(1) Effective March 1, 2002, every insurer
authorized to insure employers in the State of Florida, except for individual
self-insurers approved under Section
440.38, F.S., shall file policy
information electronically to the Division rather than by filing on paper forms
previously required.
Every insurer shall send to the Division by electronic data
interchange electronic policy information for Certificates of Insurance,
Endorsements, Reinstatements, Cancellations and Non-Renewals pursuant to the
filing time periods in Rule
69L-56.210, F.A.C., of this
chapter. Such policy information shall be sent in accordance with the "EDI
Trading Partner Requirements" set forth in Sections 2 through 6 of the Florida
Division of Workers' Compensation Proof of Coverage Electronic Data Interchange
(EDI) Implementation Manual, 1/01/2009, which is incorporated herein by
reference. A copy of the manual may be obtained from the Division of Workers'
Compensation at its website,
http://www.myfloridacfo.com/Division/WC/EDI/POC_EDI.htm,
or by sending a request to the Division of Workers' Compensation, Bureau of
Data Quality and Collection, 200 East Gaines Street, Tallahassee, Florida
32399-4226. The Division will not accept an electronic transaction that fails
to comply with the "EDI Trading Partner Requirements" in Sections 2 through 6
in this manual. The insurer shall send electronic transmissions either directly
to the Division or through a third party vendor.
(2) On or before April 2, 2007, all
electronic form equivalents of Proof of Coverage data shall be sent in the
Proof of Coverage formats adopted by the IAIABC and located in Section 2 of the
IAIABC EDI Implementation Guide for Proof of Coverage: Insured, Employer,
Header, Trailer & Acknowledgement Records, Release 2.1, 6/01/2007
Edition.
(3)
(a) At least one (1) business day before the
insurer or third party vendor sends its first transmission to the Division, the
insurer or third party vendor shall send to the Division in an email addressed
to poc.edi@myfloridacfo.com, their profile information using the following
forms adopted in Rule
69L-56.001, F.A.C.:
1. "EDI Trading Partner Profile,"
DFS-F5-DWC-EDI-1 (1/01/2008); and,
2. "EDI Trading Partner Insurer/Claim
Administrator ID List," DFS-F5-DWC-EDI-2 (10/01/2006); and,
3. "EDI Transmission Profile - Sender's
Specifications," DFS-F5-DWC-EDI-3 (10/01/2006).
(b) The insurer or third party vendor shall
report changes to its profile information to the Division at least one (1)
business day before sending transactions containing new profile-related
information. The insurer or third party vendor shall report the new profile
information by emailing a revised "EDI Trading Partner Profile,"
DFS-F5-DWC-EDI-1 (1/01/2008), and if applicable, the "EDI Trading Partner
Insurer/Claim Administrator ID List," DFS-F5-DWC-EDI-2 (10/01/2006), and if
applicable, the "EDI Transmission Profile - Sender's Specifications,"
DFS-F5-DWC-EDI-3 (10/01/2006) to the Division at
poc.edi@myfloridacfo.com.
(c) If
the insurer suspends the use of a third party vendor and begins sending its
electronic Proof of Coverage data directly to the Division, the insurer shall,
at least one (1) business day prior to the effective date of this change, email
a revised "EDI Transmission Profile - Sender's Specifications,"
DFS-F5-DWC-EDI-3 (10/01/2006), to the Division at
poc.edi@myfloridacfo.com.
(d) If
the insurer changes third party vendors, the insurer shall, at least one (1)
business day prior to the effective date of the change, send an email to the
Division at poc.edi@myfloridacfo.com to report the name of the new vendor and
effective date on which POC transactions will be sent by the new
vendor.
(e) Insurers or third party
vendors that experience a catastrophic event resulting in the insurer's failure
to meet the filing requirements of this rule, shall submit a written or
electronic request to the Division for approval to submit required electronic
form equivalents in an alternative filing timeline. The request shall be sent
to the Division within 15 business days after the catastrophic event. The
request shall contain a detailed explanation of the nature of the event, date
of occurrence, and measures being taken to resume electronic submission. The
insurer or third party vendor shall also provide an estimated date by which
electronic submission of affected EDI filings will be resumed. Approval to
submit in an alternative filing timeline shall be granted by the Division if a
catastrophic event prevents electronic submission. The approval must be
obtained from the Division's Bureau of Data Quality and Collection, 200 E.
Gaines Street, Tallahassee, Florida 32399-4226, or via email at
poc.edi@myfloridacfo.com.
