FROI/SROI & WCIO 2023 Updates Recap

December 6, 2023 / 9 min read

There was certainly no shortage of reporting changes on the First Report of Injury (FROI), Subsequent Report of Injury (SROI), and Workers’ Compensation Insurance Organizations (WCIO) compliance fronts in 2023. These new compliance updates and changes kept insurers busy and will have a significant impact for insurers going forward in the new year.

A disorganized pile of paper, folders, and envelopes, viewed from the side.

To help stay on top of these changes, the author provides an overview of key events in 2023 and outlines items to consider as we head into 2024 as follows:

Detail Claim Information (DCI) sunsets and the Indemnity Data Call (IDC) takes over effective January 2024

In a major development, the DCI will be sunsetting at the end of December 2023 and is being replaced by the Indemnity Data Call (IDC) effective January 1, 2024, for all jurisdictions except Texas. NCCI made this decision as the volume of data being consumed from the Indemnity Data Call will become the main source of legislative pricing.^[1] In addition, the IDC call is being collected by NCCI on behalf of the following three independent DCOs: Minnesota, North Carolina, and Wisconsin. Regarding eligibility participation in the remaining independent DCOs, the following states are at .5% market share over the most recent three years: Delaware, California, Massachusetts, and Pennsylvania. New Jersey and Michigan align with the NCCI at a 1% market share.^[2] Beginning January of 2024, New York has eliminated all eligibility threshold and all insurers must participate.

As discussed more fully in the author’s prior article, the key differences between IDC and DCI reporting can be broken down into two components: (1) The frequency of data submissions and (2) the amount of data being collected. DCI was reported to the NCCI on an annual basis and as of a certain evaluation date. In contrast, the Indemnity Data Call is required to be reported quarterly and will contain all activity that occurred in that specific quarter.^[3]

To view IDC reporting more graphically, insurers may wish to review NCCI’s “Transactional Record Reporting Table” and “Quarterly Record Reporting Table” which outline key quarters, transaction dates, claim valuation dates, and due dates. This information is contained as part of the NCCI Manual Library Indemnity Data Call Reporting Guidebook – Part 2 – General Rules, Section D – Reporting Time Frames.

Of note, the IDC uses data elements from both Detailed Claim Information (DCI) and Unit Statistical Reporting (USR), as well as introducing an array of new data elements to the call. All data elements can be found within the Indemnity Data Call Reporting Guidebook at the NCCI.^[4] There are two distinct records that are required in the Indemnity Data Call which provide the NCCI, as well as the Independent DCOs on which the robust data is reliant.

The transactional record contains details of each indemnity payment transaction on a specific claim and consists of eighteen total data elements.^[5] Although the due date for all transactional records is the last day of the following quarter, insurers are allowed to submit transactional records at any point in time up until the due date.^[6]The quarterly record contains the inception-to-date aggregated details of each indemnity claim and consists of thirty-seven data elements.^[7] Similar to the transactional record, the quarterly record can be submitted any time after it has been generated up until the due date which is the last day of the following quarter.^[8]As we head into 2024, it is important that insurers are aware of the NCCI’s reporting requirements pertaining to the upcoming sunset of DCI.

New York expands medical and indemnity data call reporting

In another significant development, the Board of Governors of the New York Compensation Insurance Rating Board (”Rating Board”) in February 2023 announced that it was expanding MDC and IDC reporting “regardless of premium market share.”^[9] This expansion becomes effective starting either January 1, 2024, or January 1, 2025, depending on a member carrier group’s current reporting status.

As outlined more fully in the author’s prior article, the Rating Board will implement New York’s MDC and IDC reporting expansion in two phases as follows:

Phase 1: Member Carrier Groups Reporting MDC and IDC in Other Jurisdictions (transactions on and after January 1, 2024) -- These groups will be required to report MDC and IDC data to the Rating Board reflecting transactions occurring on and after January 1, 2024, with the first data submission due on June 30, 2024.^[10]

Phase 2: Member Carrier Groups Not Reporting MDC and IDC in Any Jurisdiction (transactions on or after January 1, 2025) -- The Rating Board is giving these groups additional time to prepare for this expansion. On this point, the Rating Board states that it “recognizes that member carrier groups who do not currently report MDC and IDC data in other jurisdictions have likely not yet developed the infrastructure to effect reporting in the near term, and that the requisite information technology development effort may be time intensive.”^[11] As such, the Rating Board notes that these groups will be required to report MDC and IDC data to the Rating Board reflecting transactions on and after January 1, 2025, with the first data submission due on June 30, 2025.^[12] Further, the Rating Board notes that it will be contacting these group in March of 2023 to discuss the implementation timeline for each member carrier group.^[13]

Regarding the above timelines, the Rating Board notes that it “will work with member carrier groups who are unable to satisfy the timelines listed above to find a mutually agreeable implementation timeline.”^[14] Likewise, the Rating Board indicates that it will work with new carrier groups entering the New York marketplace in the future “to find a mutually agreeable implementation timeline.”^[15]

Of note, member groups who refuse to participate in the MDC and IDC will be penalized. On this point, the Rating Board states: “A member carrier group’s refusal to participate in the MDC and IDC will result in a financial penalty in an amount to be determined by the Rating Board, and such penalty shall continue and compound with interest until such member carrier group comes into compliance with the Rating Board’s data reporting requirements.”^[16]

Looking ahead to 2024, insurers must be prepared for this upcoming change and ready to participate in both the Indemnity Data Call and Medical Data Call. If insurers have not heard from the Rating Board regarding reporting timelines, they should consider contacting the Rating Board for confirmation.

FROI/SROI R.3.1 transitions

In 2023, Texas and Idaho transitioned to R.3.1 for both FROI and SROI reporting, effective July 26, 2023, and September 14, 2023, respectively. Vermont was also originally scheduled to transition to FROI/SROI R.3.1 effective November 6, 2023. However, in late October the Vermont Department of Labor (VDOL) announced it was delaying Vermont’s FROI/SROI R.3.1 transition (the VDOL did not provide a new date for Vermont’s transition). Meanwhile, Louisiana transitioned to FROI R.3.1 (only) effective May 22, 2023. As of the time this article was drafted, no states are scheduled to transition to R.3.1. in 2024.

Getting ready for 2024

As noted above, there were significant changes that encompassed the IAIABC and WCIO landscape in 2023. Each of these changes are contributing factors to the way data will be reported in 2024 regarding which insurers and trading partners will need to be prepared. In 2024, as discussed above, we will see the Indemnity Data Call become the primary data source of legislative pricing by the NCCI and New York will welcome the full participation of IDC & MDC across the WCIO community. We will also need to see when Vermont will ultimately transition to FROI/SROI R.3.1. As we know this is an ever fluid industry, we need to be prepared for further changes being announced in the new year. The author will, of course be following future developments and will provide updates as warranted.

How Verisk can help!

As both IAIABC and WCIO continues to change rapidly, Verisk offers the Workers’ Compensation industry a variety of solutions that can assist you! For example, wcPrism is a complete suite of Workers’ Compensation EDI and WCIO compliant reporting products for insurers that leverage a true transaction-based approach. Through our suite of services, we can help you stay compliant, reduce penalties/assessments, and navigate through the ever-changing reporting requirements. Please do not hesitate to contact the author if you have any questions at Nicholas.Guarda@verisk.com or 732-887-7556.

[1] NCCI Circular, Detailed Claim Information – Announcing Future Detailed Claim Information Sunset Plan (DCI-2019-01).

[2] This information was obtained from the following resources:

Delaware Compensation Rating Bureau (DCRB) - Circular, Changes To The Medical Data Call and Indemnity Data Call Eligibility Requirements (Circular No. 1009 – Nov 5, 2021).
Pennsylvania Compensation Rating Bureau (PCRB) – Circular, Changes To The Medical Data Call and Indemnity Data Call Eligibility Requirements (Circular No. 1772 – Nov 5, 2021).
Workers Compensation Rating and Inspection Bureau of Massachusetts (WCRIBMA) – Circular, Massachusetts Indemnity Data and Medical Data Call Eligibility (Circular No. 2408 – October 10, 2022).
Workers Compensation Insurance Rating Bureau of California (WCIRB) – Reporting Guidebook – Section 2 – General Rules – Participation/Eligibility.
New Jersey Compensation Rating and Inspection Bureau (NJCRIB) – Indemnity Data Call Implementation Guide – Section 2 General Rules – Participation/Eligibility.

Regarding Michigan, information concerning the eligibility threshold as noted above was obtained from the author’s contact with the Compensation Advisory Organization of Michigan (CAOM) on February 24, 2023.

[3] NCCI Circular, Indemnity Data Call – Frequently Asked Questions (FYI-IND-2019-02), P.1, FAQ #1, FAQ #3, FAQ #4, FAQ #5.

[4] NCCI Manual Library Indemnity Data Call Reporting Guidebook – Part 6 – Data Dictionary.

[5] NCCI Circular, Indemnity Data Call – New Indemnity Data Call Effective Second Quarter 2020 (IND-2018-01) – Attachment B.

[6] NCCI Circular, Indemnity Data Call – Frequently Asked Questions (FYI-IND-2019-02), P,2, FAQ #6.

[7] NCCI Circular, Indemnity Data Call – New Indemnity Data Call Effective Second Quarter 2020 (IND-2018-01) – Attachment B.

[8] NCCI Circular, Indemnity Data Call – Frequently Asked Questions (FYI-IND-2019-02), P,2, FAQ #7.

[9] Letter from Jeremy Attie, President and CEO, New York Compensation Insurance Rating Board to “Members of the Rating Board,” dated February 27, 2023 (R.C. 2577), p. 1. On this point, the first paragraph of Mr. Attie’s letter states: “I write to inform you that on February 16, 2023, the Board of Governors of the New York Compensation Insurance Rating Board (“Rating Board”) approved a proposal requiring all member carrier groups, regardless of premium market share in New York State, to report data in response to the Medical Data Call (“MDC”) and Indemnity Data Call (“IDC”). The rationale and details related to this new requirement are set forth below.” Id.

[10] Letter from Jeremy Attie, President and CEO, New York Compensation Insurance Rating Board to “Members of the Rating Board,” dated February 27, 2023 (R.C. 2577), p. 2.

[11] Id.

[12] Id.

[13] Id.

[14] Id.

[15] Id.

[16] Letter from Jeremy Attie, President and CEO, New York Compensation Insurance Rating Board to “Members of the Rating Board,” dated February 27, 2023 (R.C. 2577), p. 3.