1 / 35

Proof of Coverage

Find proof of coverage for employers in Illinois using the online search tool. Learn about the requirements, functionality, and tips for verifying coverage.

carrollc
Télécharger la présentation

Proof of Coverage

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Proof of Coverage Employer Insurance Coverage Search Tool

  2. AgendaIllinois Proof of Coverage • What Is Proof of Coverage • What is NCCI’s Role • Who Reports It and When • How Does Illinois Use It • -POC On-Line Inquiry • -Cancellations/Reinstatement Reports • How Can the Public Verify Coverage • -Employer Insurance Coverage Search • Functionality and Search Tips • Scenarios Which Can Result in Coverage Not Found • Summary

  3. What Is Proof of Coverage? • Verification that employers operating in Illinois have workers compensation coverage -Voluntary Market -Assigned Risk Market -Individual Self Insureds • Illinois requires carriers to report issuance, termination or changes to coverage to IL WCC through NCCI -New coverage - within 5 days of effective date -Cancellations - at least 10 days prior -Reinstatement - within 5 days of reinstatement action

  4. What Is Proof of Coverage? • State Workers Compensation Act allows IWCC to assess a civil penalty up to $500 per day for lack of coverage -Employers may face criminal charges and/or a stop work order • Illinois is a continuous coverage state -Policy do not expire on the policy expiration date unless the carrier notices the IL WCC of intent to non-renew -Non renewals are due 10 prior to termination effective date

  5. Proof of Coverage Benefits Workers & Employers • States use Proof of Coverage to help deliver benefits to both workers and employers • Employers are protected against business/personal loss due to work related injuries • Injured workers are ensured access to medical care and wage replacement • WCC’s are putting technology to work to identify employers that “go bare” ….before an injury occurs • NCCI provides a range of POC services that states bundle or use in combination with other resources to ensure compliance

  6. State Agencies Share Responsibility forWorker’s Compensation Workers Compensation Commission (WCC) Department of Insurance (DOI) • POC Designated DCO • Focus is on employer compliance and the timely delivery of benefits to injured workers • WCC limited to workers compensation • WCC sets reporting requirements to the state on coverage, terminations or changes in coverage • WCC ensure proper administration of benefits to injured workers • Statistical Agent and/or Advisory Organization • Focus is on carrier business practices and requirements • Approve carriers to offer insurance • Monitor carrier performance • DOI regulate all lines of insurance • DOI approves policy structure and set rules for notifications by carriers to insureds of changes to coverage

  7. NCCI’s Role in Illinois • Designated Statistical Agent and Advisory Organization to the Department of Insurance -Loss costs/rates -Experience Rating System -Classification System -Legislative Pricing and Impact Analysis • Designated as Data Collection Organization (DCO) for POC to the Worker’s Compensation Commission -POC On-Line Inquiry -Employer Insurance Coverage Search -Cancellation/Reinstatement Reports -Other Compliance Data Tools and Reports

  8. Proof of CoverageWhy Do We Do It?

  9. NCCI’s Collects WC Data! NCCI Collects Workers Compensation Data POLICY POC UNIT REPORTS MEDICAL DATA DCI FINANCIAL CALLS

  10. Why Do We Do It? • States needed more complete coverage information faster than paper processes support • Carriers wanted to use the electronic policy data reported routinely to NCCI to replace hard copy reporting for POC • In response, NCCI developed an entry level service called POC On-Line Inquiry • Provided states access to carrier policy data • Search by insured or policy # • In exchange, 37 states eliminated paper reporting requirements

  11. 37 States NCCI POC States POC States

  12. Proof of CoverageHow Can the Public Access Coverage Information

  13. Illinois WCC’s Employer Insurance Coverage Search • Public access to employer carrier of record information • Designed to be imbedded within a the state’s own website • In 28 states including Illinois • Available 24/7 • Coverage data is fresh – system is updated in real time

  14. Employer Insurance Coverage Search Criteria • Searches are by employer or primary insured name -including DBA or other names listed on the policy • Searches are date driven -accident or illness date - default search is today’s date • Date drives the results -system will seek coverage enforce on the date requested -based on date search can vary from the current carrier of record • Name “contains” search will cast the widest net -will return coverage data for current year + 3 years • Name “starts with” search while more finite will access current year and all prior years on-line - Currently, at least 15 years

  15. Why Did My Search Show No Results • Coverage information available to the public mirrors the data used by the ILWCC for compliance • The following are some scenarios that might affect your ability to locate coverage information over the ILWCC employer search • Name discrepancies or spelling • Employer may be part of a self insured pool or entered an employee leasing arrangement • May be timing issue • Employer may change carriers and new carrier has not yet reported policy • A cancelled policy may be reinstated with no gap in coverage (late payment of premium, etc.) • Employer may be out of business or out of compliance • If no coverage results are found contact ILWCC for assistance

  16. In Summary…….Employer Insurance Coverage Search is a user friendly data search tool available on a flexible basis without cost or need for password authentication.

  17. Questions

More Related