Code of Maine Rules
90 - INDEPENDENT AGENCIES
351 - WORKERS' COMPENSATION BOARD
Chapter 3 - FORM FILING
Section 351-3-5 - Electronic filing of proof of coverage

(1) Unless a waiver has been granted pursuant to subsection (1)(B) of this section, insurance companies shall file with the Board notice of the new, renewal, or endorsement of any workers' compensation policy to an employer using International Association of Industrial Accident Boards and Commissions ("IAIABC") Proof of Coverage Release 2.1.

(2) The required notice must be filed with the Board no later than 30 days after issuance, renewal or policy initiating endorsement.

(1) The Board, at its discretion by majority vote of its membership, may grant an insurer a waiver of the filing requirements of this section if the insurer establishes to the satisfaction of the Board that compliance with these requirements would cause undue hardship. For purposes of this section, undue hardship means significant difficulty or expense. Requests for waivers must be submitted in writing and addressed to the Chair of the Workers' Compensation Board, 27 State House Station, Augusta, Maine 04333-0027.

(2) Individual waiver. An individual notice of Proof of Coverage can be filed by paper or fax if the Executive Director or the Executive Director's designee finds that the insurer was prevented from complying with this section because of circumstances beyond the control of the insurer. A decision by the Executive Director or the Executive Director's designee may be appealed to the Board of Directors. The appeal must be in writing; must set forth the reasons why the appealing party believes the decision should be reversed; and must be filed within 7 (seven) days of the date of the decision appealed from.

(1) HD. The transmission was rejected and the Proof of Coverage is not filed.

(2) TA (Transaction accepted). The transaction was accepted and the Proof of Coverage is filed.

(3) TE (Transaction accepted with errors). The transaction was accepted with errors and the Proof of Coverage is filed. The error or errors will be identified in the acknowledgement transmission that is sent by the Board. All identified errors must be corrected within 14 days after the date the acknowledgement transmission was sent by the Board.

(4) TR (Transaction rejected). The entire transaction has been rejected and the Proof of Coverage is not filed.

(5) TW and TN. These application acknowledgement codes are not used.

(1) M (Mandatory). The data element must be present and must be in a valid format or the transaction will be rejected.

(2) MC (Mandatory/Conditional). The data element is mandatory if the conditions defined in the Maine Workers' Compensation Board Proof of Coverage Release 2.1 Conditional Requirement Table (Appendix X) exist.

(3) E (Expected). The data element is expected when a transaction is submitted. The transaction will be accepted without the data element and the notice of Proof of Coverage is filed but is incomplete. The entity submitting the transaction will receive a message indicating the transaction was accepted with errors and identifying the missing or incorrect data element or elements. The notice of Proof of Coverage must be completed by submitting the missing or corrected data element or elements within 14 days after the error message is sent by the Board or prior to any subsequent submission for the same policy, whichever is sooner.

(4) EC (Expected/Conditional). The data element is expected if the conditions defined in the Maine Workers' Compensation Board Proof of Coverage Release 2.1 Conditional Requirement Table (Appendix X) exist. The transaction will be accepted without the data element and the notice of Proof of Coverage is filed but is incomplete. The entity submitting the transaction will receive a message indicating the transaction was accepted with errors and identifying the missing or incorrect data element or elements. The notice of Proof of Coverage must be completed by submitting the missing or corrected data element or elements within 14 days after the error message is sent by the Board or prior to any subsequent submission for the same policy, whichever is sooner.

(5) IA (If Available). The data element should be sent if available. If the data element is sent, the Workers' Compensation Board may edit the data to ensure valid value and format. A filing will not be rejected if the only error is a missing data element designated IA.

(6) NA (Not Applicable). The data element does not apply to the triplicate code and does not have to be sent. The Board will not edit these data elements.

(7) R (Restricted).

(8) F or FT (Fatal Technical). Data elements that must be sent. If a data element designated F is not present and in a valid format, the filing will be rejected.

(9) X (Exclude). The data element does not apply to the triplicate code and does not have to be sent. The Board will not edit these data elements.