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Test Audit Inquiries

 

Test Audit Program

The Test Audit Program was initiated May 1, 1982. The most recent changes to the program were made effective October 1, 2007. Details of the current program appear in Bureau Circular 1532.

 

Test Audit Bulletins

Test Audit Bulletins are used to disseminate educational information regarding the Test Audit Program.

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Bulletin Number

Description

Date
99 Test Audit Appeal Decision 09 / 23 / 08
98 Test Audit Appeal Decision 06 / 10 / 08
97 Test Audit Online – Policy Selection Lists 02 / 28 / 08
96 Staff Retirement 01 / 03 / 08
95 Test Audit Appeal Decision 05 / 11 / 07
94 Test Audit Online 02 / 22 / 07
93 Test Audit Appeal Decision 10 / 25 / 06
92 Claims Verification 07 / 15 / 05
91 Test Audit Appeal Decision 01 / 03 / 05
90 Minimum Wage Adjustment 11 / 09 / 04
89 Procedures Pertaining to Submission of Action Plans (Section VIII) 10 / 27 / 04
88 Test Audit Appeal Decision 08 / 20 / 04
87 Nursing and Personal Care Homes - Classification Guide 06 / 15 / 04
86 Sole Proprietors and Partners (Delaware SAWW) - Update of Bulletin #83 05 / 25 / 04
85 Claims Verification 02 / 13 / 04
84 C - Report Compliance 02 / 13 / 04
83 Sole Proprietors and Partners (Delaware SAWW) - Update of Bulletin #79 10 / 09 / 03
82 New vs. Renewal 09 / 09 / 03
81 Test Audit Appeal Decision 08 / 27 / 03
80 Action Plan Submissions 01 / 03 / 03
79 Sole Proprietors and Partners (Delaware SAWW)
Update of Bulletin #68		 11 / 06 / 02
78 Request for E-Mail Addresses 09 / 13 / 02
77 Classifications Most Often Involved in Test Audit Differences 09 / 13 / 02
76 Test Audit Appeal Decision 09 / 13 / 02
75 Test Audit Appeal Decision 09 / 13 / 02
74 Non-Productive Rescinds 04 / 18 / 02
73 Acceptability of Revised Audits 04 / 18 / 02
72 Documentation Examples 04 / 18 / 02
71 Audit Committee Appeal 01 / 11 / 02
70 Audit Committee Appeal 01 / 11 / 02
69 Failed Request Incentive Charge 10 / 08 / 01
68 Sole Proprietors and Partners (Delaware SAWW)
Update of Bulletin #58		 10 / 05 / 01
67 Classification Survey Questions 09 / 14 / 01
66 Test Audit Procedures - Designation of Informants 07 / 13 / 01
65 Regular and Frequent 07 / 13 / 01
64 Executive Officers - Classification Assignment 06 / 07 / 01
63 Audit Committee Appeal 02 / 23 / 01
62 Revisions to Test Audit Program - Effective April 1, 2001 02 / 20 / 01
61 Cashiers (Supersedes Bulletin #56) 10 / 16 / 00
60 Audit Committee Appeal 09 / 15 / 00
59 Volunteer Ambulance Corps - Stipends Paid to Members. 08 / 21 / 00
58 Sole Proprietors And Partners (Delaware SAWW)
Update of Bulletin #55		 08 / 30 / 00
57 Audit Committee Appeal 01 / 17 / 00
56 Cashiers 12 / 15 / 99
55 Sole Proprietors And Partners (Delaware SAWW)
Update of Bulletin #49		 07 / 30 / 99
54 Collection of Additional Premium 05 / 03 / 99
53 Correction for Bulletin #48 01 / 15 / 99
52 Audit Committee Appeal 01 / 15 / 99
51 Audit Committee Appeal 09 / 30 / 98
50 Audit Committee Appeal 09 / 30 / 98
49 Sole Proprietors And Partners (Delaware SAWW)
Update of Bulletin #44		 08 / 03 / 98
48 Automobile Dealerships Audits
Update of Bulletin #36		 05 / 12 / 98
47 Audit Committee Appeal 03 / 17 / 98
46 Audit Committee Appeal 03 / 03 / 98
45 Audit Committee Appeal 03 / 03 / 98
44 Sole Proprietors And Partners (Delaware SAWW)
Update of Bulletin #41		 08 / 05 / 97
43 Carrier Withdraw From Test Audit Program 06 / 24 / 97

Test Audit Bulletins issued prior to June 1997 are available upon written request to the PCRB.

 

Frequently Asked Questions

 

Q: WHAT IS THE PURPOSE OF A TEST AUDIT?
A: The Test Audit Program was designed to monitor the accuracy and consistency of carrier premium audits. The test audit verifies that the classifications, rates, experience modifications and related rules applied on the audit are correct. The Test Audit Program also assures the statistical data reported to the Bureau is accurate and consistent with Pennsylvania Manual rules.
 
Q: HOW WAS I SELECTED FOR TEST AUDIT?
A: Policies subject to a test audit are randomly selected on a monthly basis. Once an insured is selected for test audit and the test audit is completed, this insured will not be selected again for at least five years.
 
Q: WHAT CRITERIA IS USED FOR TEST AUDIT SELECTION?
A: Policies eligible for test audit are subject to a minimum annual policy premium of $2500. Test audit selections include physical, voluntary and waived or estimated audits. The number of policies selected for test audit may not exceed sixteen (16) policies per month for each participating carrier group.
 
Q: CAN A CARRIER'S AUDIT BE DISPUTED?
A: Yes. If an insured or agent disagrees with a carrier's audit, a letter must be sent to the Field Operations Department of the Bureau explaining the nature of the dispute. If an insured is disputing the payroll allocations of the audit, the Bureau must be provided with the names of the employee(s) whose payroll is being disputed and a description of their specific job duties. Once received and reviewed a field representative will, as necessary, visit the insured and gather the information needed to resolve the matter. A letter will then be sent to the originator of the request explaining the Bureau’s decision on the proper classification of the employee(s) in question.
 
Q: WILL THE BUREAU INTERVENE IN AN AUDIT DISPUTE ON BEHALF OF A CARRIER?
A: No. It is neither the intent nor the responsibility of the Test Audit Program to resolve payroll allocations on behalf of the carrier. Therefore, it is incumbent on insurers to properly apply and explain the classification plan to their policyholders. The carrier should conduct their audit in full compliance with Pennsylvania Manual rules and in accordance with their own company guidelines. The Bureau will only intervene after the parties involved have reached an impasse and the employer submits a written request.
  
Q: IS THE INSURED ENTITLED TO A COPY OF THE TEST AUDIT?
A: The PCRB does not release copies of test audits without the written authorization of the carrier of record. Contact your carrier for a copy of the test audit.
 
Q: HOW OFTEN CAN AN INSURED BE SELECTED FOR TEST AUDIT?
A: The Test Audit Program states that no insured can be test audited more than once in a five-year period.
 
Q: CAN THE INSURED BE BILLED FOR ADDITIONAL PREMIUM RESULTING FROM THE TEST AUDIT?
A: No. If the results of the test audit produce an additional premium, the carrier may not bill the insured for the additional premium for the policy period test audited. However, the carrier may apply the basis for the additional premium to your current policy, provided circumstances have remained unchanged.
 
Q: IS IT MANDATORY TO COMPLY WITH A TEST AUDIT?
A: Notwithstanding the standard policy condition which provides the PCRB with the right to conduct a test audit, compliance is not mandatory. However, given that one of the primary purposes of a test audit is to verify the accuracy of carrier audits, employer cooperation is critical.

Classification Survey Questions

In response to numerous requests from the membership for assistance on classification procedure the Bureau presents the following standard classification survey instructions used by Bureau field representatives in conducting both classification surveys and test audits. Every current classification is addressed to varying degrees. We believe this document can provide some guidance in establishing the type of information needed to effectively determine the proper classification for an employer.

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Classification Survey Questions