Skip to content

Insurance Carriers

Medical Benefit

Reasonable fees for medical care necessary to treat workplace injuries.

Indemnity Benefit

A workers’ compensation benefit is due and payable when the claimant has satisfied all legal requirements applicable to that benefit.

Electronic Data Interchange (EDI)

Standardized transactions sets have been developed so that documents can be electronically exchanged. 

Uninsured Employers Fund (UEF)​

The UEF was established in 1994 to provide benefits to injured workers whose employers did not maintain the statutorily required workers’ compensation insurance and otherwise cannot pay because of insolvency.

Employers Reinsurance Fund (ERF)​

The ERF pays certain workers’ compensation benefits to eligible workers (and their dependents) as a result of work accidents that occurred prior to July 1994.

Medical Benefit​

The Utah Labor Commission annually sets the medical fee standards and updates, as needed, administrative rules for medical providers as defined and authorized in Utah Code Ann. §34-2-407, Utah Code Annotated. 

Indemnity Benefit​

Payments are a portion of the worker’s average weekly wage, and take into consideration the extent of the disability. A workers’ compensation benefit is due and payable when the claimant has satisfied all legal requirements applicable to that benefit.

What is EDI?​

EDI is defined as a computer-to-computer exchange of data in a standardized format. Each trading partner (insurance carriers, adjusters, third-party administrators who submit documents) must agree to use the standardized format and set of rules in order to participate in EDI. EDI is widely used in industry to transmit traditional documents such as invoices and purchase orders between companies. Standardized transactions sets have been developed so that hundreds of different documents now can be electronically exchanged. The result is a highly efficient means of conducting business.

The International Association of Industrial Accident Boards and Commissions (IAIABC)

The International Association of Industrial Accident Boards and Commissions (IAIABC) is a private association of workers’ compensation professionals from public and private sectors with a basic objective to strengthen and improve the administration of workers’ compensation laws.

On a national level, the IAIABC has spearheaded a program to use EDI for workers’ compensation. State jurisdictions, insurance carriers, self-insured employers, third-party administrators, vendors (those who process the electronic forms) and the IAIABC have formed national EDI committees to develop, implement and maintain EDI formats for the workers’ compensation system.

EDI Advantages​

The electronic submission of workers’ compensation claim information has many advantages over the submission of paper forms. Benefits for both the Industrial Accidents Division and its stakeholders include:

Proof Of Coverage EDI

Oversight of workers’ compensation policy reporting consists of matching policy data to Utah employers reporting employees.

Since October 1998 Utah has been an electronic data reporting state. All workers’ compensation insurance carriers are required to report policy data through the National Council on Compensation Insurance (NCCI) or Insurance Services Office (ISO), these agencies then send the data to the Industrial Accidents Division.

Utah Code Ann. §34A-2-205 establishes the requirement of insurance carriers to report workers’ compensation policy information to the Industrial Accidents Division. The accuracy of the policy information provided by the insurance carriers assists the Division in identifying uninsured employers for the purpose of bringing them into compliance with the Workers’ Compensation Act.

Claims EDI Implementation Overview

EDI will be implemented in two parts:

  1. The process to receive the First Report of Injury (FROI)
  2. The process to receive Subsequent Reports of Injury (SROI).

EDI Service Vendors

The Industrial Accidents Division is pleased to announce that, after careful consideration, it has chosen to authorize all six EDI service vendors that bid on solicitations NH18043 & NH18042-1 to offer their services to our trading partners.

Aerie EDI Group

Pat Cannon
315 Kennedy Road
Chase City, VA 23924
(434) 509-4494
patc@aerieedigroup.com

Ebix, Inc.

Shayne Garner
1679 Gateway Circle
Grove City, OH 43123
(801) 208-5493
shayne.garner@ebix.com

Health Tech, Inc.

Mark Hughes
11730 W 135th Street, Suite #31
Overland Park, KS 66221
(913) 764-9347 x 112
mhughes@htedi.com

Mitchell International, Inc.​

Kyle Devereaux
110 Theory
Irvine, CA 92617
(858) 368-7593
kyle.devereaux@mitchell.com

Insurance Services, Inc.​

Alfred Faber
545 Washington Blvd.
Jersey City, NJ 07310
(201) 469-2375
afaber@iso.com

Riskonnect Inc.​

Kristy Robinson
200 W Monroe Suite 1100
Chicago, IL 60606
(312) 300-0664
kristy.robinson@riskonnect.com

Note: Industrial Accidents Division neither endorses nor recommends the products or services of any particular vendor. Industrial Accidents Division’s authorization of vendors is based solely on their specific Claims Release 3 EDI experience. Our goal is to provide you, our trading partners, with competent firms to select from. Industrial Accidents Division suggests careful review of vendor products and claims as well as to contact current and past customers prior to contracting a vendors’ service.

keyboard-2308477_640

Mandatory Implementation Information

All new claims being reported are required to be sent to the Division through EDI. FROI became mandatory as of December 31, 2012 and SROI became mandatory as of July 1, 2019.

Please check this page often as it will be updated when the Claims EDI tables are updated.

Utah Claims R3 EDI Tables

New (Last Updated 2/27/2019)

Claims EDI Trading Partner Forms

Workers' Compensation Insurance Organization Injury Description Codes

Uninsured Employers Fund (UEF)

The UEF was established in 1994 to provide benefits to injured workers whose employers did not maintain the statutorily required workers’ compensation insurance and otherwise cannot pay because of insolvency.

Money for this fund is collected by the Tax Commission from a surcharge on workers’ compensation insurance premiums in Utah, in addition to an assessment to employers that are self-insured for workers’ compensation. Penalties imposed against employers who fail to maintain workers’ compensation insurance are also deposited to the UEF. Money collected is invested with the State Treasurer where interest is earned.

An independent actuarial review of the future liabilities is completed each year.

Employers Reinsurance Fund (ERF)

The ERF pays certain workers’ compensation benefits to eligible workers (and their dependents) as a result of work accidents that occurred prior to July 1994. For many years, the Fund acted as a reinsurer to the commercial insurance market (1) for claimants that exceed a specific period of benefits with the private insurer or (2) to pay the liability for pre-existing impairment of workers rendered disabled by an industrial accident.

With legislation passed in 1994, the ERF discontinued acting as a reinsurer for new injuries and it now only covers injuries that occurred up to June 30, 1994.

The fund had an unfunded liability in 1994, and it has been working since that time to generate sufficient money to fund the liability. In order to meet this objective, the fund must collect more money each year than it pays out. Money going into the fund is collected by the Tax Commission from a surcharge on workers’ compensation insurance premiums in Utah, plus an assessment to self-insured employers. Money that is collected is invested with the State Treasurer where interest is earned.

An independent actuarial review of the future liabilities is completed each year.