NCCI Proof of Coverage Start Date |
05/01/09 |
State Contact Information |
Industrial Commission of Arizona
800 W. Washington Street
Phoenix, AZ 85007
Contact Name: Noreen Thorsen
Tel: 602-542-6689
Fax: 602-542-3373
E-mail: nthorsen@ica.state.az.us
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How NCCI Provides Data to State |
- NCCI POC format, daily submissions
- POC Online Inquiry
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Policies—Compliance Requirements
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- Must be filed within five days after undertaking to insure an employer.
- IAIABC Form POC1 (as a binder) may be submitted if the policy will not be issued within five days after undertaking to insure an employer. (This does not eliminate the need to submit the policy.)
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Notice of Cancellation—Compliance Requirements |
A notice of cancellation must be filed 30 or more days prior to the effective date of the cancellation or nonrenewal. The insurance carrier must promptly notify the Commission of any cancellation by the employer or failure of the employer to renew the policy. Policies may not be cancelled by the insurer except for nonpayment. Arizona is not a continuous coverage state; Non-renewals are not required. |
Reinstatements—Compliance Requirements |
Due within five days after the reinstatement. |
FEIN—Compliance Requirements |
Required |
Address Reporting Requirement |
Not accepting Employer Names linked to Address Type 6 – No Physical Location. Must submit out-of-state address. |
Fines—Compliance Requirements |
Possible Bad Faith Patterns and Practices fine of $1,000 for each incident if coverage provider and/or processing Third Party Administrator (TPA) is consistently reporting late, which results in delay of benefits. |
| Appeals—Compliance Requirements |
May appeal fines to the Industrial Commission of Arizona. |
| Special Compliance Requirement |
Insurance companies writing workers compensation policies that use a TPA to process claims must register and provide the TPA contact information through the Industrial Commission of Arizona's Web application within five days of reporting the policy to NCCI. The Web application can be found at www.ica.state.az.us/tpa/. Please provide a contact name and phone number to the ICA for policy/TPA clarification purposes. If you have questions about the TPA information or coverage issues, please contact Melanie Young, Industrial Commission of Arizona, 602-542-6713.
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