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ABC Company
| Payroll | $1,000,000 |
| WC Rate per Hundred of Payroll | $2.50 |
| Experience Modification Factor (Mod) | 0.95 |
| Rating Credit or Debit (Ranges from +/25%) | -10% |
| WCB Assessment | 2.11% |
| SBFA Assessment | 1.90%2 |
| Premium Discount1 | -6% |
| Expense Constant1 | $140 |
| WCB Assessment for FY 2005 (July 1, 2004 June 30, 2005) | |
| Manual Premium (Payroll/100 * Rate)> | $25,000 |
| Modified Premium (Manual Premium * Mod.) | $23,750 |
| Rating Credit or Debit (10%) | (2,375) |
| Standard Premium (Modified PremiumRating Credit) | $21,375 |
| WCB Assessment Percentage | 2.11% |
| WCB Dollar Assessment | $451.01 |
| Supplemental Benefits Fund Assessment | |
| Manual Premium (Payroll/100 * Rate) | $25,000 |
| Modified Premium (Manual Premium * Mod.) | $23,750 |
| Rating Credit or Debit (10%) | (2,375) |
| Standard Premium (Modified PremiumRating Credit) | $21,375 |
| SBFA Assessment % | 1.90% |
| SBFA Dollar Assessment | $ 406.13 |
1Premium
Discounts and Expense Constants vary by insurer and the amounts shown are for
illustrative purposes.
Rating
Credit includes approved schedule rating plans or other rating plans.
The WCB Administrative Fund Assessment and Supplemental Benefit Fund Assessment are based on standard premium (after experience rating). The charge for TRIA and for Domestic Terrorism, Earthquakes and Catastophic losses is calculated at a later point in the premium calculation. Therefore, they are not included as part of base premium for either assessment.
2For calender year 2007
For information regarding the Supplemental Benefits Fund Assessment please call Steven Hoxie at 207-883-8289
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