Quarterly Call for Third Quarter of Calendar Year 2014 (CA-QT-3Q14) Due Date: October 31, 2014

September 8, 2014 525 Market Street, Suite 800 San Francisco, CA 94105-2767 Voice 415.777.0777 www.wcirb.com escad@wcirb.com David M. Bellusci Executive Vice President, COO & Chief Actuary To: Primary Contacts for WCIRB Aggregate Financial Data Calls RE: Data Call for Direct California Workers Compensation Experience Quarterly Call for Third Quarter of Calendar Year 2014 (CA-QT-3Q14) Due Date: October 31, 2014 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 October 31, 2014. 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, 2010. The attached Call, which is due on October 31, 2014, 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 94105-2767 Attention: Actuarial Department Email: escad@wcirb.com 1

September 8, 2014 Data Call for Direct California Workers Compensation Experience Any questions regarding the SCAD program or this Call should be directed to the WCIRB's Actuarial Department by sending an email to escad@wcirb.com. David M. Bellusci Executive Vice President, COO & Chief Actuary Enclosures: Quarterly Call for Third Quarter of Calendar Year 2014 Forms Instructions Guidelines for Computing Pure Premiums 2

Data Call for Direct California Workers' Compensation Experience Third Quarter Calendar Year 2014 (CA-QT-3Q14) R WCIRBCalifornia Due Date: October 31, 2014 I. Premium Exhibit a. Direct Written Premium i. 2011 and prior policies ii. 2012 policies iii. 2013 policies iv. 2014 policies Total Calendar Period 7/1/14 9/30/14 1 2 Pure Premium Premium at Advisory Pure at Insurer Level Premium Rate Level b. Direct Earned Premium i. 2011 and prior policies ii. 2012 policies iii. 2013 policies iv. 2014 policies Total Name Title Email Date Filed Telephone Fax Group Group Name C Workers' Compensation Insurance Rating Bureau of California. All rights reserved. Page 1 of 7

Data Call for Direct California Workers' Compensation Experience Third Quarter Calendar Year 2014 (CA-QT-3Q14) R WCIRBCalifornia Due Date: October 31, 2014 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 Part I, column (2). Please complete the following. The Pure Premium at Advisory Pure Premium Rate Level (Part I, column (2)) was computed using the following methodology: 1 2012 2013 2014 Policies Policies Policies 1. By summing Exposure written (or earned) for all 2012 (2013 or 2014) 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 2012 (2013 or 2014) policies. 3. By applying a weighted average rate departure factor (removing company expenses and deviations) across all classifications to your company's premium for 2012 (2013 or 2014) policies. 4. By applying a ratio of insurer rates to pure premium rates by classification to your company's premium by classification for 2012 (2013 or 2014) policies. 5. By a method not described above. 2 1. 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. 2. Please explain fully and in detail the procedures used to convert Premium at Insurer Level (Part I, column (1)) to Pure Premium at Advisory Pure Premium Rate Level (Part I, column (2)). Include all factors necessary for reconciliation and clearly define all figures shown. If necessary, email any additional supporting information to escad@wcirb.com. Be sure to clearly indicate your reporting group/company name and code, data call code (shown in header of this page) and version # of the submission (search for this call in the Data Calls section after submission) in the email or in the attachment. C Workers' Compensation Insurance Rating Bureau of California. All rights reserved. Page 2 of 7

Data Call for Direct California Workers' Compensation Experience Third Quarter Calendar Year 2014 (CA-QT-3Q14) R WCIRBCalifornia Due Date: October 31, 2014 Premium Verification Worksheet (Continued) Please read the instructions prior to completing. If 2, 3, 4 or 5 is checked on Page 2, please answer (a) and (b) below. a. The Pure Premium at Advisory Pure Premium Rate Level should be computed based on the Premium at Insurer Level (Part I, column (1)) excluding the average overall impact on premium of all rating plans except for the California Experience Rating Plan, such as schedule rating, merit rating, minimum premiums, surcharge plans, premium discount, 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 ratios was applied? If "NO", please explain in detail below: What was the combined percentage change to the Premium at Insurer Level (Part 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. 2012 policies % ii. 2013 policies % iii. 2014 policies % 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. 2012 policies ii. 2013 policies iii. 2014 policies If reporting as a combined insurer group basis, the factor should be representative for the group. If more than one rate per classification was used, please explain below how the average factor was computed. If the WCIRB standard classification system was not used, please explain below how you adjusted the premium in your insurer classification to the pure premium in the corresponding WCIRB standard classification. C Workers' Compensation Insurance Rating Bureau of California. All rights reserved. Page 3 of 7

Data Call for Direct California Workers' Compensation Experience Third Quarter Calendar Year 2014 (CA-QT-3Q14) R WCIRBCalifornia Due Date: October 31, 2014 II. Accident Year Exhibit Indemnity Medical 1 2 3 4 5 6 7 7a Total Paid Cost of Medical Incurred Losses Cost Containment Accident Loss Reserves Loss Reserves Including IBNR Programs Included Year Paid Losses Excluding IBNR Paid Losses Excluding IBNR IBNR 1+2+3+4+5 Paid ALAE in ALAE* Prior to 1983 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 * Column 7a should be reported as applicable to claims on policies incepting on or after July 1, 2010. C Workers' Compensation Insurance Rating Bureau of California. All rights reserved. Page 4 of 7

Data Call for Direct California Workers' Compensation Experience Third Quarter Calendar Year 2014 (CA-QT-3Q14) R WCIRBCalifornia Due Date: October 31, 2014 II. Accident Year Exhibit (continued) Indemnity Medical 1 2 3 4 5 6 7 7a Total Paid Cost of Medical Incurred Losses Cost Containment Accident Loss Reserves Loss Reserves Including IBNR Programs Included Year Paid Losses Excluding IBNR Paid Losses Excluding IBNR IBNR 1+2+3+4+5 Paid ALAE in ALAE* 2013 2014 a. As of 09/30/2014 b. As of 06/30/2014 c.quarter Change (a) (b) * Column 7a should be reported as applicable to claims on policies incepting on or after July 1, 2010. C Workers' Compensation Insurance Rating Bureau of California. All rights reserved. Page 5 of 7

Data Call for Direct California Workers' Compensation Experience Third Quarter Calendar Year 2014 (CA-QT-3Q14) R WCIRBCalifornia Due Date: October 31, 2014 II. Accident Year Exhibit (continued) 8 9 10 11 12 13 Paid Medical Paid Indemnity Paid Medical Accident on Medical-Only Losses on Open Losses on Open Open Indemnity Total Indemnity Total Year Claims Indemnity Claims Indemnity Claims Claim Counts Claim Counts Claim Counts a. 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 As of 09/30/2014 C Workers' Compensation Insurance Rating Bureau of California. All rights reserved. Page 6 of 7

Data Call for Direct California Workers' Compensation Experience R WCIRBCalifornia Calendar Year 2014 (CA-QT-3Q14) Due Date: October 31, 2014 Companies included in the report Name Status C Workers' Compensation Insurance Rating Bureau of California. All rights reserved. Page 7 of 7

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 7 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

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 2007. (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 http://www.wcirb.com/document/123, 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 - 1995. 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 7 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

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 http://www.wcirb.com/document/123, 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 http://www.wcirb.com/document/123, 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 http://www.wcirb.com/document/123, for a more detailed definition of ALAE data to be reported to the WCIRB. Please note that 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 7 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

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 that are not related to Independent Bill Review (IBR) and Independent Medical Review (IMR). 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: Indemnity and medical case reserves Indemnity and medical reserve for reopened claims 6 Total Incurred Losses Including IBNR This is the sum of columns 1 through 5. 7 Paid ALAE Report cumulative ALAE (including costs of IBR and IMR) amount paid for each accident year as of the evaluation date of the call. For claims covered by policies incepting on or after July 1, 2010 only, also include the cumulative paid cost of medical cost containment programs that are not related to IBR and IMR. 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 costs related to IBR, IMR, and other 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 7 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

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 containment programs that are not related to Independent Bill 9 Paid Indemnity Losses on Open Indemnity Claims 10 Paid Medical Losses on Open Indemnity Claims 11 Open Indemnity Claim Counts 12 Total Indemnity Claim Counts Review (IBR) and Independent Medical Review (IMR). 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 that are not related to Independent Bill Review (IBR) and Independent Medical Review (IMR). 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) is 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. Page 5 of 7 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

Instructions Call for Direct California Workers' Compensation Experience Quarterly Call (CA-QT-xQyy) - Premium Exhibit, Accident Year Exhibit, and Calendar Year Exhibit (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). (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 7 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

Instructions Call for Direct California Workers' Compensation Experience Quarterly Call (CA-QT-xQyy) - Premium Exhibit, Accident Year Exhibit, and Calendar Year Exhibit (r) Paid IBR & IMR Costs when in question can be clarified with the chart below: * Note that Paid Medical on Medical-Only Claims (Column 8) and Paid Medical Losses on Open Indemnity Claims (Column 10) should also be reported on this basis. Page 7 of 7 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

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 - 1995 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 www.wcirb.com. The Overview option within Regulatory Filings provides several years filing documents and includes files containing approved pure premium rates. Page 1 of 15 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

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 WC001 9995 1,000 5.55 150% 8,325 9996 2,000 9.03 150% 27,090 9997 3,000 7.73 150% 34,785 WC002 9997 6,000 7.73 120% 55,656 9998 8,000 7.04 120% 67,584 WC003 9999 15,000 12.70 90% 171,450 Total 35,000 364,890 (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 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

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% 20.625 % (ii) (5) Company Expense Loading (the applicable Pure Premium Rate Modifiers from company rate filings) 1.250 (6) Company Uniform Rate Deviation Factor (the uniform rate deviation factor applicable to yyyy rates) 0.900 (7) Multiplicative Factor (5) x (6) 1.125 (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: (8) = (1) x 1.0 + (4) (7) Page 3 of 15 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

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% 20.625% (ii) (5) Company Weighted Average Rate Departure Factor: 1.112 (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) 9995 1,000 4.50 4,500 5.55 5,550 9996 40,000 12.50 500,000 9.03 361,200 9997 100,000 6.00 600,000 7.73 773,000 : : : : : : : : : : : : 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 = 1.112. 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 1.0 + (4) (5) Page 4 of 15 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

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) WC001 9995 950 1,000 5.55 6.66 833 120% 1,000 9996 1,950 2,000 9.03 9.03 2,000 120% 2,400 Sub-total 2,900 3,000 2,833 120% 3,400 WC002 9997 5,950 6,000 7.73 8.50 5,456 80% 4,365 9998 7,950 8,000 7.04 7.04 8,000 80% 6,400 9999 14,950 15,000 12.70 15.24 12,500 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 1.20 + 29,000 x 0.80) 31,750-1.0 = -15.59% (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 1.20 + 29,000 x 0.80) (2,833 x 1.20 + 25,956 x 0.80) = 1.109 (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 1.0 + (iv) / (v) or 24,165 = 31,750 x 1.0 + (-15.59%) / 1.109 (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 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

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 0005 5.12 2108 6.97 3018 2.33 3634 5.78 4361 2.55 5146 7.09 6003 9.48 0016 8.22 2109 8.59 3022 5.87 3643 3.41 4362 2.66 5160 2.47 6011 7.89 0034 7.33 2111 6.30 3030 9.24 3647 7.59 4410 7.77 5183 6.91 6204 11.67 0035 4.12 2113 13.61 3039 8.53 3651 3.12 4420 12.95 5184 4.52 6206 7.52 0036 7.89 2116 5.87 3040 9.64 3681 1.40 4432 6.17 5185 7.22 6213 2.63 0038 12.75 2117 10.28 3060 7.51 3682 1.82 4470 4.28 5186 2.65 6216 5.26 0040 4.43 2121 4.88 3066 5.49 3683 5.06 4478 6.88 5187 5.01 6218 6.70 0041 6.66 2123 6.01 3070 0.61 3719 2.61 4492 4.64 5190 5.49 6220 5.00 0042 7.24 2142 3.69 3076 7.87 3724 4.97 4494 6.36 5191 2.28 6233 2.70 0044 8.07 2150 10.32 3081 8.39 3726 4.32 4495 7.87 5192 7.52 6235 6.81 0045 5.29 2163 7.74 3082 9.15 3805 1.48 4496 6.22 5195 7.68 6237 2.21 0050 7.54 2211 14.76 3085 10.51 3808 5.28 4497 5.00 5201 7.69 6251 7.09 0079 3.50 2222 6.64 3099 4.48 3815 6.82 4498 6.33 5205 5.32 6258 6.34 0096 6.55 2362 10.95 3110 9.91 3821 12.11 4499 5.78 5207 6.58 6307 11.29 0106 17.97 2402 7.73 3131 5.20 3828 5.59 4511 1.23 5212 10.32 6308 5.85 0171 8.16 2413 8.47 3146 4.90 3830 2.23 4512 0.48 5213 7.64 6315 8.79 0172 5.74 2501 4.70 3152 2.95 3831 3.48 4557 3.54 5214 4.60 6316 5.45 0251 5.81 2570 10.36 3165 3.99 3840 6.24 4558 3.95 5222 9.92 6325 5.93 0400 4.78 2571 10.08 3169 5.28 4000 5.48 4611 2.74 5225 11.14 6361 5.20 0401 17.86 2576 7.00 3175 7.37 4034 8.58 4623 8.65 5348 5.42 6364 8.32 1122 9.76 2584 7.09 3178 3.05 4036 2.94 4635 2.80 5403 15.36 6400 8.08 1123 17.36 2585 9.48 3179 3.87 4038 8.67 4665 8.22 5432 6.49 6504 7.67 1124 10.13 2586 5.36 3180 6.70 4041 6.82 4683 5.39 5436 5.78 6834 8.50 1320 3.46 2589 5.36 3220 4.59 4049 5.40 4691 2.17 5443 7.48 7133 3.98 1322 5.68 2660 3.66 3241 5.96 4111 2.52 4692 2.12 5446 7.43 7198 8.99 1330 7.76 2683 6.50 3257 6.58 4112 0.80 4717 8.23 5447 4.95 7207 12.75 1438 7.82 2688 7.15 3339 6.98 4114 10.25 4720 4.27 5467 11.73 7219 11.12 1452 3.52 2702 23.28 3365 7.37 4130 9.27 4740 1.71 5470 7.19 7227 8.61 1463 6.02 2710 8.38 3372 6.00 4150 3.79 4771 2.82 5473 11.38 7232 10.67 1624 9.76 2727 16.43 3383 3.63 4239 5.36 4828 3.88 5474 9.83 7248 3.52 1699 2.22 2731 6.44 3400 6.11 4240 16.72 4829 2.71 5479 6.71 7272 10.20 1701 6.88 2757 10.17 3401 6.44 4243 6.39 4831 6.11 5482 5.96 7332 6.06 1710 7.00 2759 8.75 3501 5.79 4244 7.59 4922 2.77 5484 12.11 7360 8.99 1741 5.60 2790 3.94 3507 6.73 4250 4.84 4983 5.16 5485 7.19 7365 10.92 1803 8.73 2797 9.68 3560 5.05 4251 5.86 5020 5.30 5506 6.25 7382 10.01 1925 13.73 2806 6.25 3568 2.40 4279 6.04 5027 10.72 5507 3.84 7392 8.61 2002 7.62 2812 6.88 3569 3.57 4283 4.14 5028 6.51 5538 8.62 7403 9.89 2003 6.42 2819 9.43 3570 3.87 4286 7.53 5040 13.67 5542 4.45 7405 2.78 2014 8.29 2840 7.78 3572 1.46 4295 5.48 5057 8.62 5552 28.54 7409 7.22 2030 7.57 2842 8.85 3573 2.14 4297 0.51 5059 20.30 5553 13.59 7410 6.80 2063 5.16 2852 10.71 3574 4.25 4299 5.51 5102 6.90 5606 1.37 7421 1.68 2081 8.97 2881 10.34 3577 1.94 4304 10.29 5107 6.76 5632 15.36 7424 2.08 2095 10.86 2883 9.94 3612 4.65 4312 5.71 5108 12.02 5633 6.49 7428 5.39 2102 6.84 2915 5.98 3620 6.58 4351 2.61 5128 1.55 5650 9.65 7429 6.15 2107 5.68 2923 7.39 3632 4.88 4354 2.35 5140 3.09 5951 0.92 7500 4.80 *Pure Premium Rates are per $100 of payroll unless otherwise noted. Page 8 of 15 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

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 (Continued) Legend: (A) See below 7515 1.64 8039 4.45 8264 10.90 8745 9.91 8852 2.71 9151 1.20 7520 4.80 8041 5.19 8265 9.74 8748 1.60 8859 0.17 9154 4.35 7538 6.44 8042 4.37 8267 8.15 8749 0.38 8868 1.20 9155 2.43 7539 2.52 8046 4.77 8278 (A) 8755 1.21 8875 1.56 9156 7.65 7580 5.90 8057 6.82 8286 12.51 8800 4.23 9007 4.50 9180 6.52 7600 9.10 8059 5.84 8290 6.20 8801 1.32 9008 9.64 9181 18.24 7601 12.26 8060 2.85 8291 7.36 8803 0.23 9009 3.83 9182 2.65 7605 4.15 8061 4.65 8292 11.11 8804 4.15 9010 7.76 9184 11.81 7606 6.09 8062 2.07 8293 15.32 8806 5.88 9011 5.96 9185 39.08 7607 0.38 8063 3.98 8304 5.99 8807 0.85 9015 7.37 9220 7.70 7610 1.17 8064 4.68 8324 5.32 8808 0.91 9016 5.30 9402 5.49 7706 4.96 8065 3.94 8350 7.00 8810 0.49 9031 7.07 9403 9.14 7707 (A) 8066 2.26 8387 4.52 8813 0.94 9033 6.39 9410 1.67 7720 4.22 8070 2.70 8388 6.12 8818 0.85 9043 2.18 9420 7.77 7721 5.24 8071 2.12 8389 5.22 8820 0.47 9048 6.49 9422 5.61 7722 (A) 8078 2.64 8390 5.28 8821 2.51 9050 7.54 9424 8.16 7855 4.35 8102 2.52 8391 4.56 8822 0.95 9053 2.83 9426 10.26 8001 5.02 8103 10.19 8392 5.57 8823 6.10 9059 3.76 9501 4.90 8004 4.78 8106 8.05 8393 4.30 8827 6.13 9060 4.96 9507 4.50 8006 5.80 8107 5.11 8397 4.98 8829 4.65 9061 3.83 9516 5.02 8008 3.48 8110 4.32 8400 2.78 8830 2.18 9066 4.71 9519 5.83 8013 1.87 8111 5.62 8500 9.84 8831 3.25 9067 2.71 9521 6.25 8015 6.41 8113 14.60 8601 0.51 8834 1.26 9069 5.27 9522 6.62 8017 3.99 8116 7.11 8631 28.01 8838 1.93 9070 7.92 9529 6.23 8018 6.91 8117 6.03 8720 3.52 8839 1.19 9079 3.61 9549 6.98 8019 1.60 8204 14.60 8729 1.33 8840 0.65 9085 6.06 9552 15.65 8021 8.77 8209 6.98 8740 2.49 8846 0.92 9092 3.35 9586 1.87 8028 8.21 8215 9.19 8741 0.26 8847 10.82 9096 14.14 9610 2.39 8031 8.91 8227 6.34 8742 0.55 8850 3.73 9097 4.94 9620 2.69 8032 7.41 8232 8.63 8743 0.21 8851 4.71 9101 6.19 Per Capita Firefighters, Police, Police Deputies, etc. Rate Firefighters - volunteers 7707 272.31 Police, Sheriffs volunteers 7722 361.40 Per Race Horse Racing Rate Jockeys employed at a rate per race 8278 158.53 (See Classification 8631 - Racing Stables for instructions) *Pure Premium Rates are per $100 of payroll unless otherwise noted. Page 9 of 15 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Approved July 1, 2012 Pure Premium Rates Effective July 1, 2012 on New and Renewal Policies with Anniversary Rating Dates on or after July 1, 2012 0005 5.54 2108 7.55 3018 2.52 3634 6.26 4361 2.76 5146 7.68 6003 10.26 0016 8.90 2109 9.30 3022 6.35 3643 3.69 4362 2.88 5160 2.67 6011 8.54 0034 7.94 2111 6.82 3030 10.00 3647 8.22 4410 8.41 5183 7.48 6204 12.63 0035 4.46 2113 14.73 3039 9.23 3651 3.38 4420 14.02 5184 4.89 6206 8.14 0036 8.54 2116 6.35 3040 10.44 3681 1.52 4432 6.68 5185 7.82 6213 2.85 0038 13.80 2117 11.13 3060 8.13 3682 1.97 4470 4.63 5186 2.87 6216 5.69 0040 4.80 2121 5.28 3066 5.94 3683 5.48 4478 7.45 5187 5.42 6218 7.25 0041 7.21 2123 6.51 3070 0.66 3719 2.83 4492 5.02 5190 5.94 6220 5.41 0042 7.84 2142 3.99 3076 8.52 3724 5.38 4494 6.89 5191 2.47 6233 2.92 0044 8.74 2150 11.17 3081 9.08 3726 4.68 4495 8.52 5192 8.14 6235 7.37 0045 5.73 2163 8.38 3082 9.91 3805 1.60 4496 6.73 5195 8.31 6237 2.39 0050 8.16 2211 15.98 3085 11.38 3808 5.72 4497 5.41 5201 8.33 6251 7.68 0079 3.79 2222 7.19 3099 4.85 3815 7.38 4498 6.85 5205 5.76 6258 6.86 0096 7.09 2362 11.85 3110 10.73 3821 13.11 4499 6.26 5207 7.12 6307 12.22 0106 19.45 2402 8.37 3131 5.63 3828 6.05 4511 1.33 5212 11.17 6308 6.33 0171 8.83 2413 9.17 3146 5.30 3830 2.41 4512 0.52 5213 8.27 6315 9.52 0172 6.21 2501 5.09 3152 3.19 3831 3.77 4557 3.83 5214 4.98 6316 5.90 0251 6.29 2570 11.22 3165 4.32 3840 6.76 4558 4.28 5222 10.74 6325 6.42 0400 5.17 2571 10.91 3169 5.72 4000 5.93 4611 2.97 5225 12.06 6361 5.63 0401 19.34 2576 7.58 3175 7.98 4034 9.29 4623 9.36 5348 5.87 6364 9.01 1122 10.57 2584 7.68 3178 3.30 4036 3.18 4635 3.03 5403 16.63 6400 8.75 1123 18.79 2585 10.26 3179 4.19 4038 9.39 4665 8.90 5432 7.03 6504 8.30 1124 10.97 2586 5.80 3180 7.25 4041 7.38 4683 5.84 5436 6.26 6834 9.20 1320 3.75 2589 5.80 3220 4.97 4049 5.85 4691 2.35 5443 8.10 7133 4.31 1322 6.15 2660 3.96 3241 6.45 4111 2.73 4692 2.30 5446 8.04 7198 9.73 1330 8.40 2683 7.04 3257 7.12 4112 0.87 4717 8.91 5447 5.36 7207 13.80 1438 8.47 2688 7.74 3339 7.56 4114 11.10 4720 4.62 5467 12.70 7219 12.04 1452 3.81 2702 25.20 3365 7.98 4130 10.04 4740 1.85 5470 7.78 7227 9.32 1463 6.52 2710 9.07 3372 6.50 4150 4.10 4771 3.05 5473 12.32 7232 11.55 1624 10.57 2727 17.79 3383 3.93 4239 5.80 4828 4.20 5474 10.64 7248 3.81 1699 2.40 2731 6.97 3400 6.61 4240 18.10 4829 2.93 5479 7.26 7272 11.04 1701 7.45 2757 11.01 3401 6.97 4243 6.92 4831 6.61 5482 6.45 7332 6.56 1710 7.58 2759 9.47 3501 6.27 4244 8.22 4922 3.00 5484 13.11 7360 9.73 1741 6.06 2790 4.27 3507 7.29 4250 5.24 4983 5.59 5485 7.78 7365 11.82 1803 9.45 2797 10.48 3560 5.47 4251 6.34 5020 5.74 5506 6.77 7382 10.84 1925 14.86 2806 6.77 3568 2.60 4279 6.54 5027 11.61 5507 4.16 7392 9.32 2002 8.25 2812 7.45 3569 3.86 4283 4.48 5028 7.05 5538 9.33 7403 10.71 2003 6.95 2819 10.21 3570 4.19 4286 8.15 5040 14.80 5542 4.82 7405 3.01 2014 8.97 2840 8.42 3572 1.58 4295 5.93 5057 9.33 5552 30.90 7409 7.82 2030 8.20 2842 9.58 3573 2.32 4297 0.55 5059 21.98 5553 14.71 7410 7.36 2063 5.59 2852 11.59 3574 4.60 4299 5.97 5102 7.47 5606 1.48 7421 1.82 2081 9.71 2881 11.19 3577 2.10 4304 11.14 5107 7.32 5632 16.63 7424 2.25 2095 11.76 2883 10.76 3612 5.03 4312 6.18 5108 13.01 5633 7.03 7428 5.84 2102 7.41 2915 6.47 3620 7.12 4351 2.83 5128 1.68 5650 10.45 7429 6.66 2107 6.15 2923 8.00 3632 5.28 4354 2.54 5140 3.35 5951 1.00 7500 5.20 *Pure Premium Rates are per $100 of payroll unless otherwise noted. Page 10 of 15 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Approved July 1, 2012 Pure Premium Rates Effective July 1, 2012 on New and Renewal Policies with Anniversary Rating Dates on or after July 1, 2012 (Continued) Legend: (A) See below 7515 1.78 8039 4.82 8264 11.80 8745 10.73 8852 2.93 9151 1.30 7520 5.20 8041 5.62 8265 10.54 8748 1.73 8859 0.18 9154 4.71 7538 6.97 8042 4.73 8267 8.82 8749 0.41 8868 1.30 9155 2.63 7539 2.73 8046 5.16 8278 (A) 8755 1.31 8875 1.69 9156 8.28 7580 6.39 8057 7.38 8286 13.54 8800 4.58 9007 4.87 9180 7.06 7600 9.85 8059 6.32 8290 6.71 8801 1.43 9008 10.44 9181 19.75 7601 13.27 8060 3.09 8291 7.97 8803 0.25 9009 4.15 9182 2.87 7605 4.49 8061 5.03 8292 12.03 8804 4.49 9010 8.40 9184 12.79 7606 6.59 8062 2.24 8293 16.59 8806 6.37 9011 6.45 9185 42.31 7607 0.41 8063 4.31 8304 6.48 8807 0.92 9015 7.98 9220 8.34 7610 1.27 8064 5.07 8324 5.76 8808 0.99 9016 5.74 9402 5.94 7706 5.37 8065 4.27 8350 7.58 8810 0.53 9031 7.65 9403 9.90 7707 (A) 8066 2.45 8387 4.89 8813 1.02 9033 6.92 9410 1.81 7720 4.57 8070 2.92 8388 6.63 8818 0.92 9043 2.36 9420 8.41 7721 5.67 8071 2.30 8389 5.65 8820 0.51 9048 7.03 9422 6.07 7722 (A) 8078 2.86 8390 5.72 8821 2.72 9050 8.16 9424 8.83 7855 4.71 8102 2.73 8391 4.94 8822 1.03 9053 3.06 9426 11.11 8001 5.43 8103 11.03 8392 6.03 8823 6.60 9059 4.07 9501 5.30 8004 5.17 8106 8.72 8393 4.66 8827 6.64 9060 5.37 9507 4.87 8006 6.28 8107 5.53 8397 5.39 8829 5.03 9061 4.15 9516 5.43 8008 3.77 8110 4.68 8400 3.01 8830 2.36 9066 5.10 9519 6.31 8013 2.02 8111 6.08 8500 10.65 8831 3.52 9067 2.93 9521 6.77 8015 6.94 8113 15.81 8601 0.55 8834 1.36 9069 5.71 9522 7.17 8017 4.32 8116 7.70 8631 30.32 8838 2.09 9070 8.57 9529 6.74 8018 7.48 8117 6.53 8720 3.81 8839 1.29 9079 3.91 9549 7.56 8019 1.73 8204 15.81 8729 1.44 8840 0.70 9085 6.56 9552 16.94 8021 9.49 8209 7.56 8740 2.70 8846 1.00 9092 3.63 9586 2.02 8028 8.89 8215 9.95 8741 0.28 8847 11.71 9096 15.31 9610 2.59 8031 9.65 8227 6.86 8742 0.60 8850 4.04 9097 5.35 9620 2.91 8032 8.02 8232 9.34 8743 0.23 8851 5.10 9101 6.70 Per Capita Firefighters, Police, Police Deputies, etc. Rate Firefighters - volunteers 7707 294.81 Police, Sheriffs volunteers 7722 391.25 Per Race Horse Racing Rate Jockeys employed at a rate per race 8278 171.63 (See Classification 8631 - Racing Stables for instructions) *Pure Premium Rates are per $100 of payroll unless otherwise noted. Page 11 of 15 Workers Compensation Insurance Rating Bureau of California. All rights reserved.

Guidelines for Computing Pure Premiums at the Advisory Pure Premium Rate Level Approved January 1, 2013 Pure Premium Rates Effective January 1, 2013 on New and Renewal Policies with Anniversary Rating Dates on or after January 1, 2013 0005 4.89 2108 7.66 3018 2.94 3634 7.23 4361 2.80 5146 8.40 6011 10.27 0016 9.27 2109 9.42 3022 7.57 3643 4.13 4362 2.57 5160 2.53 6204 12.32 0034 9.15 2111 6.29 3030 11.18 3647 8.32 4410 7.23 5183 8.69 6206 7.87 0035 4.58 2113 16.27 3039 10.90 3651 3.56 4420 15.55 5184 5.15 6213 2.73 0036 8.89 2116 6.14 3040 11.80 3681 1.50 4432 7.44 5185 9.10 6216 6.48 0038 16.76 2117 11.17 3060 10.50 3682 2.18 4470 4.50 5186 2.78 6218 9.27 0040 4.75 2121 6.00 3066 6.56 3683 7.23 4478 8.37 5187 6.66 6220 6.43 0041 8.36 2123 6.27 3070 0.68 3719 2.31 4492 5.98 5190 6.60 6233 2.69 0042 8.16 2142 3.99 3076 9.08 3724 6.75 4494 6.42 5191 2.40 6235 7.59 0044 9.61 2150 12.11 3081 10.48 3726 4.48 4495 7.68 5192 7.56 6237 2.96 0045 5.51 2163 10.10 3082 10.71 3805 1.47 4496 7.46 5195 10.13 6251 7.66 0050 10.60 2211 17.34 3085 13.34 3808 5.37 4497 5.90 5201 10.42 6258 6.90 0079 4.43 2222 6.54 3099 5.20 3815 7.26 4498 7.29 5205 6.62 6307 12.10 0096 7.76 2362 12.50 3110 12.98 3821 14.06 4499 6.61 5212 14.13 6308 8.56 0106 24.67 2402 8.83 3131 6.52 3828 5.83 4511 1.36 5213 8.23 6315 10.65 0171 9.30 2413 9.97 3146 5.28 3830 2.66 4512 0.56 5214 5.77 6316 6.00 0172 6.63 2501 6.05 3152 3.54 3831 4.03 4557 4.37 5222 10.24 6325 7.31 0251 6.45 2570 13.64 3165 4.76 3840 6.80 4558 4.16 5225 13.33 6361 6.33 0400 5.61 2571 11.98 3169 5.26 4000 6.20 4611 3.92 5348 7.27 6364 8.12 0401 17.69 2576 7.96 3175 7.54 4034 9.09 4623 10.76 5403 17.34 6400 10.44 1122 13.15 2584 8.38 3178 3.48 4036 3.54 4635 3.85 5432 7.47 6504 8.17 1123 20.59 2585 11.20 3179 5.32 4038 10.79 4665 9.63 5436 7.10 6834 10.18 1124 11.38 2586 7.69 3180 8.34 4041 8.52 4683 5.44 5443 8.87 7133 4.33 1320 2.99 2589 5.32 3220 5.15 4049 6.62 4691 2.79 5446 9.31 7198 9.23 1322 5.41 2660 4.59 3241 6.08 4111 2.92 4692 2.73 5447 6.32 7207 12.60 1330 10.19 2683 7.13 3257 7.10 4112 0.99 4717 7.50 5467 12.00 7219 13.49 1438 9.05 2688 8.55 3339 8.18 4114 12.12 4720 4.49 5470 8.02 7227 10.28 1452 3.77 2702 28.07 3365 8.08 4130 9.57 4740 1.49 5473 13.06 7232 12.69 1463 6.97 2710 8.27 3372 7.42 4150 3.46 4771 2.81 5474 11.72 7248 3.48 1624 13.15 2727 17.91 3383 4.45 4239 6.39 4828 4.67 5479 8.19 7272 11.23 1699 2.94 2731 6.71 3400 7.43 4240 19.49 4829 3.07 5482 6.94 7332 5.42 1701 6.94 2757 12.00 3401 7.21 4243 6.18 4831 7.61 5484 17.41 7360 8.65 1710 8.22 2759 10.94 3501 6.02 4244 8.34 4922 2.65 5485 9.60 7365 13.48 1741 6.84 2790 3.70 3507 6.53 4250 4.64 4983 5.68 5506 9.00 7382 11.33 1803 11.26 2797 11.40 3560 5.19 4251 7.53 5020 6.15 5507 5.32 7392 11.23 1925 16.34 2806 7.45 3568 3.11 4279 6.16 5027 12.48 5538 9.34 7403 9.86 2002 8.28 2812 8.88 3569 4.40 4283 4.68 5028 7.08 5542 5.35 7405 3.56 2003 7.63 2819 11.52 3570 5.32 4286 7.78 5040 17.55 5552 35.26 7409 7.86 2014 8.86 2840 8.16 3572 1.42 4295 7.54 5057 9.80 5553 18.37 7410 6.68 2030 8.05 2842 11.22 3573 2.53 4297 0.55 5059 21.26 5606 1.47 7421 1.48 2063 5.89 2852 12.17 3574 4.05 4299 6.61 5102 9.16 5632 17.34 7424 2.14 2081 10.54 2881 11.72 3577 2.00 4304 11.65 5107 8.60 5633 7.47 7428 5.76 2095 11.18 2883 12.36 3612 4.97 4312 6.04 5108 12.56 5650 11.65 7429 7.52 2102 8.30 2915 7.98 3620 7.44 4351 3.35 5128 1.96 5951 0.89 7500 4.86 2107 5.62 2923 8.06 3632 6.01 4354 3.02 5140 3.13 6003 11.53 7515 1.85 *Pure Premium Rates are per $100 of payroll unless otherwise noted. Page 12 of 15 Workers Compensation Insurance Rating Bureau of California. All rights reserved.