Test Audit Program

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.

Policies eligible for test audit are subject to a minimum annual policy premium of $2,500. 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.

Yes. If an insured or agent disagrees with a carrier’s audit, a letter must be sent to the field operations department of the PCRB explaining the nature of the dispute. If an insured is disputing the payroll allocations of the audit, the PCRB 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 PCRB’s decision on the proper classification of the employee(s) in question.

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 PCRB will only intervene after the parties involved have reached an impasse and the employer submits a written request.

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.

The test audit program states that no insured can be test audited more than once in a five-year period.

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 the current policy, provided circumstances have remained unchanged.

Standard language of your workers’ compensation policy Part 5, G states that in addition to the insurance carrier, an insured is required to provide payroll and related information to the insurance rating authority in your state, which is the DCRB.