactions, track submissions, and view reject error reports. Manage Policy is accessible to carrier organizations in the Member Products section of the WCRB Web site. Carrier users will need to be granted access by their Group Administrator. 
    
    The Manage Policy User Guide and FAQs provide instructions for using this product. Go to the Help section located in the Manage Policy product for the link to the Manage Policy User Guide and FAQs.
    
    There is no testing required to submit transactions through our Manage Policy Web site product.
    
    CDX
    WCRB is a member of the Compensation Data Exchange (CDX), which has developed a tool for entry and electronic reporting of policy information. Visit the CDX Web site for more information.
    
    Electronic submissions through CDX must be tested and approved for production. Please review the WCRB’s Policy Electronic Reporting Instructions for testing requirements.
     
14. Where should carriers file Wisconsin policy data?
    Carriers licensed to write worker's compensation in the State of Wisconsin are obligated to file ALL policy data with WCRB. If an employer is interstate rated, a copy of the policy must also be filed with NCCI.
15. What is the charge for the "Waiver of Subrogation" Endorsement?

    Carriers have two options when charging for a waiver. If a carrier does not make an election with the WCRB, the default will be option 1. The two options are as follows:
     
    1. Charge 2% of total premium for a blanket waiver, subject to experience rating; or $50 per signed contract per policy year for a specific waiver, not subject to experience rating. Premium not to be less than $50.
    2. Charge 2% of total premium for a blanket waiver, or 5% of the total premium applicable for each person or organization requesting a specific waiver, subject to experience rating. Premium not to be less than $50.
     
    Regardless of option, these charged amounts are in addition to the regular policy premium. The minimum charge cannot be prorated for periods less than one year, which includes both short term policies and policies cancelled short or pro-rata. 
    
    Please see Circular Letter 3180 for more information.
     

16. What is "Work Study"?
    Effective October 1, 2013, the charge for code 9428 is $350 and applies to secondary schools. Code 9447 applies to post-secondary schools with a charge of $1,000.  Please see Circular Letter 3098 for additional information.
17. What are nonrenewal filing requirements?
    Ch. 102.31(2), Wis. Stats., and Ins 21, Wis. Adm. Code requires that an insurer provide a 60 day notice of nonrenewal to both the insured and the WCRB. The notice to the WCRB must be submitted in an approved format and must be received and accepted not less than 60 days prior to the expiration date of the insured’s policy.
    
    Failure to provide the proper notification requires the insurer to offer a renewal to the insured, regardless of whether or not a cancellation notice was received and accepted by the WCRB. The nonrenewal notice does not cancel coverage, it solely relieves the carrier of their obligation to offer a renewal policy.
18. How can carriers review and respond to Notice to Carriers (NTCs)?
    All NTCs, also known as CRITS, MUST be replied to using the NTC Lookup product.
     
19. What is the purpose of the Wisconsin Limited Other States Insurance Endorsement?
    Endorsement WC 48 03 01 C is most commonly used with policies written through the Wisconsin Worker's Compensation Insurance Pool. However, it can also come up in situations where insurers are restricting their coverage to the State of Wisconsin only.
    
    Each state has its own worker's compensation system, and administration is in the hands of administrators within each individual state. There is no overriding federal worker's compensation law dictating when coverage must be in effect, or how coverage should be applied. Therefore, the question of when worker's compensation is necessary in another state needs to be addressed by evaluating that specific state's worker's compensation requirements.
    
    Coverage provided by insurance companies can cross state boundaries, and often does. National insurers licensed in all states typically add states to item "3A" on the information page of the policy whenever direct coverage is requested. There are circumstances, however, when an insurer is licensed only in the State of Wisconsin, or the coverage is provided through the assigned risk pool. In those situations, the insurer cannot show any state but Wisconsin under item "3A" of the policy. If the employer needs direct coverage in any other state, a separate policy is necessary to satisfy that need.
    
    The question then becomes - what is the purpose of the Wisconsin Limited Other States Insurance Endorsement? Other states' coverage provided by this endorsement is not direct coverage and does not satisfy an employer's obligations under the law of any state other than Wisconsin. Technically, it reimburses the employer for benefits paid to an employee who is injured in another state and pursues recovery of benefits under that other state's worker's compensation law. Presumably, those benefits are sought because they are "richer" than those provided for in Wisconsin. The Wisconsin Limited Other States Insurance Endorsement also presumes that the work activity of the injured employee was not sufficient to subject the employer to the other state's law requiring the employer to carry direct worker's compensation coverage in that state. An example of this would be an employee traveling by car to a meeting out-of-state who is injured in an accident while passing through another state. If that employee sought benefits under state law where the accident occurred, this ancillary out-of-state employment would not create an obligation on the employer to obtain direct coverage in this other state.
    
    There are, however, many employers domiciled in the State of Wisconsin who regularly do business in states adjoining Wisconsin. In those circumstances, it would be necessary for that employer to obtain coverage from an insurer licensed in each of those states. Even if all the employees working for this employer live in Wisconsin, they could have potential worker's compensation claims which would fall into the jurisdiction of the adjoining states.
    
    Whenever it has been identified that a pool insured has, or may have, exposure in a state other than Wisconsin, the Wisconsin Limited Other States Insurance Endorsement should be attached to the policy. However, even when coverage is excluded in a state other than Wisconsin, the payroll for those employees living in other states should be included for premium development in Wisconsin, unless the employer has a worker's compensation policy in effect for workers in that state. For a compensable injury, Wisconsin benefits are always available to an employee of an employer who is located in the State of Wisconsin.
    
    Therefore, the Wisconsin Limited Other States Insurance Endorsement operates as a bar to payment of benefits at a rate different than the rates paid in the State of Wisconsin. If the Wisconsin Limited Other States Insurance Endorsement provisions do not apply, then the payments are made pursuant to the policy on a reimbursement basis to the insured.
    
    The simple rule of thumb is if the employer has operations in other states, and received coverage through the assigned risk pool, the Wisconsin Limited Other States Insurance Endorsement should be used to exclude those operations in other states, and a separate policy of insurance should be purchased for those states.
    
    
     
20. What happens if my policy is rewritten with a new effective date?
    If an employer changes the effective date of their current policy, the rates and rules effective on the new date apply. While the employer may, in some cases, see a reduction in class code rate for the current policy, the change may have adverse effects on the overall premium for the insured such as:
    
    • Short rate cancellation penalty
    • Increase in experience modification
    • Losses remaining in the experience modification calculation for an extended period
    • Loss of dividend
    
    Wisconsin statute contains specific prohibitions for a carrier to cancel a policy except for issues such as nonpayment of premium, breach of the policy terms, fraud, and misrepresentation. Cancelling and rewriting a policy for the carrier to charge a higher rate is not allowed.
21. What happens when WCRB receives both a cancellation and nonrenewal notice for the same policy?
    The nonrenewal notice does not cancel coverage. It allows the carrier to no longer insure the risk at the expiration date. For example:
    
    Policy Period May 1 to May 1

    • Cancellation for nonpayment is filed with WCRB on January 1 with an effective date of February 1
    • A nonrenewal notice is filed with the insured and WCRB on March 1, which can only have an effective date of May 1 (expiration date)
    • The insured no longer has worker’s compensation insurance coverage effective 12:01 A.M. on February 1

    Policy Period May 1 to May 1

    • A nonrenewal notice is filed with the insured and WCRB on March 1, which can only have an effective date of May 1 (expiration date)
    • Cancellation for nonpayment is filed with WCRB on April 15
    • Cancellation is not effective until 30 days after receipt by the WCRB, or May 15. In this case, the carrier has extended the coverage beyond the expiration date of the policy but is not required to offer a renewal to the insured
22. What is the Audit Non-compliance Charge (ANC)?

    The Audit Noncompliance Charge (ANC) rule can be found in Wisconsin Basic Manual Rule XV.B AUDIT NONCOMPLIANCE CHARGE.
    
    The ANC charge:

    • is optional for policies written in the voluntary market. Carriers intending not to participate in the program must opt out of participation by completing the carrier election form found on the WCRB web site.

    NOTE: The opt out election is effective for at least one year and must be applied uniformly to all worker’s compensation policies. Any change to the above election must be filed with the WCRB prior to implementation.

    • does not apply to the Wisconsin Workers Compensation Insurance Pool (Pool).
    • is approved for use in Wisconsin and is one times the estimated premium charge. The correct charge must be reflected in the ANC endorsement so the WCRB can ensure the correct charge is being applied to the policy.
    • is not part of standard premium, subject to premium tax, and is not premium for ratemaking or experience rating purposes.
23. Why was endorsement WC 48 03 23 WISCONSIN DESIGNATED NAMED INSURED CANCELLATION ENDORSEMENT created?

    Prior to the creation of the new endorsement, carriers would remove the named insureds by issuing a change transaction with the WCRB.    The change transaction would be compared to the policy currently on file with the WCRB.  If a named insured was not reported on the transaction, WCRB records would show that the named insured was “expired” on the effective date of the change transaction.  A 30-day coverage cancellation period was not applied to the notice filed by the insurance carrier with the WCRB, though by statute would be required.    

24. Do most/all other states use an endorsement similar to endorsement WC 48 03 23?

    No.  Other states have a similar issue but do not address it via endorsement.

25. Does endorsement WC 48 03 23 change the process for insurers?

    Only if the insured is going to remove a named insured during the policy period. If the named insured gets coverage elsewhere, WCRB will tell the carrier to remove the named insured.  The 30-day requirement is waived because of the replacement coverage.

26. Consider the case where a policy has two names (FOR EXAMPLE, ABC INC is the named insured under ITEM 1 and XYZ LLC is also a named insured on the policy). If XYZ, LLC is being cancelled for "NO OPERATIONS,” is the expectation that WC 48 03 23 be attached as notice to ABC, INC and WCRB ?

    Yes.  WI statute requires a 30-day notice of cancellation of WC coverage.  This endorsement is a way for the carriers to provide that notice to both the WCRB and the insured.

27. If we only have one named insured, ABC INC, and they are being cancelled for “NO EXPOSURE” does WC 48 03 23 need to be submitted?

    No.  The normal cancellation notice would be sent to both the WCRB and the insured.

Unit Statistical Reporting

1. Where should carriers file Wisconsin unit statistical data?
   Carriers licensed to write worker's compensation in Wisconsin are obligated to file all unit statistical data with WCRB. There are two filing options for carriers. The data can either be filed directly with WCRB, or with NCCI and they (NCCI) transmit the data to WCRB on the insurer's behalf.
   
    
2. Why do Carriers receive Wisconsin rejections that have passed NCCI edits?
   While NCCI and WCRB make every effort to keep our edits in sync, NCCI has limitations on editing WCRB data as they do not have a complete policy and statistical WI database. Therefore, although a report may pass NCCI’s edits, it is also subject to WCRB edits and may result in failures.
    
3. When should each correction type be used?
   Type E: Correcting exposure information only
   Type L: Correcting loss information only
   Type A: Correcting loss information only for an aggravated inequity claim
   Type T: Correcting totals only
   Type H: Correcting header information only
   Type M: Correcting multiple record types (i.e. exposure and loss records; exposure and header records; loss and header records)
   
   Note: Correction types E, L and A above should include the updated totals
4. When doing an adjustment upon audit and the earned payroll is less than the minimum premium and is less than the expense constant (see Minimum Premium Rule found in the WI Basic Manual), how is this reported on the USR?
   Stat code 0990, (Amount to Balance to Minimum) is used to balance to minimum premium for the governing class code filed on the policy.
    
5. What is the desired method of correcting a unit report?
   When a carrier has elected to file unit statistical data directly with the WCRB, it is acceptable to file correction or replacement reports for rejected USRs.
   
   If the carrier has elected to file through NCCI, they must file a correction report with NCCI.
    
6. What tools are available to a carrier to assist in managing and responding to estimated audit and reject letters?
   WCRB has a member product called Manage USR. Carrier web site members who are assigned full edit rights to this product can access their letters, respond if no correction is required, or submit any necessary corrections directly to WCRB.
    
7. Can loss corrections be filed for changes in claim amounts between valuation dates?
   A correction of a loss report can only be filed between valuation dates when any of the following occurs:
   -  Loss values are found to have been included or excluded through a mistake other than error of judgment.
   -  One or more claims are declared noncompensable as defined in the WI Experience Rating Plan Manual.  When reporting noncompensable claims, the indemnity and medical amounts must be reported as zero.  Expense dollars may be reported.
   -  The carrier has obtained a subrogation recovery in an action against a third party or has received, or anticipates receiving reimbursement from the Second Injury Fund.
   -  A clerical error in either the classification assignment or the injury code assignment of a given claim, or group of claims, has been discovered.
   -  The determination of an aggravated inequity has occurred. Refer to the WI Experience Rating Plan Manual.
   
   Correction reports shall NOT be filed to revise values because of developments in the claim amounts and/or injury type between two valuation dates except in cases involving an aggravated inequity.  WCRB will reject any loss correction reports that are not reported as an Aggravated Inequity, Noncompensable, or Subrogation, and require an explanation for the loss correction.  This is to insure that loss corrections, not coded as stated above, are actually due to a clerical error.
    
8. If a claim becomes noncompensable or receives a recovery which reduces the indemnity and medical amounts to 0, do we need to report the ALAE as 0 even if ALAE has been paid and not recovered?
   No, report the accurate ALAE value.
    
9. When the claim is noncompensable, is it correct to report the type of settlement code as 05, and the ALAE amount paid on the claim?
   Yes.
    
10. Are claims with ALAE only always reported with an Injury Code 06?
    No. Report the injury code used to set up the claim’s reserve. If there was no reserve, report Injury Code 06.
     
11. Does a subrogation recovery need to be reported on all report levels?

    Yes, when a subrogation recovery has been received, the recovery received must be reflected on all previous and subsequent report levels and the recovery type must be reported as 03 as specified in the WI STAT PLAN MANUAL.
    
     

Vendor Information

1. What is the relationship between WCRB and NCCI, and what services does NCCI provide?
   WCRB and NCCI (National Council on Compensation Insurance) work together in a number of areas including the exchange of premium and loss information we each collect for use in experience rating, ratemaking, publications, etc. NCCI also provides auditing functions of insurers who are responsible for servicing policyholders that have been placed in the Wisconsin Worker's Compensation Insurance Pool.
2. Who completes the annual rate filing and benefit change for Wisconsin?
   Effective January 1, 2002, WCRB entered into a contractual relationship with Milliman, Inc. to perform all related actuarial work for both the annual rate filing and benefit change.

WCPAP

1. What is the purpose of the Wisconsin Contractor’s Premium Adjustment Program (WCPAP)?
   The Wisconsin Contractor’s Premium Adjustment Program is designed to reduce an employer’s worker’s compensation premium by way of a premium credit based upon the employer’s average hourly wage level.  In an attempt to balance the premium difference between high and low wage paying employers in the construction or contracting trades, this program grants a policy credit based on the average hourly wage paid by employers.  Because higher wages are paid to more experienced workers, the cost for worker’s compensation coverage is higher for those employers paying a higher than average hourly wage.  The employer paying the higher wage is then at a disadvantage when bidding against the lower paying competition for contracts.  The WCPAP attempts to correct this inequity.  The higher the wage paid, the higher the credit, which allows for a more equitable premium charge for employers in the same industry.
2. What qualifies a risk for a Policy Credit Factor?
   • Must contain one or more contracting classifications to apply for and qualify for WCPAP.
   • Must have at least 50% of payroll or premium allocated to contracting classification(s).
   • Credit will be determined based on total 3rd quarter (July-September) gross wages paid and hours worked of the calendar year preceding the policy inception date as reported to taxing authorities. Overtime premium is not included.
   • In the absence of specific records for salaried employees, it will be assumed that each employee worked forty (40) hours per week.
   • May be combined with other policies with common ownership and contracting classifications to calculate a single credit for all policies. An application must be submitted for each policy, and 50% of the payroll or premium must remain allocated to contracting classes.
3. What is the Average Hourly Wage Schedule?

   The policy credit factor will be whole number credits between 1% and 10%.
   
   For policies effective July 1, 2023 through June 30, 2024
   Average Hourly Wage      Credit Percentage
   $32.43 to $33.42                         1%
   $33.43 to $34.42                         2%          
   $34.43 to $35.42                         3%
   $35.43 to $36.42                         4%
   $36.43 to $37.42                         5%
   $37.43 to $38.42                         6%
   $38.43 to $39.42                         7%
   $39.43 to $40.42                        8%
   $40.43 to $41.42                         9%
   $41.43 and Higher                     10%

   For policies effective July 1, 2024 through June 30, 2025
   Average Hourly Wage      Credit Percentage
   $33.47 to $34.46                         1%
   $34.47 to $35.46                         2%          
   $35.47 to $36.46                         3%
   $36.47 to $37.46                         4%
   $37.47 to $38.46                         5%
   $38.47 to $39.46                         6%
   $39.47 to $40.46                         7%
   $40.47 to $41.46                         8%
   $41.47 to $42.46                          9%
   $42.47 and Higher                    10%
    

4. How do I apply?
   • Go to the wcrb.org home page. Find the orange “Employer” box. Select WCPAP Online Application Please review instructions before completing this application.
   • Review the WCPAP Online Application Schedule for Participation Deadline.
   • Complete and submit the application no less than 90 days prior the first day of the month of renewal.
5. When is my Online WCPAP Application Due?
   Annually, the eligible employer’s WCPAP Online Application is due no less than 90 days prior to the first day of the month of which, the worker’s compensation insurance renews., (i.e., renewal date is 7/15/2021 therefore, WCPAP Online Application is due no later than 4/2/2021).
   
   Please Note: Submit the 3rd quarter (July-September) preceding the renewal date (i.e., policy renewal is effective 7/15/2021 therefore, submit the 3rd quarter 2020, if there were no operations during the 3rd quarter of 2020 submit the 3rd quarter of 2019). 
   
   The WCPAP Online Application is updated each year, on the evening of the last day of the 3rd quarter (i.e., September 30th).  Therefore, each year you may complete this online application as soon as October 1st.  Applications will be processed accordingly, to accommodate the employer’s renewal.
    

   Policies Expiring	WCPAP Online Application Deadline
   January	* November 3
   February	November 3
   March	December 1
   April	January 1
   May	January 31
   June	March 3
   July	April 2
   August	May 3
   September	June 3
   October	July 3
   November	August 3
   December	September 2

    
   *January policyholders application deadline is calculated in order to
   provide time to submit the 3rd quarter preceding the renewal.
6. Do I need a Member Login User ID and Password to complete my WCPAP Application?
   No. You do not need a User ID and Password to complete the WCPAP application.  Find the orange “Employer” box on our home page and select the  WCPAP Online Application. It is also listed in the Forms area and is named WCPAP.ED11.
7. May I have my accountant, agent, carrier, neighbor, friend, etc. complete my WCPAP application for me?
   Yes, you may have another party complete and submit your application for you.  You are responsible for making sure your application is received no later than the due date.
8. How is the carrier notified of the Policy Credit Factor to be applied?
   Carriers are notified via e-mail when a new WCPAP letter and Worksheet is available in the WCPAP Worksheet member product.
9. When is the carrier required to apply the policy with the Policy Credit Factor?
   The WCPAP Policy Credit Factor should be applied upon inception; however, the insurer has the option of waiting until audit for any reimbursement.  Carriers failing to report the WCPAP Policy Credit Factor properly are in violation of our filing.  Noncompliance is contrary to insurance laws and could subject you to forfeiture or other disciplinary action by the Insurance Commissioner.  Please review your procedures to make sure you are in compliance.  Refer to the information contained in the  Wisconsin Worker’s Compensation and Employers Liability Insurance Manual (WI Basic Manual), Part One Appendix—Page A-70.  Separate unit statistical instructions are found in Sections II and IV of the Wisconsin Worker’s Compensation Statistical Plan Manual.  The WCRB does edit all policies and unit statistical reports for compliance.  Carriers not in compliance will be sent a Notice to Carrier letter notifying them their documents failed our edits.
   
   The Rating Effective Date rule is applied as follows:

   • An effective date is established by the WCRB
   • A policy credit will be issued to be effective for twelve months.
   • The policy credit factor effective on the rating effective date shall apply for the full term of the policy commencing on that date.
   • Or any policy commencing up to three months after that date.

   No policy may be cancelled and rewritten to take advantage of the provision of this Program.
    
10. What other role does the carrier play in administering WCPAP?
    • Verify the base wages paid and regular hours worked used in the promulgation of the policy credit factor. If discrepancies are found, a completed WCPAP Carrier Audit Form shall be forwarded to the employer with instructions to review, sign and return within 30 days. The carrier will defer its audit for no more than thirty (30) days, giving the insured an opportunity to comply. The carrier will forward the signed WCPAP Carrier Audit form to the WCRB for processing. The WCRB will recalculate and release a revised credit. The revision to the credit may deem the insured ineligible for a credit.
    • If the carrier has not received a revised Carrier Audit Form from the employer or policy credit worksheet from the WCRB within thirty days; then a written request to withdraw the policy credit must be sent to the WCRB. Once the policy credit is withdrawn the carrier may complete the audit to exclude the policy credit.
    • If no contracting codes apply at audit, the policy credit is withdrawn.
    • The credit, authorized by the WCRB, shall appear in Item 4 of the Information Page of the policy under code 9046.
11. How is the Policy Credit Factor used in the premium determination process?
    The policy credit factor is applied after experience modification (if any), and is followed by other applicable discounts, surcharges, etc. See Premium Algorithm for where the policy credit factor is applied in the premium calculation.  The policy credit factor and adjusted premium amount must be exhibited on the policy as reported on the policy credit worksheet using stat code 9046.
    
    NOTE: The policy credit factor shall not reduce the policy minimum below the applicable minimum premium.
12. If a Policy Credit Factor is not available at the time the renewal policy is issued, should the expiring credit be applied?
    No, if the renewal policy credit factor is not available, the expiring policy credit should not be applied.
    
    If a risk submits a qualifying application no later than the deadline, the carrier will issue an endorsement to show the policy credit factor and premium adjustment upon notification, or at the time of audit.
13. What classifications are assigned to the "Contracting" Industry Group?
    "Contracting classifications" are those classifications subject to the following code numbers:
     

    0042	5146	5437	5610	6235	9554
    2799	5160	5443	5645	6237
    3365	5183	5445	5703	6251
    3719	5184	5462	5705	6252
    3724	5188	5474	6003	6306
    3726	5190	5478	6005	6319
    5020	5213	5479	6045	6325
    5022	5215	5480	6204	6400
    5037	5221	5491	6206	7538
    5040	5222	5507	6213	7605
    5057	5223	5535	6216	7855
    5059	5348	5537	6217	8227
    5086	5402	5551	6229	9529
    5102	5403	5606	6233	9534

14. What is considered overtime?
    Overtime means those hours worked for which there is an increase in the rate of pay.  See Part One Rule V E. of the Wisconsin Worker’s Compensation and Employers Liability Insurance Manual (WI Basic Manual) for the detailed criteria.

WCRB Web Membership

1. How can I become a member of the WCRB Web site?
   To become a member, a Group Administrator Registration form needs to be completed and submitted.
2. What is the procedure after a completed Group Administrator Registration is submitted?

   When the completed Group Administrator Registration is submitted, the Applicant and Authorizing Officer will receive an e-mail notification confirming their application was received and will be reviewed within two business days.
   
   If the review determines there is a problem with the application, the applicant and the Authorizing Officer will receive an email from  wcrbwebmaster@wcrb.org explaining the problem and steps to resolve the issue.
   
   If the application review is successful, the Group Administrator and Authorizing Officer will receive a "Confirm your new WCRB membership account" email that contains a security code to complete your account setup. This security code is only active for 24 hours. If your code expired, please contact the wcrbwebmaster@wcrb.org for assistance.

3. Who is eligible for a WCRB Web site membership?
   Carriers and Agents licensed in the State of Wisconsin as well as Employers can become a member of our Web site. Membership offers specific products based on organization type. 
4. What products are available to members?
   Membership offers specific products based on organization type. See the last page of the Member User Guide for the detailed product listing by organization.
    
5. What is the role of the Group Administrator?
   A Group Administrator must be established for every WCRB Web site member organization. The Group Administrator has the ability to control the following for their organization's Web site members:
   - create, edit and inactivate User and Administrator accounts
   - clear the suspended status from User and Administrator accounts
   - reset passwords for User and Administrator accounts
   - assign Member Product permissions for User and Administrator accounts 
6. How do I replace the Group Administrator for my organization?
   To replace the Group Administrator for your organization, a Change Existing Group Administrator application needs to be completed and submitted to the Webmaster.