ISO WCIS: EDI POC Transaction Overview

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Binder	New Policy	Renewal	Change Endorsements	Cancellation	Non-Renewal by Insured	Non-Renewal by Insurer	Reinstate	Rewrite/ Reissue

Transaction			Business Assumption	Carrier/ Insurer Submits	Trans Set Purp Code	Trans Set Type Code	Trans Reas Code	File Processing Examples
Binder - Establishing Document			The Carrier/Insurer has written a temporary agreement, which legally provides coverage until the Carrier/Insurer issues a formal contract (policy).	A	00	05	01	1A
Binder - Insured has no physical location in jurisdiction. - Establishing Document			The Carrier/Insurer has written a temporary agreement, which legally provides coverage until the Carrier/Insurer issues a formal contract (policy). The insured does business in the jurisdiction and the binder provides coverage for the jurisdiction. The insured, however, does not have a physical address in the jurisdiction (e.g., Interstate common carriers).	I	00	05	80	1B
Binder - Named Employer(s) with no jurisdiction address			The Carrier/Insurer has written a temporary agreement, which legally provides coverage until the Carrier/Insurer issues a formal contract (policy). The insured does business in the jurisdiction and the binder provides coverage for the jurisdiction. In addition, one or more employers operate in the jurisdiction but do not have a physical address in the jurisdiction (e.g., Interstate common carriers). Carrier/Insurer cannot submit this transaction as a stand-alone transaction. This transaction must be submitted following one of the two Binder transactions above.	EN/M	00	05	86	1C-D
New Policy - Establishing Document			Carrier/Insurer has written a new policy for an employer.	A	00	10	01	2A
New Policy - Insured has no physical location in jurisdiction. - Establishing Document			Carrier/Insurer has written a new policy for an employer. The insured does business in the jurisdiction and the policy provides coverage for the jurisdiction. The insured, however, does not have a physical address in the jurisdiction (e.g., Interstate common carriers).	I	00	10	80	2B
New Policy - Named Employer(s) with no jurisdiction address			The Carrier/Insurer has written a new policy for an employer. The insured does business in the jurisdiction and the policy provides coverage for the jurisdiction. In addition, one or more employers operate in the jurisdiction but do not have a physical address in the jurisdiction (e.g., Interstate common carriers). Carrier/Insurer cannot submit this transaction as a stand-alone transaction. This transaction must be submitted following one of the two New Policy transactions above.	EN/M	00	10	86	2C-D
Renew Policy - Establishing Document			Carrier/Insurer has continued the insurance policy/contract coverage for another term.	A	00	20	01	3A
Renew Policy - Insured has no physical location in jurisdiction. - Establishing Document			Carrier/Insurer has continued the insurance policy/contract coverage for another term. The insured does business in the jurisdiction and the policy provides coverage for the jurisdiction. The insured, however, does not have a physical address in the jurisdiction (e.g., Interstate common carriers).	I	00	20	80	3B
Renew Policy - Named Employer(s) with no jurisdiction address			The Carrier/Insurer continued the insurance policy/contract coverage for another term. The insured does business in the jurisdiction and the policy provides coverage for the jurisdiction. In addition, one or more employers operate in the jurisdiction but do not have a physical address in the jurisdiction (e.g., Interstate common carriers). Carrier/Insurer cannot submit this transaction as a stand-alone transaction. This transaction must be submitted following one of the two Renew Policy transactions above.	EN/M	00	20	86	3C-D
Change	Change Name - all or any Employer location		Employer has changed demographic information for all or specific locations covered by the subject policy. Employer has reported changes in the employers business which affects the Coverage for all or specific locations covered by the subject policy. Carrier/Insurer must submit PAIRED transactions to: 04 Flag Current records affected by change 05 Replace altered records	PE	04	32	85	4A-D
	Change Address - all or any Employer location				04	32	85
	Change SIC Code - (Employer Level)				05	32	85
	Change # of Employees - (Employer Level)				05	32	85
Change (continued)	Change Legal Status - (Insured Level)		Insured has changed demographic information for the subject policy. Insured has reported Changes in the Insured business, which affects the coverage for the subject policy.	I	00	32	84	4E-H
	Change Insured Name - (Insured Level)
	Change Governing Class - (Insured Level)
	Change Total Payroll - (Insured Level)
	Change Insured Address - (Insured Level)
	Change Telephone Number - (Insured Level)
	Change Business Market - (Insured Level)
	Change Wrap Up Indicator - (Insured Level)
	Change Assignment Date - (Insured Level)
	Change Employer FEIN		Employer has changed the FEIN for all or specific locations covered by the subject policy. Carrier/Insurer must submit PAIRED transactions to: 04 Flag Current records affected by change 05 Replace altered records	PE	04	32	77	4I, 4Q
	Change Employer FEIN			PE	05	32	77	4I, 4Q
	Change Employer UI		Employer has changed the UI Number for all or specific locations covered by the subject policy. Carrier/Insurer must submit PAIRED transactions to: 04 Flag Current records affected by change 05 Replace altered records	PE	04	32	78	4J
	Change Employer UI			PE	05	32	78	4J
	Change Policy Number - Establishing Document		Carrier/Insurer has changed the Policy Number for the subject policy. This transaction results in a new establishing document for the policy. Carrier/Insurer must submit PAIRED transactions to: 04 Flag Current records affected by change 05 Replace altered records The jurisdiction will flag the old policy and employer locations covered by the prior policy within the jurisdiction. The jurisdiction will create a new insured level record using data supplied by the transaction. The jurisdiction will create new corresponding employer location records by copying employer location records attached to the prior policy number.	PI	04	32	79	4K
	Change Policy Number - Establishing Document			PI	05	32	79	4K
	Add New Insured FEIN		The Insured has acquired a new FEIN. The Carrier/Insurer is updating the subject policy for the Insured new FEIN. Carrier/Insurer must submit PAIRED transactions to: 04 Flag Current records affected by change 05 Replace altered records	PI	04	32	76	4L
	Add New Insured FEIN			PI	05	31	76	4L
Change (continued)	Change Erroneous Insured FEIN		The Carrier/Insurer has previously transmitted an erroneous FEIN for the Insured. The Carrier/Insurer is updating the subject policy to correct the Insured FEIN. Carrier/Insurer must submit PAIRED transactions to: 04 Flag Current records affected by change 05 Replace altered records	PI	04	33	76	4M
	Change Erroneous Insured FEIN			PI	05	32	76	4M
	Change Erroneous Effective Date		The Carrier/Insurer has previously transmitted an erroneous Effective Date for the policy. The Carrier/Insurer is updating the subject policy to correct the Effective Date. Carrier/Insurer must submit PAIRED transactions to: 04 Flag Current records affected by change 05 Replace altered records	PI	04	32	81	4N
	Change Erroneous Effective Date			PI	05	32	81	4N
	Change Erroneous Expiration Date		The Carrier/Insurer has previously transmitted an erroneous Expiration Date for the policy. The Carrier/Insurer is updating the subject policy to correct the Expiration Date. Carrier/Insurer must submit PAIRED transactions to: 04 Flag Current records affected by change 05 Replace altered records	PI	04	32	82	4O
	Change Erroneous Expiration Date			PI	05	32	82	4O
	Change Erroneous Carrier/Insurer FEIN		The Carrier/Insurer has previously transmitted an erroneous Carrier/Insurer FEIN for the policy. The Carrier/Insurer is updating the subject policy to correct the Carrier/ Insurer FEIN. Carrier/Insurer must submit PAIRED transactions to: 04 Flag Current records affected by change 05 Replace altered records	PI	04	32	83	4P
	Change Erroneous Carrier/Insurer FEIN			PI	05	32	83	4P
Endorsements	Include Corporate Officer/Partner/Sole Proprietor		Carrier/Insurer has adjusted policy coverage to include Corporate Officer/Partner/ Sole Proprietor	I	00	32	67	5A
	Exclude Corporate Officer/Partner/Sole Proprietor		Carrier/Insurer has adjusted policy coverage to exclude Corporate Officer/Partner/ Sole Proprietor	I	00	32	68	5B
	Add Location(s)		Carrier/Insurer has added a new employer jurisdiction location to an existing.	E/M	00	31	54	5C
	Add Employer(s) with no jurisdiction address		Carrier/Insurer has added a new employer to an existing policy for the jurisdiction. The employer operates in the state, but does not have a physical address in the jurisdiction.	EN/M	00	31	87	5J
	Add Jurisdiction		Carrier/Insurer has added the jurisdiction to an existing policy. The policy did not previously provide coverage in the jurisdiction.	A	00	31	72	5D
	Add Jurisdiction with no State Location		Carrier/Insurer has added the jurisdiction to an existing policy for an employer who does not have a physical location in the jurisdiction. The policy did not previously provide coverage in the jurisdiction.	I	00	31	80	5E
Endorsements (continued)	Add Jurisdiction - Named Employer(s) with no jurisdiction address		Carrier/Insurer has added the jurisdiction to an existing policy and one or more employers operate in the jurisdiction but do not have a physical address in the jurisdiction (e.g., Interstate common carriers). The policy did not previously provide coverage in the jurisdiction. Carrier/Insurer cannot submit this transaction as a stand-alone transaction. This transaction must be submitted following one of the two Add Jurisdiction transactions above.	EN/M	00	31	86	5H-I
	Delete Location(s)		Carrier/Insurer no longer covers an employer jurisdiction location with an existing policy.	E/M	00	33	56	5F, 5K
	Delete Jurisdiction		Carrier/Insurer no longer covers an employer jurisdiction location with an existing policy and the policy no longer reflects any jurisdiction business. The jurisdiction must use the policy number to search out and flag all employer records attached to the insured record.	I	00	33	73 >	5G
Cancel Policy	Canceled by Carrier/Insurer	Non Payment	Policy canceled by Carrier/Insurer for cause. Contract Terminated. Employer uninsured. The Carrier/Insurer will submit an insured record and a single employer record for all jurisdiction locations covered by the policy level record using data supplied by the transaction. The jurisdiction will update all corresponding employer location records attached to the current insured record.	E/M	00	41	59	6A-F
		Rewrite/Reissue			00	41	71
		Underwriting Reason			00	41	64
		Failure to Pay Deductible			00	41	69
		Misrepresentation of Information on Application			00	41	70
		Revocation of Voluntary Market Acceptance			00	41	66
	Canceled by Insured	Coverage Placed Elsewhere	Policy canceled by insured for cause. Contract terminated. Employer uninsured. The jurisdiction will update the insured level record using data supplied by the transaction The jurisdiction will update all corresponding employer location records attached to the current insured record.	> I	00	42	60	6G-L
		Duplicate Coverage			00	42	61
		Business Sold			00	42	63
		Change of Ownership			00 <	42	62
		No Employees/No Exposure/No Operations			00	42	65
		Out of Business			00	42	45
		Reason Unknown			00	42	01
Non-Renewal of Policy by Insured		Coverage Placed Elsewhere	Insured has chosen not to renew the policy at the end of its term. Employer uninsured. The jurisdiction will update the insured level record using data supplied by the transaction The jurisdiction will update all corresponding employer location records attached to the current insured record.	I	00	60	60	7A-F
		Business Sold			00	60	63
		Change of Ownership			00	60	62
		No Employees/No Exposure/No Operations			00	60	65
		Reason Unknown			00	60	01
		Out of Business			00	60	45
Non-Renewal of Policy by Insurer		Underwriting Discretion	Carrier/Insurer has chosen not to renew the policy at the end of its term. Employer uninsured. The Carrier/Insurer will submit an insured record and all employer records for all jurisdiction locations covered by the policy. The jurisdiction will update the insured level record using data supplied by the transaction. The jurisdiction will update corresponding employer location records attached to the current insured record. The employer records are transmitted because of the need to pass the Employer Notification Date to the jurisdiction.	E/M	00	60	64	7G
Reinstate Policy			Carrier/Insurer has canceled policy for cause but has now reconciled the dispute with the insured. Carrier/Insurer reinstates the policy for the original term. Effective date may indicate a gap in coverage. The jurisdiction will update the insured level record using data supplied by the transaction. The jurisdiction will update corresponding employer location records attached to the current insured record.	I	00	70	01	8
Rewrite/Reissue Policy - Establishing Document			Carrier/Insurer has canceled policy for cause but has now reconciled the dispute with the insured. Carrier/Insurer rewrites the policy for the original term. Carrier/Insurer will use a new policy number. The Carrier/Insurer must submit a new insured level record keyed on the new policy number and must supply the old policy number in the prior policy number field. The jurisdiction will flag the old policy and employer locations covered by the prior policy within the jurisdiction. The jurisdiction will create new insured and employer level records using data supplied by the transaction.	A	00	50	01	9A
Rewrite/Reissue Policy - Insured has no physical location in jurisdiction. - Establishing Document			Carrier/Insurer has canceled policy for cause but has now reconciled the dispute with the insured. Carrier/Insurer rewrites the policy for the original term. Carrier/Insurer will use a new policy number. The insured does business in the jurisdiction and the rewrite/reissue provides coverage for the jurisdiction. The insured, however, does not have a physical address in the jurisdiction (e.g., Interstate common carriers). The Carrier/Insurer must submit a new insured level record keyed on the new policy number and must supply the old policy number in the prior policy number field.	I	00	50	80	9B
Rewrite/Reissue Policy - Named Employer(s) with no jurisdiction address			The Carrier/Insurer has canceled policy for cause but has now reconciled the dispute with the insured. Carrier/Insurer rewrites the policy for the original term. Carrier/Insurer will use a new policy number. The insured does business in the jurisdiction and the rewrite/reissue provides coverage for the jurisdiction. In addition, one or more employers operate in the jurisdiction but do not have a physical address in the jurisdiction (e.g., Interstate common carriers). Carrier/Insurer cannot submit this transaction as a stand-alone transaction. This transaction must be submitted following one of the two Rewrite/Reissue Policy transactions above.	EN/M	00	50	86	9C-D

Carrier/Insurer Submits Key (Version 1.0 April 1, 2001)

A	Requires a single insured record and employer record for all jurisdiction locations.
E	Requires a single insured record and one employer record for the impacted jurisdiction. For canceled by Carrier/Insurer and Nonrenewal of Policy by Insurer, the Insured will be used on the employer record when there is no specific employer location for the jurisdiction.
E/M	Requires a single insured record and one or more employer records for the impacted jurisdiction as agreed to in the Trading Partner Agreement.
EN/M	Requires a single insured record and any employer record(s) for employers operating in or through the state and not having a physical location in the state.
M	Requires a single insured record and more than one employer record for the impacted jurisdiction locations.
I	Requires a single insured record only.
PI	Requires paired insured records only.
PE	Requires paired insured records with one corresponding employer record for the impacted jurisdiction location.

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Binder	New Policy	Renewal	Change Endorsements	Cancellation	Non-Renewal by Insured	Non-Renewal by Insurer	Reinstate	Rewrite/ Reissue