Property and Casualty Insurance · Casualty Insurance · 6 min read
Payroll Classification and Experience Rating
- Identify how employee remuneration is classified and calculated to determine workers compensation manual premium.
- Explain how the experience modification factor is determined and how it adjusts an employer's premium based on past loss history.
- Describe the final premium audit process, including the handling of estimated payroll, subcontractor exposures, and additional rating adjustments.
Job Classifications and the Payroll Basis
Workers compensation premium is based primarily on payroll assigned to job classifications, with applicable rates and rating adjustments. The National Council on Compensation Insurance (NCCI) or an independent state rating organization maintains workers compensation classification codes where its system is used. Workers compensation classifications generally describe an employer's business operations, although applicable rules classify certain occupations, such as qualifying clerical office employees, separately. Each classification has an applicable manual rate reflecting the expected cost of insuring that type of work, and these rates can vary by state and insurer.
Higher risk job classifications carry higher premium rates per unit of payroll than lower risk classifications. For example, clerical office employees typically receive a low-hazard classification code with a low manual rate. In contrast, roofers, loggers, and structural steel workers carry high-hazard classification codes with high manual rates because their daily duties expose them to much greater injury hazards.
Under NCCI rules, the governing classification generally is the applicable classification with the largest payroll, excluding standard exceptions. Standard exceptions are specified occupations that may be classified separately from the employer's governing classification when the rating rules permit. Qualifying clerical office employees and outside salespersons are common standard exceptions, while drivers are classified separately only when the applicable rules permit. General exclusions are operations, such as aviation or new construction, that applicable rating rules require to be classified separately from the governing classification.
Employers must keep accurate records of employees' duties and payroll so remuneration can be assigned to the correct classifications. If an employer cannot document how payroll is divided among applicable classifications, rating rules may require assigning the entire unallocated payroll to the highest-rated applicable classification, which significantly increases premium costs.
Common mistakes
- Assuming an experience modification factor can be wiped clean by canceling a policy and purchasing coverage from a different insurance carrier.
- Believing that one large, catastrophic claim hurts an employer's experience mod more than many small, recurring claims that equal the same dollar total.
- Assuming that the initial premium paid when the policy is bound represents the final, fixed cost of the workers compensation coverage.
- Thinking that simply possessing a subcontractor's certificate of insurance automatically guarantees the auditor will exclude their pay from the general contractor's payroll basis.
Key points
- Workers compensation manual premium is generally calculated using classifications for the employer's operations, applicable separate classifications, payroll, and rates typically expressed per $100 of payroll.
- The governing classification represents the operation with the largest payroll, excluding standard exceptions such as qualifying clerical office employees and outside salespersons.
- Payroll is based on employee remuneration, which includes wages, salaries, bonuses, and sick pay, but generally excludes tips, severance, and employer benefit contributions.
- Experience rating adjusts manual premium using an experience modification factor based on eligible loss history, typically using a three-year period that excludes the most recent policy year.
- An experience mod below 1.00 provides a premium credit, while a mod above 1.00 applies a premium debit; the formula penalizes claim frequency more heavily than claim severity.
- Initial premiums are based on estimates, and the insurer retains the right to audit financial records at policy expiration to calculate the final earned premium.
- Uninsured subcontractor payments may be added to a contractor's payroll basis at audit unless acceptable proof of separate workers compensation coverage is verified.
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