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| Workers Compensation Calculation |
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| Policy Period: October 1, 2005 - October 1, 2006 |
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Payroll |
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Estimated |
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10/1/02 to |
Annualized |
Annualized |
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Estimated |
Premium |
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7/31/2003 |
Payroll |
Premium |
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Code |
Rate |
Annual Payroll |
100 |
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44 Weeks |
1.181818182 |
100 |
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| Clerical |
1000 |
0.58 |
50,000 |
290 |
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55,829 |
65,980 |
383 |
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6.13% |
| Salespersons |
2000 |
0.75 |
262,000 |
1,965 |
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251,508 |
297,237 |
2,229 |
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| Field - Local # |
3000 |
5.29 |
600,000 |
31,740 |
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639,802 |
756,130 |
39,999 |
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| Subtotal |
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912,000 |
33,995 |
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947,139 |
1,119,346 |
42,611 |
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| Other Adjustments |
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| Increased Limits |
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|
677 |
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677 |
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| Experience MOD |
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0.58 |
0.52 |
(18,029) |
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(22,510) |
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| Express Claims Reporting |
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0.97 |
0.03 |
(499) |
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(623) |
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| Schedule Credit |
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0.15 |
(2,496) |
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(3,117) |
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| Premium Discount |
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(1,268) |
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(1,268) |
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| Expense Constant |
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225 |
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225 |
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| Total Estimated Annual Premium |
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12,604 |
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15,995 |
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| Work Comp Exp YTD |
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15,979 |
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Total Expense yet to be recorded |
16 |
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July - Sept |
3 |
5 |
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| GL Insurance |
Wages |
1000 |
Rate |
Expense |
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| Field - Local # |
639,802 |
639.802 |
24.815 |
15,877 |
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YTD expense |
14,187 |
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Curr Month Exp |
1,690 |
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