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    • NEW YORK EXPERIENCE RATING PLAN MANUAL LATEST - RULE 2 -
      C. ELEMENTS OF THE EXPERIENCE RATING FORMULA AND WORKSHEET
      1. Expected Loss Rate

        The Expected Loss Rate (“ELR”) is a factor reflecting the amount of expected losses per unit of exposure for experience rating purposes for each classification. The ELR is applied to each $100 of payroll for payroll-based classifications and to exposure for non-payroll-based classifications) for a classification.

        ELRs are listed in Table I – Expected Loss Rates of this Plan.

      2. Expected Losses

        The Expected Losses for each payroll-based classification are determined by multiplying the ELR by payroll divided by 100. For non-payroll classifications, the classification’s exposure is multiplied by the ELR. The result is rounded to the nearest whole number.  Within the experience rating calculation, the expected losses represent the benchmark level of losses expected for all employers in the state within a particular classification.

        Note: In determining the modification for risks subject to the New York Payroll Limitation Law, expected losses are based on limited payrolls.

      3. Primary/Excess Split Point Value

        The dollar value which splits a loss into its primary and excess portions is known as the primary/excess split point. This value varies by size of risk in terms of expected losses and can be found in Table II – Primary/Excess Split Points of this Plan.

      4. Discount Ratio

        The Discount Ratio (“D-Ratio”) is a factor applied to the expected losses for each classification and Split Point to determine Expected Primary Losses.

        Discount ratios by classification and Split Point are listed in Table III – D-Ratios of this Plan.

      5. Expected Primary Losses

        A risk’s Expected Primary Losses for each classification are determined by multiplying the Expected Losses for the classification by the classification D-Ratio for the risk’s Split Point. The result is rounded to the nearest whole number.

      6. Expected Excess Losses

        A risk’s Expected Excess Losses for each classification are the difference between the classification’s Expected Losses and Expected Primary Losses.

      7. Actual Incurred Losses

        For purposes of experience rating, Actual Incurred Losses are the loss amounts reported according to the Statistical Plan. Actual Incurred Losses include both paid amounts and carrier established reserves on each claim.

      8. Actual Primary Losses

        Actual Primary Losses are the portion of the actual incurred losses that are used in the experience rating calculation. For each actual incurred loss, the amount up to the primary/excess split point value is considered primary.

      9. Losses Employed in a Rating

        To reduce the effect of unusual or catastrophic occurrences on the modification, certain loss limitations apply.
        1. For each claim, losses considered in the determination of the modification are limited to the Split Point applicable to the individual risk. Actual excess losses (the portion of the loss that exceeds the Primary/Excess Split Point) are not used in the calculation of the modification.

          Example 1:

          Assume a risk has a Primary/Excess Split Point of $10,000. A claim is reported with a loss amount of $85,000 and appears at full value on the modification worksheet. In the determination of the modification, the loss amount will be limited to $10,000. This limitation applies to all claims that exceed $10,000 for this risk.

          Example 2:

          Assume a risk has a Primary/Excess Split Point of $20,000. A claim is reported with a loss amount of $185,000 and appears at full value on the modification worksheet. In the determination of the modification, the loss amount will be limited to $20,000. This limitation applies to all claims that exceed $20,000 for this risk.

          Example 3:

          Assume a risk has a Primary/Excess Split Point of $100,000. A claim is reported with a loss amount of $85,000 and appears at full value on the modification worksheet. In the determination of the modification, the loss amount will not be limited because the claim value is less than the Primary/Excess Split Point for this risk.

        2. Except as noted in item (c) below, for an occurrence involving two or more claims, the two largest losses are used in experience rating with each claim value limited to the Split Point applicable to the individual risk.

          Example 4:

          Company A, which has a Primary / Excess Split Point of $20,000, has three claims from a single occurrence:

          ClaimActual IncurredSplit PointActual Primary
          1$275,000$20,000$20,000
          2$42,000$20,000$20,000
          3$5,000$20,000$0
          Total$322,000 $40,000

          Claims 1 and 2 have the two largest reported loss amounts from this single occurrence and will be used in the calculation of the modification. Claim 3 is not used in the calculation.

          In addition, Claims 1 and 2 exceed the Split Point. Accordingly, the actual primary portion of each is the Split Point amount of $20,000.

          Example 5:

          Company A, which has a Primary / Excess Split Point of $20,000, has four claims from a single occurrence:

          ClaimActual IncurredSplit PointActual Primary
          1$119,000$20,000$20,000
          2$15,000$20,000$15,000
          3$5,000$20,000$0
          4$4,000$20,000$0
          Total$143,000 $35,000

          Claims 1 and 2 have the two largest reported loss amounts from this single occurrence and are used in the calculation of the modification. Claims 3 and 4 are not used in the calculation.

          In addition, Claim 1 exceeds the Split Point, and accordingly, its actual primary portion is the Split Point amount of $20,000. Claim 2 does not exceed the Split Point, therefore the actual primary portion of each is the actual reported loss amount.

          Example 6:

          As a comparison, if each loss in Example 5 above was a result of four separate occurrences, all losses would be limited individually and used in the calculation as follows:

          LossActual IncurredSplit PointActual Primary
          1$119,000$20,000$20,000
          2$15,000$20,000$15,000
          3$5,000$20,000$5,000
          4$4,000$20,000$4,000
          Total$143,000 $44,000

          Example 7:

          Company A, which has a Primary / Excess Split Point of $20,000, has four claims from a single occurrence (labeled losses 1 through 4), and two additional claims from two separate occurrences (labeled losses 5 and 6):

          OccurrenceLossActual IncurredSplit PointActual Primary
          A1$119,000$20,000$20,000
          A2$15,000$20,000$15,000
          A3$5,000$20,000$0
          A4$4,000$20,000$0
          B5$40,000$20,000$20,000
          C6$2,000$20,000$2,000
           Total$185,000 $57,000

          Claims 1 and 2 have the two largest reported loss amounts from the single occurrence and are used in the calculation of the modification.  Claims 3 and 4 are part of the same occurrence and are not used in the calculation.

          In addition, Claim 1 exceeds the Split Point, therefore its actual primary portion is the Split Point amount of $20,000.  Claim 2 does not exceed the Split Point, therefore the actual primary portion of each is the actual reported loss amount.  

          Claims 5 and 6 are included because each comes from an individual, separate occurrence. Claim 5 exceeds the Split Point, and its actual primary portion is the Split Point amount of $20,000. Claim 6 does not exceed the Split Point, and its actual primary portion is the actual reported loss amount.

        3. Claims that are directly attributable to the COVID-19 pandemic and reported with Catastrophe 12, are not subject to item (b) above.

      10. Table of Classifications with Non-Ratable Elements

        The following Non-Ratable Element Codes are not subject to experience rating:

        Classification
        Code
        Non-Ratable
        Element Code
        47710771
        74057445
        74317453
      11. Prior Formula Modification

        The Prior Formula Modification is defined as the modification or merit rating factor resulting from the application of the experience rating plan rules and formula, which was in effect until September 30, 2022 (“Prior Rules and Formula”), to the data during the experience period as defined under this Plan.

        For risks that were previously rated under the interstate rating plan administered by the National Council on Compensation Insurance (“NCCI”), the Prior Formula Modification is the modification resulting from the application of the Prior Rules and Formula to New York data during the experience period.

      12. Number of Claims

        The Number of Claims refers to the number of indemnity and medical claims incurred by the insured during the experience period. Claims are defined as those which had a medical and/or indemnity incurred loss amount.

        For occurrences involving two or more claims, the number of claims from each such occurrence is limited to two.

    • NEW YORK EXPERIENCE RATING PLAN MANUAL LATEST - RULE 1 -
      C. DEFINITIONS
      1. Statistical Plan

        The New York Workers’ Compensation Statistical Plan (“Statistical Plan”) sets forth detailed data reporting requirements for experience of individual risks.  Only 1st, 2nd, and 3rd reports, as well as corrections to such reports, are used in the experience rating calculation. Based on a risk’s experience period, an individual unit report may be used in more than one experience rating.

      2. Experience

        The experience used to calculate a risk’s modification is comprised of the exposure and losses that are reported according to the Statistical Plan. For purposes of this Plan, exposure and losses may also be referred to as data. The experience used to calculate a modification is determined by Rule 2 Section (E) of this Plan.

      3. Exposure

        For payroll-based classifications, exposure is the audited payroll for each classification in the experience period reported according to the Statistical Plan.

        For non-payroll-based classifications, exposure is the following:

        1. Per capita classes: The number of employees as reported in accordance with Part III (6) (b) of the Statistical Plan
        2. Per location class: The number of locations as reported in accordance with Part III (6) (c) of the Statistical Plan

        3. Volunteer Firefighters class: The number of exposure units reported in accordance with Part III (6)(d) of the Statistical Plan multiplied by the rating period manual loss costs for the coverage based on population size during the coverage period.
        4. Volunteer Ambulance Workers class: The number of exposure units reported in accordance with Part III (6)(e) of the Statistical Plan applied to the rating period manual loss costs for such exposure units.

      4. Losses

        Losses used in this Plan are incurred losses which are defined as loss payments plus reserves for future payments as of the valuation date. Incurred losses for each classification in the experience period are those reported according to the Statistical Plan.

        1. No loss is excluded from the experience of a risk even if the employer was not responsible for the accident that caused such loss.

          Exceptions:

          1. Losses reported with Catastrophe Number 12 and date of accident prior to November 1, 2022 are excluded from experience rating calculations. Catastrophe Number 12 claims include all workers’ compensation claims directly attributable to the COVID-19 pandemic. Losses reported with Catastrophe Number 12 and date of accident on or
            after November 1, 2022 are included in experience rating calculations.
          2. A loss is not included in the experience of a risk if it is not required to be reported to the New York State Workers’ Compensation Board as defined in Section 110 of the New York Workers’ Compensation Law provided that the employer pays the claim in the first instance or reimburses the carrier for the treatment rendered to the employee.

            Note: An employer is not required to file a claim notice with the New York State Workers’ Compensation Board if the accident or illness requires ordinary first aid or causes loss of time from work of only one day beyond the working day or shift on which the accident or illness occurred.

        2. Loss amounts may be limited in the experience rating calculation.  For application of a loss limitation, refer to Rule 2 Section (C)(9) of this Plan.

      5. Entity

        An entity is an individual, partnership, corporation, unincorporated association, fiduciary, or other legal entity.

      6. Risk

        A risk consists of all entities eligible for combination under this Plan, regardless of whether insurance is provided by one or more policies or insurance carriers.  A risk may be:

        1. A single entity, or
        2. Two or more entities that qualify for combination according to Rule 3 Section (D) of this Plan.

      7. Subject Premium

        Subject premium is reported according to the Statistical Plan.

      8. Unity (1.00) Factor

        A unity (1.00) factor may apply to a risk for reasons including, but not limited to:

        1. It does not qualify for experience rating.  Refer to Rule 2 Section (A) of this Plan for eligibility requirements.
        2. It does not meet the minimum data requirements.  Refer to Rule 4 Section (C) of this Plan for an explanation.

        3. It is a new business with no data available for calculation of an experience rating modification.
        4. It qualifies for experience rating, with the calculation resulting in a 1.00 modification.

        5. Data could not be provided as a result of an ownership change.  Refer to Rule 3 Section (C) of this Plan for an explanation.
    • NEW YORK MANUAL FOR WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE - PART TWO - CLASSIFICATION CODE INTERPRETATIONS
      Woodenware Mfg. - NOC
      Notes:

      Applies to the sawing, molding, or turning only of brush or broom backs or handles, with no assembling.      
       
      Includes manufacturing of metal parts in connection with the manufacturing of wooden shade rollers.

      Description:

      Code 2841 applies to employers engaged in manufacturing a variety of non-furniture, non-cabinet or millwork type of wood products, such as baseball bats, bobbins, bowls, brush or broom handles, coat hangers, cork products, crutches, handles, golf heads or shafts, gunstocks, hat blocks, jewelry trays, pegs, shade rollers, shuttles and similar products requiring only a minor amount of finishing and assembly work.

      This classification also applies to employers engaged in manufacturing wooden pencils and penholders. Employers may begin with raw logs or pencil slats that are purchased from pencil stock manufacturers. They may manufacture their own wood pencil stock or purchase pencil stock from other manufacturers. The types of machines used in the process of manufacturing pencils are kilns, wood shapers, grinding mills, punch presses, extrusion presses and coating machines. The wooden stock is cut and shaped as necessary. The appropriate “lead” for the types of pencil being manufactured is added. Metal eraser tips are stamped out on presses, fitted with rubber erasers and attached to the pencils. Employers may stamp out erasers on presses or send pencils to other concerns to have erasers added.

      Assignment by Analogies:

      • Chest of drawers – corrugated – wooden framing
      • Rafts, life rafts – covered with balsam – balsam inside raft materials
      • Scooters – not motorized – wood

      Operations To Be Separately Rated:
      1. Manufacturing:

        1. Architectural wood windows or doors.  Refer to Code 2817 “Cabinet Works – NOC – With Power Machinery.”
        2. Ballpoint or fountain pens, felt tip markers and mechanical pencil manufacturing. Refer to Code 4432 “Fountain Pen Mfg.”
        3. Brush or broom. Includes assembling and sawing, molding or turning of backs and handles. Refer to Code 2835 “Brush or Broom Mfg. – NOC.”
        4. Crayons. Refer to Code 4710 “Candle Mfg.”
        5. Planed or dressed lumber manufacturing, including unassembled millwork. Refer to Code 2731 “Planing or Molding Mill.”
      2. Sawmill operations. Refer to Code 2710 “Saw Mill.”

    • NEW YORK EXPERIENCE RATING PLAN MANUAL LATEST - RULE 1 -
      D. ADMINISTRATION
      1. The Rating Board determines the applicability of all Plan rules.

      2. The modification is calculated, issued and, if necessary, revised by the Rating Board.
      3. Unless otherwise provided by this Plan, modification issuance and revision is limited to the current and two preceding modifications.

      4. The calculated modification factor is applied by the carrier(s) in accordance with this Plan, other applicable rules, statutes, and regulations.
      5. The Rating Board publishes experience rating information for each eligible risk on the Rating Board’s Manage Data application, which is accessible to the membership via the Rating Board’s website, www.nycirb.org. The carrier of record is provided access to the experience rating worksheets for its own insureds on this application. Producers and other users can view modification factors for individual risks by subscribing to the NYMods application. Registration for access to this application can be obtained via the Rating Board’s website at www.nycirb.org.

      6. Individual employers, carriers, and other authorized representatives of record may request rating worksheets, as well as Employer Experience Reports, by contacting the Rating Board via email to RatingServices@nycirb.org. Letters of Authority must be furnished to the Rating Board for non-authorized representatives of employers either:
        1. On the employer’s stationery, authorizing such individuals as their representative and must be signed by an officer, partner, or principal of the employer; or

        2. Through an online application available on the Broker / Employer section of the Rating Board’s website at www.nycirb.org.
    • NEW YORK MANUAL FOR WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE - PART ONE - RULE I:
      I. INQUIRIES
      1. Written

        The Rating Board will respond to written inquiries received from employers or their authorized representatives. Inquiries must be received by the Rating Board within twelve (12) months of the expiration date of the policy.

      2. Telephone

        The Rating Board will accept telephone inquiries on matters such as classification assignments, Manual rule interpretations, ownership rules, and experience modification factors relating to an individual employer, however, it will only do so with authorized parties.

        Telephone inquiries of a general nature, not regarding a specific employer, are answered by Rating Board employees who are knowledgeable in specific subject areas.

        Phone based comments or views expressed by the Rating Board relating to an individual risk are not binding and should be regarded as advisory only.

      3. Letters of Authority

        Letters of Authority must be furnished to the Rating Board for non-authorized representatives of employers either:

        1. On the employers’ stationery, authorizing such individuals as their representative and must be signed by an officer, partner, or principal of the employer; or
        2. Through an online application available on the Rating Board’s website at www.nycirb.org.
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