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Office of Self Insurance Plans (OSIP)

OSIP Audit Unit

 

Audit Methodology and Random Selection

 

The OSIP Audit Unit looks at a sample of open files, closed files, and files that were denied within the last twelve months preceding the audit.

The sample of open files are randomly selected and are based on the population of the open indemnity claim files for the annual year reported. The number of indemnity claims randomly selected for audit is based on the table set forth in CCR 10107.1(d). In order to assure true random selection, the OSIP Audit Team uses a program that randomly selects the files to be audited.

The Auditors review the claim files for both over and under-reserving of future liabilities. The amount of over and under-reserving of future liabilities are divided by the amount of reported future liabilities in the annual report for the claim files reviewed.

The audit findings will be taken into consideration upon receipt of a complete actuarial study and regulatory actuarial summary report due no later than May 1, 2013 pursuant to 8CCR§15209(a).