WORKERS COMPENSATION AND EMPLOYERS LIABILITY

WORKERS COMPENSATION AND EMPLOYERS LIABILITY Page S1 CLASS MIN CLASS MIN CLASS MIN CLASS MIN CLASS MIN CODE RATE PREM CODE RATE PREM CODE RATE PREM CODE RATE PREM CODE RATE PREM 0005 3.80 1257 2003 7.32 1500 2702X* 54.72 1500 3180 3.49 1175 3851 7.27 1500 0008 5.28 1500 2014 8.39 1500 2705X* 98.61 1500 3188 3.56 1193 3865 3.11 1074 0016 11.32 1500 2016 4.27 1382 2710X 16.87 1500 3220 2.48 907 3881 7.77 1500 0034 5.24 1500 2021 6.45 1500 2714 10.21 1500 3223 6.38 1500 4000 12.60 1500 0035 4.45 1429 2039 7.43 1500 2719X 20.99 1500 3224 6.87 1500 4021 9.20 1500 0036 8.08 1500 2041 6.00 1500 2731 7.12 1500 3227 7.12 1500 4024D 8.41 1500 0037 8.15 1500 2065 7.05 1500 2735 7.97 1500 3240 7.23 1500 4034 14.30 1500 0042 10.88 1500 2070 9.49 1500 2759 10.79 1500 3241 5.66 1500 4036 3.58 1199 0050 12.53 1500 2081 4.77 1500 2790 2.98 1040 3255 2.95 1032 4038 8.37 1500 0059D 0.54 2089 5.53 1500 2797 9.33 1500 3257 6.51 1500 4053 4.50 1443 0065D 0.09 2095 8.68 1500 2799 7.81 1500 3270 6.83 1500 4061 5.33 1500 0066D 0.09 2105 6.78 1500 2802 14.41 1500 3300 11.12 1500 4062 3.67 1223 0067D 0.09 2110 4.25 1376 2804X 9.82 1500 3303 5.68 1500 4101 6.42 1500 0079 6.29 1500 2111 4.63 1477 2812 3307 6.20 1500 4109 1.23 576 0083 8.66 1500 2112 6.53 1500 2835 5.15 1500 3315 12.71 1500 4110 2.48 907 0106 36.57 1500 2114 3.96 1299 2836 5.08 1500 3334 6.60 1500 4111 4.03 1318 0113 9.13 1500 2121 3.78 1252 2841 8.46 1500 3336 6.67 1500 4112 0170 7.59 1500 2130 6.80 1500 2881 8.37 1500 3365 11.35 1500 4113 4.43 1424 0251 6.20 1500 2131 5.24 1500 2883 8.26 1500 3372 8.17 1500 4114 5.01 1500 0400 11.17 1500 2143 5.77 1500 2913 7.18 1500 3373 8.06 1500 4130 6.51 1500 0401 16.43 A 2157 9.51 1500 2915 5.57 1500 3383 2.19 830 4131 5.01 1500 0771N 0.90 2172 3.94 1294 2916 5.98 1500 3385 1.70 701 4133 4.03 1318 0908P 231.00 481 2174 6.33 1500 2923 4.03 1318 3400 8.68 1500 4149 1.37 613 0913P 774.00 1024 2211 15.02 1500 2942 4.86 1500 3507 4.21 1366 4150 0917 16.43 1500 2220 5.26 1500 2960 9.69 1500 3515 3.92 1289 4206 11.50 1500 1005* 7.34 1500 2286 4.92 1500 3004 3.49 1175 3548 2.84 1003 4207 2.91 1021 1016X* 26.88 1500 2288 8.50 1500 3018 5.75 1500 3559 5.08 1500 4239 4.68 1490 1164D 11.01 1500 2300 4.54 1453 3022 10.16 1500 3574 2.19 830 4240 4.12 1342 1165D 6.06 1500 2302 17.99 1500 3027 5.46 1500 3581 3.56 1193 4243 5.01 1500 1320 4.39 1413 2305 7.94 1500 3028 8.77 1500 3612 4.39 1413 4244 4.43 1424 1322 13.43 1500 2361 4.12 1342 3030 8.21 1500 3620X 5.46 1500 4250 3.60 1204 1430 11.93 1500 2362 2.69 963 3040 8.33 1500 3629 3.63 1212 4251 4.81 1500 1438 10.61 1500 2380 7.94 1500 3041 8.55 1500 3632X 6.45 1500 4263 5.10 1500 1452 4.57 1461 2386 3.96 1299 3042 9.00 1500 3634 4.32 1395 4273 9.27 1500 1463 24.08 1500 2388 4.03 1318 3064 9.22 1500 3635 4.41 1419 4279 4.27 1382 1472 6.94 1500 2402 4.34 1400 3069 3638 3.13 1079 4282 4.63 1477 1473X 3.58 1199 2413 4.83 1500 3076 6.40 1500 3639X 5.21 1500 4283 4.27 1382 1624D 5.32 1500 2416 4.36 1405 3081DX 8.62 1500 3642 2.42 891 4299 4.14 1347 1642 6.22 1500 2417 2.86 1008 3082D 7.32 1500 3643 6.09 1500 4304 11.64 1500 1654 13.74 1500 2501 4.99 1500 3085DX 8.57 1500 3647 4.57 1461 4307 4.12 1342 1655 5.19 1500 2503 2.37 878 3110 8.30 1500 3648 4.19 1360 4351 1.84 738 1699 7.43 1500 2534 4.50 1443 3111 4.32 1395 3681 2.24 844 4352 2.69 963 1701 6.98 1500 2570 7.12 1500 3113 3.31 1127 3685 1.70 701 4360 2.15 820 1710D 15.19 1500 2585 8.08 1500 3114 4.25 1376 3719 2.62 944 4361 2.78 987 1741D 7.03 1500 2586 5.15 1500 3118 5.48 1500 3724 10.16 1500 4362 1747 3.92 1289 2587 5.13 1500 3119 2.10 807 3726 8.35 1500 4410 6.47 1500 1748 8.03 1500 2589 4.97 1500 3122 3.25 1111 3803 5.39 1500 4420 7.94 1500 1803D 11.64 1500 2600 4.81 1500 3126 5.04 1500 3807 4.57 1461 4431 2.93 1026 1852D 5.77 1500 2623 12.06 1500 3131 3.04 1056 3808 3.76 1246 4432 3.07 1064 1853 4.41 1419 2651 3.63 1212 3132 5.77 1500 3821 8.91 1500 4439 4.27 1382 1860 3.96 1299 2660 5.08 1500 3145 8.46 1500 3822 9.18 1500 4452 6.60 1500 1924 3.94 1294 2670 3.33 1132 3146 3.56 1193 3824 9.42 1500 4459 5.21 1500 1925 6.45 1500 2683 3.49 1175 3169 5.77 1500 3826 2.37 878 4470 3.78 1252 2001 2688 4.81 1500 3175D 8.57 1500 3827 4.92 1500 4484 5.21 1500 2002 4.92 1500 2701 27.06 1500 3179 4.70 1496 3830 4.03 1318 4493 3.92 1289 * Refer to the Footnotes Page for additional information on this class code.

WORKERS COMPENSATION AND EMPLOYERS LIABILITY Page S2 CLASS MIN CLASS MIN CLASS MIN CLASS MIN CLASS MIN CODE RATE PREM CODE RATE PREM CODE RATE PREM CODE RATE PREM CODE RATE PREM 4511 1.50 648 5443 7.72 1500 6827FX 31.24 1500 7445N 0.90 8232X 9.96 1500 4557 5.82 1500 5445 15.91 1500 6829FX 15.17 1500 7453N 0.87 8233 5.55 1500 4558 2.64 950 5462 17.93 1500 6834 5.91 1500 7502 5.13 1500 8235 6.51 1500 4561 5472 9.35 1500 6836 6.00 1500 7515 2.60 939 8263 12.51 1500 4568 4.52 1448 5473 14.82 1500 6837X 8.28 1500 7520 8.12 1500 8264 18.33 1500 4581 2.08 801 5474 12.58 1500 6843F 25.18 1500 7538 16.76 1500 8265 13.32 1500 4583 8.50 1500 5478 10.03 1500 6845F 21.35 1500 7539 3.18 1093 8279 11.35 1500 4585X 3.31 1127 5479 12.73 1500 6854 8.64 1500 7540 6.15 1500 8288 14.55 1500 4586X 2.75 979 5480 9.60 1500 6872F 15.93 1500 7580 4.61 1472 8291 6.71 1500 4611 4.07 1329 5491 4.21 1366 6874F 47.07 1500 7590 11.64 1500 8292 4.45 1429 4635 9.18 1500 5506 12.53 1500 6882 7.34 1500 7600 8.41 1500 8293 17.64 1500 4653 3.92 1289 5507 9.02 1500 6884 6.33 1500 7601 8295X 4.54 1453 4665 13.11 1500 5508D 25.91 1500 7016M 4.72 1500 7605 6.51 1500 8304 12.69 1500 4670 23.25 1500 5535 16.99 1500 7024M 5.24 1500 7610 0.85 475 8350 6.69 1500 4683 6.36 1500 5537 8.28 1500 7038M 8.77 1500 7611 8353X 7.61 1500 4686 3.80 1257 5551 34.49 1500 7046M 14.17 1500 7612 8380 6.58 1500 4692 1.01 518 5606 3.27 1117 7047M 9.74 1500 7613 8381 3.94 1294 4693 1.41 624 5610 11.12 1500 7050M 18.08 1500 7705 10.65 1500 8385 5.06 1500 4703 4.03 1318 5645 28.47 1500 7090M 9.74 1500 7710 13.20 1500 8392 3.54 1188 4717 4.54 1453 5651 7098M 15.73 1500 7711 13.20 1500 8393 2.93 1026 4720 3.85 1270 5703 32.97 1500 7099M 29.23 1500 7720 5.17 1500 8500 15.76 1500 4740 3.16 1087 5705 21.87 1500 7133 9.15 1500 7855 11.62 1500 8601 1.32 600 4741 4.90 1500 5951 1.34 605 7151M 11.12 1500 8001 4.61 1472 8602 1.75 714 4751 6.22 1500 6003 15.15 1500 7152M 22.96 1500 8002 5.55 1500 8603 0.36 345 4771N 5.01 1500 6005 6.78 1500 7153M 12.35 1500 8006 4.81 1500 8606 8.10 1500 4777 8.93 1500 6017 12.13 1500 7222 8.30 1500 8008 2.73 973 8709F 15.11 1500 4825 4.77 1500 6018 4.45 1429 7228 12.15 1500 8010 3.36 1140 8719 6.04 1500 4828 4.86 1500 6045 4.52 1448 7229 13.16 1500 8013 0.67 428 8720 2.17 825 4829 3.04 1056 6204 21.75 1500 7230 15.13 1500 8015 1.59 671 8721 0.72 441 4902 6.94 1500 6206 7.97 1500 7231 14.41 1500 8017 3.72 1236 8723 0.49 380 4923 2.35 873 6213 3.47 1170 7232 9.74 1500 8018 5.06 1500 8725 4.03 1318 5020 11.23 1500 6214 12.26 1500 7309F 32.54 1500 8021 5.35 1500 8726F 5.24 1500 5022 14.32 1500 6216 12.98 1500 7313F 6.47 1500 8031 4.90 1500 8734M 1.32 600 5037 32.76 1500 6217 9.22 1500 7317F 15.29 1500 8032 5.73 1500 8737M 1.19 565 5040 24.66 1500 6229 15.53 1500 7327F 48.90 1500 8033 5.04 1500 8738M 2.46 902 5057 5.93 1500 6233 7.12 1500 7333M 7.32 1500 8037 4.54 1453 8742 0.98 510 5059 34.47 1500 6235 25.47 1500 7335M 8.12 1500 8039 3.85 1270 8745 8.37 1500 5069 77.48 1500 6236 24.08 1500 7337M 15.08 1500 8044 6.71 1500 8748 1.07 534 5102 13.45 1500 6237 2.48 907 7350F 24.17 1500 8045 0.96 504 8755 0.98 510 5146 9.00 1500 6251D 12.11 1500 7360 7.30 1500 8046 4.57 1461 8799 1.19 565 5160 4.41 1419 6252D 9.54 1500 7370 12.91 1500 8047 1.41 624 8800 2.69 963 5183 6.96 1500 6260D 11.48 1500 7380 7.86 1500 8058 5.13 1500 8803 0.20 303 5188 8.48 1500 6306 13.97 1500 7382 7.77 1500 8072 1.59 671 8805M 0.72 441 5190 7.52 1500 6319 10.14 1500 7390 6.78 1500 8102 3.31 1127 8810 0.54 393 5191 1.75 714 6325 13.79 1500 7394M 6.78 1500 8103 5.06 1500 8814M 0.65 422 5192 8.86 1500 6400 11.46 1500 7395M 7.54 1500 8105 6.38 1500 8815M 1.34 605 5213 10.34 1500 6503 3.94 1294 7398M 14.01 1500 8106 9.89 1500 8820 0.49 380 5215 8.88 1500 6504 5.17 1500 7402 0.51 385 8107 5.48 1500 8824 7.47 1500 5221 8.86 1500 6702M* 14.12 1500 7403 5.46 1500 8111 6.20 1500 8825 5.17 1500 5222 23.28 1500 6703M* 29.14 1500 7405N 1.66 928 8116 4.92 1500 8826 3.98 1305 5223 8.46 1500 6704M* 15.69 1500 7420* 9.15 1500 8203 16.18 1500 8829 4.81 1500 5348 8.19 1500 6801F 8.77 1500 7421 1.70 701 8204 4.99 1500 8831 2.89 1016 5402 8.21 1500 6811 12.44 1500 7422 3.36 1140 8209 6.13 1500 8832 0.58 404 5403 16.54 1500 6824F 12.80 1500 7425 10.05 1500 8215 5.55 1500 8833 1.90 754 5437 12.96 1500 6826F 9.98 1500 7431N 1.61 907 8227 9.76 1500 8835 3.02 1050 * Refer to the Footnotes Page for additional information on this class code.

WORKERS COMPENSATION AND EMPLOYERS LIABILITY Page S3 CLASS MIN CLASS MIN CLASS MIN CLASS MIN CLASS MIN CODE RATE PREM CODE RATE PREM CODE RATE PREM CODE RATE PREM CODE RATE PREM 8842 4.90 1500 8855 0.67 428 8856 0.54 393 8864 2.28 854 8868 0.87 481 8869 2.64 950 8871 0.27 322 8901 0.51 385 9012 3.09 1069 9014 4.57 1461 9015 7.94 1500 9016 5.10 1500 9019 3.85 1270 9033 4.43 1424 9040 8.35 1500 9044 2.78 987 9052 5.06 1500 9058 3.02 1050 9059 9060 3.47 1170 9061 1.97 772 9062 3.13 1079 9063 1.59 671 9077F 5.62 1500 9082 3.56 1193 9083 2.71 968 9084 2.75 979 9088a a a 9089 2.28 854 9093 3.04 1056 9101 6.15 1500 9102 5.39 1500 9154 2.64 950 9156 6.74 1500 9170 12.33 1500 9178 13.58 1500 9179 21.37 1500 9180 7.68 1500 9182 4.03 1318 9186 17.64 1500 9220 9.51 1500 9402 12.85 1500 9403 21.69 1500 9410 5.73 1500 9501 5.37 1500 9505 6.71 1500 9516 9.85 1500 9519 5.86 1500 9521 7.65 1500 9522 4.99 1500 9534 6.60 1500 9554 19.67 1500 9586 1.84 738 9600 5.21 1500 9620 1.77 719 * Refer to the Footnotes Page for additional information on this class code.

Page S4 WORKERS COMPENSATION AND EMPLOYERS LIABILITY FOOTNOTES a A D Rate for each individual risk must be obtained from NCCI Customer Service or the Rating Organization having jurisdiction. Minimum Premium $100 per ginning location for policy minimum premium computation. Rate for classification already includes the specific disease loading shown in the table below. See Basic Manual Rule 3-A-7. Code No. Disease Loading Symbol Code No. Disease Loading Symbol Code No. Disease Loading Symbol 0059D 0.54 S 1710D 0.11 S 3175D 0.07 S 0065D 0.09 S 1741D 0.67 S 4024D 0.04 S 0066D 0.09 S 1803D 0.49 S 5508D 0.11 S 0067D 0.09 S 1852D 0.11 Asb 6251D 0.07 S 1164D 0.11 S 3081DX 0.09 S 6252D 0.07 S 1165D 0.04 S 3082D 0.11 S 6260D 0.07 S 1624D 0.04 S 3085DX 0.09 S Asb=Asbestos, S=Silica F M N Rate provides for coverage under the United States Longshore and Harbor Workers Compensation Act and its extensions. Rate includes a provision for the USL&HW Assessment. Risks are subject to Admiralty Law or Federal Employers Liability Act (FELA). However, the published rate is for risks that voluntarily purchase standard workers compensation and employers liability coverage. A provision for the USL&HW Assessment is included for those classifications under Program II USL Act. The listed codes of 6702, 6703, 6704, 7151, 7152, 7153, 8734, 8737, 8738, 8805, 8814, and 8815 under the Federal Employers Liability Act (FELA) for employees of interstate railroads are not applicable in the residual market. This code is part of a ratable / non-ratable group shown below. The statistical non-ratable code and corresponding rate are applied in addition to the basic classification when determining premium. Class Non-Ratable Code Element Code 4771 0771 7405 7445 7431 7453 P X Classification is computed on a per capita basis. Refer to special classification phraseology in these pages which is applicable in this state. * Class Codes with Specific Footnotes 1005 Rate includes a non-ratable disease element of $1.32. (For coverage written separately for federal benefits only, $1.30. For coverage written separately for state benefits only, $0.02.) 1016 Rate includes a non-ratable disease element of $3.96. (For coverage written separately for federal benefits only, $3.87. For coverage written separately for state benefits only, $0.09.) 2702 An upset payroll of $10.00 per cord shall be used for premium computation purposes only when verifiable payroll records are not available. 2705 An upset payroll of $10.00 per cord shall be used for premium computation purposes in all instances. 6702 Rate and rating values only appropriate for laying or relaying of tracks or maintenance of way - no work on elevated railroads. Otherwise, assign appropriate construction or erection code rate and elr each x 1.215. 6703 Rate and rating values only appropriate for laying or relaying of tracks or maintenance of way - no work on elevated railroads. Otherwise, assign appropriate construction or erection class rate x 2.508 and elr x 2.442. 6704 Rate and rating values only appropriate for laying or relaying of tracks or maintenance of way - no work on elevated railroads. Otherwise, assign appropriate construction or erection class rate and elr each x 1.35. 7420 ELR of 16.80 will be applied to policies in the experience rating period that were effective prior to 3/1/2013. As a result of the increase in maximum payroll for this class, an ELR of 2.10 will be applied to any policies in the experience rating period that are effective 3/1/2013 and subsequent.

WORKERS COMPENSATION AND EMPLOYERS LIABILITY Page S5 MISCELLANEOUS VALUES Basis of premium applicable in accordance with Basic Manual footnote instructions for Code 7370 -- "Taxicab Co.": Employee operated vehicle $53,200 Leased or rented vehicle $35,500 Catastrophe (other than Certified Acts of Terrorism) - (Assigned Risk) 0.01 Expense Constant applicable in accordance with Basic Manual Rule 3-A-11 $250 Loss Sensitive Rating Plan (LSRP) - The factors which are used in the calculation of the LSRP are as follows: Basic Premium Factor 0.40 Loss Development Factors Minimum Premium Factor 0.75 1st Adjustment 0.19 Maximum Premium Factor 1.75 2nd Adjustment 0.12 Loss Conversion Factor 1.212 3rd Adjustment 0.08 Tax Multiplier 1.045 4th Adjustment 0.06 Maximum Weekly Payroll applicable in accordance with Basic Manual Rule 2-E-1 -- "Executive Officers" and the Basic Manual footnote instructions for Code 9178 -- "Athletic Sports or Park: Non-Contact Sports," and Code 9179 -- "Athletic Sports or Park: Contact Sports"... $2,300 Minimum Weekly Payroll applicable in accordance with Basic Manual Rule 2-E-1 -- "Executive Officers" $700 Premium Determination for Partners and Sole Proprietors in accordance with Basic Manual Rule 2-E-3 (Annual Payroll).... $35,500 Terrorism - (Assigned Risk)..... 0.01 United States Longshore and Harbor Workers' Compensation Coverage Percentage applicable only in connection with Basic Manual Rule 3-A-4........ 88% (Multiply a Non-F classification rate by a factor of 1.88 to adjust for differences in benefits and loss-based expenses. This factor is the product of the adjustment for differences in benefits (1.80) and the adjustment for differences in loss-based expenses (1.044).) Experience Rating Eligibility A risk is eligible for intrastate experience rating when the payrolls or other exposures developed in the last year or last two years of the experience period produced a premium of at least $9,000. If more than two years, an average annual premium of at least $4,500 is required. The Experience Rating Plan Manual should be referenced for the latest approved eligibility amounts by state.

Page S6 RESERVED FOR FUTURE USE