workers compensation Experience modification Rate

x the salue in in are (anit) Elah Hane Nive mor sernen Sutein Dredurtion Date: State: KY \begin{tabular}{|c|c|c|c|c|c|c|c|c|} \hline \multicolumn{9}{|c|}{ Workers Compensation Experience Rating } \\ \hline \multirow{2}{*}{\multicolumn{3}{|c|}{\begin{tabular}{l} Risk Name: \\ Rating Effective Date: \end{tabular}}} & \multirow{2}{*}{\multicolumn{2}{|c|}{\begin{tabular}{l} SpecialchemCo \\ 1/1/19 \end{tabular}}} & \multirow{2}{*}{\multicolumn{2}{|c|}{\begin{tabular}{l} RiskiD: 8675309 \\ Production Date: \end{tabular}}} & \multirow{2}{*}{\multicolumn{2}{|c|}{ State: KY}} \\ \hline & & & & & & & & \\ \hline State & WT & \begin{tabular}{l} Exp Excess \\ Losses \end{tabular} & Exp Losses & Dxp Prim Losses & Act Exc Losses & Ballast & Act Inc Losses & Act Prim Losses \\ \hline KY. & 0.15 & $91,076.15 & 5184,592.92 & $93,516.76 & 719,086 & 30,800 & 869,836 & 150,750 \\ \hline \begin{tabular}{l} (A) \\ WT \end{tabular} & (B) & \begin{tabular}{l} (C) Excess \\ Losses (DC) \end{tabular} & \begin{tabular}{l} (D) Expected \\ Losses \end{tabular} & \begin{tabular}{l} (0) Oxp Prim \\ Losses \end{tabular} & \begin{tabular}{l} (F) Actual Exc Losses \\ (H-1) \end{tabular} & (G) Ballast & \begin{tabular}{l} (H) Act inc \\ tosses \end{tabular} & \begin{tabular}{l} (1) Act Prim \\ Losses \end{tabular} \\ \hline 0.15 & & 91,076 & 184,593 & 93,517 & & 30,800 & & \\ \hline \multicolumn{9}{|c|}{ (t) } \\ \hline \multicolumn{4}{|c|}{ PrimaryLosses } & \multicolumn{2}{|c|}{ Stabillining Value } & \multicolumn{2}{|c|}{ Ratable Excess } & Totals \\ \hline \multicolumn{2}{|c|}{ Actual } & (1) & & \multicolumn{2}{|l|}{C(1A)+G} & \multicolumn{2}{|c|}{(A)(n)} & (0) \\ \hline \multicolumn{2}{|c|}{ Expected } & (G) & & C(1A)+G & 108,215 & ( A) (C) & & (K) \\ \hline \multirow{2}{*}{\multicolumn{8}{|c|}{ RATING REFLECTS A DECAEASE OF 70\% MEDICAL ONLY PRIMARY AND EXCESS LOSS DOLLARS WHERE ERAIS APPLIED }} & Exp Mod \\ \hline & & & & & & & & J/K \\ \hline \end{tabular} 1. What is SpecialChemCo's EMR for the three year period provided? Answer must reflect two digits to the right of the decimal point, e.g., 1.2 Assumptions: A. Assume the following payroll data: 21 201 2C B. Assume the claim data presented is accurate C. Medical only claims are reduced 70% when calculating SpecialChemCo's EMR. F. The following injury codes apply: x the salue in in are (anit) Elah Hane Nive mor sernen Sutein Dredurtion Date: State: KY \begin{tabular}{|c|c|c|c|c|c|c|c|c|} \hline \multicolumn{9}{|c|}{ Workers Compensation Experience Rating } \\ \hline \multirow{2}{*}{\multicolumn{3}{|c|}{\begin{tabular}{l} Risk Name: \\ Rating Effective Date: \end{tabular}}} & \multirow{2}{*}{\multicolumn{2}{|c|}{\begin{tabular}{l} SpecialchemCo \\ 1/1/19 \end{tabular}}} & \multirow{2}{*}{\multicolumn{2}{|c|}{\begin{tabular}{l} RiskiD: 8675309 \\ Production Date: \end{tabular}}} & \multirow{2}{*}{\multicolumn{2}{|c|}{ State: KY}} \\ \hline & & & & & & & & \\ \hline State & WT & \begin{tabular}{l} Exp Excess \\ Losses \end{tabular} & Exp Losses & Dxp Prim Losses & Act Exc Losses & Ballast & Act Inc Losses & Act Prim Losses \\ \hline KY. & 0.15 & $91,076.15 & 5184,592.92 & $93,516.76 & 719,086 & 30,800 & 869,836 & 150,750 \\ \hline \begin{tabular}{l} (A) \\ WT \end{tabular} & (B) & \begin{tabular}{l} (C) Excess \\ Losses (DC) \end{tabular} & \begin{tabular}{l} (D) Expected \\ Losses \end{tabular} & \begin{tabular}{l} (0) Oxp Prim \\ Losses \end{tabular} & \begin{tabular}{l} (F) Actual Exc Losses \\ (H-1) \end{tabular} & (G) Ballast & \begin{tabular}{l} (H) Act inc \\ tosses \end{tabular} & \begin{tabular}{l} (1) Act Prim \\ Losses \end{tabular} \\ \hline 0.15 & & 91,076 & 184,593 & 93,517 & & 30,800 & & \\ \hline \multicolumn{9}{|c|}{ (t) } \\ \hline \multicolumn{4}{|c|}{ PrimaryLosses } & \multicolumn{2}{|c|}{ Stabillining Value } & \multicolumn{2}{|c|}{ Ratable Excess } & Totals \\ \hline \multicolumn{2}{|c|}{ Actual } & (1) & & \multicolumn{2}{|l|}{C(1A)+G} & \multicolumn{2}{|c|}{(A)(n)} & (0) \\ \hline \multicolumn{2}{|c|}{ Expected } & (G) & & C(1A)+G & 108,215 & ( A) (C) & & (K) \\ \hline \multirow{2}{*}{\multicolumn{8}{|c|}{ RATING REFLECTS A DECAEASE OF 70\% MEDICAL ONLY PRIMARY AND EXCESS LOSS DOLLARS WHERE ERAIS APPLIED }} & Exp Mod \\ \hline & & & & & & & & J/K \\ \hline \end{tabular} 1. What is SpecialChemCo's EMR for the three year period provided? Answer must reflect two digits to the right of the decimal point, e.g., 1.2 Assumptions: A. Assume the following payroll data: 21 201 2C B. Assume the claim data presented is accurate C. Medical only claims are reduced 70% when calculating SpecialChemCo's EMR. F. The following injury codes apply