Workers Compensation pays statutory medical and indemnity benefits to injured workers and Employers Liability to the employer. Carriers, MGAs, and TPAs writing WC need a platform that handles NCCI class codes, experience modification, and state-by-state statutory benefits.
Workers Compensation insurance is the statutorily-required coverage that pays medical and indemnity (lost-wage) benefits to workers injured in the course and scope of employment, in exchange for an exclusive-remedy bar that protects the employer from most employee tort suits. The companion Employers Liability coverage (Part Two) protects the employer from gaps left by the exclusive-remedy bar.
This page is a line-of-business reference for WC carriers, MGAs, TPAs, state funds, and self-insured groups evaluating a policy administration platform with claims administration for statutory workers compensation.
A WC policy has two parts. Part One pays the statutory benefits required by the state of injury — medical, temporary disability, permanent disability, and death benefits. Part Two Employers Liability pays the employer's legal liability for employment-related injury claims that fall outside the exclusive remedy.
The platform has to model Part One benefits state by state and Part Two limits at standard or per-loss caps. Multi-state policies have to capture state-by-state classifications and payrolls separately.
WC is rated by NCCI (or state-bureau) class code against payroll, with state-specific rates. The account's loss history is reflected through an experience modification factor (e-mod) that multiplies the manual premium up or down.
Mercury's configurable rating engine supports class-code-by-state rating, e-mod application, premium-discount tables, schedule rating, and assigned-risk variants — all date-driven through the policy lifecycle.
WC premium is estimated at issuance based on projected payroll and audited at policy expiration based on actual payroll. The audit can produce additional premium or a return premium and feeds the next policy term's renewal.
Mercury supports configurable audit workflows, voluntary and physical audit types, audit-result endorsements, and feed of audit data into the renewal rating run.
WC claims handling is heavily statutory: medical fee schedules, indemnity-rate calculations, state EDI filings (IAIABC), MMSEA Section 111 reporting, and return-to-work workflows are all required, with state-by-state variation.
Mercury's claims administration supports configurable benefit calculations, state filings, medical bill review interfaces, reserve worksheets, and reinsurance ceding for excess-of-retention recoveries.
Does Mercury support multi-state WC policies with state-by-state classifications?
Yes. Mercury's product configuration supports multi-state WC policies with separate state-by-state classifications, payrolls, rates, and statutory benefit schedules on a single policy record.
Can Mercury apply experience modification factors to WC rating?
Yes. Mercury's rating engine applies experience modification factors, premium discount, schedule rating, and surcharges in the prescribed sequence for NCCI states and independent-bureau states.
Does Mercury support WC payroll audit and EDI claims filing?
Yes. Mercury supports configurable WC payroll-audit workflows and IAIABC EDI claims filing through the API-first architecture, with state-by-state filing variation handled by configuration.
