April 7, 2000 BUREAU CIRCULAR NO Re: STATISTICAL PLAN REVISIONS EFFECTIVE VARIOUS DATES AS INDICATED

Transcription

1 April 7, 2000 BUREAU CIRCULAR NO To All Members of the Bureu: Re: STATISTICAL PLAN REVISIONS EFFECTIVE VARIOUS DATES AS INDICATED The Bureu hs filed nd the Insurnce Commissioner hs pproved mendments nd dditions to the Pennsylvni Workers Compenstion Sttisticl Pln, to be effective on vrious dtes nd bses s set forth in the body of this circulr. The vrious subjects included in these revisions nd their corresponding Sttisticl Pln Mnul revisions re shown below. Sttisticl Pln Mnul Lnguge This revision is necessry to remedy n error in lnguge contined in the Sttisticl Pln Mnul (Mnul), s it ddresses volunteer hzrdous mterils response tems nd is EFFECTIVE JULY 1, The Mnul lnguge mendments re shown below with new wording underlined nd deleted wording brcketed. SECTION II - REPORTING REQUIREMENTS B. Exposure Informtion 5. Exposure - Other Thn Pyroll f. Per Compny - Volunteer Hzrdous Mterils Response Tem - Clss 996. Where the policy provides coverge of [v]volunteer[s of ] Hzrdous Mterils Response Tem, enter the number of [volunteers on per]such compny/tems [bsis] in the spce provided for the exposure mount, crried to the nerest tenth. [The premium derived is not subject to experience or retrospective rting. The exposure nd premium shll be entered on lines D, E or F.] Premium Algorithm This generl re requires n ddition to the Sttisticl Pln Mnul (Mnul) to be EFFECTIVE on n optionl bsis JULY 1, 2000 nd on mndtory bsis for new nd renewl policies with norml nniversry rting dtes on or fter JANUARY 1, The purpose of this ddition is to develop premium lgorithm tht will set forth specificlly the sequence nd rithmetic clcultion of workers compenstion premium. Such clcultions hve become incresingly detiled nd complex by virtue of the growing number nd vriety of specil pricing progrms pplicble to workers compenstion insurnce creted by virtue of both legisltive enctment nd competitive inititive, which hs incresed n interest in ccounting for nd nlyzing the impcts of certin of these vilble progrms. The revisions to the Mnul re shown below with new wording underlined nd deleted wording brcketed. Plese note tht ll references to Delwre re pending filing with nd pprovl by the Delwre Insurnce Commissioner.

2 Bureu Circulr No Pge 2 SECTION X [NOTES]PREMIUM CALCULATION ALGORITHM Pennsylvni nd Delwre Premium Algorithm Prefce: Optionl use upon July 1, Mndtory use for policies effective on or fter Jnury 1, The computtion of workers compenstion premium includes brod complement of potentil rting vlues, pricing progrms nd other similr or relted vribles. To the extent tht these component prts of premium determintion my be pplied in prescribed sequence nd using defined formuls nd/or reltionships, severl potentil benefits rise including the following: Competitive differences within the mrketplce cn be more clerly defined nd consistently pplied; Similrly situted risks cn receive comprble tretment with respect to specific rting vlues, pricing progrms or other fctors, incresing the equity of the mrketplce; Anlysis of the effects of vrious components of overll premium determintion cn be better understood nd more intelligently compred cross crriers, sttes nd/or time; In the event tht new pricing progrms or other fctors re introduced in the future, the defined existing formuls cn provide consistent bsis for the development of progrms nd system procedures within the workers compenstion industry. Pennsylvni nd Delwre Workers Compenstion Premium Algorithm Premium Clcultion Algorithm Line # Item Nme Associted Sttisticl Code Line # Source & Derivtion (1) Clssifiction XXXX (1) Crrier vlue (2) Exposure XXXX (2) Risk chrcteristic (3) Crrier Rting Vlue XXXX (3) Crrier vlue (4) Clssifiction Mnul Premium (4) (2)/100x(3) if clssifiction hs pyroll exposure. Specil procedures pply to non-pyroll clsses (5) Totl Policy Mnul Premium (5) Sum of (4) for ll clssifictions on the policy (6) Employer Libility Incresed Limits Fctor 9807 (6) Crrier vlue (7) Employer Libility Incresed Limits 9807 (7) (5)x[(6) expressed s deciml] Premium Chrge (8) Minimum Premium Employer Libility 9848 (8) Crrier vlue Incresed Limits (9) Minimum Premium Employer Libility Incresed Limits Premium Chrge 9848 (9) [(8)-(7)] if (7)<(8) nd (6),>0, otherwise zero (10) Subject Deductible Credit Percentge 9664 (10) Crrier vlue (11) Subject Deductible Premium Credit 9664 (11) [(5)+(7)+(9)]x(-10) expressed s deciml (12) Wiver of Subrogtion Chrge (DE) 0930 (12) Crrier vlue - subject to experience modifiction (13) Wiver of Subrogtion Premium (DE) 0930 (13) Vlue from Line (12) (14) Totl Subject Premium (14) [(5)+(7)+(9)+(11)+(13)] (15) Experience Modifiction 9898 (15) Zero for non-experience-rted risks (16) Modified Premium (16) (14)x(15) (17) Merit Rting Credit Fctor 9885 (17) Zero if Merit Rting Credit does not pply (18) Merit Rting Credit 9885 (18) (14)x[(-17) expressed s deciml (19) Merit Rting Neutrl Fctor 9884 (19) Zero if Merit Rting Neutrl Adjustment (no credit or debit) does not pply (20) Merit Rting Neutrl Fctor 9884 (20) (14)x(19)[expressed s deciml] (21) Merit Rting Debit Fctor 9886 (21) Zero if Merit Rting Debit does not pply (22) Merit Rting Chrge 9886 (22) (14)x(21)[expressed s deciml] (23) Premium After Experience Modifiction or Merit Rting (23) (16) if Experience-Rted, (14)+[(18) or (20) or (22)] if Merit-Rted, (14) if Non-Rted (24) Occuptionl Disese Exposure 0067 (24) Portion of pyroll exposure subject to OD hzrd (25) Occuptionl Disese Loding 0067 (25) Crrier vlue

3 Bureu Circulr No Pge 3 Line # Item Nme Associted Sttisticl Code Line # Source & Derivtion (26) Occuptionl Disese Premium 0067 (26) (24)/100x(25) [bsed on pplicble OD exposure] (27) Supplementl Rdition Exposure 9985 (27) Portion of pyroll exposure subject to rdition hzrd (28) Supplementl Rdition Loding 9985 (28) Crrier vlue (29) Supplementl Rdition Premium 9985 (29) (27)/100x(28) [bsed on pplicble rdition exposure] (30) Occuptionl Disese Incresed Limits 9807 (30) Crrier vlue Fctor (31) Occuptionl Disese Incresed Limits 9807 (31) [(26)+(29)]x[(30)) expressed s deciml] Premium Chrge (32) Occuptionl Disese Incresed Limits 9848 (32) Crrier vlue Minimum Premium (33) Occuptionl Disese Incresed Limits Minimum Premium Chrge 9848 (33) [(32)-(31)] if (31) < (32) nd (30) > 0, otherwise zero (34) Aircrft Set Surchrge 9108 (34) Crrier vlue (35) Aircrft Set Surchrge Exposure (# of 9108 (35) Actul number of sets for insured risk sets) (36) Aircrft Set Surchrge Indicted Premium 9108 (36) (34)x(35) (37) Aircrft Set Surchrge Mximum 9108 (37) Crrier vlue Premium (38) Aircrft Set Surchrge Premium Chrge 9108 (38) (37) if (36) > (37), otherwise (36) (39) Premium Before Schedule Rting (39) (23)+(26)+(29)+(31)+(33)+(38) (40) Schedule Rting Pln Adjustment Fctor 9887/9889 (40) Crrier vlue - use 9887 for schedule credits nd 9889 for schedule debits. (41) Schedule Rting Pln Premium Adjustment 9887/9889 (41) (39)x[(40) expressed s deciml]. For schedule credits Line (40) will be negtive. (42) Certified Sfety Committee Credit Fctor (PA) 9890 (42) Credit pplies if insured is certified nd hs remining yer(s) of eligibility (43) Certified Sfety Committee Premium Credit 9890 (43) [(39)+(41)]x[(-42) expressed s deciml] (PA) (44) Workplce Sfety Progrm Credit Fctor 9880 (44) Credit pplies if insured qulifies (DE) (45) Workplce Sfety Progrm Premium Credit 9880 (45) [(39)+(41)]x[(-44) expressed s deciml] (DE) (46) Construction Clssifiction Premium Adjustment Progrm Credit Fctor 9046 (46) Bsed on wge level(s), ppliction to rting orgniztion (47) Construction Clssifiction Premium 9046 (47) [(39)+(41)]x[(-46) expressed s deciml] Adjustment Progrm Premium Credit (48) Drug-Free Workplce Fctor (DE) 9846 (48) Crrier vlue (49) Drug-Free Workplce Credit (DE) 9846 (49) [(39)+(41)+(45)+(47)]x(-48) expressed s deciml] (50) Mnged Cre Fctor (DE) 9874 (50) Crrier vlue (51) Mnged Cre Credit (DE) 9874 (51) [(39)+(41)+(45)+(47)+(49)]x[(-50) expressed s deciml] (52) Pckge Credit Fctor (DE) 9721 (52) Crrier vlue (53) Pckge Credit (DE) 9721 (53) [(39)+(41)+(45)+(47)+(49)+(51)]x[(-52) expressed s deciml] (54) Premium After Mnged Cre nd (54) [(39)+(41)+(43)+(45)+(47)+(49)+(51)+(53)] Pckge Credit If Applicble (55) Assigned Risk Surchrge Fctor (DE) 0277 (55) My pply to some or ll ssigned risks bsed on pln nd chrcteristics of individul insured (56) Assigned Risk Premium Surchrge (DE) 0277 (56) (54)x[(55) expressed s deciml] (57) Deductible Credit Fctor 9663 (57) Crrier vlue (58) Deductible Premium Credit 9663 (58) [(54)+(56)]x[(-57) expressed s deciml] (59) Loss Constnt 0032 (59) Crrier vlue - my vry bsed on risk premium size (60) Loss Constnt Chrge 0032 (60) Line (59) if pplicble (61) Short Rte Cncelltion Fctor 0931 (61) Crrier vlue - zero if short rte cncelltion does not pply (62) Short Rte Premium 0931 (62) [(54)+(56)+(58)+(60)]x[(61) ] if (61) > 0, otherwise zero

4 Bureu Circulr No Pge 4 Line # Item Nme Associted Sttisticl Code Line # Source & Derivtion (63) Expense Constnt 0900 (63) Crrier vlue (64) Expense Constnt Chrge 0900 (64) Line (63) if pplicble (65) Minimum Premium 0990 (65) Crrier vlue (66) Minimum Premium Chrge 0990 (66) If (65)>([(54) +(56)+(58)+(60)+(62)+(64)], (65) -[(54)+(56)+(58)+(60)+(62)+(64)], otherwise zero (67) Unit Sttisticl Report Totl Stndrd (67) [(54)+(56)+(58)+(60)+(62)+(66)] Premium (68) Premium Discount Amount 0063/0064 (68) Crrier vlue bsed on [(54)+(56)+(58)+(60)+(62)+(64)+(66)] (69) Totl Premium (69) (64)+(67)-(68) (70) Employer Assessment Fctor Pursunt to 0938 (70) Bureu vlue for the specific purpose of Act 57 of 1997 (PA) (71) Employer Assessment Amount Pursunt to Act 57 of 1997 (PA) computing employer ssessments 0938 (71) [(69)-(11)-(58)]x(70) NOTE: Cells (11) nd (58) re credits. Subtrcting these credits s shown effectively dds the premium reduction given for deductible coverge bck into the premium for purposes of clculting employer ssessments. Pension Tbles These tbles re periodiclly updted to incorporte vrious provisions, nd this revision dopts recent chnges in pension tble vlues in use in other jurisdictions ntionlly, llowing Pennsylvni writers who lso provide insurnce in other sttes to use consistent set of pension tbles for multiple jurisdictions. The PCRB hs reched n greement with the Ntionl Council on Compenstion Insurnce, Inc. (NCCI) which provides for the PCRB s filing nd its members use of these tbles in Pennsylvni with pproprite ttribution to NCCI. These tbles, which re EFFECTIVE on mndtory bsis JULY 1, 2000, mend the Sttisticl Pln Mnul in Section V - Tbles nd re ttched to this circulr s Exhibit 1. Housekeeping Updtes The housekeeping revisions to the Sttisticl Pln Mnul pper in Sections I, II, III, IV nd VI nd re EFFECTIVE on mndtory bsis JULY 1, The chnges include revisions in coding nd terminology which re generlly intended to bring the pproved Sttisticl Pln Mnul up-to-dte with Advisory Sttisticl Work Group (ASWG) recommendtions nd current prctices. Bureu stff believes tht this coding is consistent with most crriers prctice in Pennsylvni, s well s other jurisdictions. One of the more substntive chnges involves requiring the reporting of Frudulent Clim Indictor, which would pply only in instnces where finding of frud hs been issued by court of proper jurisdiction nd uthority. This does not require crriers to ttempt to identify potentil or suspected frud by wy of this indictor. However, given the specil emphsis nd brod interest ttched to frud issued in the workers compenstion environment, it is impertive tht Bureu sttistics be cpble of reporting ctivity in this re on meningful nd objective bsis. The Mnul lnguge revisions re shown below with new wording underlined nd deleted wording brcketed.

5 Bureu Circulr No Pge 5 SECTION I GENERAL RULES/DEFINITIONS L. Loss Rules. 10. Incurred Losses. Enter the totl of ll pid nd outstnding compenstion in the field cptioned Indemnity nd the totl of ll pid nd outstnding medicl in the field cptioned Medicl. The outstnding costs shll be the compny s individul cse estimtes of future pyments s of the dte of vlution. [For specil instructions regrding the reporting of Employers Libility clims, refer to Item L.7. of this Section.] All pid compenstion nd pid medicl shll be reported on gross (first-dollr) bsis nd shll not be reduced by ny mount(s) reimbursed or reimbursble under ny pplicble deductible progrm(s). All cse estimtes of future pyments reported s outstnding compenstion nd medicl shll be reported on gross (first-dollr) bsis nd shll not be reduced by ny mount(s) reimbursed or reimbursble under ny pplicble deductible progrm(s). For specil instructions regrding the reporting of Employers Libility clims, refer to Item L.7. of this Section. A. Rules Common to Premiums nd Losses 8. Policy Type ID Code. SECTION II REPORTING REQUIREMENTS Identifies. policy. Type of Coverge Code Description 01 Stndrd Workers Compenstion Policy 09 Non-Stndrd Policy Pln Type Code Description 01 Voluntry Policy 02 Norml Assigned Risk Policy Non-Stndrd Type Code Description 01 Non-Stndrd Code Does Not Apply 08 Exclusion of Executive Officers [02]09 Voluntry Coverge Not Mndted by Stte Act 9. Deductible Type/ Report. reported.

6 Bureu Circulr No Pge 6 First Two Positions Code Description 00 No Deductible Applies Blnce of this portion remins unchnged. Second Two Positions Code Description 00 No Deductible Applies Blnce of this portion remins unchnged. Blnce of A. remins unchnged. B. Exposure Informtion. 2. Exposure Coverge. Report ssocited. Code Description 01 Stte or Federl Act, excl. USL&HW 02 USL&HW F or non F Coverge 10 Voluntry Coverge Not Mndtory by Stte Act Items 3. through 8. remin unchnged. 9. Miscellneous Premium nd Credits.. Premium Subject left blnk. [(4) Rte Devition Applied to Mnul Premium before Appliction of Experience Modifiction. For crrier using devition, report the premium djustment resulting from the ppliction of the devition to the Mnul premium (before ppliction of the experience modifiction) under the pproprite code. Code Downwrd Devition (to be subtrcted when computing Totl Subject Premium) Code Upwrd Devition NOTE: USE ONLY POSITIVE VALUES] b. Premium Not.. Report. [(1) Rte Devition Applied to Mnul Premium After the Appliction of Experience Modifiction. For crrier using devition, report the premium djustment resulting from the ppliction of the devition to the Mnul premium (fter ppliction of the experience modifiction) under the pproprite code. Code Downwrd Devition (to be subtrcted when computing the Totl Stndrd Premium) Code Upwrd Devition NOTE: USE ONLY POSITIVE VALUES]

7 Bureu Circulr No Pge 7 [(2)](1) Loss Constnt industry groups. [(3)](2) Aircrft.. Section. [(4)](3) Short Rte.. Section VI.). [(5)](4) Pennsylvni. Code [(6)](5) Certified Sfety. Code (6) Merit Rting Pln Adjustments - Applicble on Lines D, E or F (on the pper copy of the unit sttisticl report) in lieu of experience modifiction. Code Neutrl Adjustment - no credit or debit. Code % Credit Adjustment - to be subtrcted when clculting stndrd premium. Code % Debit Adjustment - to be dded when clculting stndrd premium. Merit Rting Adjustments re pplicble to mnul premium before ppliction of ny schedule rting, Pennsylvni Sfety Committee Credit or Pennsylvni Construction Clssifiction Premium Adjustment Progrm. (7) Schedule Rting Pln Adjustments Schedule Rting Pln Adjustments must be pplied s percentge fctor pplicble to mnul premium fter ppliction of experience/merit rting but prior to ny other credit (i.e., Pennsylvni Sfety Committee credit, Pennsylvni Construction Clssifiction Premium Adjustment Progrm.) Code Schedule Rting Credit - to be subtrcted when clculting stndrd premium. Code Schedule Rting Debit - to be dded when clculting stndrd premium. NOTE: USE ONLY POSITIVE VALUES c. Premium. Stndrd Premium. d. Employer Assessment Not Subject to Experience Rting, to be reported on Line K on the hrd copy unit sttisticl report. Employer Assessment Fctor - Code 0938 Clcultion of Employer Assessment Premium Bse proceeds by dding bck to the totl policy premium the mount of ny deductible credits. Blnce of this item remins unchnged. C. Loss Informtion. 9. Loss Conditions. Report. Act.. conditions. Type of Coverge Type of Settlement Code Description 00 Clim Not Subject to Settlement 03 Stipulted Awrd (Crrier/Climnt Settlement) 04 Findings nd Awrd (Judicil Awrd) 05 Dismissl (Non-Compensble) 06 Compromise Settlement 09 All Other Settlements

8 Bureu Circulr No Pge 8 Items 10. through 16. remin unchnged. 17. [Pid Indemnity.]Frudulent Clim Code. [Report the whole dollr mount of pid indemnity expenses for the clim s of the loss vlution dte. These losses consist of ll pid benefits due to n employee s lost wge or inbility to work, including compenstion pid to decesed prior to deth, buril expense, climnt s ttorney fees, voctionl rehbilittion benefits, pyments top the stte nd employers libility losses nd expenses.] Report the 2-position code tht indictes the clim sttus s respects occurrence of frud. Code to be determined bsed on entry or filing of n order or other forml finding by court or other judicil uthority hving jurisdiction over the cse. 18. [Pid Medicl.]Pid Indemnity. [Report the whole dollr mount of medicl losses pid for the clim s of the loss vlution dte.] Report the whole dollr mount of pid indemnity expenses for the clim s of the loss vlution dte. These losses consist of ll pid benefits due to n employee s lost wge or inbility to work, including compenstion pid to decesed prior to deth, buril expense, climnt s ttorney fees, voctionl rehbilittion benefits, pyments top the stte nd employers libility losses nd expenses. 19. [Climnt s Attorney Fees Incurred. (Optionl)]Pid Medicl. [Report the whole dollr mount pid plus outstnding reserves for climnt s legl representtion during the settlement of the clim s of the loss vlution dte.]report the whole dollr mount of medicl losses pid for the clim s of the loss vlution dte. 20. [Employer s Attorney Fees.]Climnt s Attorney Fees Incurred. (Optionl) [Report the whole dollr mount pid plus outstnding reserves for employer s legl representtion during the settlement of the clim s of he loss vlution dte.]report the whole dollr mount pid plus outstnding reserves for climnt s legl representtion during the settlement of the clim s of the loss vlution dte. 21. [Allocted Loss Adjustment Pid (ALAE)]Employer s Attorney Fees. [Report the whole dollr mount of loss djustment expense llocted nd pid for this clim s of the loss vlution dte.]report the whole dollr mount pid plus outstnding reserves for employer s legl representtion during the settlement of the clim s of he loss vlution dte. 22. [Allocted Loss Adjustment Incurred (ALAE) (Optionl)]Allocted Loss Adjustment Pid (ALAE). [Report the whole dollr mount of loss djustment expense llocted nd pid or reserved for this clim s of the loss vlution.]report the whole dollr mount of loss djustment expense llocted nd pid for this clim s of the loss vlution dte. 23. Allocted Loss Adjustment Incurred (ALAE) (Optionl). Report the whole dollr mount of loss djustment expense llocted nd pid or reserved for this clim s of the loss vlution. The blnce of this item remins unchnged.

9 Bureu Circulr No Pge 9 A. Individul Cse Reports Rules. SECTION III INDIVIDUAL CASE REPORTS 2. Generl Instructions UNIT REPORT. d. Trnsction Type Code (3) Revised Report - Code 3. Individul Cse Report filed [when the crrier discovers need for chnge on n Individul Cse Report previously filed for the prticulr clim.]due to the rejection by the Bureu Unit Review System of previous Individul Cse Report filed for prticulr clim. All dt on the correction report must be identicl to the dt on the originl report except for Trnsction Type nd the dt elements being corrected. (4) Correction Report - Code 4. Individul Cse Report filed [due to the rejection by the Bureu Unit Review System of previous Individul Cse Report filed for prticulr clim. All dt on the correction report must be identicl to the dt on the originl report except for Trnsction Type nd the dt elements being corrected.]when the crrier discovers need for chnge on n Individul Cse Report previously filed for the prticulr clim. Subtopics e through dd remin unchnged. ee. Lump Sum Indictor. Report whether or not the clim ws settled with pyment of specified mount to the climnt. Report [ 1 ] Y for lump sum pyment nd [ 2 ] N for other thn lump sum pyment. Subtopics ff through jj remin unchnged. kk. Dte of Hire. (Not pplicble in Pennsylvni) Items 3 nd 4 remin unchnged. 5. Totls. d. Socil Security or Other Offset Amount. [This field is not required in Pennsylvni.] Enter the whole dollr mount of ny socil security or other offset pid s of the vlution dte. Subtopics e through v remin unchnged. B. Exposure Informtion Codes. 3. Premium Codes. SECTION IV CODES b. Premium Not Subject to Experience Modifiction (Reported on lines D, E or F )

10 Bureu Circulr No Pge 10 (11)Merit Rting Pln Adjustment - Neutrl Code 9884 (12)Merit Rting Pln Adjustment - 5% Credit Adjustment Code 9885 (13)Merit Rting Pln Adjustment - 5% Debit Adjustment Code 9886 (14)Schedule Rting Pln Credit Code 9887 (15)Schedule Rting Pln Debit Code 9889 D. Individul Cse Report Codes 9. Lump Sum Indictor. Code [1]Y [2]N Description Lump Sum Other thn Lump Sum 10. Frudulent Clim Indictor. Code Description 0 Not Frudulent 1 Prtilly Frudulent 2 Fully Frudulent Blnce of this subtopic remins unchnged. E. Employer Assessment Surchrge 1. Employer Assessment Surchrge Code 0938 The revised codes for Prt of Body, Nture of Injury, Cuse of Injury re ttched s Exhibit 2. *** *** *** *** *** *** Questions concerning these revisions should be directed to Bruce E. Decker, Vice President - Public Informtion & Sttisticl Reporting, Extension 223, or bdecker@pcrb.com. Sttisticl Pln Mnul reprints will be vilble t lter dte. kg D Attchments Timothy L. Wisecrver President Remember to visit our web site t for more informtion bout this nd other topics.

11 PENSION TABLES EXHIBIT 1

12 TABLE I-A Surviving Spouse Pension Tble* Age t Widowhood (X) [x] [x]+1 [x]+2 [x]+3 [x]+4 [x]+5 Attined Age** (X+5) Notes: * U.S. Decennil Life Tble for Femle Popultion Remrrige rtes bsed on 1979 NCCI study Annul Rte of Interest = 3.5% Annul Rte of Escltion = 0.0% ** For durtions beyond 5 yers from deth of climnt, use the nnuity vlue in the column for ge (X+5) corresponding to the beneficiry s ttined ge Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

13 TABLE I-A Surviving Spouse Pension Tble* Age t Widowhood (X) [x] [x]+1 [x]+2 [x]+3 [x]+4 [x]+5 Attined Age** (X+5) Notes: * U.S. Decennil Life Tble for Femle Popultion Remrrige rtes bsed on 1979 NCCI study Annul Rte of Interest = 3.5% Annul Rte of Escltion = 0.0% ** For durtions beyond 5 yers from deth of climnt, use the nnuity vlue in the column for ge (X+5) corresponding to the beneficiry s ttined ge Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

14 TABLE I-A Surviving Spouse Pension Tble* Age t Widowhood (X) [x] [x]+1 [x]+2 [x]+3 [x]+4 [x]+5 Attined Age** (X+5) Notes: * U.S. Decennil Life Tble for Femle Popultion Remrrige rtes bsed on 1979 NCCI study Annul Rte of Interest = 3.5% Annul Rte of Escltion = 0.0% ** For durtions beyond 5 yers from deth of climnt, use the nnuity vlue in the column for ge (X+5) corresponding to the beneficiry s ttined ge Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

15 TABLE II-A Present Vlue of Remrrige Dowry* Age t Attined A A A A A A Widowhood Age** (X) [x] [x]+1 [x]+2 [x]+3 [x]+4 [x]+5 (X+5) : Notes: * U.S. Decennil Life Tble for Femle Popultion Remrrige rtes bsed on 1979 NCCI study Annul Rte of Interest = 3.5% Annul Rte of Escltion = 0.0% ** For durtions beyond 5 yers from deth of climnt, use the nnuity vlue in the column for ge (X+5) corresponding to the beneficiry s ttined ge Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

16 TABLE II-A Present Vlue of Remrrige Dowry* Age t Attined A A A A A A Widowhood Age** (X) [x] [x]+1 [x]+2 [x]+3 [x]+4 [x]+5 (X+5) Notes: * U.S. Decennil Life Tble for Femle Popultion Remrrige rtes bsed on 1979 NCCI study Annul Rte of Interest = 3.5% Annul Rte of Escltion = 0.0% ** For durtions beyond 5 yers from deth of climnt, use the nnuity vlue in the column for ge (X+5) corresponding to the beneficiry s ttined ge Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

17 TABLE II-A Present Vlue of Remrrige Dowry* Age t Attined A A A A A A Widowhood Age** (X) [x] [x]+1 [x]+2 [x]+3 [x]+4 [x]+5 (X+5) Notes: * U.S. Decennil Life Tble for Femle Popultion Remrrige rtes bsed on 1979 NCCI study Annul Rte of Interest = 3.5% Annul Rte of Escltion = 0.0% ** For durtions beyond 5 yers from deth of climnt, use the nnuity vlue in the column for ge (X+5) corresponding to the beneficiry s ttined ge Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

18 TABLE III-M-A Pension Tble* (Other thn Surviving Spouse) (Present Vlue of $1 per Annum Pyble Until Deth) Mle Age Present Vlue Age Present Vlue Age Present Vlue * U.S. Decennil Life Tble for Mle Popultion Annul Rte of Interest = 3.5% Annul Rte of Escltion = 0.0% Florid: For Permnent Totl Disbilities, Supplementl Benefits re n dditionl 5% of the insured worker s weekly benefit multiplied by the number of clendr yers since the dte of injury. The sum of the Supplementl Benefits nd the Workers Compenstion Benefit is limited to the current mximum benefit. Effective July 1, 1990, s result of legisltive chnges, Supplementl Benefits re llowed only until ge 62 if Socil Security Benefits become pplicble. The clcultion of the present vlue for the Supplementl Benefits is highly technicl in nture. Becuse of the incrementing schedule of the benefits, one of the following cturil formuls should be utilized: Effective for Clims with ccident dtes July 1, 1984 through June 30, 1990: x +.05(l) x Bsic Benefits (Tble III-A) Florid Supplementl Benefits (Tble V-A) Effective for Clims with ccident dtes fter July 1, 1990 x +.05(l) x62-x Bsic Benefits (Tble III-A) Florid Supplementl Benefits (Tble V-A) where x = ge of climnt Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

19 TABLE III-F-A Pension Tble* (Other thn Surviving Spouse) (Present Vlue of $1 per Annum Pyble Until Deth) Femle Age Present Vlue Age Present Vlue Notes: * U.S. Decennil Life Tble for Femle Popultion Annul Rte of Interest = 3.5% Annul Rte of Escltion = 0.0% 1998 Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

20 TABLE I-B Surviving Spouse Pension Tble* Age t Widowhood (X) [x] [x]+1 [x]+2 [x]+3 [x]+4 [x]+5 Attined Age** (X+5) Notes: * U.S. Decennil Life Tble for Femle Popultion Remrrige rtes bsed on 1979 NCCI study Annul Rte of Interest = 3.5% Annul Rte of Escltion = 4.0% ** For durtions beyond 5 yers from deth of climnt, use the nnuity vlue in the column for ge (X+5) corresponding to the beneficiry s ttined ge Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

21 TABLE I-B Surviving Spouse Pension Tble* Age t Widowhood (X) [x] [x]+1 [x]+2 [x]+3 [x]+4 [x]+5 Attined Age** (X+5) Notes: * U.S. Decennil Life Tble for Femle Popultion Remrrige rtes bsed on 1979 NCCI study Annul Rte of Interest = 3.5% Annul Rte of Escltion = 4.0% ** For durtions beyond 5 yers from deth of climnt, use the nnuity vlue in the column for ge (X+5) corresponding to the beneficiry s ttined ge Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

22 TABLE I-B Surviving Spouse Pension Tble* Age t Widowhood (X) [x] [x]+1 [x]+2 [x]+3 [x]+4 [x]+5 Attined Age** (X+5) Notes: * U.S. Decennil Life Tble for Femle Popultion Remrrige rtes bsed on 1979 NCCI study Annul Rte of Interest = 3.5% Annul Rte of Escltion = 4.0% ** For durtions beyond 5 yers from deth of climnt, use the nnuity vlue in the column for ge (X+5) corresponding to the beneficiry s ttined ge Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

23 TABLE II-B Present Vlue of Remrrige Dowry* Age t Attined Widowhood A' A' A' A' A' A' Age** (X) [x] [x]+1 [x]+2 [x]+3 [x]+4 [x]+5 (X+5) Notes: * U.S. Decennil Life Tble for Femle Popultion Remrrige rtes bsed on 1979 NCCI study Annul Rte of Interest = 3.5% Annul Rte of Escltion = 4.0% ** For durtions beyond 5 yers from deth of climnt, use the nnuity vlue in the column for ge (X+5) corresponding to the beneficiry s ttined ge Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

24 TABLE II-B Present Vlue of Remrrige Dowry* Age t Attined Widowhood A' A' A' A' A' A' Age** (X) [x] [x]+1 [x]+2 [x]+3 [x]+4 [x]+5 (X+5) Notes: * U.S. Decennil Life Tble for Femle Popultion Remrrige rtes bsed on 1979 NCCI study Annul Rte of Interest = 3.5% Annul Rte of Escltion = 4.0% ** For durtions beyond 5 yers from deth of climnt, use the nnuity vlue in the column for ge (X+5) corresponding to the beneficiry s ttined ge Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

25 TABLE II-B Present Vlue of Remrrige Dowry* Age t Attined Widowhood A' A' A' A' A' A' Age** (X) [x] [x]+1 [x]+2 [x]+3 [x]+4 [x]+5 (X+5) Notes: * U.S. Decennil Life Tble for Femle Popultion Remrrige Rtes bsed on 1979 NCCI study Annul rte of Interest = 3.5% Annul Rte of Escltion = 4.0% ** For durtions beyond 5 yers from deth of climnt, use the nnuity vlue in the column for ge (X+5) corresponding to the beneficiry s ttined ge Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.

26 TABLE III-M-C Pension Tble* (Other thn Surviving Spouse) (Present Vlue of $1 per Annum Pyble Until Deth) Mle Age Present Vlue Age Present Vlue Notes: * U.S. Decennil Life Tble for Mle Popultion Annul Rte of Interest = 3.5% Annul Rte of Escltion = 4.0% 1998 Ntionl Council on Compenstion Insurnce, Inc. All rights reserved. Reprinted with permission.