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["Instructions for Completing the Workers' Compensation\nRate Application"]
["1)","In the Workers' Compensation Rate Application, areas of insurer input are generally identified with blue font text, light blue background,\nand/or light blue outlined boxes."]
["2)","Should a model be in use, fill in and submit the Model Checklist and Model Disclosure forms that are provided on SERFF."]
["3)","Insurers must submit the following for all filing types:\n"]
[null,"Ø"," A Memorandum which details the following information:"]
[null,null,"• ","All proposed changes being made to each company or companies in the group"]
[null,null,"• ","If there is a pending non-standard Workers Compensation form filing, include the SERFF filing #s"]
[null,null,null,"(Note: CDI does not review Workers' Compensation forms, they must be submitted to the WCIRB for review and approval.)"]
[null,"Ø","The Workers' Compensation Rate Application in both excel (.xlsx format with formulas intact) and PDF (searchable text) format.\n"]
[null,null,"• ","Enter general filing characteristics associated with this application as well as company-specific information on the \"1.General\" page."]
[null,null,null,"§","If this is a Group filing (i.e. contains group data), use the lead company information to fill in the \"1. General\" page and select the 'Y' indicator on line 28 of the \"1.General\" page. The \"3. Proposed Impact\" page will automatically unhide to be filled in and allow for the identification of each other company to which this filing applies."]
[null,null,"• ","Enter the type of filing to which this application applies on the \"2. Filing Type and Checklist\" page.  Complete and submit all exhibits and documents required for the designated type of filing as listed on the \"2. Filing Type and Checklist\" page."]
[null,null,"• ","Fill in the \"5. Rating Plans\" page"]
[null,"Ø","An Affidavit with the signature of an authorized representative of the insurer, declaring under penalty of perjury that the information contained in the filing is true, complete, and correct. The company tracking number(s) stated on the Affidavit should be the same as the company tracking number(s) used in SERFF."]
["4)","Submit the following with a Pure Premium Rate adoption filing:\n\n"]
[null,"Ø\n\n","Historical Losses, LAE, and Expenses Exhibit: An exhibit that details the insurer's expenses in the categories listed in the Pure Premium tab for the latest 3 calendar years, complementary 3 year historical Loss & LAE exhibit, and Projected Loss Ratio\n\n\n\n"]
[null,"Ø\n\n","Rating Examples: At least two rating examples in excel with formulas intact and in PDF searchable text format (Note: if selected class modifiers are used, show how they are applied in a rating example)\n"]
[null,"Ø\n\n","Rating Algorithm: Details how the final rates are determined, this should be a breakdown of all calculations used\n Provide an actuary's opinion pursuant to CCR 2509.32 (j)"]
[null,"Ø\n\n","If the WCIRB plan is adopted with modification (i.e. WCIRB classifications are split into sub-classes, straying from the WCIRB plan. For example, class 003 is split into 003a and 003b), provide a Classification System Modification Exhibit: An exhibit that (1) describes in detail all modifications and (2) demonstrate how the data thereby produced can be reported consistent with the Uniform Statistical Plan and include\na letter of certification from the WCIRB "]
[null,"Ø\n\n","Fill in  \"4. Pure Premium\" page(s) of the Workers' Compensation Rate Application"]
["5)","Filings subject to CIC § 11735 (c):\n     "]
[null,"Ø\n\n","Page '2. Filing Type & Checklist': categorized as 'Rate' > 'Consent to Rate'"]
[null,"Ø\n\n","Must be submitted 30 days before the effective date"]
[null,"Ø\n\n","If the policy is not issued, insurer must submit a request to withdraw the filing"]
[null,"Ø\n\n","Submit Consent to Rate  written agreement between insurer and insured, and include the following information:"]
[null,null,"•\n•\n•\n•\n•\n•","Reason(s) for the excess rate on the specified risk\nEffective Date\nClassification code(s) and corresponding rate(s) per $100/payroll\nApplicable percentage in excess of the filed rates on the specified risk\nDated signature and title of the Insurer or Insurer's representative\nDated signature and title of the Insured or Insured's representative"]
["6)","For Program Withdrawal filings refer to the 'PW Instructions' page in this application."]
["7)","Note: \n"]
[null,"Ø\n\n","Page \"3. Group Info & Proposed Impact\" will unhide to be filled in if the filing is marked as a Group Filing in page \"1. General\" (i.e. Y is marked). Otherwise, it will remain hidden and does not need to be filled in."]
[null,"Ø\n\n","Page \"4. Pure Premium\" will unhide to be filled in if the filing type is marked as a 'New Program' or 'Rate' filing in page \"2. Filing Type & Checklist.\" For all other filing types, page \"4. Pure Premium\" will remain hidden and does not need to be filled in."]
[null,"Ø\n\n","For New Program or Rate type Group filings, additional copies of Page \"4. Pure Premium\" will unhide to be filled in for however many companies are listed in page \"3. Group Info & Proposed Impact.\""]
[null,"Ø\n\n","Please email any questions regarding the application to the following: "]
[null,null,"RRB_PARA@insurance.ca.gov"]
[null,"Ed. 07/02/26"]

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["For Program Withdrawal Only"]
[null,"A Program Withdrawal (PW) occurs when an insurer ceases all underwriting and operational activities for a specific insurance program. This process involves discontinuing the sale of new policies and non-renewing all existing policies upon their expiration.  A PW filing is required as the currently filed program will no longer utilize all rates and supplementary rate information necessary to determine the applicable premium for an insured.  The rates may be inadequate and/or unfairly discriminatory (CIC §11730(j), §11732, §11732.5, §11735(a)). "]
[null,"There are three distinct circumstances under which an insurer may initiate a PW, all of which require submission of a PW filing:"]
["1)","Withdrawal of a Program with No In-Force Policies"]
[null,"a) ","No business has ever been written under the program, or"]
[null,"b) ","Business was previously written, but there are currently no in-force policies or premiums in the program"]
["2)","Withdrawal of a Program with Existing In-Force Policies"]
[null,"a) ","The book of business is not being transferred. All policies are to be non-renewed upon expiration, or"]
[null,"b) ","The book of business is being transferred to an unaffiliated insurer/insurer group, or"]
[null,"c) ","The book of business is being transferred to another company within the same insurer group. "]
["3)","Withdrawal from a Line of Insurance"]
[null,null,"An insurer decides to withdraw, wholly or substantially, from Worker’s Compensation insurance.  “Substantially withdraw,” is defined as an insurer’s intent to nonrenew in excess of 50 percent of its current policyholders in the line upon their next renewal. "]
["Program Withdrawal Filing Requirements"]
[null,"Insurers must submit a separate Workers’ Compensation Rate Application filing for each program being withdrawn with all of the following components to initiate a PW: "]
[null,"Ø","Rate Application:\n\n\n\n\n"]
[null,null,"• \n","Page '2. Filing Type & Checklist': categorized as 'Rate' > 'Program Withdrawal'\n "]
[null,"Ø","SERFF Filing Type: categorized as 'Rate'"]
[null,"Ø","Sample Non-Renewal Notice (NRN)  pursuant to CIC §11664"]
[null,"Ø","Notice of Intent to Withdraw (California) Form:"]
[null,null,"One Notice of Intent to Withdraw (California) form must be submitted for each company impacted by the PW. This form is a formal notice, with the signature of an authorized representative of the insurer that declares under penalty of perjury: "]
[null,null,"•\n\n•\n","The company’s intent to withdraw from a specified program as of a specified effective date, with a clear explanation of the rationale for the program withdrawal, and\nThat all associated rates and rules will be withdrawn as of that specified effective date."]
[]
[null,"Ed. 07/02/26"]

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[]
["CALIFORNIA DEPARTMENT OF INSURANCE"]
["WORKERS' COMPENSATION RATE APPLICATION"]
[]
["Company Information"]
["Company Name:"]
["Group Name:"]
["NAIC Company Code:"]
["NAIC Group Code:"]
[]
["Latest Applicable CDI Filing #"]
[]
["Contact Name:"]
["Title:"]
["Phone #:"]
["Email:"]
["Mailing Address:"]
[]
[]
["Proposed effective date - This filing will apply to new & renewal policies as of:"]
["Proposed overall rate impact:",null,null,null,null,null,null,null,"% (required)"]
["Insurer direct written premium for Calendar Year 20",null,null,null,null,null,":"]
[null,"California workers' compensation:",null,null,null,"$"]
[null,"Aggregate, all lines, all states:",null,null,null,"$"]
[null,"Aggregate in California workers’ comp. in the classes or program affected by this rate filing.",null,null,null,"$"]
[]
[]
["Is this a Group Filing? If Y (yes), complete page 3.\t",null,null,null,null,null,null,{"$f":"IF($G$28 =\"N\",\"        (Page 3 hidden and doesn't need to be filled in)\",\"\")","v":""},null,null,null,null,null,{"$f":"IF(Group = \"\",\"Error! You must select Y (yes) or N (no) for Group Filing\",\"\")","v":"Error! You must select Y (yes) or N (no) for Group Filing"}]
[null,null,null,null,null,null,null,{"$f":"IF($G$28 =\"Y\",\"        (Page 3 will unhide to be filled out)\",\"\")","v":""}]

{"sheet":"2. Filing Type & Checklist","index":3,"n_rows":91,"n_cols":15,"rows_kept":91,"cut":false,"hidden":false,"merged":[[0,6,0,12],[5,8,6,12],[15,0,15,12],[61,2,61,5],[4,0,4,10],[1,6,1,7],[10,2,10,4],[1,8,1,12]]}
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,null,"Company Name:",null,{"$f":"[0]!Co_Name","v":0}]
[]
["FILING TYPE"]
["Complete the following questions in order to generate the filing checklist:\nSelect Y (yes) or N (no) for each of the dropdowns."]
["1. Is this a New Program filing?",null,null,null,null,null,null,null,{"$f":"IF($H$6 =\"Y\",\"(New Program filing type selected. Mark 'N' for the other filing types and move on to Filing Checklist field below)\",\"\")","v":""},null,null,null,null,{"$f":"IF(OR(H6=\"Y\", H7=\"Y\", H12=\"Y\"), \"\", IF(SUM(COUNTIF(H6,\"N\"), COUNTIF(H7,\"N\"), COUNTIF(H12,\"N\"))>1, \"ERROR! You must select a filing type\", IF(SUM(COUNTIF(H6,\"\"), COUNTIF(H7,\"\"), COUNTIF(H12,\"\"))>1, \"ERROR! You must select a filing type\", \"\")))","v":"ERROR! You must select a filing type"}]
["2. Is this a Rate filing?",null,{"$f":"IF(AND($H$7=\"Y\", $H$8=\"N\", $H$9=\"N\", $H$10=\"N\", $H$11=\"N\"),\"(Rate filing selected. Specify the type of Rate filing from the list below)\",\"\")","v":""}]
[null,"2a.  Is this a Pure Premium Rate Adoption filing?",null,null,null,null,null,"N",null,null,null,null,null,null,{"$f":"IF(SUM(COUNTIF(H8:H11,\"Y\"))=1, \"\", IF(SUM(COUNTIF(H8:H11,\"N\"))>1, \"ERROR! You must select a specific Rate Filing type\", IF(SUM(COUNTIF(H8:H11,\"\"))>1, \"ERROR: You must select a specific Rate Filing type\", \"\")))","v":"ERROR! You must select a specific Rate Filing type"}]
[null,"2b. Is this a Consent to Rate filing?",null,null,null,null,null,"N"]
[null,"2c. Is this a Program Withdrawal?",null,null,null,null,null,"N"]
[null,"2d. Other:",null,null,null,null,null,"N",null,null,null,null,null,null,{"$f":"IF(AND(H11=\"Y\", C11=\"\", NOT(OR(H6=\"Y\", H8=\"Y\", H9=\"Y\", H10=\"Y\", H12=\"Y\"))), \"ERROR: You must provide a description in the adjacent box when 'Other' is selected\", \"\")","v":""}]
["3. Does this filing propose new Rule(s) or any changes to existing Rule(s)?",null,null,null,null,null,null,null,{"$f":"IF(OR($H$6=\"Y\", $H$8=\"Y\", AND($H$6=\"\", $H$7=\"\", $H$12=\"\"), AND($H$7=\"Y\", $H$8<>\"Y\", $H$9<>\"Y\", $H$10<>\"Y\", $H$11<>\"Y\")),\"\",\"        (Page 4 hidden and does not need to be filled in)\")","v":""}]
[null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(H6=\"Y\",H7=\"Y\"),AND(H6=\"Y\",H12=\"Y\"),AND(H6=\"Y\",H8=\"Y\"),AND(H6=\"Y\",H9=\"Y\"),AND(H6=\"Y\",H10=\"Y\"),AND(H6=\"Y\",H11=\"Y\"),AND(H8=\"Y\",H9=\"Y\"),AND(H8=\"Y\",H10=\"Y\"),AND(H8=\"Y\",H11=\"Y\"),AND(H9=\"Y\",H10=\"Y\"),AND(H9=\"Y\",H11=\"Y\"),AND(H9=\"Y\",H12=\"Y\"),AND(H10=\"Y\",H11=\"Y\"),AND(H10=\"Y\",H12=\"Y\"),),\"WARNING: Invalid Filing Type\",\"\")","v":""}]
[]
["FILING CHECKLIST"]
["Once the Filing Type field above is populated, the corresponding checklist will appear below. This checklist outlines the required documents.\nUse this checklist to indicate submission of ALL items listed in the format(s) required (either PDF, or Excel and PDF)."]
["Submit a 1) current, 2) redlined, and 3) clean, proposed version of ALL documents with proposed changes."]
[]
["PDF","Excel","Workers' Compensation - New Program"]
["(searchable text format)","(.xlsx format w/ formulas intact)"]
[null,null,"Memorandum1"]
[null,null,"Complete Rate and Rule Manual",null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(A22=FALSE,\"ERROR! Submit the complete rate and rule manual\",\"\")","v":"ERROR! Submit the complete rate and rule manual"}]
[null,null,"Miscellaneous Value Pages"]
[null,null,"State Exception Pages"]
[null,null,"Complete Underwriting Eligibility Guidelines"]
[null,null,"Company/Tier Placement Guidelines4"]
[null,null,"Letter of Authorization4"]
[null,null,"Proposed Pure Premium Rate sheets"]
[null,null,"Rating Examples"]
[null,null,"Rating Algorithm"]
["PDF","Excel","Workers' Compensation - Pure Premium Rate Filing"]
["(searchable text format)","(.xlsx format w/ formulas intact)"]
[null,null,"Memorandum1"]
[null,null,"Complete Rate and Rule Manual",null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(A34=FALSE,\"ERROR! Submit the complete rate and rule manual\",\"\")","v":"ERROR! Submit the complete rate and rule manual"}]
[null,null,"Miscellaneous Value Pages"]
[null,null,"State Exception Pages4"]
[null,null,"Complete Underwriting Eligibility Guidelines"]
[null,null,"Company/Tier Placement Guidelines4"]
[null,null,"Letter of Authorization4"]
[null,null,"Proposed Pure Premium Rate sheets"]
[null,null,"Supporting Loss & LAE data and rationale"]
[null,null,"Expense exhibit for the latest 3 calendar years2"]
[null,null,"Complimentary 3 year historical Loss & LAE exhibit"]
[null,null,"Projected Loss Ratio"]
[null,null,"Rating Examples2"]
[null,null,"Rating Algorithm2"]
[null,null,"Actuarial Opinion2"]
["PDF",null,"Workers' Compensation - Classification System Adopted WITH Modification"]
["(searchable text format)",null,"Classification system adopted WITHOUT modifications do not need to fill out the following part of the checklist:"]
[null,null,"Classification System Modification exhibit2,4"]
[null,null,"Letter of certification from the WCIRB4"]
["PDF",null,"Workers' Compensation - Consent to Rate"]
["(searchable text format)"]
[null,null,"Consent to Rate written agreement3"]
["PDF",null,"Workers' Compensation - Program Withdrawal"]
["(searchable text format)"]
[null,null,"Memorandum1"]
[null,null,"Sample Non-Renewal Notice (NRN)5"]
[null,null,"Notice of Intent to Withdraw (California) Form5"]
[null,null,"Letter of Authorization4"]
["PDF","Excel","Workers' Compensation - Other Rate Filing"]
["(searchable text format)","(.xlsx format w/ formulas intact)"]
[null,null,"Memorandum1"]
[null,null,"Complete Rate and Rule Manual",null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(A64=FALSE,\"ERROR! Submit the complete rate and rule manual\",\"\")","v":"ERROR! Submit the complete rate and rule manual"}]
[null,null,"Miscellaneous Value Pages4"]
[null,null,"State Exception Pages4"]
[null,null,"Complete Underwriting Eligibility Guidelines"]
[null,null,"Company/Tier Placement Guidelines4"]
[null,null,"Letter of Authorization4"]
[null,null,"Proposed Pure Premium Rate sheets4"]
[null,null,"Supporting Loss & LAE data and rationale4"]
[null,null,"Expense exhibit for the latest 3 calendar years4"]
[null,null,"Complimentary 3 year historical Loss & LAE exhibit4"]
[null,null,"Projected Loss Ratio4"]
[null,null,"Rating Examples4"]
[null,null,"Rating Algorithm4"]
[null,null,"Actuarial Opinion"]
["PDF",null,"Workers' Compensation - Rule Filing"]
["(searchable text format)"]
[null,null,"Memorandum1"]
[null,null,"Complete Rate and Rule Manual",null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(A81=FALSE,\"ERROR! Submit the complete rate and rule manual\",\"\")","v":"ERROR! Submit the complete rate and rule manual"}]
[null,null,"Complete, redline copy of documents with proposed changes"]
[null,null,"Complete, clean copy of documents with proposed changes"]
[null,null,"Letter of Authorization4"]
[]
[]
["1 See Instructions Tab section 3"]
["2 See Instructions Tab section 4"]
["3 See Instructions Tab section 5"]
["4 Submit this if applicable"]
["5 See PW Instructions Tab > Program Withdrawal Filing Requirements section"]

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["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,"Company Name:",{"$f":"[0]!Co_Name","v":0}]
[]
["INSURER GROUP INFORMATION AND IMPACT OF PROPOSED CHANGES"]
[]
[]
["List each insurance company included in the group filing to which this application applies, as well as the info required below. Lead company information provided in tab 1. General is auto-populated. If there are more than 20 companies in your group, please fill out a second copy of the application."]
[]
[null,null,null,null,"Insurer direct written premium for Calendar Year 20",null,{"$f":"'1. General'!F22","v":0}]
["#","Company","NAIC Company Code","Proposed % Change1","California workers' compensation\n$","Aggregate, all lines, all states\n$","Aggregate in California workers’ comp. in the classes or program affected by this rate filing\n$"]
[-1,{"$f":"Co_Name","v":0},{"$f":"'1. General'!D8","v":0},{"$f":"'1. General'!G21/100","v":0},{"$f":"'1. General'!G23","v":0},{"$f":"'1. General'!G24","v":0},{"$f":"'1. General'!G25","v":0},{"$f":"IF(AND(COUNTA(B11:F11)>=1,COUNTA(B11:F11)<=3),\"←ERROR! Fill out each cell in this row.\",\"\")","v":""}]
[-2,null,null,null,null,null,null,""]
[-3,null,null,null,null,null,null,""]
[-4,null,null,null,null,null,null,""]
[-5,null,null,null,null,null,null,""]
[-6,null,null,null,null,null,null,""]
[-7,null,null,null,null,null,null,""]
[-8,null,null,null,null,null,null,""]
[-9,null,null,null,null,null,null,""]
[-10,null,null,null,null,null,null,{"$f":"IF(AND(COUNTA(B20:F20)>=1,COUNTA(B20:F20)<=3),\"←ERROR! Fill out each cell in this row.\",\"\")","v":""}]
[-11,null,null,null,null,null,null,{"$f":"IF(AND(COUNTA(B21:F21)>=1,COUNTA(B21:F21)<=3),\"←ERROR! Fill out each cell in this row.\",\"\")","v":""}]
[-12,null,null,null,null,null,null,""]
[-13,null,null,null,null,null,null,""]
[-14,null,null,null,null,null,null,""]
[-15,null,null,null,null,null,null,""]
[-16,null,null,null,null,null,null,""]
[-17,null,null,null,null,null,null,""]
[-18,null,null,null,null,null,null,""]
[-19,null,null,null,null,null,null,""]
[-20,null,null,null,null,null,null,""]
["Total Combined Rate Impact1",null,null,null,null,null,null,{"$f":" IF(ISBLANK(D31), \"ERROR! You must fill in the Total Combined Rate Impact.\",\"\")","v":"ERROR! You must fill in the Total Combined Rate Impact."}]
[]
[]
["1 The Proposed % Change refers to the percentage change in an individual company, while Total Combined Rate Impact is the aggregate for all companies in the group filing. "]

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[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B11","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4. Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.1 Pure premium","index":6,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B12","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.1 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.2 Pure premium","index":7,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B13","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.2 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.3 Pure premium","index":8,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B14","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.3 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.4 Pure premium","index":9,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B15","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.4 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.5 Pure premium","index":10,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B16","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.5 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.6 Pure premium","index":11,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B17","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.6 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.7 Pure premium","index":12,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B18","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.7 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.8 Pure premium","index":13,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B19","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.8 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.9 Pure premium","index":14,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B20","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.9 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.10 Pure premium","index":15,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B21","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.10 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.11 Pure premium","index":16,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B22","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.11 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.12 Pure premium","index":17,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B23","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.12 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.13 Pure premium","index":18,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B24","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.13 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.14 Pure premium","index":19,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B25","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.14 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.15 Pure premium","index":20,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B26","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.15 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.16 Pure premium","index":21,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B27","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.16 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.17 Pure premium","index":22,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B28","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.17 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.18 Pure premium","index":23,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B29","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.18 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"4.19 Pure premium","index":24,"n_rows":42,"n_cols":12,"rows_kept":42,"cut":false,"hidden":true,"merged":[[36,8,36,9],[38,8,38,9],[32,2,32,5],[32,8,32,9],[33,8,33,9],[34,2,34,7],[34,8,34,9],[35,2,35,4],[35,8,35,9],[29,2,31,10],[22,2,22,4],[22,8,22,9],[23,2,23,4],[23,8,23,9],[24,2,24,4],[24,8,24,9],[25,2,25,4],[25,8,25,9],[26,2,27,5],[26,8,26,9],[28,2,28,5],[21,2,21,8],[2,7,2,10],[5,1,6,10],[7,2,7,4],[7,7,7,8],[9,4,9,7],[9,8,9,9],[12,4,13,10],[14,4,14,10],[15,2,18,10],[20,1,20,7],[20,8,20,9]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"'3. Group Info & Proposed Impact'!B30","v":0}]
[]
["Pure Premium Rate Filings"]
["A. ","Pure Premium Rates and Deviations (Complete A.1 or A.2, or both. Permits deviation from the advisory Loss & LAE provisions.)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(B8 = FALSE, B16 = FALSE), AND(B8 = TRUE, B16 = TRUE)), \"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing.\", \"\")","v":"ERROR! You must select ONE: check mark if it is a reference filing OR that it is a non-reference filing."}]
[1,false,"By reference to the CDI Ruling #",null,null,"REG-",null,"Effective date:",null,"09/01/20"]
[null,null,"WCIRB Pure Premium Rates adopted",null,null,null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, G9=\"\", B16=FALSE),\"ERROR! You must select Proposed or Approved WCIRB Pure Premium rates.\", \"\")","v":""}]
[null,null,"(a)",null,"Uniform class modification, factor =",null,null,null,null,null,"Approved",{"$f":"IF(OR(AND(D11 = TRUE,I10 = \"\"), AND(I10<>\"\",D11 =FALSE)),\"ERROR! It seems this filing contains a uniform class modification factor: You must check off the associated checkbox AND fill in the factor number.\",\"\")","v":""}]
[null,null,null,false,"Pure premiums without deviation (factor = 1.00)"]
[null,null,null,null,"(Provide supporting Loss & LAE data and rationale.)",null,null,null,null,null,null,{"$f":"IF(AND(B8 = TRUE, D11 = FALSE,D13 = FALSE, B16 = FALSE),\"ERROR! You must check mark uniform class modification factor, selected class modifications, or both.\",\"\")","v":""}]
[null,null,"(b)",false,"Selected class modifications. (Provide a list of deviations and classifications to which they apply. Include supporting Loss Ratio data.)"]
[]
[]
[2,false,"Non-reference filing. Insurer has developed and filed pure premiums and rates without reference to, or reliance on, the approved pure premiums of the WCIRB. (Non-reference filings must include sufficient actuarial justification that follows the scope and format the WCIRB has filed to support its most recent filing.)"]
[]
[]
[]
[]
["B. ","Underwriting Expense Loading =[1/ line 10 total, expressed as a factor)]:",null,null,null,null,null,null,{"$f":"100/I37","v":1}]
[null,null,"Projected expenses (ratio to standard premium at proposed company rates)"]
[null,"1.","Commission",null,null,null,null,null,null,null,"%"]
[null,"2.","Other acquisition expense",null,null,null,null,null,null,null,"%"]
[null,"3.","General expense",null,null,null,null,null,null,null,"%"]
[null,"4.","Taxes, licences, & fees",null,null,null,null,null,null,null,"%"]
[null,"5.","Profits & contintgencies, including offset for investment income",null,null,null,null,null,null,null,"%"]
[]
[null,null,"(Investment income, separatly stated",null,null,null,null,"%)"]
[null,null,"(= profit & contingency provision minus investment income provision. Attach an exhibit \nshowing how the insurer arrived at its underwriting profit load and how it reflected investment \nincome in the derivation of the profit loading.)"]
[]
[]
[null,"6.","Lobbying & political advertising expense",null,null,null,null,null,null,null,"%"]
[null,"7. ","Penalties, fines and bad faith judgements",null,null,null,null,null,null,null,"%"]
[null,"8.","Other off-balance provisions (provide supporting exhibit) ",null,null,null,null,null,null,null,"%"]
[null,"9. ","TOTAL PROJECTED EXPENSES ",null,null,null,null,null,{"$f":"I23+I24+I25+I26+I27+I33+I34+I35","v":0},null,"%"]
[null,"10. ","Permissible Loss and LAE Ratio ( = 100% minus line 9)",null,null,null,null,null,{"$f":"100-I36","v":100},null,"%"]
[]
["C.","Final Pure premium rate modifier (A x B)",null,null,null,null,null,null,{"$f":"'4.19 Pure premium'!I10*I21","v":0}]
[null,"(Applies to pure premium rates after any deviations & after the projected expense loading above.)"]
[]
["D. ","Historical Losses, LAE, and Expenses  (See Instructions tab section 4)"]

{"sheet":"5. Rating Plans","index":25,"n_rows":62,"n_cols":14,"rows_kept":62,"cut":false,"hidden":false,"merged":[[45,2,48,9],[36,3,36,6],[2,7,2,11],[5,0,10,12]]}
[]
["CALIFORNIA DEPARTMENT OF INSURANCE",null,null,null,null,"WORKERS’ COMPENSATION RATE APPLICATION"]
[null,null,null,null,null,"Company Name:",null,{"$f":"[0]!Co_Name","v":0}]
[]
["1. New or Revised Rating Plans and Supplementary Rate Information"]
["For each new rating plan filing or revision, submit exhibits, manuals, and supporting documentation that explains how the plan applies and how the rates or factors in this plan will be applied. For each item checked in the left column, state the source of the plans in the right column. If your company is adopting by reference an unmodified WCIRB rating plan, do not submit a copy of the entire plan. Simply reference the Bureau plan below, and provide the expense related rating values used in computing the premiums. If there is more than one source code for the item(s), make a note in the memorandum with all codes that should be marked in this tab for the item(s)."]
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["Check off new submissions or revisions affected by this filing in the left column."]
["Indicate source of affected rating plan or program in the right column."]
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["SOURCE CODES:       WCIRB: 1       NCCI: 2       INDEPENDENT/INSURER: 3       OTHER: 4"]
[]
[false,"Classification Minimum Premiums",null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(A18=FALSE, \"\", IF(ISBLANK(I18), \"ERROR: Select Source Code!\", \"\"))","v":""}]
[false,"Deductible / Loss Reimbursement Plan(s)",null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(A19=FALSE, \"\", IF(ISBLANK(I19), \"ERROR: Select Source Code!\", \"\"))","v":""}]
[false,"Excess Workers' Compensation Rates",null,null,null,null,null,null,null,null,null,null,null,""]
[null,"Expense Constants, Policy Fees, or other Fixed Policy Charges1",null,null,null,null,null,null,null,null,null,null,null,""]
[null,"Foreign Voluntary and Repatriation Coverage",null,null,null,null,null,null,null,null,null,null,null,""]
[false,"Group Insurance Program / Safety Group",null,null,null,null,null,null,null,null,null,null,null,""]
[null,"Installment Fees or Deposit Premium Schedules & Charge2",null,null,null,null,null,null,null,null,null,null,null,""]
[null,"Managed Care / Coordinated Benefits Provision(s)",null,null,null,null,null,null,null,null,null,null,null,""]
[null,"Non-Standard Classification / Subclass",null,null,null,null,null,null,null,null,null,null,null,""]
[null,"Premium (size-of-risk) Discount",null,null,null,null,null,null,null,null,null,null,null,""]
[null,"Rating and Underwriting Manual3",null,null,null,null,null,null,null,null,null,null,null,""]
[false,"Retrospective Rating Plan(s)4",null,null,null,null,null,null,null,null,null,null,null,""]
[false,"Schedule Rating or other Merit Rating Plans(s)",null,null,null,null,null,null,null,null,null,null,null,""]
[false,"Territory Rating Plan/Factors",null,null,null,null,null,null,null,null,null,null,null,""]
[null,"Terrorism Rate(s)",null,null,null,null,null,null,null,null,null,null,null,""]
[false,"Tiered Rating Underwriting Guidelines (intra-group placement criteria)",null,null,null,null,null,null,null,null,null,null,null,""]
[null,"USL&H: Non-f Classification Factor (review item 3 below)",null,null,null,null,null,null,null,null,null,null,null,""]
[null,"Waiver of Subrogation / Right to Recover Rates",null,null,null,null,null,null,null,null,null,null,null,""]
[false,"Consent To Rate (CTR)",null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(A36=FALSE, \"\", IF(ISBLANK(I36), \"ERROR: Select Source Code!\", \"\"))","v":""}]
[false,"Other Plan(s):",null,null,null,null,null,null,null,null,null,null,null,""]
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["2. Classification System"]
[false,"Current WCIRB classification system adopted without modification.",null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AND(A41= FALSE, A42= FALSE), \"ERROR! You must check that the WCIRB classification system is adopted without modification OR adopted with modification\", \"\")","v":"ERROR! You must check that the WCIRB classification system is adopted without modification OR adopted with modification"}]
[false,"WCIRB classification system adopted with modifications. (See Instructions tab section 7)"]
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["3. USL&H - Does this company write any USL&H exposures?"]
[false,"Yes.","(NOTE: The non-f classification factor is the only USL&H component that can be\n filed under Workers' Compensation. All other USL&H Rates, rules, forms, etc. must\nbe submtted under a separate prior  approval commercial other liability line filing.)\nProvide an exhibit that justifies/supports the filed non-f classification factor",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(A46=A51, \"ERROR! You must check Yes or No\", \"\")","v":"ERROR! You must check Yes or No"}]
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[null,null,"CDI Filing# of last USL&H Filing subject to CIC 1861.01 (c): "]
[false,"No."]
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["4. Model - Is there a model in use?"]
[false,"Yes.","Fill out the model checklist & disclosure form.5",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(A55=A56, \"ERROR! You must check Yes or No\", \"\")","v":"ERROR! You must check Yes or No"}]
[false,"No."]
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["1If an expense constant is in use, there should not be a separate policy fee and vice versa"]
["2Installment Fees/Plans include \"Pay As You Go\" plans, if applicable"]
["3With respect to any reference or language regarding return premium, a company cannot waive an insured’s return premium pursuant to CIC 481.5(b)(1)"]
["4If the Retrospective Rating Plan includes LRARO, the eligibility requirements must be included in the plan"]
["5See Instructions Tab section 2"]