Form Filing Changes

Last Updated: December 5, 2000

Date:

August 15, 1996

To:

All Insurers Authorized to Transact Business in Wisconsin

From:

Josephine W. Musser, Commissioner of Insurance

Subject:

Form Filing Changes

We have revised some of the Class, Coverage, and Type of Filing codes used in the transmittal information you submit with your form filings. The codes affect what you enter into columns #8, #9, and #10 of the Insurance Form Listing [OCI 26-015]. A summary of all valid codes is listed below.

INSURERS SHOULD START USING THE NEW CODES IMMEDIATELY.

If you have any questions concerning these changes, please contact Jennifer Harris (608) 266-3709 or Katherine Childs (608) 264-6231.

PROPERTY & CASUALTY

The main change to the property and casualty two-digit class number is the new distinction between coverages for personal and commercial classes. The previous Motor Vehicle class of "10" and the Property and Casualty Miscellaneous class of "90" are now split into two categories, personal lines (classes "10" and "90") and commercial lines (classes "15" and "95"). Also, the second digit of the class code (column #8) ends in "5" for all commercial coverages and "0" for personal lines coverages. Other changes consist of:

Garage Liability is relocated to Liability "65" from the previous Motor Vehicle "10."

Owners, landlords & tenants coverage is listed under Commercial Property "25" as well as Homeowner and Farm Owner "30."

Condominium coverage is listed under Homeowner and Farm Owner "30."

A Wisconsin worker's compensation pool class is added under Worker's Compensation "75."

(Since insurers do not file worker's compensation forms in Wisconsin, the 75 WCP and 75 WWP codes are used only by the Wisconsin Compensation Rating Bureau.)

In the miscellaneous coverages, some coverages were eliminated (All-Terrain Vehicle, Snowmobile, and Windstorm) and some were added (Pet Health, Recreation Vehicle, Rust Proofing, Travel/Accident, and Excess Managed Care)

s Compensation "75."

(Since insurers do not file worker's compensation forms in Wisconsin, the 75 WCP and 75 WWP codes are used only by the Wisconsin Compensation Rating Bureau.)

In the miscellaneous coverages, some coverages were eliminated (All-Terrain Vehicle, Snowmobile, and Windstorm) and some were added (Pet Health, Recreation Vehicle, Rust Proofing, Travel/Accident, and Excess Managed Care).

LIFE & HEALTH

The changes to the health and life coverage codes consist of:

The elimination of coverage codes "OIB," "VUL," and "IWL" in the Individual Life section, and the coverage code "VUL" in the Group Life section.

Instead of a single category for annuities, there is now coverage class "43" for Individual Annuities and coverage class "44" for Group Annuities ("44" previously was used for Credit Life which has been changed to "45").

Credit Life "45" and Credit Accident & Health "55" include new coverage codes "ALL" for forms used with all credit categories, and "RAT" for rates.

Coverage codes "MSB," "MSM," and "MST" have been eliminated from the Individual Accident & Health section, while stop-loss coverage codes "51STL" and "54STL" have been changed to new coverage class "97STL."

In the Group Accident & Health section, coverage codes "BAO," "BGN," "BHI," "BHS," "BMM," and "BSP" (blanket policies) have been combined into one new code "BKT."

New coverage codes have been added to the Health Maintenance Organization section "56" and the Preferred Provider section "57." They are conversion - "CVN," group/long-term care - "GLT," group/Medicare Cost - "GMC," individual/dental - "IDT," individual/long-term care - "ILT," and individual/Medicare Cost - "IMC." In addition, group dental codes "56DTL" and "57DTL" have changed to "56GDT" and "57IDT," respectively.

A new coverage code for Point-of-Service Plans "57POS" has been added to the Preferred Provider section, and new coverage codes for group and individual chiropractic plans "58GCP" and "58ICP" have been added to the Limited Service Health Organization section

and individual/Medicare Cost - "IMC." In addition, group dental codes "56DTL" and "57DTL" have changed to "56GDT" and "57IDT," respectively.

A new coverage code for Point-of-Service Plans "57POS" has been added to the Preferred Provider section, and new coverage codes for group and individual chiropractic plans "58GCP" and "58ICP" have been added to the Limited Service Health Organization section.

Coverage class "97," Health & Life Miscellaneous, is new and includes coverage codes for continuing care retirement community - "CCR," excess managed care coverage - "EMC," stop-loss - "STL," and other - "OTH."

TYPE OF FILING

The codes for Type of Filing (column #10) are also revised. The changes include a new code "C" for a Certificate, a new code "N" for a Notice, and a revision of code "R" for Rider/Endorsement/Amendment which now includes endorsements. The previous code "E" for Endorsement/Amendment has been eliminated.

CERTIFICATE OF COMPLIANCE

(see

Ins. 6.05

, Wis. Adm. Code, Appendix A)

INFORMATION ABOUT CERTIFYING READABILITY

(see

Ins. 6.07 (6)

, Wis. Adm. Code, for instructions)

Below is a link to the Wisconsin Revisor of Statutes Web site containing Wisconsin Administrative Code for the Commissioner of Insurance. Choose

Ins 6 General

to view s. Ins 6.05, Wis. Adm. Code (Filing of Insurance Forms) and s. Ins 6.07, Wis. Adm. Code (Insurance Policy Language Simplification).

Wisconsin Administrative Code, Commissioner of Insurance

10 PERSONAL MOTOR VEHICLE

Column #8

Coverage

Class

Column #9

Coverage

Code

10

10

10

10

10

10

10

10

10

10

ATA

ALI

AMP

MTH

MCY

OTH

APD

PPA

UIM

AUM

Antique automobile

Liability

Medical payment

Motor home

Motorcycle

Personal motor vehicle, other

Physical damage

Private passenger auto

Underinsured motorist

Uninsured motorist

15 COMMERCIAL MOTOR VEHICLE

Column #8

Coverage

Class

Column #9

Coverage

Code

15

15

15

15

15

15

15

15

15

15

ATA

CAU

OTH

ALI

LHT

AMP

MTH

APD

UIM

AUM

Antique automobile

Commercial automobile (taxi, fleet, ambulance, etc.)

Commercial motor vehicle, other

Liability

Long-haul

or home

Motorcycle

Personal motor vehicle, other

Physical damage

Private passenger auto

Underinsured motorist

Uninsured motorist

15 COMMERCIAL MOTOR VEHICLE

Column #8

Coverage

Class

Column #9

Coverage

Code

15

15

15

15

15

15

15

15

15

15

ATA

CAU

OTH

ALI

LHT

AMP

MTH

APD

UIM

AUM

Antique automobile

Commercial automobile (taxi, fleet, ambulance, etc.)

Commercial motor vehicle, other

Liability

Long-haul truck

Medical payment

Motor home

Physical damage

Underinsured motorist

Uninsured motorist

25 COMMERCIAL PROPERTY

Column #8

Coverage

Class

Column #9

Coverage

Code

25

25

25

25

25

25

ALL

BOP

CFA

CMP

OTH

OLT

All coverages listed in class 25

Business owners policy

Commercial fire & allied

Commercial multi-peril

Commercial property, other

Owners, landlords & tenants

30 HOMEOWNER AND FARM OWNER

Column #8

Coverage

Class

Column #9

Coverage

Code

30

30

30

30

30

30

30

30

30

ALL

CON

FRO

HOM

OTH

MHO

PPD

REN

OLT

All coverages listed in class 30

Condominium

Farm/ranch owner

Home owner

Homeowner/farmowner, other

Mobile homeowner

Personal property/dwelling

Renter

Owners, landlords & tenants

41 INDIVIDUAL LIFE

Column #8

Coverage

Class

Column #9

Coverage

Code

41

41

41

41

41

41

41

41

41

41

41

41

41

41

41

41

41

41

41

41

41

41

41

41

ADB

ADD

ACD

ALL

ANF

DIN

END

GUI

HHC

OTH

CHB

FAB

SPB

LAS

LTC

NUR

TER

JTE

UNL

VAL

WAP

PAW

WHL

JWL

Accelerated death benefit

Accidental death and disability benefit

Accidental death benefit

All lines listed in class 41 excluding VAL

Annuity fund rider

Disability income benefit

Endowment

Guaranteed insurability benefit

Home health care

Individual life, other

Insurance benefit/children

Insurance benefit/family

Insurance benefit/spouse

Last survivor life

Long-term care

Nursing home

Term life

Term life/joint

Universal life

Variable life

Waiver of premium benefit

Waiver of premium benefit/payer

Whole life

Whole life/joint

42 GROUP LIFE

Column #8

Coverage

Class

Column #9

Coverage

Code

42

42

42

42

42

42

42

42

42

42

42

42

42

42

42

42

42

42

42

ADB

ADD

ACD

ALL

DIN

END

OTH

HHC

CHB

FAB

SPB

LTC

NUR

TER

UNL

VAL

WAP

PAW

WHL

Accele

it/spouse

Last survivor life

Long-term care

Nursing home

Term life

Term life/joint

Universal life

Variable life

Waiver of premium benefit

Waiver of premium benefit/payer

Whole life

Whole life/joint

42 GROUP LIFE

Column #8

Coverage

Class

Column #9

Coverage

Code

42

42

42

42

42

42

42

42

42

42

42

42

42

42

42

42

42

42

42

ADB

ADD

ACD

ALL

DIN

END

OTH

HHC

CHB

FAB

SPB

LTC

NUR

TER

UNL

VAL

WAP

PAW

WHL

Accelerated death benefit

Accidental death and disability benefit

Accidental death benefit

All coverages listed in class 42 excluding VAL

Disability income benefit

Endowment

Group life, other

Home health care

Insurance benefit/children

Insurance benefit/family

Insurance benefit/spouse

Long-term care

Nursing home

Term life

Universal life

Variable life

Waiver of premium benefit

Waiver of premium benefit/payer

Whole life

43 ANNUITY

Column #8

Coverage

Class

Column #9

Coverage

Code

43

43

43

43

43

43

43

43

ALL

OTH

IFD

IFL

IIM

ISD

VIA

IRA

All coverages listed in class 43 excluding VIA

Annuity, other

Individual/fixed premiums deferred annuity

Individual/flexible premium deferred annuity

Individual/immediate annuity

Individual/single premium deferred annuity

Individual/variable annuity

Tax-related annuity (IRA)

44 GROUP ANNUITY

Column #8

Coverage

Class

Column #9

Coverage

Code

44

44

44

44

44

44

44

44

ALL

OTH

GDA

GFD

GFL

GIM

GSD

VGA

All coverages listed in class 44 excluding VGA

Annuity, other

Group deposit administration

Group/fixed premium deferred annuity

Group/flexible premium deferred annuity

Group/immediate annuity

Group/single premium deferred annuity

Group/variable annuity

45 CREDIT LIFE

Column #8

Coverage

Class

Column #9

Coverage

Code

45

45

45

45

45

45

45

ALL

OTH

GMT

GMP

GSP

GST

RAT

All coverages listed in class 45

Credit life, other

Group/monthly O.B

cluding VGA

Annuity, other

Group deposit administration

Group/fixed premium deferred annuity

Group/flexible premium deferred annuity

Group/immediate annuity

Group/single premium deferred annuity

Group/variable annuity

45 CREDIT LIFE

Column #8

Coverage

Class

Column #9

Coverage

Code

45

45

45

45

45

45

45

ALL

OTH

GMT

GMP

GSP

GST

RAT

All coverages listed in class 45

Credit life, other

Group/monthly O.B. life - truncated benefit

Group/monthly premium life

Group/single premium life

Group/single premium life - truncated benefit

Rates

51 INDIVIDUAL ACCIDENT & HEALTH

Column #8

Coverage

Class

Column #9

Coverage

Code

51

51

51

51

51

51

51

51

51

51

51

51

51

51

51

51

51

51

51

51

51

51

51

51

AON

ADD

ALL

CAN

CVN

DTL

DIN

FRC

HHC

HIN

HSM

OTH

LTC

MAM

MDC

MER

MDS

MSP

NUR

PHC

SPD

TAC

VOC

WAP

Accident only

Accidental death and dismemberment

All coverages listed in class 51

Cancer

Conversion

Dental

Disability income

Franchise

Home health care

Hospital indemnity

Hospital-surgical-medical

Individual accident and health, other

Long-term care

Major medical

Medicare cost

Medicare risk

Medicare select

Medicare supplement

Nursing home

Pharmaceutical

Specified (dread) disease

Travel/accident

Vision

Waiver of premium

54 GROUP ACCIDENT & HEALTH

Column #8

Coverage

Class

Column #9

Coverage

Code

54

54

54

54

54

54

54

54

54

54

54

54

54

54

54

54

54

54

54

54

54

54

54

54

54

AON

ADD

ALL

BKT

CAN

DTL

DIN

OTH

HC

HIN

HSM

LTC

MAM

MDC

MER

MDS

MSP

NUR

PHC

SPD

SSA

SSM

TAC

VOC

WAP

Accident only

Accidental death and dismemberment

All coverages listed in class 54

Blanket

Cancer

Dental

Disability income

Group accident & health, other

Home health care

Hospital indemnity

Hospital-surgical-medical

Long-term care

Major medical

Medicare cost

Medicare risk

Medicare select

Medicare supplement

Nursing home

Pharmaceutical

Specified (dread) disease

Student/accident

Student/school medical

Travel/accident

Vision

Waiver of premium

55 CREDIT ACCIDENT & HEALTH

Column #8

Coverage

Class

Column #9

Coverage

Code

55

55

55

55

55

55

55

ALL

OTH

GMT

GMP

GSP

GST

RAT

All lines listed in class

tal-surgical-medical

Long-term care

Major medical

Medicare cost

Medicare risk

Medicare select

Medicare supplement

Nursing home

Pharmaceutical

Specified (dread) disease

Student/accident

Student/school medical

Travel/accident

Vision

Waiver of premium

55 CREDIT ACCIDENT & HEALTH

Column #8

Coverage

Class

Column #9

Coverage

Code

55

55

55

55

55

55

55

ALL

OTH

GMT

GMP

GSP

GST

RAT

All lines listed in class 55

Credit accident & health, other

Group/monthly O.B. premium - A&H truncated benefit

Group/monthly premium A&H

Group/single premium A&H

Group/single premium A&H truncated benefit

Rates

56 HEALTH MAINTENANCE ORGANIZATION (HMO)

Column #8

Coverage

Class

Column #9

Coverage

Code

56

56

56

56

56

56

56

56

56

56

56

56

56

56

56

56

56

56

56

56

56

CVN

GAH

GDT

GHC

GLT

GMC

GMR

GMS

GNH

OTH

IAH

IDT

IHC

ILT

IMC

IMR

IMS

INH

PHC

POS

VCO

Conversion

Group/accident & health

Group/dental

Group/home health care

Group/long-term care

Group/Medicare cost

Group/Medicare risk

Group/Medicare select

Group/nursing home

HMO, other

Individual/accident & health

Individual/dental

Individual/home health care

Individual/long-term care

Individual/Medicare cost

Individual/Medicare risk

Individual/Medicare select

Individual/nursing home

Pharmaceutical

Point of service

Vision

57 PREFERRED PROVIDER PLAN PPP

Column #8

Coverage

Class

Column #9

Coverage

Code

57

57

57

57

57

57

57

57

57

57

57

57

57

57

57

57

57

57

57

57

GAH

GDT

GHC

GLT

GMC

GMR

GMS

GNH

IAH

IDT

IHC

ILT

IMC

IMR

IMS

INH

PHC

POS

OTH

VCO

Group/accident & health

Group/dental

Group/home health care

Group/long-term care

Group/Medicare cost

Group/Medicare risk

Group/Medicare select

Group/nursing home

Individual/accident & health

Individual/dental

Individual/home health care

Individual/long-term care

Individual/Medicare cost

Individual/Medicare risk

Individual/Medicare select

Individual/nursing home

Pharmaceutical

Point of service

PPP, other

Vision

58 LIMITED SERVICE HEALTH ORGANIZATION (LSHO)

Column #8

Coverage

Class

Column #9

Coverage

Code

58

58

58

58

58

58

58

58

58

GCP

GDT

GMN

GVC

ICP

IDT

IMN

IVC

0TH

Group/c

nt & health

Individual/dental

Individual/home health care

Individual/long-term care

Individual/Medicare cost

Individual/Medicare risk

Individual/Medicare select

Individual/nursing home

Pharmaceutical

Point of service

PPP, other

Vision

58 LIMITED SERVICE HEALTH ORGANIZATION (LSHO)

Column #8

Coverage

Class

Column #9

Coverage

Code

58

58

58

58

58

58

58

58

58

GCP

GDT

GMN

GVC

ICP

IDT

IMN

IVC

0TH

Group/chiropractic

Group/dental

Group/mental and nervous

Group/vision

Individual/chiropractic

Individual/dental

Individual/mental and nervous

Individual/vision

LSHO, other

65 LIABILITY

Column #8

Coverage

Class

Column #9

Coverage

Code

65

65

65

65

65

65

65

65

65

65

65

65

65

CEX

CUM

CTL

DOS

EOM

GAR

GEN

OTH

LIQ

MML

NUC

PPL

PRO

Commercial excess

Commercial umbrella

Contractual

Directors and officers

Errors and omissions

Garage

General

Liability, other

Liquor

Medical malpractice

Nuclear

Pollution-legal

Professional

75 WORKER'S COMPENSATION (RSO Only)

Column #8

Coverage

Class

Column #9

Coverage

Code

75

75

WCP

WWP

Worker's compensation

Wisconsin worker’s comp pool

85 BONDS

Column #8

Coverage

Class

Column #9

Coverage

Code

85

85

FID

SUR

Fidelity

Surety

90 PERSONAL PROPERTY & CASUALTY MISCELLANEOUS

Column #8

Coverage

Class

Column #9

Coverage

Code

90

90

90

90

90

90

90

90

90

90

90

90

90

90

90

90

90

90

AVI

BOT

CRU

CRI

FLO

MBI

MTG

MCS

PEX

PIM

OTH

PET

RVS

RST

TTL

TAC

VSC

WPS

Aviation/aircraft

Boat owner

Credit unemployment

Crime

Flood

Mechanical breakdown

Mortgage guaranty

Motor club

Personal excess umbrella

Personal inland marine

Personal P&C misc., other

Pet health

Recreational vehicle (ATV, jet ski, snowmobile, etc.)

Rust proofing

Title

Travel/Accident

Vehicle service contract

Warranty plan

95 COMMERCIAL PROPERTY & CASUALTY MISCELLANEOUS

Column #8

Coverage

Class

Column #9

Coverage

Code

95

95

95

95

95

95

95

95

95

95

95

95

95

95

95

95

AVI

BAM

BOT

CPL

CIM

OTH

CRP

CRI

CHL

EMC

FLO

GLA

LEX

LSM

MTG

TTL

Aviation/aircraft

Boiler/machinery

Boat owner

Collateral protection

Commercial inland marine

Commercial P&C misc., other

Credit property

Crime

Cro

ident

Vehicle service contract

Warranty plan

95 COMMERCIAL PROPERTY & CASUALTY MISCELLANEOUS

Column #8

Coverage

Class

Column #9

Coverage

Code

95

95

95

95

95

95

95

95

95

95

95

95

95

95

95

95

AVI

BAM

BOT

CPL

CIM

OTH

CRP

CRI

CHL

EMC

FLO

GLA

LEX

LSM

MTG

TTL

Aviation/aircraft

Boiler/machinery

Boat owner

Collateral protection

Commercial inland marine

Commercial P&C misc., other

Credit property

Crime

Crop/hail

Excess manage care

Flood

Glass

Legal expense

Livestock mortality

Mortgage guaranty

Title

97 HEALTH & LIFE MISCELLANEOUS

Column #8

Coverage

Class

Column #9

Coverage

Code

97

97

97

97

CCR

EMC

OTH

STL

Continuing care retirement community

Excess managed care

Health & Life Misc., other

Stop loss

YPE OF FILING (For Column #10 on the Transmittal)

A=Application

B=Binder

C=Certificate

D=Declaration/Schedule/Data Page

I=Informational Filing

J=Jacket

M=Matrix

N=Notice

O=Outline of Coverage

P=Policy

R=Rider/Endorsement/Amendment

S=Single Page