Tentative Classification Standards issued by the Division of Classification & Compensation are shared with the operating agencies of State government for their consideration and comment. Accordingly, this document that you are viewing is subject to change and will be issued in final form at the completion of the review period.

TENTATIVE

Occ. Code 6852100

 

UNDERWRITER 1, GRADE 18

6852100

UNDERWRITER 1 (DISABILITY BENEFITS), GRADE 18

6852110

UNDERWRITER 2, GRADE 23

6852200

UNDERWRITER 2 (DISABILITY BENEFITS), GRADE 23

6852210

UNDERWRITER 3, GRADE 25

6852300

ASSISTANT DIRECTOR INSURANCE FUND UNDERWRITING, M-3

6851700

DIRECTOR INSURANCE FUND UNDERWRITING, M-4

6851800

 

 

New York State Department of Civil Service

 

Classification Standard

 

BRIEF DESCRIPTION OF CLASS SERIES

          Positions in this series assess and define the insurance risk assumed by the New York State Insurance Fund (NYSIF) and perform technical services in underwriting workers compensation and disability benefits claims cases including paid family leave.  Incumbents determine rate differentials and discounts; process policy renewals and cancellations; and price workers compensation and/or disability benefits coverage.

          These positions are found only at the New York State Insurance Fund.

DISTINGUISHING CHARACTERISTICS

          UNDERWRITER 1:  full performance level; services policies with large premiums and resolves underwriting issues that are potentially difficult, sensitive, or costly to NYSIF.

          UNDERWRITER 1 (DISABILITY BENEFITS):  full performance level; services policies by providing technical assistance in the areas of premium establishment and the processing of new policies; coordinates policy renewal and cancellation activities.

 

          UNDERWRITER 2:  first supervisory level; manages high premium risk problems; defines insurance coverage parameters and pricing risk for policies under investigation for potential fraud.

          UNDERWRITER 2 (DISABILITY BENEFITS):  first supervisory level; assists in overseeing underwriting activities for disability benefits and paid family leave claims in the Disability Benefits program.

          UNDERWRITER 3: second supervisory level; directs all aspects of quality assurance for a major underwriting group; reviews and authorizes quotes and prepares proposals on all highly difficult and large premium policies.

          ASSISTANT DIRECTOR INSURANCE FUND UNDERWRITING: one-position class; supervises Underwriters 3; oversees activities of the Underwriting Department.

          DIRECTOR INSURANCE FUND UNDERWRITING: one-position class; formulates policy, procedures and guidelines for Statewide underwriting activities.

RELATED CLASSES

          Policyholder Services Representatives solicit new business for SIF and provide account and risk management services, and perform policy analysis activities for workers compensation insurance policies at all premium levels.

          Claims Services Representatives process workers compensation or disability benefits claims filed with SIF.  Incumbents examine accident and medical reports to determine compensability and liability; analyze claims records and initiate proper processing procedures; examine medical bills and authorize payment; and negotiate an adjustment or recommend arbitration.


ILLUSTRATIVE DUTIES

          UNDERWRITER 1:  under the general direction of an Underwriter 2, analyzes and evaluates applications for workers compensation insurance policies; services policies with large premiums and resolves underwriting issues that are potentially difficult, sensitive or costly to SIF; determines if the policy is properly underwritten; analyzes previous loss and premium data, experience rating data, and claims material to price coverage; issues endorsements; defines, restricts or qualifies the policy coverage; represents SIF at hearings before the Workers Compensation Board and testifies in depositions and trials as an expert witness; and corresponds frequently with policyholders or their representatives, brokers, the New York Compensation Insurance Rating Board (NYCIRB), the New York State Insurance Department, and other SIF departments concerning payrolls and premiums, coverage, classifications, experience rating, certificates of insurance, affidavits, endorsements, laws, rules and procedures.

          UNDERWRITER 1 (DISABILITY BENEFITS):  under the general direction of an Underwriter 2 (Disability Benefits), performs professional underwriting activities over the life of a disability benefits policy including paid family leave benefits insurance; reviews insurance policy applications by evaluating the information provided, obtaining missing information, determining favorable or unfavorable claims performance and imposing fair experience modifications to policyholders with consistently high claims performance; communicates the experience modification to the policyholder in the renewal or application then approves or rejects the application; provides full underwriting services for policies over the life of the policy by preparing and presenting the initial quote for coverage ensuring that the information presented is accurate and timely for both statutory and enriched coverage, processes the application for coverage and bills the policyholder if the initial quote is accepted; processes retention and cancellation of policies with accurately underwritten premiums for all policies under renewal; performs policy maintenance functions when the policyholder or their representative amends the policy; reconciles policyholder reported premium by conducting a review and analysis of policyholder payroll data; performs higher level underwriting tasks such as evaluation of individual risks, reviewing application information for purpose of making accept/decline coverage decisions and conducting account level underwriting due diligence and reviewing collected underwriting reports; carries out assignments on the most complex policies requiring disability benefits and paid family leave underwriting (complex policies are those with employers greater than 15 employees, ownership issues with policies covering multiple entities or assignment of interest when transferring ownership of a business, policies requiring the application of coverage endorsement, etc.); establishes proficiency in understanding and communicating the fundamentals of disability benefits insurance with the ability to interpret and implement the disability benefits law and the paid family leave benefits law and underwriting rules, policies and procedures pertaining to policyholder services to employers, insurance representatives, policyholders, and prospective policyholders; and maintains a high level of customer service by performing a variety of account functions, such as, reaching out to high premium policyholders in pending non-payment cancellation to encourage payment to benefit policy retention for the agency.

          UNDERWRITER 2:  under the general direction of an Underwriter 3, audits and reviews selected policies with respect to quality, accuracy, and compliance with laws, rules and regulations; ensures that SIFs rate structure, policy forms and safety management resources are employed to write all levels of risk; serves as an authority on all retrospective rating quotations; reviews and audits Retrospective Rating Plan accountings; advises staff on policies where cancellation involves high premiums loss; manages high premium risk, and critical, potentially costly and/or sensitive policyholder problems; resolves highly sensitive customer complaints; defines coverage parameters and pricing risk for policies under investigation for potential fraud; analyzes and makes recommendations on proposed legislation and the impact on underwriting; and supervises the quality, quantity and planning of workflow relating to reviewing work for accuracy and timeliness.

          UNDERWRITER 2 (DISABILITY BENEFITS):  under the general direction of the Director NYSIF Disability Benefits Fund, assists in overseeing underwriting services for disability benefits policies including paid family leave benefits insurance; provides guidance and research on complex cases and issues that involve the daily activities in the life of a policy and includes reviewing employers insurance history, researching outstanding premium balances, determining eligibility of coverage, policy maintenance/amendments, and renewal reviews, cancellations, reinstatements and compliance; assigns policyholder services workload to the appropriate level of staff based on the level of complexity of the policy; determines the caseloads of lower-level staff to ensure equitable workloads; manages the production output by communicating workflow priorities to staff in order to accurately, efficiently and timely process new applications, cancellations, reinstatements, payroll reports and policy amendments; establishes and disseminates policies and procedures to ensure the effective and efficient processing of all underwriting assignments; documents all policies, procedures and underwriting processing workflows in the Disability Benefits and Paid Family Leave Claims and Policyholder Services Manual; reviews the underwriting process to ensure that appropriate internal controls are in place to prohibit premium calculation errors, fraud, failure to follow established policies, and inconsistent application of processing procedures; annually reviews and reports on the status of all program controls reviews, addresses and documents, remedial actions on all internal control audit findings;  performs a full range of supervisory duties for subordinate staff in assigned unit; administers initial or ongoing training to staff; disseminates regulations promulgated by the Superintendent of Financial Services, in consultation with the chair of the Workers Compensation Board, that determine such factors as whether policies shall be experience rated or community rated, and establish and update rates for community rated family leave benefit coverage; and serves as a lead for project management initiatives including electronic systems modification and updates, and process improvement initiatives for underwriting functions.

          UNDERWRITER 3:  under the general direction of the Assistant Director Insurance Fund Underwriting, directs all aspects of quality assurance for a major underwriting group; advises and makes decisions on coverage involving highly difficult, sensitive, and/or large premium policies; reviews and authorizes quotes and prepares proposals on all highly complex and large premium policies; monitors the delivery of underwriting products, services and productivity levels; advises District Managers and Underwriters on emerging issues, legislative action, and changing rules and regulations that impact underwriting; represents SIF at meetings with policyholders and/or their representatives; and develops and prepares budget requests to meet operational needs.

          ASSISTANT DIRECTOR INSURANCE FUND UNDERWRITING: under the general direction of the Director Insurance Fund Underwriting, directs the daily activities of the Underwriting Department; oversees training activities to ensure that all staff is familiar with current practices; ensures the consistent application of sound underwriting practices Statewide; oversees the resolution of complex underwriting issues; represents the Director Insurance Fund Underwriting on NYCIRB; implements NYCIRBs mandated rate changes or classification system changes and new or revised rules affecting the underwriting program; and assists in risk management activities to produce a favorable underwriting ratio, the measurement of profitability for an insurance carrier.

          DIRECTOR INSURANCE FUND UNDERWRITING: formulates policy, procedures and guidelines for Statewide underwriting activities; analyzes new laws and changes in existing laws and regulations concerning workers compensation and disability benefits; oversees internal control and quality control initiatives for the Underwriting Department; oversees risk management activities to produce a favorable underwriting ratio; serves NYCIRB committees, and as advisor to the Executive Director and Board of Commissioners on underwriting issues.

 

MINIMUM QUALIFICATIONS

          UNDERWRITER 1

Open Competitive: bachelors degree and satisfactory completion of a two-year traineeship.

          UNDERWRITER 1 (DISABILITY BENEFITS)

Open Competitive: bachelors degree and satisfactory completion of a two-year traineeship.

          UNDERWRITER 2

Open Competitive: one year of services as an Underwriter 1.

          UNDERWRITER 2 (DISABILITY BENEFITS)

Promotion:  one year of service as an Underwriter 1 (Disability Benefits).

          UNDERWRITER 3

Promotion:  one year of service as an Underwriter 2.

          ASSISTANT DIRECTOR INSURANCE FUND UNDERWRITING

Promotion: one year of service as an Underwriter 3.

          DIRECTOR INSURANCE FUND UNDERWRITING

Promotion:  one year of service as an Assistant Director Underwriting; or two years of service as an Underwriter 3.

 

 

Date:  3/17

 

 

 

NOTE:  Classification Standards illustrate the nature, extent and scope of duties and responsibilities of the classes they describe.  Standards cannot and do not include all of the work that might be appropriately performed by a class.  The minimum qualifications above are those which were required for appointment at the time the Classification Standard was written.  Please contact the Division of Staffing Services for current information on minimum qualification requirements for appointment or examination.