Florida Regulations 69L-56.100 130

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§ Mandate of Proof of Coverage (POC) EDI.



(1) Effective March 1, 2002, every insurer authorized to insure employers in the State of Florida shall file policy information

electronically to the Division rather than by filing on paper forms previously required by Rule 69L- 6.014, F.A.C. Every insurer shall transmit by electronic data interchange all required data elements specified in the Florida Division of Workers' Compensation Proof of Coverage Electronic Data Interchange (EDI) Implementation Manual, November 2001, which is herein incorporated by reference in this rule. A copy of the manual may be obtained from the Division of Workers' Compensation at its website, www2.myflorida.com/les/wc/, or by sending a request to the Division of Workers' Compensation, Bureau of Information Management, 200 East Gaines Street, Tallahassee, Florida 32399-4226. The Division will not accept an electronic transaction that fails to comply with the requirements in this manual. The insurer shall send electronic submissions either directly to the Division or through an authorized third party vendor.

(2) Electronic Proof of Coverage Forms shall be sent in the Proof of Coverage national standard, adopted by the IAIABC. The insurer or third party vendor shall utilize the IAIABC EDI Implementation Guide for Proof of Coverage: Insured, Employer, Header, Trailer & Acknowledgement Records, Release 2, November 1, 2001, to implement Florida workers� compensation proof of coverage data electronically.

(3) If an insurer is unable to report all or part of the data elements required pursuant to this section, by the time frame indicated in Rule Chapter 69L-6, F.A.C., the insurer shall submit a request for a variance in accordance with Section 120.542, F.S., by sending an e-mail to the Division at pocedi@wcpost.fdles.state.fl.us. The variance shall state the specific reasons the terms of the mandate cannot be achieved, and shall also identify the length of the extension needed to comply with the electronic reporting requirements specified in the rule.

(4) All insurers or third party vendors shall submit to the Division as an attachment in an e-mail to pocedi@wcpost.fdles.state.fl.us, DWC Form POCEDI-1, 'POC EDI Production Profile,' no later than one month prior to the effective date of the POC mandate. The POC EDI Production Profile shall include:

(a) Name and Federal Employer Identification Number (FEIN) of any third party vendor submitting proof of coverage data on behalf of an insurer.

(b) Name of the insurer and all subsidiary companies in the insurer's corporate structure.

(c) The Federal Employer Identification Numbers (FEIN�s) for all entities.

(d) Estimated volume of proof of coverage transactions for the current calendar year and whether volume is expected to substantially increase or decrease during the following calendar year.

(e) Insurer or third party vendor if applicable, EDI business and technical contact persons with telephone numbers and e-mail addresses.

Once filed, the insurer or third party vendor shall report any changes to its POC EDI Production Profile to the Division.

(5) The electronic cancellation shall include the minimum information required to identify the transmission as a cancellation for a specific policy, as referenced in the Florida Proof of Coverage (POC) Element Requirement Table contained within the Florida Division of Workers' Compensation Proof of Coverage Electronic Data Interchange (EDI) Implementation Manual, November 2001, which is hereby incorporated by reference in this rule. If the insurer files electronically through a third party vendor, the 30-day deadline shall be calculated from the first day following the Jurisdiction Designee Received Date, and shall include the minimum information required to identify the transmission as a cancellation for a specific policy, as referenced in the FL POC Element Requirement Table.

Specific Authority 440.591, 440.593 FS. Law Implemented 440.593 FS. History-New 3-5-02, Formerly 38F-56.100, 4L-56.100.