Ariz. Admin. Code § 20-5-1406
Current through Register Vol. 30, No. 50, December 13, 2024
Section R20-5-1406 - Cancer Reporting; Required General Data ElementsA. Name of Data Provider (i.e., What entity is reporting the data?): The name of the insurance carrier, self-insured employer, self-insurance pool, or designee submitting the cancer-related claim data.B. Data Provider Type Code: Insurance Carrier; Self-Insured Employer; Self-Insurance Pool; Third-Party Administrator; or Other Designee.C. Name of Person Submitting Data: The name of the individual submitting the cancer-related claim data.D. Name of Data Provider Primary Contact: The name of the individual designated by the Data Provider who can be contacted regarding the data submission. (May be the same as the "Name of Person Submitting the Data.")E. Data Provider Primary Contact Phone Number: The phone number of the Data Provider Primary Contact.F. Data Provider Primary Contact Email Address: The email address of the Data Provider Primary Contact.G. Loss valuation date: The last day of the 12-month reporting period.H. Total Number of New Cancer-Related Claims: Total number of cancer-related claims filed by or on behalf of firefighters and fire investigators during the applicable reporting period (whether or not the claims are included in the detailed reporting). 1. Accepted: Total number of new cancer-related claims accepted during the applicable reporting period.2. Denied: Total number of cancer-related claims denied during the applicable reporting period.3. Pending: Total number of cancer-related claims pending decision on the applicable loss valuation date.Ariz. Admin. Code § R20-5-1406
New section made by final rulemaking at 28 A.A.R. 1481, effective 6/10/2022.