Industry experts for workers compensation data collection and assigned risk placement in Michigan
Note: CAOM is currently not onboarding new POC carries until further notice. Please contact poc@caom.com with any questions.
ELECTRONIC PROOF OF COVERAGE OVERVIEW
In Michigan, carriers must file all:
Carriers must file with WDCA the following POC forms: WC-400 Insurer’s Notice of Issuance of Policy; WC-401 Notice of Termination of Liability; and WC-403 Insurer’s Notice of Name or Address Change.
Carriers must file with CAOM all carrier policy data electronically in the Workers Compensation Policy Reporting Specifications (WCPOLS) format.
For ease of doing business, carriers may seek CAOM’s assistance in electronically reporting a carrier’s POC data to WDCA. Once a carrier is approved for electronic POC reporting using CAOM’s free service, forms 400, 401 and 403 will be generated from the WCPOLS data submitted to CAOM, thus eliminating the need for the carrier to send these forms to WDCA. CAOM converts the WCPOLS data to the required IAIABC format and forwards it to WDCA. Transaction 06 (policy replacement due to a key field change) and Transaction 15 (policy replacement due to add/deleted state change), however, are not sent. The carrier is still required to file forms directly to WDCA for those transactions.
Because CAOM and WDCA are two different entities, each has separate reporting requirements that must be satisfied in order for CAOM to successfully report a carrier’s POC data to WDCA.
Please refer to:
Contact WDCA to determine when they can work with you to get approved for electronic POC. When you are ready, CAOM can begin performing test POC edits on your WCPOLS data.
Communication among the carrier, CAOM and WDCA is essential and is detailed in the following sections.
Testing with CAOM for Electronic POC Reporting
Electronic POC reporting includes the following WCPOLS transactions:
Carriers that want CAOM to electronically report their carrier POC data to the WDCA must follow specific steps:
1. Policy Data Reconciliation between Carrier and WDCA (“Reconciliation”).
You must participate in a database cleanup effort with the WDCA in order to ensure all policy data filings are up-to-date, the correct Federal Employer Identification Number is being used, and the WDCA records are updated with the most current policy number.
This step can occur any time during the testing process, however, it must be completed before approval is received. Email LEO-WC-EDI-POC@michigan.gov to schedule reconciliation. You are responsible for notifying CAOM when reconciliation is complete.
For details on the specific steps in the test plan with the WDCA, click here.
2. Carrier Compliance with WCPOLS Filing Guidelines.
Certain WCPOLS fields allow for more than one way to report data. In order for CAOM to convert the WCPOLS data to the IAIABC format required by the WDCA, specific reporting requirements must be met. See the Proof of Coverage-EDI Guide (michigan.gov) for details.
Certain valid WCPOLS data cannot be mapped to an acceptable record for the WDCA. In these cases, the data will be rejected and sent back to you for correction and resubmission. All corrections must be electronically resubmitted to CAOM. Data that cannot be electronically corrected will require a paper filing to the WDCA.
3. Carrier Testing with CAOM (“Test Phase”).
The purpose of this phase is to verify your WCPOLS data can be cleanly converted. In Test, CAOM will provide you with a report of POC edits for every WCPOLS production file you submit. The reports will show the errors that would not pass edits if you were in production (once in production, transactions that error would need to be corrected and resubmitted). The reports will be stored on CAOM’s FTP server and will not be transferred to the WDCA. This allows you to address certain issues before you begin testing with the WDCA.
During testing, you will continue to submit regular production files for CAOM purposes. Rejection for POC purposes does not equate to rejection for CAOM purposes or vice versa.
Issues that require significant WCPOLS programming changes must be tested with CAOM prior to implementing in production. Failure to provide test submissions prior to moving upgrades into production can severely impact both you and CAOM. You must make necessary entry and or system changes to meet POC requirements. CAOM requires no more than a 5% error ratio in this phase before moving you to the next phase. See the MI-POC-R30 Edit Matrix for more information.
We highly recommend you include CAOM testing of WCPOLS data in your test plans. Contact 734-462-9600 ext. 265 or poc@caom.com to arrange for WCPOLS testing.
4. CAOM Testing with WDCA (“Certify Phase”).
When the WDCA is ready, it will request CAOM provide the IAIABC file on a test basis. The WDCA will provide error and acknowledgement reports to CAOM and CAOM will forward those reports to you. The reports will be stored on CAOM’s FTP server.
You must successfully complete three consecutive submissions from CAOM to WDCA.
You will continue to file all required forms on paper with the WDCA during this phase.
5. WDCA Approves Carrier for Production (“Production Phase”).
The WDCA will advise you and CAOM when you are approved for electronic POC. All parties sign a Trading Partner (EDI) agreement. The agreement specifies CAOM will electronically report a list of triplicate codes for POC to the WDCA on behalf of the insurance company(ies) named in the agreement. Once production begins, you will discontinue separate paper filings to the WDCA for the approved transactions that pass the edits.
All reports are deployed to CAOM’s FTP server which you will need to retrieve. Let us know when you are ready so we can produce the reports. A FEIN will be required for each carrier in the group that will be involved.
The carrier is responsible for monitoring all CAOM Errors and WDCA ACK Errors and notifying CAOM as soon as possible with any questions so the errors can be quickly resolved. As part of the Proof of Coverage process, CAOM creates a report for each file CAOM receives. These reports are stored on CAOM’s FTP server.
Contact POC@caom.com for your user name and password.
The report files will be PDFs with the names of CAOMERROR and SOMACK with a timestamp on them. You have only read access to those files.
We keep approximately 15 days of files on our web server in your primary folder.
We suggest you use WS_FTP from Ipswitch. CAOM uses WS_FTP Server from Ipswitch. You can download and purchase the software at http://www.ipswitch.com/products/ws_ftp/index.asp.
If you want to just test the FTP Interface to our site you could use COREFTP, a shareware program that we have found works.
Other FTP programs may also work but CAOM will only support the above products.
Our FTP server requires SSH protocol.
WS_FTP supports synchronized folders. By running on any server or workstation, it will regularly go out to our server and synchronize a folder on your network with the folder on our server. When we add a file to the list, then only that file will be added onto your network folder. When we delete a file from the list, then the sync program will delete the file from your network. This is a very easy setup.
The file names have a timestamp on it in the format of mmddyyyyhhmmsstt with the guarantee that the timestamp is always 16 characters long.
If there are any technical questions, please contact POC team at poc@caom.com.
Due to the increased volume of transactions, the current POC 3.0 ACK reports availability schedule is as follows:
The above schedule is subject to change. We will notify you of any change.
CAOM copies ACK Reports to the FTP server for Carrier access weekdays at 4:00 AM, 6:00 AM, 7:45 AM, 10:00 AM, 12:00 PM, 2:00PM and 4:00 PM.
If CAOM receives your WCPOLS file through CDX and rejects the entire file, CDX will notify you.
If CAOM accepts your WCPOLS file, two things happen:
If there are reporting issues with the file or a specific transaction CAOM cannot process, CAOM will notify you via email or crit via Michigan’s Manage Policy System (MPS). MPS allows a carrier to view CAOM’s processing status of each transaction as well as view any CAOM crit messages.
You will need to establish an individual or team to manage POC responses and correct CAOM POC errors and WDCA ACK errors on a consistent, daily basis.
Keep in mind, CAOM’s POC process is separate and independent of POC reports generated for the WDCA and by the WDCA.
If a carrier changes or updates their system, CAOM will require a WCPOLS test file.
How do I comply with the Legal Nature of Entity requirements for Record Type Code 02?
The WDCA requires the Legal Nature of Entity for every name record reported. In order to comply with the requirement Record Type Code 02, field 11 must be filled with the appropriate code.
Which Cancellation/Reinstatement Reason Codes are accepted?
The WDCA does not accept Reason for Cancellation code 99 (other). The WDCA requires a Reason for Cancellation code for non-renewals (Cancellation / Reinstatement ID Code 3)
If CANCELLATION/REINSTATEMENT ID CODE (Position 48) is 2 (Reinstatement), report the REASON FOR REINSTATEMENT CODE.
See the Proof of Coverage-EDI Guide (michigan.gov) for details.
How do I report a FEIN change?
According to the Michigan Worker’s Disability Compensation Agency (WDCA), carriers should not submit FEIN changes with change transactions (Transaction code 08, 10 or 14).
Carriers should first issue a policy cancellation (Transaction code 05) followed by a new policy (Transaction code 01) with the corrected FEIN(s).
How soon must ACK errors be resolved?
Correcting ACK errors on a daily and consistent basis is critical. Each carrier must establish a plan to address and resolve error messages. An individual or team must be responsible for managing POC responses and understand the timeline for doing so.
Can I send multiple transactions for a policy in one transmission?
Carriers should avoid filing multiple transactions for a policy in one transmission. Transactions should always be sent in chronological order.
If the carrier sends a paper transaction to WDCA to fix an acknowledgement (ACK) error, does the carrier have to send a WCPOLS transaction to CAOM replicating what was sent?
Yes. This practice ensures both CAOM and WDCA have the same data and will avoid future errors.
To read how CAOM currently processes Proof of Coverage, click here To read how CAOM currently processes Policy Data, click here To read general data reporting rules, click here To access State of Michigan Workers Compensation EDI section, click here.
* While contacting CAOM, please provide the Insurance carrier code(s). Also confirm if you are the POC contact for your company. If you have already done this, thank you.