Attachment 2

BENEFIT ACCURACY MEASUREMENT
DENIED CLAIMS ACCURACY

ERROR RATES REPORT
State:
Report Date: 01/26/2005
Batch Range: 200401 ~ 200452

Denial TypePopulationCases Completed*
Monetary 1,917 91
Separation 52,623 122
Nonseparation 71,267 124

Denial Type Total
Errors
Improper
Denial
Adjusted
Improper
Denial**
Overpayment Proper
Denial***
Monetary 29.56% 29.56% 21.84% 0.00% 0.00%
Separation 12.46% 3.94% 2.37% 1.61% 6.90%
Nonseparation 14.95% 7.89% 5.94% 3.17% 4.93%

* Excludes cases not meeting DCA definition for inclusion in population, withdrawn claims, and claims for which monetary eligibility was established upon receipt of CWC, UCFE, and/or UCX wage credits.

** Adjusted rate excludes erroneous denials that were corrected by agency or reversed on appeal prior to DCA case completion.

*** Properly denied, but for wrong reason or section of the law.

The state completed 76.35 percent of the Monetary denials sample cases within 90 days. The program standard is 85 percent completed within 90 days.

The state completed 78.43 percent of the Separation denials sample cases within 90 days. The program standard is 85 percent completed within 90 days.

The state completed 79.87 percent of the Nonseparation denials sample cases within 90 days. The program standard is 85 percent completed within 90 days.

BENEFIT ACCURACY MEASUREMENT
DENIED CLAIMS ACCURACY

IMPROPER DENIALS RATES REPORT
State:
Report Date: 01/26/2005
Batch Range: 200401 ~ 200452

Denial TypePopulationCases Completed*
Monetary 1,917 91
Separation 52,623 122
Nonseparation 71,267 124

Denial Type Improper
Denial
95% C.I
(+/-)
Adjusted
Improper
Denial**
95% C.I
(+/-)
Monetary 29.56% 8.95% 21.84% 7.67%
Separation 3.94% 3.50% 2.37% 2.72%
Nonseparation 7.89% 4.91% 5.94% 4.33%

* Excludes cases not meeting DCA definition for inclusion in population, withdrawn claims, and claims for which monetary eligibility was established upon receipt of CWC, UCFE, and/or UCX wage credits.

** Adjusted rate excludes erroneous denials that were corrected by agency or reversed on appeal prior to DCA case completion.

Note: 95% C.I. is the 95 percent confidence interval for the estimated rate. The interval is the range between the rate minus the value in the 95% C.I. column and the rate plus the value in the 95% C.I. column. For example, the interval for 10.0% +/- 2.5 is 7.5% to 12.5%. The true rate is expected to lie within 95 percent of the intervals constructed from repeated samples of the same size and selected in the same manner as the BAM DCA sample.

The state completed 76.35 percent of the Monetary denials sample cases within 90 days. The program standard is 85 percent completed within 90 days.

The state completed 78.43 percent of the Separation denials sample cases within 90 days. The program standard is 85 percent completed within 90 days.

The state completed 79.87 percent of the Nonseparation denials sample cases within 90 days. The program standard is 85 percent completed within 90 days.

BAM Denied Claims Accuracy Rates Report Definitions

Population

The number of denial determinations that constitute the sampling frames for all weeks in CY 2004 for which the state pulled a BAM DCA sample, adjusted to exclude agency actions that do not meet the definition of the BAM DCA population (for example, monetary redeterminations, nonmonetary determinations that are not reportable on the ETA 207 and 9052 reports, and denied TEUC claims). These excluded cases are coded 8 (TEUC) or 9 (all other excluded records) in the Program code data element in the b_dca_master table of the UI database. The software also adjusts the DCA populations to exclude two types of cases for which there is no denial issue to investigate: 1) cases in which monetary eligibility was established upon receipt of Combined Wage Claims, Unemployment Compensation for Federal Employees, and/or Unemployment Compensation for Ex-service Members wage credits within the two-week sampling lag (Action Code Flag 0); and 2) claims withdrawn by the claimant (Action Code Flag 8).

Sample Size

Total DCA cases selected during CY 2004 (BAM batches 200401 through 200452) and completed (supervisor sign-off) by c.o.b. April 30, 2003, excluding cases that do not meet the BAM DCA population definition. This is the number of BAM DCA sample cases from which the accuracy rates are estimated.

Improper Denial Rate

The weighted proportion of denied claims for which the DCA investigation concluded that the claimant should have been eligible for UI benefits or was underpaid UI benefits (Error Issue Action Code = 20, 21, 22, or 23), expressed as a percentage.

Adjusted Improper Denial Rate

Improper Denial Rate excluding cases in which erroneous denials were corrected by the agency (Prior Agency Action = "20" to "29" or eligibility was established through appeal (Results of Appeal of Initial Determination = 1 or 3) prior to DCA case completion.

Overpayment Rate

The weighted proportion of denied claims for which the DCA investigation concluded that the claimant should have been ineligible for UI benefits for weeks that had been paid (Error Issue Action Code = 10, 11, 12, 13, 14, 15, or 16), expressed as a percentage.

Proper Denial Rate

The weighted proportion of denied claims for which the DCA investigation concluded that the claimant was properly denied but for the wrong or different section of the law (Error Issue Action Code = 30), expressed as a percentage.

Weighting Procedures

Accuracy rates are computed separately for each batch with at least two completed DCA cases and weighted by the batch population, adjusted to exclude cases that do not meet the BAM DCA definition (Program code 8 or 9) or cases with Action Codes 0 (monetary eligibility established upon receipt of CWC, UCFE, and/or UCX wage credits) or 8 (withdrawn claims). The accuracy rate equals the sum of the products of the batch rates and weights. Batches with only one completed case are merged to insure that each batch has a minimum of two completed cases.

95 Percent Confidence Interval

A confidence interval, expressed as +/- x percentage points, is constructed for each of the estimated accuracy rates. The actual rate is expected to lie within 95 percent of the intervals constructed from repeated samples of the same size and selected in the same manner as the BAM sample.

BAM Denied Claims Accuracy Footnotes

Footnote 1

Estimated rates apply to less than the total population of [sample type] denials due to the state not pulling a sample for x weeks.

Condition: There is no record in the b_dca_comparison table of the UI database for one or more batches specified in the batch range for sample type y, where b_dca_comparison.samptype = 2 (monetary), 3 (separation), or 4 (nonseparation).

Footnote 2

Estimated rates for [sample type] denials are based on data collection procedures that were not completely in accordance with the program methodology prescribed in ET Handbook No. 395.

Condition: Based on program monitoring conducted by the Department of Labor regional and national offices. This footnote will be generated from a footnote look-up table for each sample type: 2 (monetary), 3 (separation), or 4 (nonseparation).

Footnote 3

The state completed x percent of the [sample type] denials sample cases within 90 days. The program standard is 85 percent completed within 90 days.

Condition: The percentage for sample type y, where b_dca_master.samptype = 2 (monetary), 3 (separation), or 4 (nonseparation), will be calculated using the same method used in the BAM DCA Case Completion and Time Lapse report. Cases not meeting the BAM DCA population definition (b_dca_master.program = 8 or 9) or withdrawn claims (b_dca_master.actflag = 8) are not counted in calculating state time lapse rates.

Footnote 4

x percent of the [sample type] denials sample cases were not completed when this report was prepared. This exceeds the program requirement that no more than 2 percent of the cases for the year are incomplete 120 days after the end of the calendar year.

Condition: The percentage is based on the number of BAM DCA cases that were not completed (b_dca_master.supcomp is NULL) by c.o.b. April 30, YYYY+1 (April 29 if YYYY+1 is a leap year), divided by the number of valid cases selected for BAM DCA weekly samples during CY YYYY (BAM batches YYYY01 through YYYY52 or YYYY53). Cases that do not meet the BAM DCA population definition (b_dca_master.program = 8 or 9) or withdrawn claims (b_dca_master.actflag = 8) are not counted in calculating state case completion rates. A percentage will be calculated for each sample type y, where b_dca_master.samptype = 2 (monetary), 3 (separation), or 4 (nonseparation).

This footnote will be generated only if the user specifies an annual report for CY YYYY or the user specifies the batch range YYYY01 to YYYY52 (or YYYY53).

Footnote 5

The annual sample of [sample type] denials is x cases below the allocated annual sample of 150 BAM DCA cases per year. The precision of the data might be reduced due to the failure to sample at the prescribed level.

Condition: The state's annual sample selection is 38 or more cases below its allocated annual sample of 150 cases). Cases that do not meet the BAM population definition (b_dca_master.program = 8 or 9) are not counted toward meeting the annual sample allocation. This footnote will be generated from a footnote look-up table for each sample type: 2 (monetary), 3 (separation), or 4 (nonseparation).

This footnote will be generated only if the user specifies an annual report for CY YYYY or the user specifies the batch range YYYY01 to YYYY52 (or YYYY53).

Footnote 6

The sampling frames from which the [sample type] denials samples were selected may not include all of the determinations that meet the definition for inclusion in the DCA population or may include records that do not meet the DCA population definition. This limits the degree to which inferences about the population can be made from BAM DCA data.

Condition: The size of the DCA population for CY 2004 varies by more than the statistical control limit from the benchmark population. The benchmark populations are:

Monetary: Percent of determinations denied in ETA 218 report times number of new initial claims (intrastate and interstate liable) plus transitional claims in ETA 5159 report.

Separation: Percent of determinations denied in ETA 207 report times number of separations in ETA 9052 report.

Nonseparation: Percent of determinations denied in ETA 207 report times number of nonseparations in ETA 9052 report.

This footnote will be generated from a footnote look-up table for each sample type: 2 (monetary), 3 (separation), or 4 (nonseparation).

This footnote will be generated only if the user specifies an annual report for CY YYYY or the user specifies the batch range YYYY01 to YYYY52 (or YYYY53).