Quarterly Call for Fourth Quarter of Calendar Year 2012 (CA-QT-4Q12) Due Date: February 14, 2013

Transcription

1 December 10, Market Street, Suite 800 San Francisco, CA Voice David M. Bellusci Senior Vice President and Chief Actuary To: Primary Contacts for WCIRB Aggregate Financial Data Calls RE: Data Call for Direct California Workers Compensation Experience Quarterly Call for Fourth Quarter of Calendar Year 2012 (CA-QT-4Q12) Due Date: February 14, 2013 For the WCIRB to proceed with its ratemaking function in an orderly and effective manner, the accurate and timely submission of experience is essential. It is therefore necessary that the requested data be filed via escad in the exact manner prescribed. Several quantitative examples of computing pure premium at advisory pure premium rate level are also included in order to assist insurers in completing the data call. This Quarterly Call must be received by the WCIRB on or prior to February 14, It is incumbent upon each responsible company officer to make certain that this deadline is achieved. Earlier submissions, if possible, would be extremely helpful. The WCIRB has instituted the "Program for Submission of California Aggregate Data" ( SCAD ), adopted on December 20, 1995 by the Governing Committee, to encourage the reporting of aggregate data in a timely and accurate manner. The WCIRB published an updated SCAD Program, effective July 1, The attached Call, which is due on February 14, 2013, will be subject to the SCAD program. A processing fee of $250 will be incurred for each non-escad submission of WCIRB aggregate data call types that can be submitted directly via the escad application. Please address all non-escad data call submissions to: Workers' Compensation Insurance Rating Bureau of California 525 Market Street, Suite 800 San Francisco, CA Attention: Actuarial Department escad@wcirbonline.org 1

2 December 10, 2012 Data Call for Direct California Workers Compensation Experience WCIRBCalifornia Any questions regarding the SCAD program or this Call should be directed to the WCIRB's Actuarial Department by sending an to David M. Bellusci Senior Vice President and Chief Actuary Enclosures: Schedule of Experience Calls Due in 2013 Quarterly Call for Fourth Quarter of Calendar Year 2012 Forms Instructions Guidelines for Computing Pure Premiums 2

3 Workers Compensation Insurance Rating Bureau of California Schedule for Experience Calls Due in 2013 Scheduled Call Due Date for Data Call Packet Issue Complete Data Call Date Submission CA-QT-4Q12 QUARTERLY CALL AS OF DECEMBER 31, 2012 / FOURTH QUARTER /10/2012 2/14/2013 CA-LD-2012 LARGE DEDUCTIBLE CALL AS OF DECEMBER 31, /14/2013 3/12/2013 CA-NC-2012 ABRIDGED CALENDAR YEAR CALL 2012 (This is the only annual call required of insurers NOT required to report Quarterly Calls) 1/14/2013 3/19/2013 CA-IM-2012 AGGREGATE INDEMNITY AND MEDICAL COSTS CALL /1/2013 4/2/2013 CA-EX-2012 EXPENSE CALL /1/2013 5/1/2013 CA-QT-1Q13 QUARTERLY CALL AS OF MARCH 31, 2013 / FIRST QUARTER /1/2013 5/7/2013 CA-DC-2012 DATA CERTIFICATION FORM THROUGH MARCH 31, /1/2013 6/4/2013 CA-QT-2Q13 QUARTERLY CALL AS OF JUNE 30, 2013 / SECOND QUARTER /1/2013 8/1/2013 CA-QT-3Q13 QUARTERLY CALL AS OF SEPTEMBER 30, 2013 / THIRD QUARTER /1/ /1/2013 Issued 12/10/2012 WCIRBCalifornia

4 Data Call for Direct California Workers Compensation Experience Fourth Quarter of Calendar Year 2012 (CA-QT-4Q12) Due Date: February 14, 2013 I. PREMIUM EXHIBIT (1) a. Direct Written Premium Calendar period 10/1/12-12/31/12 Premium at Insurer Level (2) Pure Premium at Advisory Pure Premium Rate Level i and prior policies XXXXXX ii policies iii policies iv policies v policies (if applicable) vi. Total calendar period 10/1/12-12/31/12 b. Direct Earned Premium Calendar period 10/1/12-12/31/12 XXXXXX i and prior policies XXXXXX ii policies iii policies iv policies v policies vi. Total calendar period 10/1/12-12/31/12 XXXXXX Name (Please print or type) Title Company (List all companies included in report) Date Filed Mailing Address Telephone No. Fax No. Page 1 of 6

5 Data Call for Direct California Workers Compensation Experience Fourth Quarter of Calendar Year 2012 (CA-QT-4Q12) Due Date: February 14, 2013 Premium Verification Worksheet This worksheet serves to verify the procedure(s) used by the insurer in the derivation of the Pure Premium at Advisory Pure Premium Rate Level reported in Section I, column (2). Please complete the following. The Pure Premium at Advisory Pure Premium Rate Level (Section I, column (2)) was computed using the following methodology: (Check one only for each policy year. If more than one method applies for a policy year, please select Method 5 and explain how the different methods were used.) 2010 Policies 2011 Policies 2012 Policies 2013 Policies 1. by summing ( ) exposure written (or earned) for all 2010 (or 2011, 2012 or 2013) policies X approved advisory pure premium rates X Experience Modification 2. By applying a consistent multiplicative factor (removing company expenses and deviations) across all classifications to your company's premium for 2010 (or 2011, 2012 or 2013) policies (Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level, paragraph A). 3. By applying a weighted average rate departure factor (removing company expenses and deviations) across all classifications to your company's premium for 2010 (or 2011, 2012 or 2013) policies (Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level, paragraph B1). 4. By applying a ratio of insurer rates to pure premium rates by classification to your company's premium by classification for 2010 (or 2011, 2012 or 2013) policies (Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level, paragraph B2). 5. By a method not described above. Please explain fully and in detail the procedures used to convert Premium at Insurer Level (Section I, column (1)) to Pure Premium at Advisory Pure Premium Rate Level (Section I, column (2)). Include all factors necessary for reconciliation and clearly define all figures shown. Company Page 2 of 6

6 Data Call for Direct California Workers Compensation Experience Fourth Quarter of Calendar Year 2012 (CA-QT-4Q12) Due Date: February 14, 2013 Premium Verification Worksheet (Continued) Please read the instructions prior to completing. If 2, 3, 4 or 5 is checked, please answer (a) and (b) below. a) The Pure Premium at Advisory Pure Premium Rate Level must be computed based on the Premium at Insurer Level (Section I, column (1)) excluding the average overall impact on premium of all rating plans except for the California Workers Compensation Experience Rating Plan , such as schedule rating, merit rating, minimum premiums, surcharge plans, premium discount, advisory Insolvent Insurer Rating Adjustment Plan, expense and loss constants. Were all premium adjustments, other than adjustments due to experience modifications, removed or excluded from the premium to which the factor(s) or ratio(s) was (were) applied? YES NO If "NO", please explain in detail. What was the combined percentage change to the Premium at Insurer Level (Section I, column (1)) of all the premium adjustments? (If this figure is different for written and earned premium, please report the figure pertaining to earned premium.) i) 2010 policies: % ii) 2011 policies: % iii) 2012 policies: % iii) 2013 policies (if applicable): % b) What was the multiplicative factor (if 2 was checked), weighted average rate departure factor (if 3 was checked), or average ratio of insurer rates to pure premium rates (if 4 was checked) used? (If this figure is different for written and earned premium, please report the figure pertaining to earned premium.) i) 2010 policies: ii) 2011 policies: iii) 2012 policies: iv) 2013 policies (if applicable): (If reporting on a combined insurer group basis, the factor must be representative for the group. If more than one rate per classification was used, please explain how the average factor was computed. If the WCIRB standard classification system was not used, please explain how you adjusted the premium in your insurer classification to the pure premium in the corresponding WCIRB standard classification.) Company Page 3 of 6

7 Data Call for Direct California Workers Compensation Experience Fourth Quarter of Calendar Year 2012 (CA-QT-4Q12) Due Date: February 14, 2013 II. ACCIDENT YEAR EXHIBIT Accident Year Prior to (a) As of 12/31/2012 (b) As of 9/30/2012 (c) Quarter Change (a) (b) (d) As of 12/31/2011 (e) YTD Change (a) (d) Indemnity Medical Paid Cost of Medical Paid Losses Loss Reserves Excluding IBNR Paid Losses Loss Reserves Excluding IBNR IBNR Total Incurred Losses Including IBNR (1)+(2)+(3)+(4)+(5) Paid ALAE Cost Containment Programs Included in ALAE* (1) (2) (3) (4) (5) (6) (7) (7a) * Column (7a) must be reported as applicable to claims on policies incepting on or after July 1, Company Page 4 of 6

8 Data Call for Direct California Workers Compensation Experience Fourth Quarter of Calendar Year 2012 (CA-QT-4Q12) Due Date: February 14, 2013 II. ACCIDENT YEAR EXHIBIT (continued) (a) Accident Year Prior to As of 12/31/2012 Paid Medical on Medical- Paid Indemnity Losses on Paid Medical Losses on Open Indemnity Total Indemnity Only Claims Open Indemnity Claims Open Indemnity Claims Claim Counts Claim Counts Total Claim Counts (8) (9) (10) (11) (12) (13) Company Page 5 of 6

9 Data Call for Direct California Workers Compensation Experience Fourth Quarter of Calendar Year 2012 (CA-QT-4Q12) Due Date: February 14, 2013 III. CALENDAR YEAR EXHIBIT a. Direct Written Premium Calendar period 1/1/12-12/31/12 (1) Premium at Insurer Level (2) Pure Premium at Advisory Pure Premium Rate Level i and prior policies XXXXXX ii policies iii policies iv policies v policies (if applicable) vi. Total calendar period 1/1/12-12/31/12 XXXXXX b. Direct Earned Premium Calendar period 1/1/12-12/31/12 i and prior policies XXXXXX ii policies iii policies iv policies v policies (if applicable) vi. Total calendar period 1/1/12-12/31/12 XXXXXX Company Page 6 of 6

10 Instructions Call for Direct California Workers' Compensation Experience Quarterly Call (CA-QT-xQyy) - Premium Exhibit, Accident Year Exhibit, and Calendar Year Exhibit A. FOR ALL PARTS OF THIS CALL, information reported must be in accordance with the following: (a) Include experience (premium, losses, ALAE and claim counts) from: Deductible policies on a gross (first dollar) basis Standard workers compensation policies Employers liability increased limits Minimum premiums Salvage and subrogation (b) Exclude experience (premium, losses, ALAE and claim counts) from: Ceded reinsurance Reinsurance assumed Excess insurance USL&H insurance Private residence employee insurance National Defense Project insurance (c) Insurers who are members of an affiliated group are encouraged to file on a combined group ( consolidated ) basis. However, all members of the group must be individually listed. All data calls for the same evaluation period submitted to the WCIRB must be made under the same grouping structure. Any changes to the reporting group must be communicated to and approved by WCIRB prior to reporting data under the new grouping. (d) Use of the escad web-based application to submit data is highly encouraged. Insurers with access to the escad web-based application should submit this data call online via escad. Non-eSCAD submissions using only WCIRB forms and/or templates are permitted for insurers who do not yet have access to escad, subject to a $250 processing fee for each submission of this data call. For all non-escad submissions: (i) reported amounts must be rounded to whole dollars; (ii) negative amounts must be displayed enclosed within parentheses; and (iii) the horizontal and vertical totals must equal their corresponding sum of rounded details shown on the forms, not the rounded sum of actual details. (e) Quarterly calls are subject to the SCAD Program (program for Submission of California Aggregate Data). Refer to the SCAD Program effective July 1, 2010 for details. A comprehensive listing of the edits used to check the accuracy of submitted call data is available by clicking on the Help link in escad. Page 1 of 6 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

11 Instructions Call for Direct California Workers' Compensation Experience Quarterly Call (CA-QT-xQyy) - Premium Exhibit, Accident Year Exhibit, and Calendar Year Exhibit B. For PART I: PREMIUM EXHIBIT and PART III: CALENDAR YEAR EXHIBIT*, information reported must be in accordance with the following: (a) Premium information is to be segregated by the designated policy years within the calendar period requested. For a particular calendar period (quarter x of year yy), premiums reported in policy year P must include the premiums generated on all policies with inception year P that were written or earned during quarter x of year yy. (b) Exclude the impact of the following items from all reported premiums: Application of any deductible credits Application of any retrospective rating plan adjustments California Insurance Guarantee Association (CIGA) assessments California Workers Compensation Revolving Fund assessments California Workers Compensation fraud surcharges Uninsured Employers Trust Fund Assessment Subsequent Injuries Benefits Trust Fund Assessment Occupational Safety & Health Fund assessments Labor Enforcement & Compliance Fund assessments Any charge for terrorism coverage pursuant to the Terrorism Risk Insurance Act of 2002 as amended by the Terrorism Risk Insurance Extension Act of 2005, or the Terrorism Risk Insurance Program Reauthorization Act of (c) Written and earned premiums must be reported at two levels: 1. Premium at Insurer Level: This is the premium charged to the insured, with exceptions noted above. (Please refer to the definition of Final Premium in Part 4, Section II of the California Workers Compensation Uniform Statistical Reporting Plan 1995 (USRP), available on the WCIRB website at for a more detailed definition of premium to be reported to the WCIRB.) 2. Pure Premium at Advisory Pure Premium Rate Level: This is the premium resulting from applying (1) the approved advisory pure premium rates to applicable exposure and (2) the applicable experience modifications computed in accordance with the California Workers Compensation Experience Rating Plan Refer to the separate guidelines on the calculation of pure premiums at the advisory pure premium level for further detail and examples. (d) Earned but not billed or booked (EBUB) premiums must be included in both the Premium at Insurer Level and the Pure Premium at Advisory Pure Premium Rate Level. *Note: Calendar Year Exhibit is applicable to the Quarterly Call for Fourth Quarter only. Page 2 of 6 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

12 Instructions Call for Direct California Workers' Compensation Experience Quarterly Call (CA-QT-xQyy) - Premium Exhibit, Accident Year Exhibit, and Calendar Year Exhibit C. For PART II: ACCIDENT YEAR EXHIBIT, information reported must be in accordance with the following: (a) The Accident Year method of compiling data requires the assignment of all data for each claim to the year in which the accident occurred, and valued as of the evaluation date for the specified call: Accident year data to be reported on the call for First Quarter must be evaluated as of March 31 of the specified evaluation year. Accident year data to be reported on the call for Second Quarter must be evaluated as of June 30 of the specified evaluation year. Accident year data to be reported on the call for Third Quarter must be evaluated as of September 30 of the specified evaluation year. Accident year data to be reported on the call for Fourth Quarter must be evaluated as of December 31 of the specified evaluation year. (b) Paid data for each accident year must be reported on a cumulative basis. This means that for each accident year, the total of all amounts paid on each claim belonging to that accident year from the time the claim is reported to the evaluation date of the data call must be included. (c) Reserves valued as of the evaluation date of the data call must be reported. Voluntary reserves must be excluded. (d) Indemnity losses (paid, reserved excluding IBNR, incurred): Please refer to the definition of Indemnity Losses in Part 4, Section II of the USRP, available on the WCIRB website at for a more detailed definition of indemnity data to be reported to the WCIRB. (e) Medical losses (paid, reserved excluding IBNR, incurred): Please refer to the definition of Medical Losses in Part 4, Section II of the USRP, available on the WCIRB website at for a more detailed definition of medical data to be reported to the WCIRB. (f) Paid ALAE: Please refer to the definition of Allocated Loss Adjustment Expenses in Part 4, Section II of the USRP, available on the WCIRB website at for a more detailed definition of ALAE data to be reported to the WCIRB. Please note, claims that contain Paid ALAE but do not have any indemnity or medical incurred value must have their Paid ALAE value reported, however they must not be included in claim counts. (g) Claim count data for each accident year must be reported on a cumulative basis. This means that for each accident year, the total number of claims belonging to that accident year as of the evaluation date of the data call must be included. Reopened claims must not be counted as a separate claim from the original claim. (Do not double-count reopened claims under the premise that because they were closed as of a prior valuation date and are open as of the given valuation date, they represent two separate claims.) (h) Indemnity claims means claims with indemnity incurred (paid plus case reserves) greater than zero as of the evaluation date of this call. (i) Medical-only claims means claims with medical incurred (paid plus case reserves) greater than zero and indemnity incurred equal to zero as of the evaluation date of this call. Page 3 of 6 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

13 Instructions Call for Direct California Workers' Compensation Experience Quarterly Call (CA-QT-xQyy) - Premium Exhibit, Accident Year Exhibit, and Calendar Year Exhibit (j) Open claims refers to claims which have not had a final loss payment made as of the evaluation date of the call (irrespective of future ALAE payments to be made). (k) Column data must conform to the following table: Col. Field Name Description 1 Paid Losses (Indemnity) Report cumulative indemnity amount paid for each accident year as of the evaluation date of the call. 2 Loss Reserves Excluding IBNR (Indemnity) Report indemnity reserves (excluding IBNR) for each accident year as of the evaluation date of the call. Include: Indemnity case reserves Indemnity reserve for reopened claims Exclude: 3 Paid Losses (medical) 4 Loss Reserves Excluding IBNR (Medical) Indemnity reserves for incurred but not reported claims Report cumulative medical amount paid for each accident year as of the evaluation date of the call. For claims covered by policies incepting prior to July 1, 2010 only, include the cumulative paid cost of medical cost containment programs. Report medical reserves for each accident year as of the evaluation date of the call. Include: Medical case reserves Medical reserve for reopened claims Exclude: Medical reserves for incurred but not reported claims 5 IBNR Report the total of indemnity and medical reserves for claims incurred but not reported for each accident year. Exclude: 6 Total Incurred Losses Including IBNR Indemnity and medical case reserves Indemnity and medical reserve for reopened claims This is the sum of columns 1 through 5. 7 Paid ALAE Report cumulative ALAE amount paid for each accident year as of the evaluation date of the call. Include the cumulative paid cost of medical cost containment programs reported in 7a (applies to claims covered by policies incepting on or after July 1, 2010 only). 7a Paid Cost of Medical Cost Containment Programs Included in ALAE For claims covered by policies incepting on or after July 1, 2010 only, report the cumulative paid cost of medical cost containment programs for each accident year as of the evaluation date of the call. The amount reported is also to be included in column 7 (Paid ALAE). Page 4 of 6 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

14 Instructions Call for Direct California Workers' Compensation Experience Quarterly Call (CA-QT-xQyy) - Premium Exhibit, Accident Year Exhibit, and Calendar Year Exhibit Col. Field Name Description 8 Paid Medical on Medical-Only Claims For each of the accident years 1989 and forward, report cumulative medical paid on claims considered as medical-only claims (open or closed) as of the evaluation date of the call. For claims covered by policies incepting prior to July 1, 2010 only, include the cumulative paid cost of medical cost 9 Paid Indemnity Losses on Open Claims 10 Paid Medical Losses on Open Claims 11 Open Indemnity Claim Counts 12 Total Indemnity Claim Counts containment programs. For each of the accident years 1989 and forward, report cumulative indemnity paid on indemnity claims which were open as of the evaluation date of the call. For each of the accident years 1989 and forward, report cumulative medical paid on indemnity claims which were open as of the evaluation date of the call. For claims covered by policies incepting prior to July 1, 2010 only, include the cumulative paid cost of medical cost containment programs. For each of the accident years 1989 and forward, report the number of indemnity claims (i) which were open as of the evaluation date of the call and (ii) where the sum of indemnity cumulative loss paid and indemnity loss case reserve for each claim as of the evaluation date of the call is greater than zero. For each of the accident years 1989 and forward, report the cumulative total number of indemnity claims (both open and closed) as of the evaluation date of the call, where the sum of indemnity cumulative loss paid and indemnity loss case reserve for each claim as of the evaluation date of the call is greater than zero. 13 Total Claim Counts For accident years 1989 and forward, report the cumulative total number of indemnity and medical-only claims (both open and closed) as of the evaluation date of the call, where the sum of indemnity and medical cumulative loss paid and indemnity and medical loss case reserves for each claim as of the evaluation date of the call is greater than zero. (l) Row (a) must be the sums of the figures in the individual accident years for each of columns (1) through (13). (m) In row (b), for columns (1) through (7a), report the corresponding data from row (a) of the call evaluated three months prior. (n) Row (c), the Quarter Change, is the difference between rows (a) and (b) for each of columns (1) through (7a). (o) In row (d) (Fourth Quarter only), for columns (1) through (7a), report the corresponding data from row (a) of the call evaluated as of December 31 of the previous evaluation year. (p) Row (e) (Fourth Quarter only), the Year-to-Date Change, is the difference between rows (a) and (d) for each of columns (1) through (7a). Page 5 of 6 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

15 Instructions Call for Direct California Workers' Compensation Experience Quarterly Call (CA-QT-xQyy) - Premium Exhibit, Accident Year Exhibit, and Calendar Year Exhibit (q) Claim counting when in question can be clarified with the chart below: Is the indemnity incurred (cumulative indemnity paid + indemnity case reserve) on this claim greater than zero? Yes No Is this claim Open? (Note, a claim is open until a final loss payment has been made, closing both the indemnity and medical portions of the claim.) Is the medical incurred (cumulative medical paid + medical case reserve) on this claim greater than zero? Yes No Yes No This claim must be included in the Total Claim Counts, Total Indemnity Claim Counts and Open Indemnity Claim Counts fields. This claim must be included in only the Total Claim Counts and Total Indemnity Claim Counts fields. This claim must be included in only the Total Claim Counts field. Do not include this claim in any claim count field. Page 6 of 6 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

16 Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Pure Premium at the Advisory Pure Premium Rate Level for a policy is defined to be the sum of the product of the exposure and the advisory pure premium rate for each classification, adjusted by application of the experience modification computed in accordance with the California Workers Compensation Experience Rating Plan 1995 (Method 1). A. For insurers who derive their authorized rates through application of a consistent multiplicative factor across all classifications to the approved pure premium rates, the factor can be used to convert premiums at the insurer level to premiums at an advisory pure premium rate level (Method 2). Insurers using this method must first modify premiums at the insurer level to remove the premium impact of any rating plans (including the advisory Insolvent Insurer Rating Adjustment Plan) other than the California Workers Compensation Experience Rating Plan before applying the multiplicative factor to derive the premiums at advisory pure premium rate level. B. For insurers employing different factors by classification, there are two scenarios: 1. For premiums that are not coded down to the classification level, a weighted average rate departure factor can be applied to the premium at the insurer level to obtain the pure premium at the WCIRB advisory pure premium rate level (Method 3). This weighted average rate departure factor, which would be divided into the premium at insurer level, is simply the ratio of: Sum (most recent exposure for each class x insurer-filed rate for each class) Sum (most recent exposure for each class x advisory pure premium for each class) 2. For premiums that are coded down to classification level, pure premiums by classification can be computed based on applying, to the insurer's premium by classification, the experience modification and the ratio of insurer's rate for each classification to the advisory pure premium rate for that classification (Method 4). Note that the premiums at insurer level are prior to the application of deductible credits. Several quantitative examples are attached for your reference. If the method used to compute pure premium does not conform to any of the Methods 1 through 4 prescribed in these Guidelines, then Method 5 should be designated on Page 2 of the call and an explanation should be provided. Sets of approved advisory pure premium rates are available in the Regulatory Filings section of the WCIRB s website at The Overview option within Regulatory Filings provides several years filing documents and includes files containing approved pure premium rates. Page 1 of 15

17 Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Example of Pure Premium Calculation Using Method 1 yyyy denotes a selected policy year. This calculation should be performed for each individually listed policy year requested on the Premium Exhibit (and Calendar Year Exhibit for fourth quarter) of the Quarterly Call. Method 1 Pure Premium at Advisory Pure Premium Rate Level computed based on Summing. All inputs in this example are hypothetical. ( ) exposure written (or earned) for all yyyy policies X approved advisory pure premium rates X Experience Modification For calendar period Example Using Method 1 (1) (2) (3) (4) (5) (6)=(3)x(4)x(5) Policy # Class WC Payroll (in hundreds) for Calendar Quarter (i) yyyy Advisory Pure Premium Rate yyyy Mod Pure Premium at Advisory PP Rate Level WC , % 8, , % 27, , % 34,785 WC , % 55, , % 67,584 WC , % 171,450 Total 35, ,890 (ii) Notes (i) Exposure was adjusted to reflect the portion of the exposure on each policy written (or earned) for the calendar quarter in question. (ii) Enter figure on Premium Exhibit, Column (2) in the row applicable to the selected policy year yyyy (page 1 of Quarterly Call). Page 2 of 15

18 Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Example of Pure Premium Calculation Using Method 2 yyyy denotes a selected policy year. This calculation should be performed for each individually listed policy year requested on the Premium Exhibit (and Calendar Year Exhibit for fourth quarter) of the Quarterly Call. Method 2 Pure Premium at Advisory Pure Premium Rate Level computed based on applying a consistent multiplicative factor (removing company expenses and rate deviations) across all classifications to your company s premium for policy year yyyy policies. All inputs in this example are hypothetical. Example Using Method 2 (1) Total Policy Year yyyy Premium at Insurer Level (for calendar period) 16,000 (i) (2) Rating Plan Adjustments Other than Experience Rating: (i.e. Schedule Rating, premium discount, etc.) a. Total Rating Plan Credits (3,500 ) b. Total Rating Plan Debits 200 c. Combined Premium Adjustments (3,300 ) (3) Premium with Rating Plan Adjustments Removed (1) (2c) 19,300 (4) Percentage Change of Combined Premium Adjustments to the Premium at Insurer Level {[(3) - (1)] / (1)} x 100% % (ii) (5) Company Expense Loading (the applicable Pure Premium Rate Modifiers from company rate filings) (6) Company Uniform Rate Deviation Factor (the uniform rate deviation factor applicable to yyyy rates) (7) Multiplicative Factor (5) x (6) (iii) (8) Total Policy Year yyyy Pure Premium at Advisory Pure Premium Rate Level (3) / (7) 17,156 (iv) Notes (i) Enter figure on Premium Exhibit, Column (1) in the row applicable to the selected policy year yyyy (page 1 of Quarterly Call). (ii) Enter figure on Pure Premium Verification Worksheet, Question a (page 3 of Quarterly Call). (iii) Enter figure on Pure Premium Verification Worksheet, Question b (page 3 of Quarterly Call). (iv) Enter figure on Premium Exhibit, Column (2) in the row applicable to the selected policy year yyyy (page 1 of Quarterly Call). WCIRB internal verification: (1) x (4) (8) = (7) Page 3 of 15

19 Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Example of Pure Premium Calculation Using Method 3 yyyy denotes a selected policy year. This calculation should be performed for each individually listed policy year requested on the Premium Exhibit (and Calendar Year Exhibit for fourth quarter) of the Quarterly Call. Method 3 Pure Premium at Advisory Pure Premium Rate Level computed based on applying a weighted average rate departure factor (removing company expenses and rate deviations) across all classifications to your company s premium for policy year yyyy policies. All inputs in this example are hypothetical. Example Using Method 3 (1) Total Policy Year yyyy Premium at Insurer Level (for calendar period) 16,000 (i) (2) Rating Plan Adjustments Other than Experience Rating: (i.e. Schedule Rating, premium discount, etc.) a. Total Rating Plan Credits (3,500 ) b. Total Rating Plan Debits 200 c. Combined Premium Adjustments (3,300 ) (3) Premium with Rating Plan Adjustments Removed (1) (2c) 19,300 (4) Percentage Change of Combined Premium Adjustments to the Premium at Insurer Level {[(3) (1)] / (1)} x 100% % (ii) (5) Company Weighted Average Rate Departure Factor: (iii) Latest Available Exposure yyyy yyyy Advisory Advisory Class (in 00s) Insurer Rate Insurer Base Premium Pure Prem. Rate Pure Prem. (a) (b) (c) (d)=(b)x(c) (e) (f)=(b)x(e) , , , , , , , , ,000 : : : : : : : : : : : : Total 500,000 3,210,000 2,885,910 (6) Total Policy Year yyyy Pure Premium at Advisory Pure Premium Rate Level (3) / (5) 17,356 (iv) Notes (i) Enter figure on Premium Exhibit, Column (1) in the row applicable to the selected policy year yyyy (page 1 of Quarterly Call). (ii) Enter figure on Pure Premium Verification Worksheet, Question a (page 3 of Quarterly Call). (iii) Weighted Average Rate Departure Factor = 3,210,000 / 2,885,910 = Enter figure on Pure Premium Verification Worksheet, Question b (page 3 of Quarterly Call). (iv) Enter figure on Premium Exhibit, Column (2) in the row applicable to the selected policy year yyyy (page 1 of Quarterly Call). WCIRB internal verification: (6) = (1) x (4) (5) Page 4 of 15

20 Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Example of Pure Premium Calculation Using Method 4 yyyy denotes a selected policy year. This calculation should be performed for each individually listed policy year requested on the Premium Exhibit (and Calendar Year Exhibit for fourth quarter) of the Quarterly Call. Method 4 Pure Premium at Advisory Pure Premium Rate Level computed based on applying a ratio of insurer rates to pure premium rates by classification to your company s premium by classification for policy year yyyy policies. All inputs in this example are hypothetical. Example Using Method 4 Policy # Class Premium at Insurer Level Insurer Base Premium (i) yyyy Advisory Rate Insurer Rate Base Pure Premium yyyy Mod Pure Premium at Advisory Rate Level (1) (2) (3) (4) (5) (6)=(3)x(4)/(5) (7) (8)=(6)x(7) WC , % 1, ,950 2, , % 2,400 Sub-total 2,900 3,000 2, % 3,400 WC ,950 6, ,456 80% 4, ,950 8, ,000 80% 6, ,950 15, ,500 80% 10,000 Sub-total 28,850 29,000 25,956 80% 20,765 Total for All Policies 31,750 (ii) 32,000 28,789 24,165 (iii) Percentage Change of Combined Premium Adjustments to the Premium at Insurer Level = Sum (Insurer Base Premium x Mod) of all yyyy policies Premium at Insurer Level for all yyyy policies minus 100% = (3,000 x ,000 x 0.80) 31, = % (iv) Average Ratio of Insurer Rate to Pure Premium Rates = = Sum (Insurer Base Premium x Mod) of all yyyy policies Sum (Base Pure Premium x Mod) of all yyyy polices (3,000 x ,000 x 0.80) (2,833 x ,956 x 0.80) = (v) Notes: (i) Base Premium = Exposure x Insurer Rate per Exposure. Exposure was adjusted to reflect the portion of the exposure on each policy written (or earned) for the calendar quarter in question. (ii) Enter figure on Premium Exhibit, Column (1) in the row applicable to the selected policy year yyyy (page 1 of Quarterly Call). (iii) Enter figure on Premium Exhibit, Column (2) in the row applicable to the selected policy year yyyy (page 1 of Quarterly Call). WCIRB internal verification: (iii) = (ii) x (iv) / (v) or 24,165 = 31,750 x (-15.59%) / (iv) Enter figure on Pure Premium Verification Worksheet, Question a (page 3 of Quarterly Call). (v) Enter figure on Pure Premium Verification Worksheet, Question b (page 3 of Quarterly Call). Page 5 of 15

21 Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Pure Premium Rate Section (Approved) Effective January 1, 2010 on New and Renewal Policies with Anniversary Rating Dates on or after January 1, 2010 No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* *Pure Premium Rates are per $100 of payroll unless otherwise noted. Page 6 of 15

22 Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Pure Premium Rate Section (Approved) Effective January 1, 2010 on New and Renewal Policies with Anniversary Rating Dates on or after January 1, 2010 (Continued) Legend: (A) and (B): See below No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* (B) (A) (A) Per Capita (A) Firefighters, Police, Police Deputies, etc. No. Rate Firefighters - volunteers Police, Sheriffs - volunteers Per Race (B) Horse Racing No. Rate Jockeys employed at a rate per race (See Classification Racing Stables for instructions) *Pure Premium Rates are per $100 of payroll unless otherwise noted. Page 7 of 15

23 Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Pure Premium Rate Section (Approved) Effective January 1, 2011 on New and Renewal Policies with Anniversary Rating Dates on or after January 1, 2011 No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* *Pure Premium Rates are per $100 of payroll unless otherwise noted. Page 8 of 15

24 Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Legend: (A) See below No. Pure Premium Rate Section (Approved) Effective January 1, 2011 on New and Renewal Policies with Anniversary Rating Dates on or after January 1, 2011 (Continued) Rate* No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* (A) (A) (A) Per Capita No. Firefighters, Police, Police Deputies, etc. Rate 7707 Firefighters - volunteers Police, Sheriffs - volunteers Per Race No. Horse Racing Rate 8278 Jockeys employed at a rate per race (See Classification Racing Stables for instructions) *Pure Premium Rates are per $100 of payroll unless otherwise noted. Page 9 of 15

25 Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Approved January 1, 2012 Pure Premium Rates Effective January 1, 2012 on New and Renewal Policies with Anniversary Rating Dates on or after January 1, 2012 No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* No. Rate* *Pure Premium Rates are per $100 of payroll unless otherwise noted. Page 10 of 15