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c a l i f o r n i a California Workers Compensation Uniform Statistical Reporting Plan 1995 Title 10, California Code of Regulations, Section PDF
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1 Workers Compensation Insurance Rating Bureau of California c a l i f o r n i a California Workers Compensation Uniform Statistical Reporting Plan 1995 Title 10, California Code of Regulations, Section Effective January 1, 2015
2 2014 Workers Compensation Insurance Rating Bureau of California. All rights reserved. No part of this work may be reproduced or transmitted in any form or by any means, electronic or mechanical, including, without limitation, photocopying and recording, or by any information storage or retrieval system without the prior written permission of the Workers Compensation Insurance Rating Bureau of California (WCIRB), unless such copying is expressly permitted in this copyright notice or by federal copyright law. Each WCIRB member company, including any registered third-party entities, (Company) is authorized to reproduce any part of this work solely for the following purposes in connection with the transaction of workers compensation insurance: (1) as necessary in connection with Company s required filings with the California Department of Insurance; (2) to incorporate portions of this work, as necessary, into Company manuals distributed at no charge only to Company employees; and (3) to the extent reasonably necessary for the training of Company personnel. Each Company and all agents and brokers licensed to transact workers compensation insurance in the state of California are authorized to physically reproduce any part of this work for issuance to a prospective or current policyholder upon request at no charge solely for the purpose of transacting workers compensation insurance and for no other purpose. This reproduction right does not include the right to make any part of this work available on any Web site or through any computer or electronic means for any purpose. Workers Compensation Insurance Rating Bureau of California, WCIRB, WCIRB California, WCIRB Online, X-Mod Direct, escad and the WCIRB California logo (WCIRB Marks) are registered trademarks or service marks of the WCIRB. WCIRB Marks may not be displayed or used in any manner without the WCIRB s prior written permission. Any permitted copying of this work must maintain any and all trademarks and/or service marks on all copies. To seek permission to use any of the WCIRB Marks or any copyrighted material, please contact the Workers Compensation Insurance Rating Bureau of California, 525 Market Street, Suite 800, San Francisco, California
3 Memorandum Regarding the January 1, 2015 Revisions to the California Workers Compensation Uniform Statistical Reporting Plan 1995 Revisions Approved Effective January 1, 2015 Part 1, General Provisions 1. Section 1, Introduction, Rule 3, Effective Date, was amended for clarity and consistency. Part 2, Policy Document Filing Requirements 2. Amend to provide greater clarity, create efficiencies and ensure consistency with national data reporting specifications. Part 3, Standard Classification System 3. Section III, General Classification Procedures, Rule 2, Single Enterprise, was amended for consistency. 4. Section IV, Special Industry Classification Procedures, Rule 6, Stores, Subrules f, g and h, was amended for consistency. 5. Section V, Payroll Remuneration, Rule 1, Payroll Remuneration, Subrule j, Executive Officers, Subrule k, Partners, Subrule l, Individual Employers, and Subrule m, Members of a Limited Liability Company, were amended to adjust the minimum and maximum payroll limitations for executive officers, partners, individual employers, and members of a limited liability company to reflect wage inflation since the minimum and maximum payroll limitations were last amended in Section VI, Administration of Classification System, Rule 2, Notification of Standard Classification Assignment, was amended to remove the requirement that hard copies of an inspection report must be provided to employers and insurers and to add language that requires the WCIRB to provide inspection reports within the time period currently required. 7. Section VI, Rule 4, Audit of Payroll, was amended to increase the physical audit threshold from $10,000 to $13,000 and to reference California Insurance Code Section 11665(a) to clarify that there are additional statutory requirements regarding the audit of C-39 license holders. 8. Section VII, Standard Classifications, Rule 1, Classification Section, Subrule a, Industry Groups, was amended to reflect the establishment of Automotive Industry as an Industry Group and for consistency. 9. Classification 3805(1), Aircraft Engine Mfg. or Rebuilding, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 10. Classification 7332, Ambulance Services, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 11. Classification 4511, Analytical or Testing Laboratories, was amended to clarify its intended application, remove the general restriction on division of payroll and provide direction as to how related operations shall be classified. 12. Classification 7198(2), Armored Car Services, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Memorandum 1
4 Memorandum 13. Classification 4740(2), Asphalt or Tar Distilling or Refining, was amended to clarify its intended application. 14. Classification 9181, Athletic Teams or Parks all players on the salary list of employer, whether regularly played or not, was amended to increase the payroll limitation for players from $109,200 to $111,800 per player per season to reflect wage inflation since the payroll limitation was last amended in An Industry Group for the Automotive Industry was established to include the classifications listed below: Classification 2797(2), Automobile Body Mfg., was amended to clarify its intended application and provide direction as to how related operations shall be classified. Classification 3808, Automobile or Motorcycle Mfg. or Assembling, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Classification 8393, Automobile or Automobile Truck Body and Fender Repairing and Painting, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Classification 8391, Automobile or Automobile Truck Dealers, was amended to clarify its intended application. Classification 8748, Automobile or Automobile Truck Dealers, was amended to clarify its intended application. Classification 3821, Automobile or Automobile Truck Dismantling, was amended to clarify its intended application. Classification 3805(2), Automobile or Automobile Truck Engine Mfg., was amended to clarify its intended application and provide direction as to how related operations shall be classified. Classification 8387, Automobile or Automobile Truck Service Stations, was amended to (1) add a suffix to reflect the establishment of alternate wordings, (2) remove the restriction on division of payroll with Classification 8388, Rubber Tire Dealers, (3) clarify its intended application, and (4) specify how Classification 8387 is distinguished from other automotive industry classifications. Classification 8387(2), Automobile or Truck Oil and Fluid Replacement Service Facilities, was established as an alternate wording to Classifications 8387(1), Automobile or Truck Service Stations, and 8387(3), Automobile or Truck Washing Facilities, to apply to automobile or truck service facilities at which the operations solely include preventative maintenance and service operations. Classification 3828, Automobile or Automobile Truck Parts Rebuilding, was amended to clarify its intended application. Classification 9516(2), Automobile Radio and Telephone Installation, Service or Repair, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Classification 8389, Automobile or Automobile Truck Repair Shops or Garages, was amended to remove the restriction on division of payroll with Classification 8388, Rubber Tire Dealers, clarify its intended application, and provide direction as to how related operations shall be classified. Classification 8392, Automobile or Automobile Truck Storage Garages or Parking Stations or Lots, was amended for clarity and consistency. Memorandum 2
5 Memorandum Classification 7227, Automobile or Automobile Truck Towing, Roadside Assistance or Freeway Repair, was amended for clarity. Classification 8397, Automobile or Automobile Truck Transmission Repairing and Rebuilding, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Classification 8387(3), Automobile or Truck Washing Facilities, was established as an alternate wording to Classifications 8387(1), Automobile or Truck Service Stations, and 8387(2), Automobile or Truck Oil and Fluid Replacement Service Facilities, to apply to facilities at which the operations include automobile or truck washing, waxing and polishing, and to employers that wash, wax and polish automobiles or trucks at customers locations. Classification 9522(3), Automobile Body Upholstering, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Classification 3840, Automobile, Automobile Truck or Motorcycle Parts Mfg., was amended to clarify its intended application and provide direction as to how related operations shall be classified. Classification 8390, Automobile Van Conversion or Customizing, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Classification 8324, Automobile Gasoline Stations, was amended to clarify its intended application. Classification 9501(3), Painting automobile or automobile truck bodies, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Classification 2797(3), Recreational Vehicle Mfg., was amended to clarify its intended application and provide direction as to how related operations shall be classified. A cross-reference to Classification 8046, Stores automobile or truck parts or accessories, which is part of the Stores Industry Group, was established. Classification 8388, Rubber Tire Dealers, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Classification 3815(2), Automobile Body Mfg. truck, trailer or bus bodies, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Classification 3815(1), Automobile Truck or Automobile Truck Trailer Mfg. or Assembling, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 16. Classification 9586, Barber Shops or Beauty Parlors, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 17. Classification 4512, Biomedical Research Laboratories, was amended to clarify its intended application, remove the general restriction on division of payroll, and provide direction as to how related operations shall be classified. 18. Classification 7605(1), Burglar Alarm and Security Alarm Systems Installation, Service or Repair, was amended to clarify its intended application and for consistency. 19. Classification 5146(1), Cabinet or Fixtures, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Memorandum 3
6 Memorandum 20. Classifications 5403/5432, Carpentry, were amended to clarify its intended application and provide direction as to how related operations shall be classified. 21. Classification 9015(4), Churches all employees other than clergy, professional assistants, organists, members of choir or Clerical Office Employees, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 22. Classification 8840, Churches clergy, professional assistants, organists, or members of choir, was amended to clarify its intended application. 23. Classification 9101, Colleges or Schools private, was amended to provide direction as to how related operations shall be classified. 24. Classification 8868, Colleges or Schools private not automobile schools, was amended for consistency and provide direction as to how related operations shall be classified. 25. Classification 5195, Communications Cabling, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 26. Classification 8859(1), Computer Programming or Software Development, was amended to clarify its intended application and remove the general restriction on division of payroll. 27. Classification 5214, Concrete or Cement Work, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 28. Classification 6325, Conduit Construction, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 29. Classification 5606, Contractors, was amended to eliminate the requirement for WCIRB approval, to clarify its intended application and provide direction as to how related operations shall be classified. 30. Classification 4244, Corrugated or Fibre Board Container Mfg., was amended to clarify its intended application and provide direction as to how related operations shall be classified. 31. Classification 9059, Day Care Centers, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 32. Classification 4692, Dental Laboratories, was amended to clarify its intended application and provide direction as to how related professions shall be classified. 33. Classification 7721(1), Detective or Patrol Agencies, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 34. Classification 4611, Drug, Medicine or Pharmaceutical Preparations Mfg., was amended to clarify its intended application and provide direction as to how a related operation shall be classified. 35. Classification 2589(1), Dry Cleaning or Laundry, was amended for clarity and consistency. 36. Classification 3570, Electric Appliance Mfg., was amended to include the manufacture of battery chargers and battery pack assemblies. 37. Classification 3724(2), Electrical Machinery or Auxiliary Apparatus, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 38. Classifications 5190/5140, Electrical Wiring, were amended to clarify its intended application and provide direction as to how related operations shall be classified. 39. Classification 3179, Electrical Apparatus Mfg., which is part of the Electronics Industry Group, was amended to include the manufacture of actuators. Memorandum 4
7 Memorandum 40. Classification 1624(2), Excavation rock, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 41. Classification 7219(2), Express Companies, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 42. The Farms Industry Group was amended to correct the reference to Section IV, Special Industry Classification Procedures, Rule Classification 9403(1), Garbage, Ashes or Refuse Collecting, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 44. Classification 9424, Garbage, Ashes or Refuse Dump Operations, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 45. A cross-reference was established to indicate that Classification 8324, Gasoline Stations, is listed under the Automotive Industry Group. 46. Classification 3146(1), Hardware Mfg., was amended to clarify its intended application and provide direction as to how related operations shall be classified. 47. Classification 8839, Dentists and Dental Surgeons, which is part of the Health and Human Services Industry Group, was amended to clarify its intended application, remove the general restriction on division of payroll and provide direction as to how related operations shall be classified. 48. Classification 8827(1), Homemaker Services, which is part of the Health and Human Services Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 49. Classification 8852, Home Infusion Therapists, which is part of the Health and Human Services Industry Group, was amended for consistency. 50. Classification 8827(2), Public Health Nursing Associations, which is part of the Health and Human Services Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 51. Classification 8834, Physicians, which is part of the Health and Human Services Industry Group, was amended to clarify its intended application, remove the general restriction on division of payroll and provide direction as to how related operations shall be classified. 52. Classification 8823, Residential Care Facilities for Children, which is part of the Health and Human Services Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 53. Classification 9085, Residential Care Facilities for the Developmentally Disabled, which is part of the Health and Human Services Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 54. Classification 3146(2), Heat Treating, was amended to clarify its intended application, remove the general restriction on division of payroll and provide direction as to how related operations shall be classified. 55. Classification 8831(1), Hospitals veterinary, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 56. Classification 8859(2), Internet or Web-Based Application Development or Operation, was amended to clarify its intended application, remove the general restriction on division of payroll and provide direction as to how related operations shall be classified. 57. Classification 9008, Janitorial Services, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Memorandum 5
8 Memorandum 58. Classification 8831(3), Kennels, was amended to clarify its intended application and provide direction as to how a related operation shall be classified. 59. Classification 2585, Laundries N.O.C., was amended for clarity and consistency. 60. Classification 9015(5), Libraries all employees other than librarians, professional assistants or Clerical Office Employees, was amended to clarify its intended application and reference its companion Classification 8810(3), Libraries librarians or professional assistants. 61. Classification 8810(3), Libraries librarians or professional assistants, was amended to clarify its intended application, reference its companion Classification 9015(5), Libraries all employees other than librarians, professional assistants or Clerical Office Employees, and provide direction as to how related operations shall be classified. 62. Classification 3632, Machine Shops, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 63. Classification 3560(1), Machinery Mfg. commercial food processing equipment, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 64. Classification 3560(2), Machinery Mfg. industrial, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 65. Classification 3560(3), Machinery Mfg. material handling equipment, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 66. Classification 8800, Mailing or Addressing Companies, was amended to clarify its intended application and remove the general restriction on division of payroll. 67. Classification 3066(3), Aluminum Ware Mfg., which is part of the Metal Working Classifications Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 68. Classification 3066(4), Coppersmithing, which is part of the Metal Working Classifications Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 69. Classification 3066(1), Sheet Metal Products Mfg., which is part of the Metal Working Classifications Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 70. Classification 3724(1), Millwright Work, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 71. The Mining Industry Group was amended to correct the reference to Section IV, Special Industry Classification Procedures, Rule Classification 1122, Mining surface, which is part of the Mining Industry Group, was amended to identify associated operations and include references to similar or related classifications. 73. Classification 2797(1), Mobile Home Mfg., was amended to clarify its intended application, remove the restriction regarding division of payroll and provide direction as to how related operations shall be classified. 74. Classification 9610, Motion Pictures production, was amended to increase the payroll limitation for actors, musicians, producers and the motion picture director from $109,200 to $111,800 per year per person to reflect wage inflation since the payroll limitation was last amended in Classification 8810(4), Libraries public librarians or professional assistants, which is part of the Municipal, State or Other Public Agencies Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Memorandum 6
9 Memorandum 76. Classification 8875(1), Public Colleges or Schools, which is part of the Municipal, State or Other Public Agencies Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 77. Classification 8838, Museums, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 78. Classification 3152(1), Nail, Tack or Rivet Mfg., was amended to clarify its intended application. 79. Classification 3152(2), Nut, Bolt or Screw Mfg., was amended to clarify its intended application and provide direction as to how related operations shall be classified. 80. A cross-reference was established to indicate that Classification 9501(3), Painting automobile or truck bodies, is listed under the Automotive Industry Group. 81. Classification 9501(1), Painting shop only, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 82. Classification 4250(1), Paper Coating or Laminating, was amended to clarify its intended application and direct that conversion of paper into paper goods is classified as 4279(1), Paper Goods Mfg. 83. Classification 7198(1), Parcel Delivery Companies, was amended to clarify its intended application. 84. Classification 7721(2), Patrol or Guard Services, was amended to clarify its intended application. 85. Classification 9031, Pest Control, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 86. Classification 8350, Gasoline or Oil Dealers, which is part of the Petroleum Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 87. Classification 4740(3), Gasoline Recovery, which is part of the Petroleum Industry Group, was amended to clarify its intended application. 88. Classification 4740(1), Oil Refining, which is part of the Petroleum Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 89. Classification 4297(1), Electronic Prepress, which is part of the Printing, Publishing and Duplicating Industry Group, was amended to clarify its intended application, remove the general restriction on division of payroll and provide direction as to how related operations shall be classified. 90. Classification 4297(2), Graphic Design, which is part of the Printing, Publishing and Duplicating Industry Group, was amended to clarify its intended application, remove the general restriction on division of payroll and provide direction as to how a related operation shall be classified. 91. Classification 9011, Apartment or Condominium Complex Operation, which is part of the Property Management/Operation Industry Group, was amended to clarify its intended application, provide direction how related operations are classified and direct that non-resident employees engaged exclusively in the rental or leasing of property shall be classified as 8741, Real Estate Agencies. 92. Classification 9007, Apartment or Condominium Complex Operation for Seniors, which is part of the Property Management/Operation Industry Group, was amended to clarify its intended application, provide direction how related operations are classified and direct that non-residing employees engaged exclusively in the rental or leasing of property shall be classified as 8741, Real Estate Agencies. 93. Classification 9015(1), Building Operation N.O.C. all other employees, which is part of the Property Management/Operation Industry Group, was amended to clarify its intended application, Memorandum 7
10 Memorandum provide direction regarding related classifications and direct that employees engaged exclusively in the rental or leasing of property shall be classified as 8741, Real Estate Agencies. 94. Classification 9009, Building Operation commercial properties all other employees, which is part of the Property Management/Operation Industry Group, was amended to clarify its intended application, provide direction regarding related classifications and direct that employees engaged exclusively in the rental or leasing of property shall be classified as 8741, Real Estate Agencies. 95. Classification 8740(2), Building Operation commercial properties property management supervisors, which is part of the Property Management/Operation Industry Group, was amended to clarify its intended application. 96. Classification 9010, Mobile Home Park Operation, which is part of the Property Management/Operation Industry Group, was amended to clarify its intended application, provide direction regarding related classifications and direct that non-residing employees engaged exclusively in the rental or leasing of property to clients shall be classified as 8741, Real Estate Agencies. 97. Classification 8741, Real Estate Agencies, which is part of the Property Management/Operation Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 98. Classification 3612, Pump or Hydraulic Apparatus Mfg. or Repair, was amended to clarify its intended application and provide direction as to how related operations shall be classified. 99. Classification 1624(1), Quarries, was amended to clarify its intended application and provide direction as to how related operations shall be classified Classification 7610, Radio, Television or Commercial Broadcasting Stations, was amended to increase the payroll limitation for players, entertainers or musicians from $109,200 to $111,800 per year per person to reflect wage inflation since the payroll limitation was last amended in A cross-reference was established to indicate that Classification 2797(3), Recreational Vehicle Mfg., is listed under the Automotive Industry Group Classification 5225, Reinforcing Steel Installation, was amended to provide direction as to how related operations shall be classified Classification 9096, Residential Cleaning Services, was amended to clarify its intended application and provide direction as to how related operations shall be classified Classification 9079(1), Restaurants or Taverns, was amended to clarify its intended application, remove the general restriction on division of payroll and provide direction as to how related operations shall be classified 105. Classifications 5552/5553, Roofing, were amended to clarify the intended application and provide direction as to how related operations shall be classified A cross-reference was established to indicate that Classification 8388, Rubber Tire Dealers, is listed under the Automotive Industry Group Classification 8847, Beverage Container Collection or Redemption, which is part of the Salvage Material Dealers Industry Group, was amended to direct that the curbside collection of recyclables, including beverage containers shall be classified as 9403(1), Garbage or Refuse Collecting Classification 8264(2), Bottle Dealers secondhand, which is part of the Salvage Material Dealers Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified Classification 8265(2), Junk Dealers N.O.C., which is part of the Salvage Material Dealers Industry Group, was amended for clarity. Memorandum 8
11 Memorandum 110. Classification 8264(1), Paper Stock Dealers secondhand, which is part of the Salvage Material Dealers Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified Classification 8264(3), Rubber Stock Dealers secondhand, which is part of the Salvage Material Dealers Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified Classification 8103, Wiping Cloth or Rag Dealers, which is part of the Salvage Material Dealers Industry Group, was eliminated as this classification does not develop sufficient data to produce a statistically credible advisory pure premium rate Classification 8264(4), Wiping Cloth or Rag Dealers including all laundry operations, which is part of the Salvage Material Dealers Industry Group, was established as an alternate wording to Classification 8264 for wiping cloth and rag dealers Classification 3152(3), Screw Machine Products Mfg., was amended to clarify its intended application and provide direction as to how related operations shall be classified Classification 5951, Serum, Anti-Toxin or Virus Mfg., was amended to clarify its intended application, provide direction as to how related operations shall be classified and for consistency Classification 5146(2), Sign Installation or Repair, which is part of the Sign Industry Group, was amended to provide direction as to how related operations shall be classified The Stores Industry Group was amended to correct the reference to Section IV, Special Industry Classification Procedures, Rule Classification 8046, Stores automobile accessories, which is part of the Stores Industry Group, was amended to clarify its intended application and provide direction as to how related operations shall be classified Classification 7365, Taxicab Operations, was amended to increase the minimum payroll from $30,500 to $31,300 per annum per taxicab to reflect wage inflation since the threshold was last amended in Classification 9156, Theaters dance, opera and theater companies, was amended to increase the payroll limitation for performers and directors of performers from $109,200 to $111,800 per year per person to reflect wage inflation since the payroll limitation was last amended in Classification 9151, Theaters music ensembles, was amended to increase the payroll limitation for performers and directors of performers from $109,200 to $111,800 per year per person to reflect wage inflation since the payroll limitation was last amended in Classification 3099, Tool Mfg. N.O.C., was amended to clarify its intended application and provide direction as to how related operations shall be classified A cross-reference was established to indicate that Classification 3815(2), Truck Body Mfg., is listed under the Automotive Industry Group Classification 7219(1), Trucking Firms, was amended to clarify its intended application and provide direction as to how related operations shall be classified A cross-reference was established to indicate that Classification 3815(1), Truck, Truck Trailer or Bus Mfg. or Assembling, is listed under the Automotive Industry Group Classification 3634, Valve Mfg., was amended to clarify its intended application and provide direction as to how related operations shall be classified Classification 8292, Warehouses general merchandise, was amended to clarify its intended application and provide direction as to how related operations shall be classified. Memorandum 9
12 Memorandum 128. Classification 7721(3), Watchpersons or Guards, was eliminated as the operations described by this classification are assignable to Classification 7721(2), Security Guard or Patrol Services Section VIII, Abbreviated Classifications Numeric Listing, was amended for clarity and for consistency. Part 4 Unit Statistical Report Filing Requirements 130. Section II, Definitions, Rule 20, Loss Adjustment Expense(s), was amended for clarity and consistency Section II, Rule 29, Open or Open Claim, and Rule 34, Resolved or Resolved Claim, were amended to remove Resolved Claim for consistency with the national reporting standards Section V, Loss Information, Rule B, Loss Data Elements, Subrule 6, Type of Settlement, was amended for consistency with national reporting standards and to provide for the submission of a statement when a non-compensable claim meets the requirements of Labor Code Section Section VII, Subsequent Reports, Correction Reports, and Reporting Methods, was amended for clarity and consistency. Appendix I, Construction and Erection Classifications 134. Appendix I was amended for consistency. Memorandum 10
13 Table of Contents Part 1 General Provisions 1 Section I Introduction 1 1. Purpose 1 2. Authority 1 3. Effective Date 1 Section II General Definitions 1 1. Audit 1 2. Classification(s) or Standard Classification(s) 1 3. Employee(s) 2 4. Employer 2 5. Employers Liability 2 6. Employers Liability Insurance 2 7. Experience 2 8. Experience Modification 2 9. Experience Rating Experience Rating Plan Exposure(s) Final Premium(s) Insurer Classification(s) Payroll(s) Physical Audit Pure Premium Rate(s) Voluntary Audit WCIRB Workers Compensation Workers Compensation Insurance 3 Section III Submission of Information 3 1. Reporting Information 3 2. Reporting Procedures 3 Section IV Corrections or Amendments 4 1. Notification of Non-Compliance and Evidence of Correction 4 2. Investigation 4 Section V Inquiries, Complaints and Requests for Action, Reconsideration and Appeals 4 1. Purpose and Time Limitation 4 2. Inquiries 4 3. Complaints and Requests for Action 5 4. Reconsideration and Appeals to the Insurance Commissioner 5 Part 2 Policy Reporting Requirements 7 Section I General Instructions 7 1. Policies 7 2. Endorsements 9 3. Cancellations or Reinstatements 10 Section II Policy Period Policy Period Continuing Form Policy or Fixed-Term Policy Written in Excess of One Year and Sixteen Days 11 Section III Additional Electronic Reporting Requirements Policy Record Reporting Section I Introduction 15 Section II Classification Terminology All Assembly or Assembling Clerical Office Employee(s) Companion Classification 15 i
14 Table of Contents 5. Division of Payroll General Exclusions General Inclusions Governing Classification Highest Rated Classification Including Interchange of Labor Location Manufacturing or Mfg Miscellaneous Employee(s) Multiple Enterprises No or Not N.O.C Or Outside Salespersons Payroll(s) Physical Separation or Physically Separated Remuneration Salespersons Outside Shall Be Separately Classified Single Enterprise Standard Exception(s) Standard Exception Employees 18 Section III General Classification Procedures Classification Description Single Enterprise Multiple Enterprises Standard Exceptions General Inclusions General Exclusions 25 Section IV Special Industry Classification Procedures Aircraft Operations Construction or Erection Work Electronic Products Design and Manufacturing Farms Mining Stores Wrecking or Demolition and Building Raising or Moving Labor Contractors 35 Section V Payroll Remuneration Payroll Remuneration Payroll Records Division of Single Employee s Payroll Drivers and Their Helpers Payroll 43 Section VI Administration of Classification System Inspection of Employer s Premises Notification of Standard Classification Assignment Effective Date of Standard Classification Assignments Audit of Payroll Test Audits 45 Section VII Standard Classifications Classification Section Standard Classifications 47 Section VIII Abbreviated Classifications Numeric Listing 169 ii
15 Table of Contents Part 4 Unit Statistical Reporting Requirements 183 Section I General Instructions Scope Date of Valuation Date of Reporting Excess Policies Foreign Construction or Erection Projects Reinsurance Insolvent Insurers 185 Section II Definitions Accident Date Allocated Loss Adjustment Expense(s) Audited Exposure Catastrophe Closed or Closed Claim Compromise and Release Compromised Death Claim(s) Contract Medical Cumulative Injury or Cumulative Injury Claim(s) Death or Death Claim Employers Liability Claim(s) Final Premium(s) Findings and Award Incurred Indemnity Incurred Loss(es) Incurred Medical Indemnity Loss(es) Insolvent Insurer Rating Adjustment Factors Joint Coverage or Joint Coverage Claim(s) Loss Adjustment Expense(s) Major Permanent Partial Disability Medical Evaluation Medical Loss(es) Medical Only or Medical Claims Only Minor Permanent Partial Disability Non-Compensable Claim(s) Nontransferable Education-Related Voucher(s) Occupational Disease Open or Open Claim(s) Outstanding Indemnity Outstanding Medical Partially Fraudulent Claim(s) Permanent Total Disability S Claim(s) Single Sum Settlement Statistical Code Stipulated Award Subrogated, Subrogation or Subrogation Claim(s) Supplemental Job Displacement Benefit Voucher(s) Temporary Total or Temporary Partial Disability Trauma Unallocated Loss Adjustment Expense(s) Weekly Wage Amount 193 Section III Link Data and Header Record Information Exposure State Code Policy Effective Date Report Level Code / Report Number Policy Expiration or Cancellation Date Estimated Audit Code 194 iii
16 Table of Contents Section IV Exposure Information Classification Code Experience Modification Effective Date Rate Effective Date Exposure Amount Update Type Code 196 Section V Loss Information 196 A. General Loss Reporting Instructions Reporting Losses Date of Valuation Supplemental Claim Information 196 B. Loss Data Elements Classification Code Weekly Wage Amount Injury Code (Injury Type) Catastrophe Number Update Type Code Type of Settlement Part of Body Nature of Injury Cause of Injury Fraudulent Claim Code Total Gross Incurred Amount 198 C. Special Loss Reporting Instructions Subrogation Claims Partially Fraudulent Claims Joint Coverage Claims Non-Compensable Claims Cumulative Injury Claims Employers Liability Claims Compromised Death or S Claims 201 Section VI Unit Total Record Data Exposure Payroll Total Final Premium Total (Standard Premium Total) Incurred Indemnity Amount Total Incurred Medical Amount Total 202 Section VII Subsequent Reports, Correction Reports, and Reporting Methods Subsequent Reports Correction Reports Reporting Methods 204 Appendix I 207 Construction and Erection Classifications 207 Appendix II 211 Payroll/Remuneration Table 211 Appendix III 221 Injury Description Codes 221 iv
17 Part 1 General Provisions Section II General Definitions Part 1 General Provisions Section I Introduction 1. Purpose This Plan contains the necessary rules and instructions for the filing of policy documents and reporting of experience in connection therewith on the direct business written by insurers for California workers compensation insurance and employers liability insurance incidental thereto and written in connection therewith. This Plan requires that separate unit statistical reports be filed for every workers compensation insurance policy written. The loss, exposure and premium data reported for each policy is used to develop experience in standard classification detail. Pure premium rates and experience modifications are based upon the data reported in accordance with this Plan. It is therefore essential that the greatest possible care be taken to furnish complete and accurate information and that the information be filed at the time and in the manner specified in this Plan. 2. Authority This Plan has been approved by the Insurance Commissioner of the State of California in accordance with Articles 2 and 3 of Chapter 3, Part 3, Division 2, and Section of the California Insurance Code. 3. Effective Date The provisions of this Plan are effective at 12:01 A.M., January 1, When an amendment to this Plan is approved, a notice summarizing the amendment and its effective date, as specified by the Insurance Commissioner, will be published by the WCIRB. This Plan and all amendments thereto, unless otherwise specifically provided, shall apply to a policy as of the first anniversary rating date of the risk, as established by the WCIRB, which occurs on or after the effective date of the amendment. (See the Experience Rating Plan, Section II, Definitions, Rule 12, Risk, for the definition of Risk, and Section V, Application of Experience Modification, Rule 1, General Application of Experience Modification, for information on the anniversary rating date). Section II General Definitions The definitions set forth in this Section shall govern the construction and meaning of the terms and phrases used in this Plan. 1. Audit A report of the policyholder s exposure by classification that is based upon either an auditor s examination of the policyholder s books of accounts and original payroll records or upon a signed payroll statement obtained from the employer. See Physical Audit and Voluntary Audit. 2. Classification(s) or Standard Classification(s) A classification of occupations, employments, industries and businesses contained in the alphabetical listing of standard classifications located in Part 3, Section VII, Standard Classifications, of this Plan. (See also Insurer Classification(s).) 1
18 Part 1 General Provisions Section II General Definitions 3. Employee(s) Every person in the service of an employer for whom the employer is obligated to provide workers compensation benefits. 4. Employer One or more entities meeting the combination of entities standards for experience rating set forth in the Experience Rating Plan. 5. Employers Liability Any liability, other than for workers compensation, imposed by the laws of the State of California upon an employer for damages on account of bodily injury to or death of employees arising out of and in the course of employment. 6. Employers Liability Insurance The insurance of employers liability when such insurance is incidental to and written in connection with the workers compensation insurance issued to and covering the same policyholder or policyholders. 7. Experience The payroll, premium, and loss data for an employer or standard classification. 8. Experience Modification The modification factor that is published by the WCIRB in accordance with the Experience Rating Plan and that is required to be applied to the policy premium. 9. Experience Rating (a) A rating procedure found in the Experience Rating Plan that utilizes past payroll and loss experience of the employer to forecast future losses by measuring the employer s loss experience against the loss experience of employers in the same classification to produce a prospective premium credit, debit, or unity modification; or, (b) the modification factor that is published by the WCIRB in accordance with the Experience Rating Plan and that is required to be applied to the policy premium. 10. Experience Rating Plan The California Workers Compensation Experience Rating Plan 1995, approved by the Insurance Commissioner of the State of California, Title 10, California Code of Regulations, Section Exposure(s) The basis against which losses shall be compared or insurer rates will be applied and, unless otherwise specified, shall mean payroll. 12. Final Premium(s) See definition of Final Premium(s) located in Part 4, Section II, Definitions, of this Plan. 13. Insurer Classification(s) Classifications of occupations, employments, industries and businesses used by an insurer in connection with its workers compensation insurance coverage. (See also Classification(s) or Standard Classification(s).) 2
19 Part 1 General Provisions Section III Submission of Information 14. Payroll(s) Synonymous with Remuneration. See definitions of Payroll(s) and Remuneration located in Part 3, Section V, Rule 1, Payroll Remuneration, of this Plan. 15. Physical Audit An audit of payroll, whether conducted at the policyholder s location or at a remote site, that is based upon an auditor s examination of the policyholder s books of accounts and original payroll records (in either electronic or hard copy form) as necessary to determine and verify the exposure amounts by classification. 16. Pure Premium Rate(s) The loss cost per unit of exposure, including loss adjustment expense, for standard classifications. 17. Voluntary Audit An audit of payroll that is based upon a signed payroll statement obtained from the employer. 18. WCIRB The Workers Compensation Insurance Rating Bureau of California, a rating organization licensed by the California Department of Insurance and designated as the Insurance Commissioner s statistical agent in accordance with the provisions of Sections et seq. of the California Insurance Code. 19. Workers Compensation The obligation imposed upon an employer by the workers compensation laws of the State of California to pay the benefits prescribed by such laws. 20. Workers Compensation Insurance Insurance for workers compensation liability and, except when otherwise stated, also refers to employers liability insurance. Section III Submission of Information 1. Reporting Information Information or documents required to be submitted pursuant to the provisions of this Plan shall be filed either electronically or on hard copy with the WCIRB, as the designated statistical agent for the Insurance Commissioner of the State of California. The address of the WCIRB is: Workers Compensation Insurance Rating Bureau of California 525 Market Street, Suite 800 San Francisco, CA Reporting Procedures The reporting procedures and forms contained in this Plan may be modified by an insurer to conform to its own recording methods, provided that such alternative reporting procedures or forms: (a) yield all of the information required under the standard procedures of this Plan, and (b) have been approved by the WCIRB as an acceptable alternative reporting procedure or form. 3
20 Part 1 General Provisions Section V Inquiries, Complaints and Requests for Action, Reconsideration and Appeals Section IV Corrections or Amendments 1. Notification of Non-Compliance and Evidence of Correction If a policy as written or data as reported does not appear to comply with the provisions of this Plan or applicable regulations of the Insurance Commissioner governing California workers compensation insurance, the WCIRB shall query the insurer, pointing out in what respects it fails to conform and requiring the insurer to make any necessary corrections. In all cases where an insurer is required to make a correction or amendment to a policy or the reported data, evidence of such correction or amendment shall be submitted to the WCIRB within a reasonable period of time. If such evidence is not received by the WCIRB in a reasonable period, it shall be the duty of the WCIRB s president to bring the case to the attention of the Governing Committee of the WCIRB. The WCIRB may, at its option, require the signature of the policyholder on any correcting endorsement, evidencing acceptance of such correction by the policyholder. The signed copy of such endorsement must be filed with the WCIRB. 2. Investigation The WCIRB may pass any policy, endorsement or reported data subject to review or investigation. If, after review or investigation, the WCIRB determines that it is required, the insurer shall conform its policy, endorsement or reported data in accordance with the provisions of this Plan or other regulations of the Insurance Commissioner governing California workers compensation insurance. Section V Inquiries, Complaints and Requests for Action, Reconsideration and Appeals 1. Purpose and Time Limitation This Section of the Plan explains how an insured employer may (a) request review if it believes its workers compensation insurance coverage as written or experience as reported is contrary to the rules of this Plan or any other regulations of the Insurance Commissioner governing workers compensation insurance; and (b) request review of a decision, action, or omission to act by the WCIRB. This process enables the insured employer to obtain review of the matter by the WCIRB and, if necessary, the Insurance Commissioner. An insured employer s initial request for review must be received by the WCIRB within twelve (12) months after the expiration date of the policy to which the request for review pertains, except if the request for review involves the application of the Revision of Losses rule found at Section VI, Rule 13, of the Experience Rating Plan. 2. Inquiries An insured employer may commence the review process by sending the WCIRB a written Inquiry. The Inquiry shall include (a) the names of the policyholder(s) and the insurer(s); and (b) detailed information explaining why the coverage as written or experience as reported is incorrect. If the Inquiry is not complete, the WCIRB may request additional information from the insured employer. The insured employer shall respond to such a request within sixty (60) days after the date of the WCIRB s request. If the insured employer fails to respond within that time, the WCIRB will deem the Inquiry closed. The WCIRB shall review and, as necessary, investigate all Inquiries. If the WCIRB sends the Inquiry to the insurer for purposes of investigation, the insurer shall respond within sixty (60) days after the WCIRB sends it the Inquiry. The WCIRB shall issue a decision regarding the Inquiry. An insured employer, insurer, or other aggrieved person who is dissatisfied with the WCIRB s decision upon an Inquiry and who seeks a further review of 4
c a l i f o r n i a WCIRBCalifornia California Workers Compensation Uniform Statistical Reporting Plan 1995
Report on Dual Classification by Wage Level Program
Workers Compensation Insurance Rating Bureau of California Workers Compensation Insurance Rating Bureau of California Report on Dual Classification by Wage Level Program Excerpt from the WCIRB Classification