Mapping Policy Download AL3 to ACORD XML 2.0 Master Message

Topics: AL3 to XML
Coordinator
May 14, 2016 at 11:37 PM
Edited Jul 14, 2016 at 9:45 AM
I am starting the process of mapping AL3 Policy Download to ACORD XML 2.0 Master Message <PolicyRq>.

To get this started I am creating documentation explaining how to map each individual Group then have each AL3 message that is mapped reference the group.

This is a work in progress and if you have a different opinion please feel free to comment here and we will update the documentation based on membership discussion.

Each ACORD XML 2.0 Transaction Specifications Meeting which will start meeting bi weekly we will discuss our / my progress in this mapping project.

I think by breaking this out into group mapping we will be able to make reusable decisions that way we don't have to revisit discussion for each message.

I have started mapping 1MHG and 2TRG

You can review the main AL3 download to XML 2.0 discussion here

Lets start the discussion.
<PolicyRq><!--1MHG 10 IMODE: Initial Transaction Mode  ex: R - Request
               1MHG 05 TRCAT: Transaction Category ex: P- Policy -->
    <RqUID>00000000-0000-0000-0000-000000000000</RqUID>
    <BusinessPurposeTypeCd>NBS</BusinessPurposeTypeCd> <!--25 CBPUR:  ex:NBS -New Business-->
    <ActivityDt>2010-01-11</ActivityDt><!--32 TRDTE: Transaction Date ex: 20100111-->
    <TransactionEffectiveDt>2010-02-01</TransactionEffectiveDt><!--33 EFFDT: Transaction Effective Date ex: 20100201 -->
    <BroadLOBCd>P</BroadLOBCd><!-- 06 RTGCD:  ex: P -Personal Lines-->
    <ACORDStandardVersionCd>200</ACORDStandardVersionCd><!--01 VERNO:  ex:90-->
    <MsgSeqNumber>5199</MsgSeqNumber><!--21 TRSEQ:  ex:5199-->
    <TransactionSeqNumber>5199</TransactionSeqNumber><!--19 TRSEQ:  ex:5199-->
    <InsuredOrPrincipal id="B10001">
        <GeneralPartyInfo>
            <NameInfo>
                <CommlName><!-- _5BIS01_N_TYP: Name Type ex:C -Commercial -->
                    <CommercialName>Sammy and Company</CommercialName><!--_5BIS_08_N_COM: -->
                </CommlName>
            </NameInfo>
            <Addr>
                <Addr1>123 SECOND AVENUE</Addr1><!--_9BIS01_ADLN: -->
                <City>CALVERT CITY</City><!--_9BIS03_CITY: -->
                <StateProvCd>KY</StateProvCd><!--_9BIS04_STATE:-->
                <PostalCode>42029</PostalCode> <!--_9BIS05ZIPCD: -->
            </Addr>
        </GeneralPartyInfo>
    </InsuredOrPrincipal>
    
    <Policy id="F10001">
        <PolicyNumber>ABC12345</PolicyNumber><!--_5BPI01_POLNO: Policy Number-->
        <CompanyProductCd>PREF</CompanyProductCd><!--_5BPI20_COPRD: -->
        <LOBCd>AUTOP</LOBCd><!--_5BPI04_LOBCD: -->
        <NAICCd>11111</NAICCd><!--_5BPI03_COCD: -->
        <ContractTerm>
            <EffectiveDt>2010-02-01</EffectiveDt><!--_5BPI37_EFFDT:  ex:20100201-->
            <ExpirationDt>2011-02-01</ExpirationDt><!--_5BPI38_EXPDT:  ex:20110201-->
        </ContractTerm>
        <CurrentTermAmt>706</CurrentTermAmt><!--_5BPI11_FPREM: Current Term Amount-->
        <NetChangeAmt>722.53</NetChangeAmt><!--_5BPI12_CPREM: Net Change Amount ?? Need to fix in standard.-->
        <OriginalInceptionDt>2010-02-01</OriginalInceptionDt><!--_5BPI_09_OPIDT: Original Policy Inception Date-->
        <BillingMethodCd>CPB</BillingMethodCd><!--_5BPI16_BLMCD: Billing Method Code ex:P -Company Policy Billed-->
        <OtherOrPriorPolicy>
            <PolicyCd>OIC</PolicyCd><!--_5BPI13_OTINS: Other Insurance with Company Code-->
        </OtherOrPriorPolicy>
        <PaymentOption>
            <PaymentPlanCd>10</PaymentPlanCd><!--_5PAY01_PAYCD: -->
        </PaymentOption>
        
    </Policy>
        <PersAutoLineBusiness>
              <Driver id="F20001">
            <ItemIdInfo>
                <InsurerId>1</InsurerId><!--_5DRV_02_DRVNO: -->
            </ItemIdInfo>
            <GeneralPartyInfo>
                <NameInfo>
                    <PersonName><!--_5DRV03_N_TYP: Name Type ex:P -Personal-->
                        <Surname>Smucker</Surname><!--_5DRV03_03_N_FST:-->
                        <GivenName>Sam</GivenName><!--_5DRV03_05_N_LST: -->
                    </PersonName>
                </NameInfo>
            </GeneralPartyInfo>
            <DriverInfo>
                <PersonInfo>
                    <GenderCd>F</GenderCd><!--_5DRV_09_SEXCD: -->
                    <BirthDt>1965-02-14</BirthDt><!--_5DRV_14_BIRDT:  ex:19650214-->
                    <MaritalStatusCd>S</MaritalStatusCd><!--_6PDR_01_MARST: -->
                </PersonInfo>
                <License>
                    <LicensedDt>1981-02-14</LicensedDt><!--_5DRV_16_LICDT:  ex:19810214-->
                    <LicensePermitNumber>D99999999</LicensePermitNumber><!--_5DRV_05_LICNO: -->
                    <StateProvCd>KY</StateProvCd><!--_5DRV_06_STATE: -->
                </License>
            </DriverInfo>
            <PersDriverInfo>
                <DistantStudentInd>N</DistantStudentInd><!--_6PDR_08_DSIND: -->
                <DriverRelationshipToApplicantCd>IN</DriverRelationshipToApplicantCd><!--_6PDR_03_DRACD:  ex:I -Insured-->
                <GoodStudentCd>N</GoodStudentCd><!--_6PDR_07_GSIND: -->
                <MatureDriverInd>N</MatureDriverInd><!--_6PDR_12_MDIND: -->
            
            </PersDriverInfo>
        </Driver>
        </PersAutoLineBusiness>

</PolicyRq>
Developer
May 15, 2016 at 6:01 PM
Great documentation on the codes. LOVE it.
I can't wait to build out a Java example.
Developer
May 15, 2016 at 10:05 PM
ACORD eLabel mappings would be very helpful to figure out where AL3 data elements and groups map to in XML standards. We recently implemented a project to send WC policy activities to a broker where we used 1.30 XML standard and used FullImageNotify. We used our AL3 download and used the XSLT that generated AL3 and modified it to generate ACORD XML. During this exercise, we ran into couple minor things. One was the support for transaction effective date on endorsement transactions. This was missing in XML. I had reached out to James Bielak and he added it. I believe 5BPI12 (Net Change Amount) can't be sent under Policy in XML standard. We ran into few codes that existed in AL3 but not in XML standard. Overall, the effort was pretty simple
Coordinator
May 15, 2016 at 10:29 PM
I did find the <NetChangeAmt> In is in PCLINEBUSINESS we need to get it added to Policy_Type <Policy> Any XSLT that you would you could share with the community would be great. My goal with this is to demonstrate what it would look like in the new 2.0 Master Message <PolicyRq>. I would then like to show them in the resource format. Another purpose for this thread is to document how it could be done. I think there is a lot of interest in this subject.
Developer
May 27, 2016 at 11:00 PM
I have started mapping WC policy. I have mapped 1MHG, 2TRG, 5BIS, 9BIS, 5NID, and 5BPI. I have mapped most commonly used data elements that I am seeing. I am capturing my mapping in a spreadsheet for now.

My findings so far:

We do need a way to map 1MHG01 & 2TRG13 (Origination Message Address) and 1MHG02 & 2TRG15 (Destination Message Address).
Nate covered NetChangeAmt which needs to be added to Policy_Type.

Attaching the full WC Policy request here.
    <PolicyRq>
        <RqUID>27b0cd96-32d3-4247-9d56-d06aa2aaab8f</RqUID>
        <BusinessPurposeTypeCd>NBS</BusinessPurposeTypeCd> <!-- 2TRG25 CBPUR Cycle/Business Purpose -->
        <TransactionRequestDt></TransactionRequestDt>  <!--1MHG17 MTDTM Message Transmission Date/Time  -->
        <ActivityDt>2015-09-08</ActivityDt> <!-- 2TRG32 TRDTE Transaction Date -->
        <TransactionEffectiveDt>2015-09-03</TransactionEffectiveDt>  <!-- 2TRG33 EFFDT Transaction Effective Date -->
        <BroadLOBCd>C</BroadLOBCd>
        <ACORDStandardVersionCd>200</ACORDStandardVersionCd>
        <MsgSeqNumber>10</MsgSeqNumber>  <!--1MHG17 MTDTM Message Transmission Date/Time  -->
        <TransactionSeqNumber>100</TransactionSeqNumber>
        <Producer>
            <ProducerInfo>
                <ContractNumber>0400003</ContractNumber>  <!-- 1MHG18 CNTNO Contract Number -->
                <ProducerSubCode>12345</ProducerSubCode>
                <NIPRId>123456</NIPRId>
            </ProducerInfo>
        </Producer>
        <InsuredOrPrincipal>
            <GeneralPartyInfo>
                <NameInfo>
                    <CommlName>
                        <CommercialName>TEST MAIN STREET  INC</CommercialName>
                    </CommlName>
                    <LegalEntityCd>CP</LegalEntityCd>
                    <TaxIdentity>
                        <TaxIdTypeCd>FEIN</TaxIdTypeCd>
                        <TaxId>12-3433333</TaxId>
                    </TaxIdentity>
                </NameInfo>
                <Addr>
                    <AddrTypeCd>MailingAddress</AddrTypeCd>
                    <Addr1>1000 S DEERFIELD AVE</Addr1>
                    <City>DEERFIELD BEACH</City>
                    <StateProvCd>FL</StateProvCd>
                    <PostalCode>33441</PostalCode>
                </Addr>
                <Communications>
                    <PhoneInfo>
                        <PhoneTypeCd>Phone</PhoneTypeCd>
                        <PhoneNumber>+1-566-2552222</PhoneNumber>
                    </PhoneInfo>
                </Communications>
            </GeneralPartyInfo>
            <InsuredOrPrincipalInfo>
                <InsuredOrPrincipalRoleCd>Insured</InsuredOrPrincipalRoleCd>
            </InsuredOrPrincipalInfo>
        </InsuredOrPrincipal>
        <Policy>
            <PolicyNumber>XWS56666666</PolicyNumber>
            <CompanyProductCd>WC</CompanyProductCd>
            <LOBCd>WORK</LOBCd>
            <LOBSubCd>NPO</LOBSubCd>
            <NAICCd>24000</NAICCd>
            <ContractTerm>
                <EffectiveDt>2015-09-03</EffectiveDt>
                <ExpirationDt>2016-09-03</ExpirationDt>
            </ContractTerm>
            <BillingAccountNumber>12345678</BillingAccountNumber>
            <BillingMethodCd>AB</BillingMethodCd>
            <CurrentTermAmt>
                <Amt>5311.00</Amt>
            </CurrentTermAmt>
            <WrittenAmt>
                <Amt>100.00</Amt>
            </WrittenAmt>
            <NetChangeAmt>
                <Amt>100.00</Amt>
            </NetChangeAmt>
            <CustomerServicingCd>AGY</CustomerServicingCd>
            <LanguageCd>E</LanguageCd>
            <PrintedDocumentsRequestedInd>1</PrintedDocumentsRequestedInd>
            <OriginalInceptionDt>2001-09-03</OriginalInceptionDt>
            <RateEffectiveDt>2015-09-03</RateEffectiveDt>
            <RenewalBillingMethodCd>AB</RenewalBillingMethodCd>
            <PaymentOption>
                <PaymentPlanCd>OT</PaymentPlanCd>
            </PaymentOption>
            <CommlCoverage>
                <CoverageCd>APMP</CoverageCd>
                <NetChangeAmt>
                    <Amt>0.00</Amt>
                </NetChangeAmt>
            </CommlCoverage>
            <CommlCoverage>
                <CoverageCd>WCEL</CoverageCd>
                <Limit>
                    <FormatInteger>100000</FormatInteger>
                    <LimitAppliesToCd>PerAcc</LimitAppliesToCd>
                </Limit>
                <Limit>
                    <FormatInteger>500000</FormatInteger>
                    <LimitAppliesToCd>DisPol</LimitAppliesToCd>
                </Limit>
                <Limit>
                    <FormatInteger>100000</FormatInteger>
                    <LimitAppliesToCd>DisEachEmpl</LimitAppliesToCd>
                </Limit>
            </CommlCoverage>
        </Policy>
        <Location id="L0001">
            <ItemIdInfo/>
            <Addr>
                <Addr1>3000 Saint  Dr</Addr1>
                <City>Memphis</City>
                <StateProvCd>TN</StateProvCd>
                <PostalCode>38127-7274</PostalCode>
                <County>Shelby County</County>
            </Addr>
        </Location>
        <Location id="L0002">
            <ItemIdInfo/>
            <Addr>
                <Addr1>200 Ramble Dr Ofc 7</Addr1>
                <City>Shelby</City>
                <StateProvCd>NC</StateProvCd>
                <PostalCode>28152-6678</PostalCode>
                <County>Cleveland County</County>
            </Addr>
        </Location>
        <WorkCompLineBusiness>
            <LOBCd>WORK</LOBCd>
            <WorkCompIndividuals>
                <IncludedExcludedCd>E</IncludedExcludedCd>
                <NameInfo>
                    <CommlName>
                        <CommercialName>TEST  WC</CommercialName>
                    </CommlName>
                </NameInfo>
            </WorkCompIndividuals>
            <WorkCompRateState>
                <StateProvCd>TN</StateProvCd>
                <NAICCd>24000</NAICCd>
                <ParticipatingPlanDescCd>N</ParticipatingPlanDescCd>
                <CommlCoverage>
                    <CoverageCd>NTRIA</CoverageCd>
                    <CoverageDesc>DTEC Terrorism Premium</CoverageDesc>
                    <CurrentTermAmt>
                        <Amt>19.00</Amt>
                    </CurrentTermAmt>
                    <NetChangeAmt>
                        <Amt>19.00</Amt>
                    </NetChangeAmt>
                    <Rate>0.03</Rate>
                </CommlCoverage>
                <CommlCoverage>
                    <CoverageCd>TRIA</CoverageCd>
                    <CoverageDesc>Terrorism Premium</CoverageDesc>
                    <CurrentTermAmt>
                        <Amt>13.00</Amt>
                    </CurrentTermAmt>
                    <NetChangeAmt>
                        <Amt>13.00</Amt>
                    </NetChangeAmt>
                    <Rate>0.02</Rate>
                </CommlCoverage>
                <WorkCompLocInfo LocationRef="L0001">
                    <WorkCompRateClass>
                        <ActualRemunerationAmt>
                            <Amt>22880.00</Amt>
                        </ActualRemunerationAmt>
                        <Rate>2.05</Rate>
                        <PremiumBasisCd>R</PremiumBasisCd>
                        <RatingClassificationCd>2222</RatingClassificationCd>
                        <Exposure>22880.00</Exposure>
                        <RatingClassificationDesc>Building or Property Management - Property Managers and Leasing Agents &amp; Clerical, Salespersons</RatingClassificationDesc>
                        <CommlCoverage>
                            <CoverageCd>WCEL</CoverageCd>
                            <CurrentTermAmt>
                                <Amt>458.00</Amt>
                            </CurrentTermAmt>
                            <NetChangeAmt>
                                <Amt>458.00</Amt>
                            </NetChangeAmt>
                        </CommlCoverage>
                    </WorkCompRateClass>
                    <WorkCompRateClass>
                        <ActualRemunerationAmt>
                            <Amt>40000.00</Amt>
                        </ActualRemunerationAmt>
                        <Rate>1.00</Rate>
                        <PremiumBasisCd>R</PremiumBasisCd>
                        <RatingClassificationCd>3333</RatingClassificationCd>
                        <Exposure>40000.00</Exposure>
                        <RatingClassificationDesc>Building or Property Management - All Other Employees</RatingClassificationDesc>
                        <CommlCoverage>
                            <CoverageCd>WCEL</CoverageCd>
                            <CurrentTermAmt>
                                <Amt>1684.00</Amt>
                            </CurrentTermAmt>
                            <NetChangeAmt>
                                <Amt>1684.00</Amt>
                            </NetChangeAmt>
                        </CommlCoverage>
                    </WorkCompRateClass>
                </WorkCompLocInfo>
                <TotalEstimatedAnnualPremiumAmt>
                    <Amt>2174.00</Amt>
                </TotalEstimatedAnnualPremiumAmt>
            </WorkCompRateState>
            <WorkCompRateState>
                <StateProvCd>NC</StateProvCd>
                <NAICCd>24000</NAICCd>
                <ParticipatingPlanDescCd>N</ParticipatingPlanDescCd>
                <CommlCoverage>
                    <CoverageCd>EXCNT</CoverageCd>
                    <CoverageDesc>Expense Constant</CoverageDesc>
                    <CurrentTermAmt>
                        <Amt>250.00</Amt>
                    </CurrentTermAmt>
                    <NetChangeAmt>
                        <Amt>250.00</Amt>
                    </NetChangeAmt>
                </CommlCoverage>
                <CommlCoverage>
                    <CoverageCd>NTRIA</CoverageCd>
                    <CoverageDesc>DTEC Terrorism Premium</CoverageDesc>
                    <CurrentTermAmt>
                        <Amt>7.00</Amt>
                    </CurrentTermAmt>
                    <NetChangeAmt>
                        <Amt>7.00</Amt>
                    </NetChangeAmt>
                    <Rate>0.01</Rate>
                </CommlCoverage>
                <CommlCoverage>
                    <CoverageCd>TRIA</CoverageCd>
                    <CoverageDesc>Terrorism Premium</CoverageDesc>
                    <CurrentTermAmt>
                        <Amt>7.00</Amt>
                    </CurrentTermAmt>
                    <NetChangeAmt>
                        <Amt>7.00</Amt>
                    </NetChangeAmt>
                    <Rate>0.01</Rate>
                </CommlCoverage>
                <WorkCompLocInfo LocationRef="L0002">
                    <WorkCompRateClass>
                        <ActualRemunerationAmt>
                            <Amt>31000.00</Amt>
                        </ActualRemunerationAmt>
                        <IfAnyRatingBasisInd>1</IfAnyRatingBasisInd>
                        <Rate>2.00</Rate>
                        <PremiumBasisCd>R</PremiumBasisCd>
                        <RatingClassificationCd>4444</RatingClassificationCd>
                        <Exposure>31000.00</Exposure>
                        <RatingClassificationDesc>Building or Property Management - Property Managers and Leasing Agents &amp; Clerical, Salespersons</RatingClassificationDesc>
                        <CommlCoverage>
                            <CoverageCd>WCEL</CoverageCd>
                            <CurrentTermAmt>
                                <Amt>639.00</Amt>
                            </CurrentTermAmt>
                            <NetChangeAmt>
                                <Amt>639.00</Amt>
                            </NetChangeAmt>
                        </CommlCoverage>
                    </WorkCompRateClass>
                    <WorkCompRateClass>
                        <ActualRemunerationAmt>
                            <Amt>42000.00</Amt>
                        </ActualRemunerationAmt>
                        <Rate>5.86</Rate>
                        <PremiumBasisCd>R</PremiumBasisCd>
                        <RatingClassificationCd>1111</RatingClassificationCd>
                        <Exposure>42000.00</Exposure>
                        <RatingClassificationDesc>Building or Property Management - All Other Employees</RatingClassificationDesc>
                        <CommlCoverage>
                            <CoverageCd>WCEL</CoverageCd>
                            <CurrentTermAmt>
                                <Amt>2398.00</Amt>
                            </CurrentTermAmt>
                            <NetChangeAmt>
                                <Amt>2398.00</Amt>
                            </NetChangeAmt>
                        </CommlCoverage>
                    </WorkCompRateClass>
                </WorkCompLocInfo>
                <TotalEstimatedAnnualPremiumAmt>
                    <Amt>3137.00</Amt>
                </TotalEstimatedAnnualPremiumAmt>
            </WorkCompRateState>
        </WorkCompLineBusiness>
</PolicyRq>
Developer
May 27, 2016 at 11:03 PM
Nate, the XSLT I have transforms our internal Policy Admin XML to ACORD XML. It does not go from AL3 to XML. In the past, we have done AL3 to XML using Java and JRuby.
Developer
May 27, 2016 at 11:23 PM
Attaching updated XML with Coverage aggregate
    <PolicyRq>
        <RqUID>27b0cd96-32d3-4247-9d56-d06aa2aaab8f</RqUID>
        <BusinessPurposeTypeCd>NBS</BusinessPurposeTypeCd> <!-- 2TRG25 CBPUR Cycle/Business Purpose -->
        <TransactionRequestDt></TransactionRequestDt>  <!--1MHG17 MTDTM Message Transmission Date/Time  -->
        <ActivityDt>2015-09-08</ActivityDt> <!-- 2TRG32 TRDTE Transaction Date -->
        <TransactionEffectiveDt>2015-09-03</TransactionEffectiveDt>  <!-- 2TRG33 EFFDT Transaction Effective Date -->
        <BroadLOBCd>C</BroadLOBCd>
        <ACORDStandardVersionCd>200</ACORDStandardVersionCd>
        <MsgSeqNumber>10</MsgSeqNumber>  <!--1MHG17 MTDTM Message Transmission Date/Time  -->
        <TransactionSeqNumber>100</TransactionSeqNumber>
        <Producer>
            <ProducerInfo>
                <ContractNumber>0400003</ContractNumber>  <!-- 1MHG18 CNTNO Contract Number -->
                <ProducerSubCode>12345</ProducerSubCode>
                <NIPRId>123456</NIPRId>
            </ProducerInfo>
        </Producer>
        <InsuredOrPrincipal>
            <GeneralPartyInfo>
                <NameInfo>
                    <CommlName>
                        <CommercialName>TEST MAIN STREET  INC</CommercialName>
                    </CommlName>
                    <LegalEntityCd>CP</LegalEntityCd>
                    <TaxIdentity>
                        <TaxIdTypeCd>FEIN</TaxIdTypeCd>
                        <TaxId>12-3433333</TaxId>
                    </TaxIdentity>
                </NameInfo>
                <Addr>
                    <AddrTypeCd>MailingAddress</AddrTypeCd>
                    <Addr1>1000 S DEERFIELD AVE</Addr1>
                    <City>DEERFIELD BEACH</City>
                    <StateProvCd>FL</StateProvCd>
                    <PostalCode>33441</PostalCode>
                </Addr>
                <Communications>
                    <PhoneInfo>
                        <PhoneTypeCd>Phone</PhoneTypeCd>
                        <PhoneNumber>+1-566-2552222</PhoneNumber>
                    </PhoneInfo>
                </Communications>
            </GeneralPartyInfo>
            <InsuredOrPrincipalInfo>
                <InsuredOrPrincipalRoleCd>Insured</InsuredOrPrincipalRoleCd>
            </InsuredOrPrincipalInfo>
        </InsuredOrPrincipal>
        <Policy>
            <PolicyNumber>XWS56666666</PolicyNumber>
            <CompanyProductCd>WC</CompanyProductCd>
            <LOBCd>WORK</LOBCd>
            <LOBSubCd>NPO</LOBSubCd>
            <NAICCd>24000</NAICCd>
            <ContractTerm>
                <EffectiveDt>2015-09-03</EffectiveDt>
                <ExpirationDt>2016-09-03</ExpirationDt>
            </ContractTerm>
            <BillingAccountNumber>12345678</BillingAccountNumber>
            <BillingMethodCd>AB</BillingMethodCd>
            <CurrentTermAmt>
                <Amt>5311.00</Amt>
            </CurrentTermAmt>
            <WrittenAmt>
                <Amt>100.00</Amt>
            </WrittenAmt>
            <NetChangeAmt>
                <Amt>100.00</Amt>
            </NetChangeAmt>
            <CustomerServicingCd>AGY</CustomerServicingCd>
            <LanguageCd>E</LanguageCd>
            <PrintedDocumentsRequestedInd>1</PrintedDocumentsRequestedInd>
            <OriginalInceptionDt>2001-09-03</OriginalInceptionDt>
            <RateEffectiveDt>2015-09-03</RateEffectiveDt>
            <RenewalBillingMethodCd>AB</RenewalBillingMethodCd>
            <PaymentOption>
                <PaymentPlanCd>OT</PaymentPlanCd>
            </PaymentOption>
            <Coverage>
                <CoverageCd>APMP</CoverageCd>
                <NetChangeAmt>
                    <Amt>0.00</Amt>
                </NetChangeAmt>
            </Coverage>
            <Coverage>
                <CoverageCd>WCEL</CoverageCd>
                <Limit>
                    <FormatInteger>100000</FormatInteger>
                    <LimitAppliesToCd>PerAcc</LimitAppliesToCd>
                </Limit>
                <Limit>
                    <FormatInteger>500000</FormatInteger>
                    <LimitAppliesToCd>DisPol</LimitAppliesToCd>
                </Limit>
                <Limit>
                    <FormatInteger>100000</FormatInteger>
                    <LimitAppliesToCd>DisEachEmpl</LimitAppliesToCd>
                </Limit>
            </Coverage>
        </Policy>
        <Location id="L0001">
            <ItemIdInfo/>
            <Addr>
                <Addr1>3000 Saint  Dr</Addr1>
                <City>Memphis</City>
                <StateProvCd>TN</StateProvCd>
                <PostalCode>38127-7274</PostalCode>
                <County>Shelby County</County>
            </Addr>
        </Location>
        <Location id="L0002">
            <ItemIdInfo/>
            <Addr>
                <Addr1>200 Ramble Dr Ofc 7</Addr1>
                <City>Shelby</City>
                <StateProvCd>NC</StateProvCd>
                <PostalCode>28152-6678</PostalCode>
                <County>Cleveland County</County>
            </Addr>
        </Location>
        <WorkCompLineBusiness>
            <LOBCd>WORK</LOBCd>
            <WorkCompIndividuals>
                <IncludedExcludedCd>E</IncludedExcludedCd>
                <NameInfo>
                    <CommlName>
                        <CommercialName>TEST  WC</CommercialName>
                    </CommlName>
                </NameInfo>
            </WorkCompIndividuals>
            <WorkCompRateState>
                <StateProvCd>TN</StateProvCd>
                <NAICCd>24000</NAICCd>
                <ParticipatingPlanDescCd>N</ParticipatingPlanDescCd>
                <Coverage>
                    <CoverageCd>NTRIA</CoverageCd>
                    <CoverageDesc>DTEC Terrorism Premium</CoverageDesc>
                    <CurrentTermAmt>
                        <Amt>19.00</Amt>
                    </CurrentTermAmt>
                    <NetChangeAmt>
                        <Amt>19.00</Amt>
                    </NetChangeAmt>
                    <Rate>0.03</Rate>
                </Coverage>
                <Coverage>
                    <CoverageCd>TRIA</CoverageCd>
                    <CoverageDesc>Terrorism Premium</CoverageDesc>
                    <CurrentTermAmt>
                        <Amt>13.00</Amt>
                    </CurrentTermAmt>
                    <NetChangeAmt>
                        <Amt>13.00</Amt>
                    </NetChangeAmt>
                    <Rate>0.02</Rate>
                </Coverage>
                <WorkCompLocInfo LocationRef="L0001">
                    <WorkCompRateClass>
                        <ActualRemunerationAmt>
                            <Amt>22880.00</Amt>
                        </ActualRemunerationAmt>
                        <Rate>2.05</Rate>
                        <PremiumBasisCd>R</PremiumBasisCd>
                        <RatingClassificationCd>2222</RatingClassificationCd>
                        <Exposure>22880.00</Exposure>
                        <RatingClassificationDesc>Building or Property Management - Property Managers and Leasing Agents &amp; Clerical, Salespersons</RatingClassificationDesc>
                        <Coverage>
                            <CoverageCd>WCEL</CoverageCd>
                            <CurrentTermAmt>
                                <Amt>458.00</Amt>
                            </CurrentTermAmt>
                            <NetChangeAmt>
                                <Amt>458.00</Amt>
                            </NetChangeAmt>
                        </Coverage>
                    </WorkCompRateClass>
                    <WorkCompRateClass>
                        <ActualRemunerationAmt>
                            <Amt>40000.00</Amt>
                        </ActualRemunerationAmt>
                        <Rate>1.00</Rate>
                        <PremiumBasisCd>R</PremiumBasisCd>
                        <RatingClassificationCd>3333</RatingClassificationCd>
                        <Exposure>40000.00</Exposure>
                        <RatingClassificationDesc>Building or Property Management - All Other Employees</RatingClassificationDesc>
                        <Coverage>
                            <CoverageCd>WCEL</CoverageCd>
                            <CurrentTermAmt>
                                <Amt>1684.00</Amt>
                            </CurrentTermAmt>
                            <NetChangeAmt>
                                <Amt>1684.00</Amt>
                            </NetChangeAmt>
                        </Coverage>
                    </WorkCompRateClass>
                </WorkCompLocInfo>
                <TotalEstimatedAnnualPremiumAmt>
                    <Amt>2174.00</Amt>
                </TotalEstimatedAnnualPremiumAmt>
            </WorkCompRateState>
            <WorkCompRateState>
                <StateProvCd>NC</StateProvCd>
                <NAICCd>24000</NAICCd>
                <ParticipatingPlanDescCd>N</ParticipatingPlanDescCd>
                <Coverage>
                    <CoverageCd>EXCNT</CoverageCd>
                    <CoverageDesc>Expense Constant</CoverageDesc>
                    <CurrentTermAmt>
                        <Amt>250.00</Amt>
                    </CurrentTermAmt>
                    <NetChangeAmt>
                        <Amt>250.00</Amt>
                    </NetChangeAmt>
                </Coverage>
                <Coverage>
                    <CoverageCd>NTRIA</CoverageCd>
                    <CoverageDesc>DTEC Terrorism Premium</CoverageDesc>
                    <CurrentTermAmt>
                        <Amt>7.00</Amt>
                    </CurrentTermAmt>
                    <NetChangeAmt>
                        <Amt>7.00</Amt>
                    </NetChangeAmt>
                    <Rate>0.01</Rate>
                </Coverage>
                <Coverage>
                    <CoverageCd>TRIA</CoverageCd>
                    <CoverageDesc>Terrorism Premium</CoverageDesc>
                    <CurrentTermAmt>
                        <Amt>7.00</Amt>
                    </CurrentTermAmt>
                    <NetChangeAmt>
                        <Amt>7.00</Amt>
                    </NetChangeAmt>
                    <Rate>0.01</Rate>
                </Coverage>
                <WorkCompLocInfo LocationRef="L0002">
                    <WorkCompRateClass>
                        <ActualRemunerationAmt>
                            <Amt>31000.00</Amt>
                        </ActualRemunerationAmt>
                        <IfAnyRatingBasisInd>1</IfAnyRatingBasisInd>
                        <Rate>2.00</Rate>
                        <PremiumBasisCd>R</PremiumBasisCd>
                        <RatingClassificationCd>4444</RatingClassificationCd>
                        <Exposure>31000.00</Exposure>
                        <RatingClassificationDesc>Building or Property Management - Property Managers and Leasing Agents &amp; Clerical, Salespersons</RatingClassificationDesc>
                        <Coverage>
                            <CoverageCd>WCEL</CoverageCd>
                            <CurrentTermAmt>
                                <Amt>639.00</Amt>
                            </CurrentTermAmt>
                            <NetChangeAmt>
                                <Amt>639.00</Amt>
                            </NetChangeAmt>
                        </Coverage>
                    </WorkCompRateClass>
                    <WorkCompRateClass>
                        <ActualRemunerationAmt>
                            <Amt>42000.00</Amt>
                        </ActualRemunerationAmt>
                        <Rate>5.86</Rate>
                        <PremiumBasisCd>R</PremiumBasisCd>
                        <RatingClassificationCd>1111</RatingClassificationCd>
                        <Exposure>42000.00</Exposure>
                        <RatingClassificationDesc>Building or Property Management - All Other Employees</RatingClassificationDesc>
                        <Coverage>
                            <CoverageCd>WCEL</CoverageCd>
                            <CurrentTermAmt>
                                <Amt>2398.00</Amt>
                            </CurrentTermAmt>
                            <NetChangeAmt>
                                <Amt>2398.00</Amt>
                            </NetChangeAmt>
                        </Coverage>
                    </WorkCompRateClass>
                </WorkCompLocInfo>
                <TotalEstimatedAnnualPremiumAmt>
                    <Amt>3137.00</Amt>
                </TotalEstimatedAnnualPremiumAmt>
            </WorkCompRateState>
        </WorkCompLineBusiness>
</PolicyRq>