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FREQUENTLY ASKED QUESTIONS

 

Question: WHAT IS THE PURPOSE OF A TEST AUDIT?
Answer: 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 State Manual rules.
 
Question: HOW WAS I SELECTED FOR TEST AUDIT?
Answer: 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, the insured will not be selected again for about a period of five years.
 
Question: WHAT CRITERIA IS USED FOR TEST AUDIT SELECTION?
Answer: 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 an X amount of policies per month for each participating carrier group.
 
Question: CAN A CARRIER'S AUDIT BE DISPUTED?
Answer: 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 Bureau 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 Bureauís decision on the proper classification of the employee(s) in question.
 
Question: WILL THE BUREAU INTERVENE IN AN AUDIT DISPUTE ON BEHALF OF A CARRIER?
Answer: 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 or Auditing firm should conduct their audit in full compliance with the State 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.
  
Question: IS THE INSURED ENTITLED TO A COPY OF THE TEST AUDIT?
Answer: The State Bureau 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.
 
Question: HOW OFTEN CAN AN INSURED BE SELECTED FOR TEST AUDIT?
Answer: The Test Audit Program usually states that no insured can be test audited more than once in a five-year period.
 
Question: CAN THE INSURED BE BILLED FOR ADDITIONAL PREMIUM RESULTING FROM THE TEST AUDIT?
Answer: 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.
 
Question: IS IT MANDATORY TO COMPLY WITH A TEST AUDIT?
Answer: Notwithstanding the standard policy condition which provides the State Bureau 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.
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