|
As a reminder, the New York State Workers’ Compensation Law (WCL) §226 authorizes the Board to penalize insurance carriers who fail to file proof of coverage (POC) transactions in a timely manner.
The Board will be measuring carrier performance quarterly on the timeliness of Add Policy (new) and Cancelation transactions. The definition of “late” depends on the transaction type, which can be determined using the following table:
Transaction type
|
Timely filing
|
Transaction late and penalized
|
|
Cancel — for non-payment of premium
|
Received at least 10 days prior to date of cancellation
|
Received after date of cancellation
|
|
Cancel — for all other reasons
|
Received at least 30 days prior to date of cancellation
|
Received after 20 days prior to date of cancellation
|
|
Add (new policy)
|
Received no later than 30 days after effective date of new policy
|
Received beyond 40 days after effective date of new policy
|
Upon implementation (exact date to be announced), carriers that do not meet an 85% performance rate will be penalized for any untimely Add Policy and Cancellation transactions.
ACTION REQUIRED:
-
Review active policies: The Board recently sent each carrier a list of all disability benefits policies showing as active in our system. Carriers are asked to review the list and cancel any policies that are no longer active by May 30, 2025. This will eliminate late cancellation filings (and penalties) going forward.
-
Review business practices: All carriers should review their business practices and processes to ensure their ongoing transactions are being submitted timely.
Next steps
In October 2025, the Board will provide each carrier their performance (percentage timely) for all measured transactions for the third quarter of 2025 (June 1 through September 30), including a list of any untimely transactions. This will enable carriers to ascertain their performance and make any necessary adjustments before the Board begins penalizing carriers for late filings.
As we move closer to going live with penalty issuance, the Board will hold a webinar to provide more detailed information, provide the carriers an opportunity to ask questions, as well as review the process carriers will use to request review of transactions and appeal penalties. Please watch for the invite.
More information
If you have questions or would like more information, please write to: DBPOCSupport@wcb.ny.gov.
|
