Indiana Workers Compensation Item Filings List prepared by ICRB Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI This item: -Revises Experience Rating Plan Manual Rule 1-D-4 so Revision to Experience Rating employers can obtain their own experience rating Board E-1401 Plan Manual Rule 1-D-4 Related 7/1/2011 modification worksheets electronically CIF-2010-19 Vote to Worksheet Distribution -Creates or revises certain state exceptions to ERM Rule 1-D-4 regarding experience rating worksheet distribution to the employer This item amends the assigned risk deposit premium rules located in the Basic Manual Rule 3-A-6 by: Revisions to Basic Manual Rule 3- • Clarifying existing rules Board Plan-IN-2010- RM-02-IN-2010 1/1/2011 yes 1 A-6 Deposit Premium • Reducing the maximum number of permitted additional Vote 02 payments during the year for policies with an estimated annual premium of at least $25,000 This item creates two Indiana state exceptions to NCCI’s Assigned Carrier Performance Standards for: Revision to Assigned Carrier • PS 3-C-2, regarding midterm policy changes resulting Performance Standards 3- Board Plan-IN-2010- RM-01-IN-2010 1/1/2011 from an employer-requested Waiver of Our Right yes 1 9/17/2010 9/22/2010 Underwriting and 7-Billing and Vote 01 to Recover From Others Endorsement (WC 00 03 13), Collection of Premium and • PS 7-A-2, regarding billing statements Revisions to Basic Manual Part Clarify and enhance the Basic Manual by creating a Board B-1421 Two-Classifications & Part Four- 1/1/2011 section to display classifications affected by transition 8/12/2010 9/22/2010 CIF-2010-17 Vote Classifications Pending programs. This item: Revisions to Basic Manual Rule 2- -Revises the procedure for determining the premium E-1-B-Executive Officers Premium basis for partners & sole proprietors Board B-1420 Determination, 2-E-3-Partners & 1/1/2011 8/12/2010 8/20/2010 CIF-2010-14 -Revises the average weekly minimum individual payroll Vote Sole Proprietors & Creation of limitation for executive officers Appendix F -Creates Basic Manual Appendix F Filed concurrently with RM-W-8036 to correspond with Enhancements to LSRP rule enhancements. Summary: Endorsements WC 00 04 17 A - WC 00 04 17 B merges WC 00 04 17 A with WC 00 04 RM-W-8036 and WC 00 04 18 E and 1/1/2011 DOI yes 1 7/1/2010 7/9/2010 Plan-2010-03 23 A Withdrawal of LSRP Endorsement - WC 00 04 18 F updates WC 00 04 18 E WC 00 04 23 A - WC 00 04 23 A withdrawn Enhances the current national assigned risk LSRP (see RM-W-8028). Filed concurrently with RM-W-8036. Summary of IN exceptions: Workers Compensation Insurance - Indiana threshold is $100,000, not $200,000 Plan (WCIP) Loss Sensitive RM-W-8035 1/1/2011 - Upon renewal, servicing carrier must notify employer DOI yes 1 7/1/2010 7/8/2010 Plan-2010-03 Rating Plan (LSRP) Basic Manual with premium of $50,000 or more of possible application Rule 4-C Enhancement of LSRP - Servicing carrier only holds the contingency deposit and return premium from a final audit until the first valuation 11/18/2010 1 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Five industries: 1) Banking & Check Cashing Stores 2) Revisions to Basic Manual Insurance Operations 3) Oil or Gas Lease, Well & Drilling Board B-1419 1/1/2012 1/27/2010 1/28/2010 CIF-2009-48 Classifications and Appendix E 4) Property & Building Management 5) Country Clubs. Vote Classifications to be clarified, created, or discontinued. Revise the General Information section as follows: update the format to be more consistent with other NCCI Revisions to Forms Manual of 7/1/2011 manuals; remove references to Advisory Forms; expand Board CIF-2009-65 P-1408 Workers Compensation and (changed from 1/27/2010 1/28/2010 the numbering for carrier specific Vote CIF-2009-67 Employers Liability Insurance 7/1/2010) endorsements; revise several national and state specific endorsements Three industries: 1) Construction Yard 2) Wallboard Revisions to Basic Manual installation and plastering 3) Painting. Classifications to Board B-1417 1/1/2011 9/16/2009 9/17/2009 CIF-2009-48 Classifications and Rules be modernized, consolidated, created, discontinued, Vote and/or clarified. Revisions to Basic Manual Establish new ―Code 7402—Aviation—Air Traffic Classifications for Air Traffic B-1418 1/1/2010 Controllers Under Contract with the FAA.‖ Reassign DOI 9/2/2009 9/10/2009 CIF-2009-45 Controllers Under Contract With payroll for these entities from Code 7403. the FAA 2009 Update to Retrospective Rating Plan Parameters–State Updates the State Hazard Group Relativities in Retro Hazard Group Relativities R-1401 1/1/2010 Manual; Discontinues alternative four-hazard-group DOI 9/2/2009 9/10/2009 CIF 2009-38 –Revision to Retrospective Rating option. Plan Manual Rule 3F –Revision to Basic Manual Appendix E 2009 Update to Retrospective Update Expected Loss Ranges and ELFs. Last update was R-1400 Rating Plan Parameters–Excess 1/1/2010 DOI 9/2/2009 9/10/2009 CIF 2009-37 in R-1397. Loss Factors Creates a national residual market TOC Program in Basic Establishment of Basic Manual Manual Rule 4F; eliminates state specific TOC rules in Board RM-W-8034 Rule 4-F - Takeout Credit 1/1/2010 yes 1 9/16/2009 9/17/2009 Plan 2009-04 Assigned Risk Miscellaneous Rules of Basic Manual; Vote Program establishes state rule exceptions as necessary. Revisions to Basic Manual Rule 3- Provide carriers option to cancel a policy other than short Board B-1416 A-3-b – Cancellation Provisions 1/1/2010 rate if they file and receive approval for a different 9/16/2009 9/17/2009 CIF-2009-27 Vote Table 4 method. Carpentry industry: delete code 5651 & reassign Revisions to Basic Manual exposure to 5645; update cross reference phraseologies; Board B-1415 Classifications and Appendix E 1/1/2011 8/5/2009 8/6/2009 CIF-2009-08 apply 3 year transition program; revise phraseology for Vote Classifications by Hazard Group codes 5102 & 5610 Multiple changes to Basic Manual Rule 3-A "Rating Definitions & Application of Premium Elements" to enhance understanding; "Explanation & Application" Revisions to Basic Manual Rules affected: ARD, Cancellation, Combination of Legal Board B-1414 Classifications and Appendix E 1/1/2010 Entities, Disease Loading, Estimated Annual Premium, 8/5/2009 8/27/2009 CIF-2009-01 Vote Classifications by Hazard Group Expense Constant, Coal Mine disease charge, Limits of Liability, Majority Interest, Minimum Premium, Nonratable Element, Other States Insurance, Premium Discount, States Added, and Waiver of Subrogation. 11/18/2010 2 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Two industries: 1) Fiber optics industry - new codes Revisions to Basic Manual 4109, 4110, 4149; discontinue codes 4112 & 4150; 2) Board B-1413 Classifications and Appendix E 1/1/2011 3/30/2009 4/17/2009 CIF-2008-47 Telecommunications - discontinue codes 7601, 7611, Vote Classifications by Hazard Group 7612, 7613 and reassign to 7600. Three industries: 1) Film 2) Varnish Mfg 3) Superstores Revisions to Basic Manual & Warehouse Clubs. Create new Code 8037 Store - Board B-1412 Classifications and Appendix E 1/1/2011 Superstores and Warehouse Clubs. Classifications to be 3/25/2009 3/27/2009 CIF-2008-44 Vote Classifications by Hazard Group modernized, consolidated, created, discontinued, and/or clarified. Two industries: 1) Carpentry: delete codes 2812 & 2792; Revisions to Basic Manual 2) Manufactured homes. Classifications to be Board B-1410 Classifications and Appendix E 1/1/2011 2/2/2009 2/26/2009 CIF-2008-33 modernized, consolidated, created, discontinued, and/or Vote Classifications by Hazard Group clarified as shown. Changes for the bakery industry to: Revisions to Basic Manual • Revise the phraseology of Codes 2003 & 6504 Board B-1409 Classifications and Appendix E 1/1/2011 • Create new Code 6503—Potato Chip, Popcorn & Snack 2/2/2009 2/26/2009 CIF-2008-19 Vote Classifications by Hazard Group Chip Mfg. NOC. • Modernize, consolidate, and clarify other codes 2009 Edition of the Retrospective Rewrite of manual in plain language without changing Rating Plan Manual for Workers Board R -1399 1/1/2010 substance and intent of rules. Manual last rewritten in 6/25/2009 7/22/2009 CIF-2009-03 Compensation and Employers Vote 1984. For endorsement filing, see P-1407(A). Liability Insurance Amends Retro endorsements to coincide with the 2009 Revised Retrospective Rating Plan Board P-1407(A) 1/1/2010 Retro Manual. See R-1399. Replaces filing P-1407 which 6/25/2009 7/22/2009 CIF-2009-14 Endorsements Vote was never filed in Indiana. Three industries: 1) Child Day Care, 2) Engineering and Revisions to Basic Manual Research, and 3) Inventory Counters. Classifications to Board B-1408 1/1/2010 1/15/2009 2/4/2009 CIF-2008-09 Classifications and Rules be modernized, consolidated, created, discontinued, Vote and/or clarified as shown. Four industries: 1) Horticulture, 2) Fruit Farms, 3) Sugar Revisions to Basic Manual Manufacturing, 4) Tobacco Mfg. Classifications to be Board B-1406 1/1/2010 2/2/2009 2/26/2009 CIF-2008-03 Classifications and Rules modernized, consolidated, created, discontinued, and/or Vote clarified as shown. • Introduction—clarify language that NCCI, and in Indiana that ICRB, has authority to determine class Revisions to Basic Manual assignments and application of Basic Manual rules. Introduction - Application of Board B-1411 4/1/2009 • Part Two—Classifications—more user friendly and 1/26/2009 2/13/2009 CIF-2008-40 Manual Rules & Part Two Vote easier to understand Classifications • Part Four—Classifications Pending—create this new section to assist with pending classification changes 2008 Update to Retrospective Update Expected Loss Ranges and ELFs. Last update was R-1397 Rating Plan Parameters – 1/1/2009 DOI blank 7/29/2008 CIF-2008-10 in R-1396. Excess Loss Factors 2008 Update to Retrospective Update State Hazard Group Relativities. Last update was R-1398 Rating Plan Parameters – 1/1/2009 DOI blank 7/29/2008 CIF-2008-11 in R-1396. State Hazard Group Relativities 11/18/2010 3 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Replace the current 2002 standards (RM-01-IN-02) Assigned Carrier Performance effective 4/1/02, which were updated in 2007 (RM-02-IN- Board RM-W-8031 1/1/2009 yes 1 3/25/2008 4/21/2008 Plan 2008-07 Standards 2006), with this 2009 edition. Adds several Indiana state Vote exceptions to document existing procedures. Clarifies the Indiana state exception which requires the Revision to Basic Manual Rule 4- assigned carrier return any unused portion of the LSRP Board Plan IN 2008- RM-01-IN-2008 10/1/2008 yes 1 8/19/2008 8/21/2008 C Loss Sensitive Rating Plan contingency deposit premium not needed after the first Vote 01 valuation. Revise endorsements so that both foreign and domestic Withdrawal of Endorsement WC terrorism are included in the same endorsement; as 00 01 13 A and Revisions to P-1406 9/1/2008 result of Terrorism Risk Insurance Program DOI 7/3/2008 7/17/2008 CIF-2008-04 Endorsements WC 00 04 21 B Reauthorization Act of 2007 (TRIPRA). In conjunction and WC 00 04 22 with Item B-1407. Catastrophe Provisions Revise values, wording, and premium algorithm as result B-1407 Miscellaneous Values, Rules and 9/1/2008 of Terrorism Risk Insurance Program Reauthorization Act DOI 7/3/2008 7/17/2008 CIF-2008-05 Statistical Codes of 2007 (TRIPRA). In conjunction with Item P-1406. 2008 Statistical Plan for Workers Statistical Plan enhancements include: reformat, update Board U-1397 Compensation and Employers 9/1/2008 code values, rule clarification, reorganization of loss & 6/26/2008 7/17/2008 Units 2008-01 Vote Liability Insurance expense information. Revise two endorsements with technical clarifications: AR 1/25/2008 Board RM-W-8030 Revision to Forms Manual 1/1/2008 LSRP Endorsement WC 00 04 18 D and AR LSRP yes 1 (mailed on 1/25/2008 Plan 2007-07 Vote Notification Endorsement WC 00 04 23 A 12/5/07) Terrorism Risk Insurance Revise Rule 3-A-24-a of the Basic Manual to remove B-1405 Program Reauthorization Act of 1/1/2008 12/31/05 expiration date & replace with "and any DOI 1/3/2008 1/3/2008 CIF-2007-09 2007 amendments thereto enacted by Congress." 1. Revise Terrorism Risk Insurance Extension Act Terrorism Risk Insurance Endorsement (old: WC 00 01 13; new: WC 00 01 13 A) P-1405 Program Reauthorization Act of 1/1/2008 2. Revise Domestic Terrorism, Earthquakes, and DOI 1/3/2008 1/3/2008 CIF-2007-10 2007 Endorsements Catastrophic Industrial Accidents Premium End (old: WC 00 04 21 A; new: WC 00 04 21 B) Elimination of the Manual of the Discontinue Coal Mine Manual. Make Code 1016 a state RM-01-IN-2007 1/1/2008 DOI 9/28/2007 10/17/2007 none Underground Coal Mine Rules special. Establish premium transition program. 2007 Update to Retrospective Update Expected Loss Ranges, State Hazard Group R-1396 1/1/2008 DOI no stamp 9/17/2007 CIF-2007-05 Rating Plan Parameters Relativities, and ELFs. Last update was in B-1403. Improve format of Appendix E: 1) Add column titled Basic Manual Revision to ―Discontinued in‖ showing the state(s) and Board B-1404 Appendix E - Table of 1/1/2008 discontinuation date in which each class code is no 8/28/2007 9/17/2007 CIF-2007-06 Vote Classifications by Hazard Group longer applicable; 2) Add effective date in the ―Applies in‖ and ―Discontinued in‖ columns Change hazard group exhibits in B-1397 to reflect new hazard group labels due to B-1403 (appendix in Basic Revision to Basic Manual B-1397 Manual). Added 3 class codes (3069, 5535, 7705) that Classifications and Rules - 7/1/2007 DOI no stamp 9/17/2007 IN-2007-05 Amendment were inadvertently omitted from the hazard group Amendment exhibit. Updated Servicing Carrier Performance Standards to reflect class code changes in Item B-1397. 11/18/2010 4 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Eight industries impacted: Ambulance and Emergency Medical Services, Athletic Team Sports and Parks, Revision to Basic Manual Board B-1397 7/1/2007 Cleaning Services and Pet Sitting, Domestics, Firefighting 3/15/2007 3/26/2007 CIF-2006-08 Classifications and Rules Vote Including Volunteer Firefighters, Logging, Mailing Companies, Sheet Metal Effective for ER mods from 5/27/02 through 6/12/07. Filing provides a new catastrophe loss code 87 to be Exclusion of Catastrophe Losses Board E-1400 3/8/2007 used to report disease losses attributable to the terrorist 2/28/2007 3/8/2007 From Experience Rating Vote attacks on the World Trade Center. Such losses will be excluded from the mod. Revision to 2002 Servicing Revise performance standards to be consistent with 2006 RM-02-IN-2006 1/1/2007 DOI yes 1 10/19/2006 10/23/2006 Carrier Performance Standards Assigned Risk Supplement Revisions to Basic Manual and Revise Hazard Groups, update Expected Loss Ranges, B-1403 Retrospective Rating Plan Manual 1/1/2007 and update State Hazard Group Relativities. Number of DOI 9/27/2006 9/27/2006 / 2006 Update to Hazard Groups hazard groups increased from 4 to 7. Clarify, eliminate or combine classifications in the Basic Revision to Basic Manual Manual for the aviation industry. Majority of aviation B-1399 Classifications for Aviation 1/1/2007 risks will be reclassified from Code 7422 to Code 7425, DOI 9/27/2006 9/27/2006 Industry which results in rate decrease. Transition program implemented over several years. Create national LSRP rule in Basic Manual, Rule 4-C and apply Indiana state rule exceptions where appropriate (Exhibit 5 of filing). Summary of IN exceptions: Rule 4C - Assigned Risk - Indiana threshold is $100,000, not $200,000 Board RM-W-8028 Mandatory Loss Sensitive Rating 7/1/2006 - Upon renewal, servicing carrier must notify employer yes 1 6/5/2006 6/6/2006 Plan 2007-07 Vote Plan (LSRP) with premium of $50,000 or more of possible application of LSRP - Servicing carrier only holds the contingency deposit and return premium from a final audit until the first valuation Create, amend, and withdraw as applicable, endorsements contained in previously filed Items B- 1383, B-1393, and P-1392 as summarized below. - Replace the TRIA Endorsement (WC 00 04 20) with new TRIA Endorsement (WC 00 01 13), used with the Terrorism Risk Insurance P-1404 1/1/2006 Foreign Terrorism Prem Endorsement (WC 00 04 22) DOI 1/26/2006 2/2/2006 Extension Act of 2005 - Amend the DTEC Industrial Accidents Premium Endorsement (WC 00 04 21) to reflect a revised definition of Domestic Terrorism - Withdraw the TRIA Endorsement (WC 00 04 20) - Withdraw the Notification Endorsement of Pending Law Change to TRIA of 2002 (WC 00 01 12) Change the name of the endorsement from Rural Revision of the Rural Electrification Administration Endorsement to Rural Board P-1401 Electrification Administration 1/1/2006 12/16/2005 12/27/2005 Utilities Service (WC 00 03 09 B) to reflect name change Vote Endorsement of the agency. 11/18/2010 5 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Update coding specs for deductible type, injury description code, and loss conditions codes; remove URE Workers Compensation Board U-1396 1/1/2006 social security number data element; reference new USR 12/12/2005 12/19/2005 Statistical Plan Update Vote Guidebook; update class code & correction reports instructions Revisions to Basic Manual Clarify or eliminate classification codes and rules in the Classifications and Rules, Board B-1394 1/1/2006 Basic Manual to reflect current business and industry 12/14/2005 12/19/2005 Addendum to Filings B-1387 and Vote needs. 15 codes impacted. B-1391 Revise assigned risk rules for employee leasing Professional Employer arrangements. Creates a national rule in Basic Manual, Board RM-W-8027 1/1/2006 yes 1 11/23/2005 12/5/2005 Organization (PEO) Arrangements Rule 4-B. Replaces "labor contractor" wording with Vote "PEO." Continues & re-lables catastrophe provisions to address Miscellaneous Values For Foreign the risk of foreign terrorism on workers compensation Board B-1398 1/1/2006 11/10/2005 11/18/2005 Terrorism policies. Replaces "TRIA" wording with "Foreign Vote Terrorism" wording. Item B-1403 did not include hazard group labels for the two new charitable codes, 8842 and 8864. This update B-1387 Update to Hazard Groups for provides a technical amendment to page 6 in Item B- 1/1/2006 DOI 4/26/2007 5/3/2007 Amendment Codes 8842 & 8864 1387, which reflects the change in hazard group labels. The labels for Codes 8842 and 8864 will be ―C-2‖, same as the codes they replace, 8861 and 9110. Amend the classification treatment of several business Revisions of Basic Manual types through a three-year transition program. Board B-1387 1/1/2006 2/28/2005 3/8/2005 Classifications (Charitable Welfare Organizations & Group Homes and Vote Bottling Operations). Eliminate or enhance selected Basic Manual classifications & Basic Manual classification advisory notes to reflect current business & industry needs relative to these items. (Bag or Sack Manufacturing, Revision to Basic Manual Board B-1391 1/1/2006 Linotype Printing, Ice Mfg., Five-&-Dime Stores, 2/28/2005 3/8/2005 Classifications Vote Restaurant, Real Estate Appraisal & Agency, Commercial Restaurant Equipment Installation, Auto Dismantling & Recycling, Book or Record Stores and Heating, Ventilation, Air-Conditioning & Refrigeration). Update the Expected Los Ranges & State Hazard Group 2005 Update to Retrospective R-1395 10/1/2005 Relativities in the Retrospective Rating Plan Manual for DOI 5/2/2005 5/4/2005 Rating Plan Parameters Workers Compensation & Employers Liability Insurance. Enhance reporting requirements to the URE Workers Compensation Statistical Plan by adding 6th - 10th unit Unit Statistical Reporting Board U-1390 7/1/2005 statistical report levels (claims) & improving the clarity of 10/18/2004 12/6/2004 Instruction Enhancements Vote the definition & reporting instructions for fraudulent claims. 11/18/2010 6 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Due to understated payroll detected after the 1/1/05 rate filing, loss costs and advisory rates for eight codes are Revision of Rates for Eight Class 1/1/2005 reduced (1655, 3085, 3365, 5472, 5473, 7601, 7720, & DOI 9/21/2005 9/21/2005 Codes 8107). Reference NCCI Circular IN-2006-01 dated 2/6/06. Addresses uncertainties in having to issue new, outstanding or renewal policies for periods effective January 1, 2005 & thereafter without knowing if Notification Endorsement of Congress will extend the Terrorism Risk Insurance Act Pending Law Change to Terrorism (TRIA) beyond December 31, 2005. Additionally, this Board P-1392 1/1/2005 10/18/2004 11/29/2004 Risk Insurance Act of 2002 (WC item will be used to clarify for policyholders that a Vote 00 01 12) premium charge for foreign terrorism may either continue to be applied, or changed from the amount currently applied, following the possible expiration of TRIA. Miscellaneous Values For Produce catastrophe provisions, by state, to address Domestic Terrorism, Earthquakes B-1393 1/1/2005 losses resulting from domestic terrorism, earthquakes & DOI 10/18/2004 11/19/2004 and Catastrophic Industrial catastrophic industrial accidents. Accidents Establish a stand-alone Indiana pooling mechanism to Indiana Workers Compensation Board None 1/1/2005 replace our current arrangement with the National yes 1 10/13/2004 11/16/2004 Reinsurance Pool Filing Vote Workers Compensation Reinsurance Pool. Revision of the Employers Remove the exclusion for bodily injury to any member of Liability Coverage Endorsement the flying crew of any aircraft from the Employers Board P-1389 (WC 00 03 03B) and Federal 10/1/2004 Liability Coverage Endorsement (WC 00 03 03B), & to 8/6/2004 8/10/2004 Vote Employers' Liability Act Coverage clarify the use of the Federal Employers' Liability Act Endorsement (WC 00 01 04) Coverage Endorsement (WC 00 01 04). Update the Expected Loss Ranges & State Hazard Group 2004 Update to Retrospective R-1388 7/1/2004 Relativities in the Retrospective Rating Plan Manual for DOI 2/19/2004 3/15/2004 Rating Plan Parameters Workers Compensation & Employers Liability Insurance. Subsequent to filing Item U-1386, several administrative errors were identified that minimally impact certain URE WCSP Pension Table U-1386A 1/1/2004 information in selected tables. The necessary corrections DOI 2/19/2004 3/15/2004 Revisions (1999 Mortality) have been made & a complete replacement to the 2004 Pension Tables is included in this item filing. Update the pension tables contained in the URE Workers Compensation Statistical Plan (Part 8) using data from URE WCSP Pension Table Board U-1386 1/1/2004 the 1999 United States Life Tables & data contained in 9/11/2003 9/17/2003 Revisions (1999 Mortality) Vote the 1980 United State Railroad Retirement Board Remarriage Table. 2003 Experience Rating Plan Introduce a new Experience Rating Plan Manual for Board E-1379 12/2/2003 2/10/2004 Manual Workers Compensation & Employers Liability Insurance. Vote Update the Expected Loss Ranges & State Hazard Group 2003 Update to Retrospective R-1385 12/1/2003 Relativities in the Retrospective Rating Plan Manual for DOI 7/15/2003 8/28/2003 Rating Plan Parameters Workers Compensation & Employers Liability Insurance. 11/18/2010 7 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Board RM-W-03-IN-02 Assigned Risk Deposit Premiums 5/1/2003 Revise the assigned risk deposit premium requirements. yes 1 1/31/2003 2/4/2003 Vote Elimination of Code 0917 - Eliminate Code 0917-Domestic Service Contractor-Inside Board 01-IN-02 Domestic Service Contractor - 1/1/2003 and reassign these operations to Code 9014-Buildings- 12/4/2002 12/6/2002 Vote Inside Operation by Contractors. Catastrophe Provision-Certified Establish catastrophe provisions by state that address Terrorism Losses (as defined in B-1383 12/20/2002 certified terrorism losses as defined in the Terrorism Risk DOI 12/27/2002 1/7/2002 Terrorism Risk Insurance Act of Insurance Act of 2002. 2002) Amended Assigned Risk Change the eligibility threshold for the Assigned Risk Board RM-02-IN-02 Mandatory Loss Sensitive Rating 12/1/2002 7/18/2002 7/22/2002 Mandatory Loss Sensitive Rating Plan (LSRP) in Indiana. Vote Plan (LSRP) Clarify reporting rules for Expense Constant and Minimum Premium on mulit-state policies. Clarify verbiage regarding fraud recoveries, which implied the URE Workers Compensation recovery was fraudulent instead of the claim being Board U-1380 11/1/2002 6/28/2002 7/3/2002 Statistical Plan Update fraudulent. Update "Workers Compensation Appeals Vote Board" to a more general term. Reformat the Injury Description Codes in Part 7, similar to the format in Part 4. Improve the clarity of various rules contained in Basic Basic Manual Rules Board B-1373 7/1/2002 Manual for Workers Compensation & Employers Liability 3/1/2002 3/5/2002 Enhancements Vote Insurance. 2002 Update to Retrospective Update the State and Hazard Group Severity Relativities R-1378 7/1/2002 DOI 2/1/2002 2/6/2002 Rating Plan Parameters of the Retrospective Rating Plan. Claims directly attributable to the terrorist acts of Exclusion of Terrorism Losses Board E-1376 5/27/2002 September 11, 2001, be excluded from experience rating 2/20/2002 2/26/2002 From Experience Rating Vote calculations for ratings effective 5/27/02 to 6/14/06. 2002 Servicing Carrier Revise & update the current Indiana servicing carrier Performance Standards & 2002 performance standards that were approved effective Board RM-01-IN-02 Servicing Carrier Performance 4/1/2002 1/1/2000; and Indiana servicing carrier performance yes 1 5/23/2002 5/20/2002 Vote Standards for Coal Mine standards for coal mine occupational disease, that were Occupational Disease (CMOD) approved effective 1/1/2001. Modifies the WC Insurance Plan (WCIP/Plan). It addresses 3 objectives concerning the Nat'l WC Reinsurance Pool's (the "Pool") authority related to the Plans. It reinsures the activities of the Plan Admin for Modified Workers Compensation such Plans, in an effort to provide the Pool Board with a Board RM-W-8021 1/1/2002 yes 1 1/22/2002 3/12/2002 Insurance Plan (WCIP) more appropriate framework within which to discharge Vote its fiduciary duties, provide the Pool members a greater voice in matters that directly affect the financial interests of the Pool participants, and assist the Regulator with Plan expense oversight. 11/18/2010 8 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Changes to the NWCRP provide for a Pool financial credit Workers Compensation Insurance policy to protect the NWCRP participants from credit risk Plan (WCIP) - Proposed of insolvent Pool members, provides the NWCRP Board of Amendments to the National Board RM-W-8024 1/1/2002 Governors with the ability to commute historical claims yes 1 12/11/2001 1/23/2002 Workers Compensation Vote or losses when it is in the best interest of the NWCRP Reinsurance Pool (NWCRP) participants, and makes several housekeeping Articles of Agreement amendments to the Articles of Agreement. Amend rules related to reporting of the Fraudulent Claim Reporting of Fraudulent Claim Board U-1374 1/1/2002Code as they appear in Unit Report Expansion (URE) 12/17/2001 1/9/2002 Code Vote Workers Compensation Plan. Provides additional direction for endorsing or changing Issuing Agency/Producer Office the "Issuing Agency/Producer Office Address Board U-1372 Address Endorsement - WC 89 06 11/16/2001 10/31/2001 11/6/2001 Endorsement (WC 89 06 25)" be added to the Policy Vote 25 Information Page Endorsement. Amend the current rule regarding employee leasing in ER-IN-2000-01 Employee Leasing 8/1/2001 DOI 7/19/2000 7/31/2000 the Experience Rating Plan Manual. Introduce a new Basic Manual for Workers Compensation & Employers Liab. Ins. The manual has been revised 2001 Basic Manual for Workers with particular emphasis on increasing the ability of Board B-1369 Compensation 7/1/2001 users to quickly find the information they need in an 6/8/2001 Vote & Employers Liability Insurance electronic environment. In addition, we expanded our plain language approach & changed the appearance of the manual to better meet our customers needs. Update the Expected Loss Rangers and State and Hazard 2001 Update to Retrospective R-1371 7/1/2001 Group Severity Relativities of the Retrospective Rating DOI 4/16/2001 4/24/2001 Rating Plan Parameters Plan. Is to introduce Premium Due Date Endorsement WC 00 04 XX. This endorsement will comply with the National Board P-1370 Premium Due Date Endorsement 1/1/2001 1/5/2001 1/29/2001 Association of Insurance Commissioners (NAIC) Vote Statement of Statutory Accounting Principles No. 6. Revise and update the current Coal Mine Occupational Board RM-02-IN-00 Coal Mine Occupational Disease 1/1/2001 Disease performance standards for Indiana servicing yes 1 12/20/2000 1/17/2001 Vote carriers in the areas of claims and loss control. Clarify the language in URE Workers Comp. Statistical Plan and provide further direction for reporting unit statistical data. In addition, this filing contains changes URE Workers Compensation to the following two rules for reporting unit statistical U-1368 Statistical Plan 1/1/2001 DOI 6/4/2001 data. ~Establish guidelines for reporting Fraud Amount Revision on claims that have been determined as fraudulent. ~Discontinue use of the ERM-6 form by affiliate self- insurers. Workers Compensation Premium Established a state algorithm in the Basic Manual to Board B-1351 07/01/00 8/31/1998 9/2/1998 Algorithm provide guidance for premium computation. Vote Permitted the assignment of yard employees of roofing Code 5551 - Roofing - Amended B-1362 07/01/00 contractors to Code 8227, eliminating the requirement DOI 2/14/2000 2/22/2000 Phraseology that they be classified to Code 5551. 11/18/2010 9 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Amends classification phraseologies for Codes 7403 - Aircraft or Helicopter Operation: Air Carrier - Scheduled or Supplemental: All Other Employees & Drivers; 7405 - Aircraft or Helicopter Operation: Air Carrier - Scheduled Codes 7603, 7405, 7423, and or Supplemental: Flying Crew; 7423 - Aircraft or Board B-1363 7431 - Air Carrier Classification - 07/01/00 2/10/2000 2/16/2000 Helicopter Operation: Air Carrier - Commuter; All Other Vote Amended Phraseologies Employees & Drivers; & 7431 - Aircraft or Helicopter Operation: Air Carrier - Commuter: Flying Crew to maintain the proper classification assignments of these codes. Basic Manual Rule IV-D.4: Clarify the intent of Basic Manual Rule IV-D.4. Board B-1364 Assignment of Additional Basic 07/01/00 2/10/2000 2/16/2000 Assignment of Additional Basic Classification. Vote Classifications 1) Is to increase the standard limit of liab under Part 2 Employers' Liab Ins for Admiralty Law (Maritime) of FELA Ins to Bodily Injury by Accident, $100,000 ea accident & Bodily Injury by Disease, $100,000 aggregate. 2) Is to Revision to Admiralty and Federal modify the ratemaking methodology for the admiralty B-1366 Employers' Liability Act 07/01/00 DOI 3/30/2000 4/5/2000 classifications so that the assigned risk rates & voluntary Classifications loss cost/advisory rates for these classifications are based upon their own experience. 3) To eliminate "A" rate or average rate indicator in the Basic Manual rate pages for FELA classifications. Update the Expected Loss Rangers and State and Hazard 2000 Update to Retrospective R-1365 07/01/00 Group Severity Relativities of the Retrospective Rating DOI 1/19/2000 1/26/2000 Rating Plan Parameters Plan. Indiana Residual Market Workers Amended RM-W-8022 to clarify that the assigned risk RM-01-IN-00 Compensation Premium 07/01/00 DOI yes 1 7/19/2000 6/16/2000 surcharge is part of standard premium. Algorithm Amendment Residual Market Workers Establish a state premium algorithm in the Basic Manual Board RM-W-8022 Compensation Premium 07/01/00 yes 1 8/31/1998 9/2/1998 to provide guidance for premium computation. Vote Algorithm Elimination or Enhancement of Eliminated or enhanced selected Basic Manual Selected Basic Manual classifications & advisory notes to reflect current Board B-1359 01/01/00 8/12/1999 8/23/1999 Classifications and Basic Manual business needs. Eliminated codes: 1470, 7323F & 8710. Vote Classification Advisory Notes Clarified codes: 2114, 3581, 4432, 4611, 4825 & 3400. 11/18/2010 10 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Enhanced various Basic Manual rules & references as outlined: ~Further defined store & farm classification assignment procedures. ~Identified classifications within the construction, farming & store industry groups. ~Omitted references to specific premium discount schedules. Basic Manual Updates of Selected Board B-1361 01/01/00 ~Added examples of premium discount calculations for 8/25/1999 8/27/1999 Rules and References Vote multi-state policies. ~Further defined minimum premium calculations for multi-state policies & cancelled policies. ~Clarified the two methods (factor or percentage) for calculating short rate premium. ~Reference explaining the ICRB or NCCI cannot provide legal advice regarding application of various state & federal laws pertaining to coverage issues. Updates to the deductible & coinsurance percentages on Indiana Advisory Voluntary & the Miscellaneous Values pages of the 1/1/00 advisory None Assigned Risk Rates - 01/01/00 voluntary & assigned risk rate filings & inclusion of Loss DOI Miscellaneous Values Update Sensitive Rating Plan factors on the assigned risk Miscellaneous Values page. 2000 Servicing Carrier Established 2000 Servicing Carrier Performance Board None 01/01/00 yes 1 7/15/1999 8/2/1999 Performance Standards Standards. Vote Updated the pension tables contained the Workers Compensation Statistical Plan (Part XII) and the 1996 WCSP Pension Table Revisions Workers Compensation Statistical Plan (Part 7) using Board U-1355 01/01/00 yes 1 4/29/1999 5/13/1999 (89-91 Mortality) data from the 1989-1991 U.S. Decennial Life Tables. In Vote addition, four examples contained in the Pension Table Guide were modified to reflect this new data. Established the URE Workers Compensation Statistical Plan as a replacement of the 1996 Workers URE Workers Compensation Compensation Statistical Plan. No changes were made to Board U-1360 01/01/00 yes 1 7/27/1999 8/9/1999 Statistical Plan the rules, however, a number of enhancements were Vote made. For example, coding specifications & statistical codes are new to the manual. Adjusts the initial Item U-1360 previously filed & approved on 8/8/99. The manual is national in scope URE Workers Compensation and used in many states. The majority of changes in Board U-1360A 01/01/00 yes 1 1/10/2000 1/12/2000 Statistical Plan (Addendum) this filing addressed state exceptions for states other Vote than Indiana. There are no exceptions required for Indiana. NOT FILED Amend the affiliate and non-affiliate ERM-6 forms to Experience Rating for Self- E-1357 10/01/99 accommodate the recent changes to the Experience Insureds - Affiliate & Non-Affiliate Rating Plan Manual rules. ERM-6 Forms 11/18/2010 11 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Amended the Basic Manual rule XII.D. to clarify that the rates for certain Admiralty/FELA classification codes U.S. Longshore and Harbor include premium for coverage under the USL&HW Act. Board B-1354 Workers' Compensation Act - 07/01/99 Accordingly, the rates for these class codes should not be 4/29/1999 5/13/1999 Vote Classifications and Rates. increased by the state USL&HW percentage increase even though such codes are not followed by the letter "F" indicating federal act coverage. Updated the State and Hazard Group Severity Relativities and the USL&HW Excess Loss Pure Premium Factors of 1999 Update to Retrospective Board B-1356 07/01/99 the Retrospective Rating Plan. Also, a rule will be 4/19/1999 5/13/1999 Rating Plan Parameters and Rules Vote introduced regarding the use of deductible or coinsurance programs with retrospectively rated policies. Added an eighth characteristic to the Indiana Schedule ER-IN-01 Drug Free Workplace Program 07/01/99 Rating Table to allow a credit or debit up to 5% for an DOI 6/9/1999 7/29/1999 employer with a Drug Free Workplace Program. Assigns Statistical Code 0935 - Second Injury Fund Surcharge as a method for tracking this assessment. Pursuant of House Enrolled Act 2085, this surcharge is Board None Second Injury Fund Surcharge 7/1/1999 not premium; however, each insurance company must Vote show the assessment on the policy as "a surcharge based on the employer's premium". Amended rules related to submission of losses as they appear in the 1996 Workers Comp Statistical Plan, Part Board U-1358 Claim Grouping Option 07/01/99 4/29/1999 5/12/1999 4, Section 2, and in the Pre-URE Workers Compensation Vote Statistical Plan, Part IV, Section 2. Enhanced classification phraseologies & footnotes for Codes 4583-Fertilizer Mfg. & Drivers, 8215-Hay, Grain or Fertilizer Dealers and Board B-1352 01/01/99 Feed Dealer & Local Managers, Drivers & 0050-Farm 8/31/1998 9/2/1998 Manufacturers Vote Machinery Operation-By Contractor & Drivers to facilitate the proper classification assignments of these codes. 1999 Servicing Carrier Established 1999 Servicing Carrier Performance Board None 01/01/99 yes 1 Performance Standards Standards. Vote Modifies the WC Insurance Plan (WCIP/Plan). It addresses 3 objectives concerning the Nat'l WC Reinsurance Pool's (the "Pool") authority related to the Plans. In reinsures the activities of the Plan Admin for Modified Workers Compensation such Plans, in an effort to provide the Pool Board with a Board RM-W-8021 01/01/99 yes 1 1/22/2002 3/12/2002 Insurance Plan (WCIP) more appropriate framework within which to discharge Vote its fiduciary duties, provide the Pool members a greater voice in matters that directly affect the financial interests of the Pool participants, and assist the Regulator with Plan expense oversight. Provided an updated Table of Insurance Charges and State & Hazard Group Relativities for the exclusive use Board R-1350 Table of Insurance Changes 11/01/98 8/31/1998 9/2/1998 by companies affiliated with NCCI for Large Account Vote License, Service, & Maintenance. 11/18/2010 12 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Combines the explosives manufacturing classification Codes 4770, 4773, 4774, 4775, 4776, 4779 and 4799 Consolidation of Selected Board B-1347 07/01/98 into classification Code 4771 and the non-ratable 11/13/1997 11/13/1997 Explosives Manufacturing Codes Vote element (NRE) Codes 0770, 0773, 0774, 0775, 0776, 0779 and 0799 into statistical Code 0771. Enhanced classification phraseologies, footnotes, and cross-references for Codes 8380-Gasoline Station-Retail & Drivers NOC, 8381-Gasoline Station-Retail-Self- Automobile Gasoline Stations and Service, and Code 8006-Grocery-Retail to facilitate the Board B-1348 07/01/98 2/27/1998 3/2/1998 Convenience Stores proper classification assignments to these codes. Vote Further, this item eliminated Code 8061-Grocery- Convenience-Retail & combined these store operations with Code 8006. Added a new rule in the Basic Manual to clarify the use of the Waiver of Right to Recover From Others Endorsement. If the carrier decides to charge premium Waiver of Right to Recover From for the endorsement (even on a individual risk basis), it Board B-1349 Others & Limited Liability 07/01/98 must file that charge with the Indiana Department of 11/24/1997 11/26/1997 Vote Companies Insurance. The ICRB has no charge (rate) filed on behalf of its members for the waiver. However, the standard endorsement is already filed & ready for use. If the carrier makes no charge, then no filing is necessary. Modifies the Revised Experience Rating Plan to substantially decrease the incentive for employers to pay their own claims. In addition, this filing served to maintain optimal performance of the experience rating E-1339 Experience Rating Adjustment 07/01/98 DOI 2/17/1998 2/18/1998 plan. The three key changes were: -Reduce the weight on medical only losses. -Increase the weight on excess losses. -Make the split of actual losses between primary & excess to be inflation-sensitive. Clarify and enhance the Basic Manual for Workers Basic Manual Rule & Classification Board B-1343 01/01/98 Compensation and Employers Liability Insurance in the 8/20/1997 8/21/1997 Enhancements Vote rules & classification code sections. Remove carpet, linoleum, vinyl, asphalt, and rubber floor Carpet, Linoleum, Vinyl, Asphalt, tile installation operations from Classification Code 9521- Board B-1346 and Rubber Floor Tile Installation- 01/01/98 House Furnishings Installation NOC & Upholstering and 8/20/1997 8/21/1997 Vote Code 5478 reassigned these operations to newly established Code 5478. Amended the Experience Rating Plan Manual rules related to recalculation of experience modifications when an insurance provider submits revised loss data. An Experience Modification Board E-1332 12/01/97 accompanying filing, (U-1344-WC Statistical Plan; 10/9/1997 10/14/1997 Recalculation Revision of Losses Vote Special Fund & Subrogation Recoveries) provides the necessary changes to the Statistical Plan Manual as a result of Item E-1332. 11/18/2010 13 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Amended the Statistical Plan Manual and the Revised Statistical Plan rules related to submission of revised loss Workers Compensation Statistical data. An accompanying filing, (E-1332-Experience Board U-1344 Plan - Special Fund and 12/01/97 10/9/1997 10/14/1997 Modification Recalculation-Revision of Losses) provides Vote Subrogation Records the proposed changes to the Experience Rating Plan Manual which necessitates the filing of Item U-1344. Remove wholesale automobile parts operation from Code Automobile Parts and Accessories 8010-Store Hardware and assign it to amended Board B-1345 10/01/97 5/9/1997 5/8/1997 Store Operation Classification Code 8046-Store: Automobile Parts and Vote Accessories NOC & Drivers. Establish a new classification procedure for sign manufacturing & installation operations by adding an additional phraseology to Code 9521 - Advertising display service & removing shop operations from Code 9521, Code 9549 - Advertising Co. & drivers, & Code 9552 - Sign Mfg. - erection, repair, or maintenance & Board shop, drivers. Provided a three-year rate/loss cost & Vote on rating value transition for Code 9545 - Bill posting & Store Revisions of Basic Manual B-1335 07/01/97 drivers, Code 9549 & Code 9552 involving a payroll Ops - 11/25/1996 12/2/1996 Classification and Related Rules weighted average of all three codes. Eliminated Codes DOI on 9545, 9549 & 9552 effective 7/1/2000 & combined these sign classification codes into a newly created Code 9554. mfg Also established two new classification codes, one for retail drugstores & the other for retail book, record, compact disc, software, video & audio cassette stores. These businesses are presently classified to Code 8017 - Store Retail NOC. Update the present percentages & factors that apply when increasing the limits of employers liability on a workers compensation and employers liability policy or a policy with Admiralty/FELA coverage. Also contemplates the creation of Appendix E in the Basic Manual, which will contain expanded tables for limits of employers liability & Admiralty/FELA coverage as well as provide for Employers Liability and corresponding minimum premium values. Further, this B-1337 07/01/97 DOI 3/10/1997 3/11/1997 Admiralty/FELA Increased Limits item was intended to clarify the application of the minimum premium for increased limits. It as also intended to provide the proper sequence for the application of the increased limits percentages to reflect the calculation of premium gross of merit rating modification or deductible credits in those states where it is permissible to provide workers compensation coverage on a deductible basis. 11/18/2010 14 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Amended Rule V of the Basic Manual for Workers Comp. & Employers Liab. Ins. to exclude from the definition of Davis-Bacon Wages Placed By An remuneration, payments made by an employer into a Board B-1340 Employer Into Third-Party 07/01/97 3/6/1997 3/7/1997 third-party pension trusts for the Davis-Bacon Act or a Vote Pension Trust similar wage law, provided the pension trust is qualified under IRC Sections 401(a) & 501(a). Amended the Basic Manual to include a general explanation of "wrap-up" & provide more information regarding the proper issuance of policies under the wrap- Board B-1342 Wrap-Up Construction Projects 07/01/97 2/26/1997 2/27/1997 up option. Also added rules to the Experience Rating Vote Plan Manual regarding the definition & administration of Wrap-Up Construction Projects. Eliminated state special classification Code 3075- Elimination of Code 3075 Board O1-IN-97 07/01/97 Coppersmith Shop & reassigned these operations to Code 4/23/1997 5/7/1997 Coppersmith Shop Vote 3315-Brass or Copper Goods Mfg. 1997 Update to Retrospective Update the State and Hazard Group Severity Relativities R-1341 07/01/97 DOI 1/24/1997 1/30/1997 Rating Plan Parameters of the Retrospective Rating Plan for each state. Revise the Articles of Agreement of the National Workers Compensation Reinsurance Pool. The intent of this Proposed Revisions to Articles of revision is to enable increased flexibility of the RM-W-8020 Agreement of the NWCRP 03/05/97 DOI reinsurance mechanism. This will allow variations of the (Withdrawn) current program, based on the local environment needs & as changes occur. Amend the original filing of Item R-1301 and provide Hazard Group assignments for the admiralty Board R-1301(A) Hazard Group Assignments 03/01/97 1/23/1997 1/27/1997 classifications which previously did not have Vote assignments. Repeal the provisions of RM-W-8015(A) related to Other States Insurance and in its place require all assigned carriers to attach the Residual Market Limited Other Residual Market Limited Other States Insurance endorsement to all new and renewal Board P-35 02/01/97 yes 1 10/4/1996 10/8/1996 States Insurance Endorsement assigned risk policies. This endorsement replaced Part Vote Three-Other States Insurance of the Workers Compensation & Employers Liability Policy with the language contained in the endorsement. Revise the previously filed Item P-35-Residual Market Residual Market Limited Other Limited Other States Insurance Endorsement. This item Board P-35(A) States Insurance Endorsement 02/01/97 yes 1 12/31/1996 1/8/1997 supersedes the Item P-35 filing which was previously Vote (Amended) submitted. Amend the Other States Insurance provision under the Workers Compensation Insurance Plan Supplement - Residual Market Limited Other Board RM-W-8018 02/01/97 Additional Coverage's Under the WCIP. This filing is yes 1 10/4/1996 10/8/1996 States Vote made in conjunction with Item P-35-Residual Market Limited Other States Insurance Endorsement. 11/18/2010 15 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Eliminated certain admiralty classifications & their phraseologies be continued as cross-references with Revisions of Basic Manual other admiralty classifications that will not be eliminated. Board B-1333 01/01/97 8/19/1996 8/21/1996 Classifications and Related Rules This filing also established new Basic Manual Rule IV-D- Vote 13 to clarify the classification procedure for recycling operations. Revise the Workers Compensation Insurance Plan (WCIP) Workers Compensation Insurance Board RM-W-8019 01/01/97 to establish a procedure for securing an effective date yes 1 1/16/1997 1/23/1997 Plan - Securing an Effective Date Vote based upon the mail submission option. Amends the schedule rating rules in the Experience 02-IN-96 Schedule Rating 12/01/96 Rating Plan Manual. Removal of Roller-Skating Rink Operation from Code 9016-Amusement Park or Exhibition Operation & Drivers and assign it to Code 9093-Bowling Lane; amended Basic Revisions of Basic Manual Manual Rule V-B.2.p. to clarify the collection of Board B-1331 10/01/96 6/17/1996 Classifications and Related Rules remuneration under this rule & established two new Vote classifications for trucking operations, which will eliminate & replace Code 7219 - Trucking - NOC - all employees & drivers. Established two new classifications for child day care center operations & non-specialty child day camp operations, established three new classifications for contractors engaged in telephone or cable TV line installation, established a new Standard Exception Revisions of Basic Manual classification, Clerical Telecommuter Employees & Board B-1330 07/01/96 10/3/1995 3/15/1996 Classifications & Related Rules amended Basic Manual Rule IV-E-2, Interchange of Vote Labor, to address the treatment of the new code. Also, established a new professional employees classification for buildings operation & amended the current classification phraseologies of Code 9015 & established two new classifications for casino gambling operations. Elimination of Chemical and Eliminate the Chemical and Dyestuff Rating Plan (CDRP) Dyestuff Rating Plan (CDRP) - and in its place establish two classifications for risks Board B-1334 07/01/96 3/8/1996 3/8/1996 Establishment of Two engaged in chemical operations which are not otherwise Vote Replacement Classifications classified in the Basic Manual. Update the (Revised) Retrospective Rating Plan for the 1996 Update to Retrospective effect of loss size inflation, which varies by state. This is Board R-1329 07/01/96 1/24/1996 3/22/1996 Rating Plan Parameters accomplished by update of the State and Hazard Group Vote Severity Relativities. Endorsement permits an insurer to provide coverage in Residual Market Multiple Board P-29 06/01/96 additional states through companies within the same yes 1 2/2/1996 2/5/1996 Company Endorsement Vote carrier group, either at policy issuance or mid-term. Simplify and modernize the Basic Manual for Workers Revised Basic Manual for Workers Compensation and Employers Liability Insurance. Board B-1327 Compensation and Employers 04/01/96 7/3/1995 7/17/1995 Several rule changes have been incorporated in this Vote Liability Insurance filing. Amend Sections II and III of the Indiana Workers RM-01-IN-96 Amendments to Indiana WCIP 04/01/96 DOI yes 1 5/21/1996 5/21/1996 Compensation Insurance Plan. 11/18/2010 16 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Revise the WCIP to support the new Residual Market Application Processing System (RMAPS) & clarified items previously established in Item RM-W-8017. Upon receipt Revised Workers Compensation Board RM-02-IN-95 04/01/96 of the deposit monies within the requested time frames, yes 1 12/14/1995 12/15/1995 Insurance Plan (Amended) Vote coverage may be bound no earlier than 12:01 a.m. on date following receipt of the completed signed application. Effective concurrently with Item RM-W-8017: Revised Indiana Workers Compensation Workers Compensation Insurance Plan. Revised ACORD Board RM-03-IN-95 Insurance Plan - Revised ACORD 04/01/96 yes 1 11/20/1995 11/27/1995 133 assigned risk application form & eliminated the Vote 133 Application Supplemental Truckers Application. Revise the Workers Compensation Insurance Plan (WCIP or Plan) to support a new application processing Revised Workers Compensation Board RM-W-8017 04/01/96 workflow as well as to clarify items previously yes 1 6/13/1995 6/16/1995 Insurance Plan Vote established in the Restructured Workers Compensation Insurance Plan (Item W-8014). Revise the explanatory wording to Indiana state special Board O1-IN-96 Revised Wording for Code 7699 02/14/96 Code 7699, Firefighters-Medical Only & Drivers to include 2/14/1996 2/14/1996 Vote reference to volunteer firefighters. Updates the premium discount program which tailors manual premium to reflect equitable expense provisions Revised Premium Discount by size of policy. The last premium discount update was Board B-1318 01/01/96 2/7/1995 8/15/1995 Program based on calendar year 1982 expenses and premiums by Vote size of policy. This filing is based on data from calendar year 1991. Create three separate classifications for restaurant Board B-1328 Restaurant Classifications 01/01/96 operations which will replace and eliminate Code 9079. 10/23/1995 10/26/1995 Vote (Codes 9082, 9083 & 9084). Item B-1318 (Revised Premium Discount Program) was recently approved in Indiana. The Premium Discount Endorsement is intended to reflect the revised premium Board None Premium Discount Endorsement 01/01/96 11/29/1995 11/30/1995 discount schedule & to inform policyholders of their Vote eligibility for premium discounts under the revised program. Workers Compensation Statistical Establish the revised procedures for the reporting of Board U-1336 01/01/96 3/22/1996 3/29/1996 Plan Revisions Workers Compensation Statistical Plan data elements. Vote Workers Compensation Insurance Amend Part Three - Other States Insurance of the Board P-33 10/01/95 yes 1 8/16/1995 8/21/1995 Plan - Other States Endorsement Workers Compensation and Employers Liability Policy. Vote Real Estate Appraisal Companies- Establish Code 8721, a new classification for real estate Board B-1325 07/01/95 5/16/1995 5/22/1995 Outside Employees-Code 8721 companies. Vote 1995 Update to Expected Loss Update the (Revised) Retrospective Rating Plan for the Size Ranges for Entry into the effect of loss size inflation. Size inflation varies by state, Board R-1316 Table of Insurance Charges & 07/01/95 12/15/1994 5/31/1995 and this is reflected in the update of the State and Vote Update to Retrospective Rating Hazard Group Severity Relativities. State & Hazard Group Relativities Manually rate six A-rated Codes and discontinue one Board B-1323 A-Rate Procedure Elimination 05/01/95 3/28/1995 3/28/1995 code. Vote 11/18/2010 17 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Adds new classification wording or amends wording of various classifications. Facilitate the proper classification of risks, correct inconsistencies in the inclusion or Changes in the Basic Manual exclusion of drivers in various cross-reference Board B-1321 04/01/95 2/14/1995 2/16/1995 Classifications and Footnotes phraseologies under the same class code, & discontinue Vote the requirement in certain classification wordings that the code be authorized by the rating organization before being used. Eliminate certain classifications of WC business which are Revision of Basic Manual Board B-1322 04/01/95 too small to develop meaningful data for ratemaking 1/19/1995 1/23/1995 Classifications Vote purposes. By withdrawing Item E-1324, simple one rule applies in Withdrawal of Item E-1324 Indiana: an employer may allow access to the experience Experience Rating Plan - E-1324 03/01/95 rating worksheet by submitting a letter of authority to DOI 12/18/1995 12/19/1995 Distribution of Experience Rating the ICRB. This withdrawal filing eliminated the Worksheet distribution of rating worksheets annually to employers. Quick Printing-Copying or Introduce Code 8015, a new separate and distinct Board B-1320 Duplicating Service-All Employees 02/01/95 11/17/1994 11/28/1994 classification for the quick printing industry. Vote & Clerical, Salespersons, Drivers Revise Hazard Group assignments for certain classifications and provide Hazard Group assignments for R-1301 Hazard Group Assignments 01/01/95 DOI 6/10/1994 6/13/1994 some classifications, which previously did not have an assignment. State special Basic Manual rule be established to provide for the inclusion of coverage for eligible members or Members of a Limited Liability O3-IN-94 11/01/94 managers of limited liability companies. Also, that the DOI 9/29/1994 10/3/1994 Company (LLC) payroll limitations applicable to partners or sole proprietors appearing in the state Establish the additional coverage's that will be made available under the Workers Compensation Insurance Additional Coverage's Under The Plan (Plan) in accordance with part (c) of the definition W-8015 Workers Compensation Insurance 10/01/94 for "workers compensation insurance" found in Section I DOI yes 1 6/22/1994 6/29/1994 Plan of the Plan. Additionally, this filing established a standard charge for waiver of subrogation under the Plan. Amendment to the original item's language regarding "Other States Insurance". The amendment makes provision of this coverage, where requested, a requirement on the assigned carrier in those Plan states Amended - Additional Coverage's where the amended language is approved. Further, this W-8015 (A) Under The Workers 10/01/94 DOI yes 1 9/29/1994 3/15/1995 amendment provides that any payment under Other Compensation Insurance Plan States Insurance be in the nature of indemnification, i.e., as indemnity against loss rather than against liability; therefore, carrier licensure should not be an obstacle to provision of this coverage. 11/18/2010 18 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Workers Compensation Insurance Revised ACORD 133 form and instructions will replace None Plan - Revised ACORD 133 09/06/94 DOI yes 1 9/6/1994 the ACORD 133 form and instructions currently in use. Application and Instructions Create a mandatory assigned risk retrospective rating program for employers having residual market premium Assigned Risk Mandatory Loss equal to or exceeding $200,000. This rating program, O2-IN-94 09/01/94 DOI yes 1 2/25/1994 4/4/1994 Sensitive Rating Plan (LSRP) the Loss Sensitive Rating Plan (LSRP), is designed to depopulate the residual market, and to promote safety & loss control, & provide fairness. A new classification Code 5536-Heating and Air Heating and Air Conditioning Conditioning Duct Work-Shop and Outside-& Drivers, be B-1313 Duct Work - Shop and Outside -- 07/01/94 DOI 4/14/1994 4/15/1994 erected for all types of air conditioning/heating duct work & Drivers fabrication and installation. 1994 Update to Expected Loss Update the (Revised) Retrospective Rating Plan for the Size Ranges for Entry into the effect of loss size inflation. Size inflation varies by state, R-1304 Table of Insurance Charges & 07/01/94 DOI 11/19/1993 2/8/1994 and this is reflected in a concomitant update in the State Update To Retrospective Rating and Hazard Group Severity Relativities. State & Hazard Group Relativities Revised USL&HW Excess Loss R-1310 07/01/94 Update the current USL&HW Excess Loss Factors. DOI 1/25/1994 1/25/1994 Pure Premium Factors Amend Basic Manual Rule VI-F-5 to reflect that the Minimum Premium Charges minimum premium for Code 8810 is the premium to be B-1308 Applicable To Which No Exposure 04/01/94 charged for a policy where no remuneration or other DOI 2/3/1994 2/3/1994 Is Developed basis of premium is developed during the term of the policy. Basic Manual Rule VIII-F, be amended to provide for additional flexibility in writing this type of business. No B-1312 Wrap-Up Construction Projects 04/01/94 specific premium requirement for risks; multiple DOI 2/17/1994 2/22/1994 locations and projects; and no project duration requirement would be permitted. Filing Program - Extension of Endorsement Effective Period - Extension of the effective period of Amendatory Board P-28 04/01/94 3/23/1993 3/23/1993 Amendatory Endorsement - WC Endorsement - WC 00 03 18 Vote 00 03 18 Classification Code 5223 be amended to remove "All Operations" from the phraseology & to allow a division of Swimming Pool payroll between Codes 5223 & 9014 for one entity. This B-1307 Construction/Maintenance 03/01/94 would require that the operations described by DOI 2/3/1994 2/3/1994 Operations Classification Codes 5223 & 9014 are conducted by separate crews with no interchange of labor & separate payroll records are maintained. Special Indiana Classification For Provide an Indiana special classification and rate for O1-IN-94 03/01/94 DOI 2/14/1994 2/14/1994 Roistered Volunteers "Rostered Volunteers". Clarify the instructions for the reporting of corrections Procedures for Reporting when subrogation recoveries are received and when U-1306 Subrogation and Special Fund 02/01/94 special fund recoveries are anticipated or received. The DOI 8/19/1994 11/15/1994 Recoveries change ensured a more consistent reporting of statistical data. 11/18/2010 19 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Indiana Workers Compensation Initial premium is determined by taking a percentage of O1-IN-93 Insurance Plan - Initial Premium 01/01/94 the estimated annual premium. This percentage varies DOI yes 1 11/9/1993 11/10/1993 Requirements with the amount of the estimated annual premium. Add greater flexibility to the Retrospective Rating Plan, while retaining the principles of actuarial balance. The Retrospective Rating Filing R-1293 10/01/93 major change is the addition of an alternate allocated DOI 4/7/1993 5/17/1993 Flexibilities loss adjustment expense option (ALAE Option) allowing inclusion of actual ALAE with loss. Workers Compensation Insurance Replace the current state-specific WCIP application form A-8016 Plan - Implementation of ACORD 07/16/93 with generic ACORD application forms - 130 and 133 in DOI yes 1 7/1/1993 7/19/1993 Application Forms this state. Establish a new classification Code 9516 (Electronic Electronic Entertainment Devices - Entertainment Devices) be erected for the installation, B-1298 07/01/93 DOI 3/8/1993 3/11/1993 Installation, Service or Repair service or repair of electronic entertainment devices including radio, television, video and audio equipment. Basic Manual Rule VII-E-1 be revised to clarify the original intent of the combination of policies for premium discount. Under the proposed rule change, multiple Premium Discount - Combination policies issued to the same insured by one or more B-1299 07/01/93 DOI 3/8/1993 3/11/1993 of Policies insurance carriers under the same management shall be combined for the purpose of computing the premium discount for the subject insured unless the insured instructs the carrier to the contrary. Basic Manual Rule V-B be revised to consolidate all Premium Basis - Revision to Basic remuneration inclusion and exclusion schedules found in B-1300 07/01/93 DOI 3/8/1993 3/11/1993 Manual Rule V both the Premium Audit Reference Book and in the Basic Manual to provide more uniformity of language. 1993 Update to Expected Loss Size Ranges for Entry into the Update the (Revised) Retrospective Rating Plan for the R-1294 Table of Charges and Update to 07/01/93 DOI 10/21/1992 3/4/1993 effect of loss size inflation. Retrospective Rating State and Hazard Group Relativities Establish a restructured Workers Compensation Insurance Plan (WCIP or Plan) which (1) provides greater regulatory oversight and scrutiny for Plan activities Restructured Workers including the reinsurance aspects of the Plan; (2) W-8014 02/01/93 DOI yes 1 1/22/1993 1/29/1993 Compensation Insurance Plan strengthens the monitoring & enforcement of servicing carrier performance of maximize efficiencies in the operation of the assigned risk plan; & (3) provides for a self-funded residual market. Expansion of the Large Risk Alternative Rating Option to include multiple line rating plans. This includes any Large Risk Alternative Rating R-1295 01/01/93 combination of workers compensation, general liability, DOI 11/6/1992 12/1/1992 Option/Multiple Lines hospital professional liability, automobile physical damage, crime and glass coverage. 11/18/2010 20 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Establish the proposed definition of allocated loss adjustment expenses (ALAE), which emphasizes the Definition of Allocated Loss U-1292 01/01/93 function of claims adjusting irrespective of who performs DOI 11/30/1992 12/4/1992 Adjustment Expenses the function (the carrier or an outside vendor). Refer to WC Statistical Plan Part IV, page 21 through 24. Amend the rules of the Retrospective Rating Plan Manual Retrospective Rating Filing which provide for the filing of individual risk R-1291 12/01/92 DOI Requirement - Revised Procedure retrospective rating plan values for approval by the rating organization, but on a specific-request basis only. New code classifications necessitates this amendment to incorporate these codes into the Deductible Hazard Table Deductible Program Amendment None 11/30/92 found in the Indiana State Special pages of the Basic DOI Hazard Tables Update Manual for Workers Compensation and Employers Liability. Codes 5472, 5473 and 7232. Establish Basic Manual rules designed to afford equitable Basic Manual Changes or B-1289 10/01/92 treatment for insureds in the addition or deletion of DOI Corrections In Classifications classifications to a policy after the inception of the policy. Establish Basic Manual and Experience Rating Plan Migrant and Seasonal Agricultural B-1290 10/01/92 Manual rules for providing Migrant and Seasonal DOI Worker Protection Act Coverage Agricultural Worker Protection Act coverage. Update to Retrospective Rating Update the State and Hazard Group Relativities of the Board R-1279 State and Hazard Group 10/01/92 (Revised) Retrospective Rating Plan, in those states that Vote Relativities have approved Item R-1259(A). Amended, eliminated & added classification phraseologies in the "C" section, & amended Rule IV-B-2- Phraseology Modernization - Board B-1285 09/01/92 c in the Basic Manual for WC & Employers Liability Basic Manual Vote Insurance be added to identify modern business operations found today. Discontinue the $1.00 per day premium charge for strike Detective or Patrol Agency duty as presently stipulated in the footnote under B-1287 09/01/92 DOI Changes for Strike Duty Classification Code 7720 in the Basic Manual for Workers Compensation and Employers Liability Insurance. Discontinue the current Workers Compensation Strike Duty Premium & Loss Statistical Plan procedures for reporting the strike duty U-1288 09/01/92 DOI Reporting Instructions premium charge under Statistical Code 0111 for Classification Code 7720. Asbestos Removal Operations Code number for Asbestos Contractor-Pipe and Boiler B-1280 07/01/92 DOI (Amended) Work Exclusively be changed from 5184 to 5472. Division of Single Employee's Basic Manual Rule IV-E-2 be amended to delete the Payroll Between restrictive word "such" from this rule. Further, that Rule Construction/Erection B-1281 07/01/92 IV-E-2 be amended to indicate that Code 8810 (Clerical) DOI Classifications and Non- and Code 8742 (Outside Salespersons) are not available Construction/Erection for division of payroll under this rule. Classifications 11/18/2010 21 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Eliminate present inconsistencies in Code 0042 and Code Code 0042-Landscape Gardening 9102 footnotes in regard to division of payroll for & Drivers vs. Code 9102-Lawn insureds engaged in both landscaping and lawn Board B-1284 07/01/92 Maintenance-Commercial or maintenance operations and to permit division of a single Vote Domestic & Drivers employee's payroll between such classifications provided proper payroll records are maintained. Numerous classification changes have been made since None Deductible Program Amendment 07/01/92 the inception of the Deductible Program necessitating a DOI change in the classification schedule. Filing Program - Revised Policy and Endorsement Forms - Endorsement used to permit insureds to purchase P-27 Migrant and Seasonal Agricultural 07/01/92 coverage for damages payable under the Migrant and DOI Worker Protection Act Coverage Seasonal Agricultural Worker Protection Act (MSAWPA). Endorsement - WC 00 01 11 1992 update to Expected Loss Update the Retrospective Rating Plan for the effect of Board R-1274 Size Ranges For Entry Into The 07/01/92 loss size inflation since the last such filing. Vote Table of Insurance Charges Add rules and four endorsements for employee leasing B-1276 Employee Leasing Arrangements 04/01/92 arrangements. Adds rules to ER Plan Manual, Basic DOI Manual, & Policy Forms Manual. Assigned Risk Cancellation Basic Manual be amended to reflect the assigned risk Premium Determination cancellation premium determination exception with Board B-1278 Exception-Insured Obtains 04/01/92 yes 1 respect to cancellation for reasons of securing coverage Vote Coverage Through the Voluntary through the voluntary market. Market Basic Manual Changes to Implement changes made in the WC & Employers Liab Accommodate Revisions in the Insurance Policy & related policy forms endorsements as B-1286 Workers Compensation and 04/01/92 DOI provided for in Item filing P-28 (WC & Employers Liab Employers Liability Insurance Ins Policy - WC 00 00 00 A). Policy Codes 8824 (Retirement Living Centers: Health Care Employees), 8825 (Retirement Living Centers: Food Board B-1268 Retirement Living Centers 01/01/92 Service Employees) and 8826 (Retirement Living Vote Centers: All Other Employees & Salespersons, Drivers) be established. Footnote to Code 8755 (Labor Union - All Employees) be Labor Unions Charges For Strike amended to remove references to additional premium for Board B-1272 01/01/92 Duty strike duty as well as eliminate parameters defining a Vote strike period. Provides a revised procedure for determining short rate Short Rate Cancellation premiums. Alternative short rate cancellation table Board B-1273 01/01/92 Basic Manual Rule X-D Appendix D of the Basic Manual limited to policies written Vote for a one-year period. Developed to encourage insurance carriers to take an None Take Out Credit Program 01/01/92 DOI yes 1 active role in depopulating the residual market. Not a change in Plan language. The Plan will be in both Workers Compensation Insurance the Basic Manual for Workers Compensation and None Plan (WCIP) - Inclusion in the 01/01/92 DOI yes 1 Employers Liability Insurance and the National Pool Basic Manual Handbook. 11/18/2010 22 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Amended Indiana Workers None 01/01/92 Corrections made under Item 5, 6 and 9 DOI yes 1 Compensation Insurance Plan Rules and endorsements to implement the deductible None Deductible and Co-Insurance 01/01/92 and co-insurance program as approved by the Indiana DOI General Assembly. Carriers will no longer collect or record the total Strike Duty Premium and Loss employee days (non payroll exposure), strike duty Board U-1275 01/01/92 Reporting Instructions premium or corresponding losses on the unit report for Vote labor union members engaged in strike duty. Equitably price retrospective rating when there are Retrospective Rating Severity differences in expected loss severity of individual Board R-1259(A) 12/01/91 Adjustments insureds selecting the plan. Secondly, introduce a new Vote retrospective rating option for large risks. Basic Manual Rule IX-C.3 be amended to provide that the additional premium charged on the policy of an insured contractor for the operators provided with mobile Remuneration For Subcontractors- Board B-1267 09/01/91 equipment by an uninsured subcontractor, in the Mobile Equipment With Operators Vote absence of payroll records, be calculated utilizing a payroll amount for the operators which shall not be less than 33-1/3% of the subcontract price. Trucking: Mail, Parcel or Package Delivery-Under Contract With The Introduce a new separate and distinct classification for Board B-1269 09/01/91 U.S. Postal Service-All Employees U.S. Postal Service contract mail haulers. Vote & Drivers (Code 7232) Voluntary Compensation and Employers Liability Coverage Endorsement - WC 00 03 11 A. The language Filing Program - Revised Policy & Board P-26 08/01/91 of the endorsement be changed to specifically reflect the Endorsements Forms Vote intent of its originators and that the phrase "arising out of and" be added to A.2. Update Part Four-B of the Retrospective Rating Plan Update to Expected Loss Size Manual, The Table of Expected Loss Ranges for entry into Board R-1266 Ranges for Entry Into The Table 07/01/91 the Table of Insurance Charges. The new ranges may be Vote of Insurance Charges found in Exhibit II. General Information Page Notes - WC 00 00 01 A. The General Information Page Notes have been amended to include a note which permits carriers showing a renewal Filing Program - Revised Policy & agreement statement on the Information Page or Board P-24 06/01/91 Endorsements Forms entering into a renewal agreement not shown on the Vote Information Page to list any or all endorsements in Item 3.D, elsewhere on the Information Page, or in an Information Page Schedule. Migrant & Seasonal Agricultural Worker Protection Act Filing Program - Revised Policy & Exclusion Endorsement-WC 00 01 00. An endorsement Board P-25 05/01/91 Endorsements Forms be approved to explicitly exclude damages under the Act Vote from coverage under the policy. Transmittal Letter Reporting Revise and simplify the transmittal letter used to submit Board U-1270 05/01/91 Instructions hard copy unit reports. Vote 11/18/2010 23 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Amends the Experience Rating Plan Manual to provide for Experience Rating Plan - Revision recalculation of an experience modification if a revised E-1264 of Losses Due to Special Fund 01/01/91 unit report is filed due to a carrier's paid or anticipated Reimbursement recovery from a special fund as defined in the Statistical Plan Manual. Removal of additional medical coverage from Indiana Removal of Additional Medical None 01/01/91 Special Classification due to change in the Indiana DOI Charge statutes. Expand the use of the statistical code 9849 currently used to designate the additional premium required to Revised Definition Statistical Board U-1262 01/01/91 balance the minimum premium for Admiralty and/or Code 9849 Vote FELA coverage. This applies to both standard & increased limits. To document additional Workers Compensation Exposure and Premium Reporting Board U-1271 01/01/91 Statistical Plan reporting requirements for no exposure Instructions Vote unit reports, on hard copy or magnetic tape mediums. Provide necessary review and audit information on WCIP Application - Supplemental employee leasing assigned risks by requesting applicants Information and Rearrangement A-8009 11/01/90 to declare their status as concerns which lease out DOI yes 1 and Supplemental Employee employees or which lease their employees from another Leasing Application firm. Trucker Supplemental None Application, including Guide for 11/01/90 yes 1 Completion Update the pension tables contained in the Workers Compensation Statistical Plan Manual using the 1979- Workers Compensation Statistical 1981 U.S. Decennial Life Tables. In addition, a Pension Board U-1260 10/01/90 Plan Manual - Part XII Tables Table Guide was developed to assist carriers in locating Vote the proper table to use when reserving claims for Survivorship Benefits. Plan be amended to require the employer or his representative to include with and as a part of the application a copy of the employer's latest filed federal Board W-8002 (A) WCIP - Payroll Verification 09/01/90 employer 941, 941E, 942 or 943 form or equivalent state yes 1 Vote or federal-required verifiable current payroll record, or notarized explanation as to why no such record is available. Plan be amended to specify that an offer of any reasonable rating plan approved for use in this Workers Compensation Insurance Board W-8003 (A) 09/01/90 jurisdiction shall be deemed an offer of insurance in a yes 1 Plan - Applicant Eligibility Vote regular manner and that disputes arising thereunder shall be resolved under the Plan. The rules of the Experience Rating Plan Manual be modified to provide, with limited exception, for the Change of Ownership continued use of experience of an entity undergoing an Board E-1261 07/01/90 Rules/Transfer of Experience ownership change. The continued experience would Vote generally be transferred to the acquiring, surviving or new entity. 11/18/2010 24 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Updated Part Four-B of the Retrospective Rating Plan Update to Expected Loss Size Manual, the Table of Expected Loss Ranges for entry into Board R-1257 Ranges For Entry Into The Table 07/01/90 the Table of Insurance Charges. The new ranges may be Vote of Insurance Charges found in Exhibit II. Establish Loss Coverage Codes which will allow for the identification of claims involving Workers Compensation Board U-1258 Revised Loss Coverage Coding 07/01/90 or Employers Liability benefits exclusively, as well as Vote those claims which contain both Workers Compensation and Employers Liability benefits. Revision To The Workers None Compensation Insurance Plan In 05/01/90 Rule 13 was changed and Rule 14 was deleted. yes 1 The State of Indiana Amended Indiana Application For WCIP Application amended to include the 25% surcharge None 01/03/90 DOI yes 1 Workers Compensation Insurance on risks with premium in excess of $2,000. Establish rules restricting the application of increases in Application of Late Experience experience modifications issued after the rating effective Board E-1255 Modifications/Contingent 01/01/90 date. It also establishes rules for the calculation of Vote Modifications experience rating modifications using the available portion of the data currently used. Statistical Codes 0133 & 0179 Establish two unique statistical codes for reporting For Reporting Supplemental supplemental disease experience in connection with Disease Experience in Connection Board U-1246 01/01/90 asbestos exposure and supplemental disease experience with Asbestos Exposure and Vote in connection with exposures not otherwise classified Exposures Not Otherwise (NOC). Classified - (NOC) Classification footnote phraseology for Code 8039 be Store: Department - Retail (Code updated to increase the minimum payroll requirement to Board B-1252 12/01/89 8039) reflect inflationary trends, and to amend the types of Vote merchandise handled. Establish a new classification Code 8061 (Store: Grocery- Store: Grocery-Convenience- Convenience-Retail) and to amend the classification Board B-1253 Retail (Code 8061) and Store: 12/01/89 footnote phraseology for Code 8006 (Store: Grocery- Vote Grocery-Retail (Code 8006) Retail). Proposed that Basic Manual Rule IV-B.4. be amended to Employer Operated Day Care Board B-1254 12/01/89 indicate that employer operated day care services are Services - General Exclusions Vote general exclusions. The following wording was added to the WCIP: The Revision To The Workers Indiana Governing Committee shall have jurisdiction over None Compensation Insurance Plan In 10/01/89 appeals from insureds and carriers on Plan matters. DOI yes 1 The State of Indiana Such Committee shall also review and prescribe operating rules and amendments for this Plan. Schedule Rating Table filed in accordance with Senate None Schedule Rating Table 09/01/89 DOI Bill 542. 11/18/2010 25 1f4cc652-8371-454e-9dce-450abf69c40b.xls Board Effective Assigned AR Received Filed by Item # Title of Filing Brief Description Vote or NCCI Circular Date Risk count at DOI DOI DOI Update to Expected Loss Size Update the Retrospective Rating Plan for the effect of Board R-1250 Ranges for Entry Into The Table 07/01/89 loss size inflation since 1988. Vote of Insurance Amend the footnote for Code 7370 (Taxicab Co. All Other Taxi Cab Company All Other Employees & Drivers) to clarify that only vehicles leased Board B-1249 05/01/89 Employees & Drivers (Code 7370) or rented to others shall be subject to the per vehicle Vote upset payroll amount. Revised WCIP Information None 05/01/89 Revised WCIP Handbook DOI yes 1 Procedures Handbook Indiana WCIP Supplemental Board None 05/01/89 Indiana WCIP Trucker Supplemental Applications. yes 1 Applications Vote Language be added to the first paragraph to provide "If Revised Filing Program Policy & an entry is shown in Item 3 of the Schedule the Endorsement Forms - Alternate Board P-20 02/15/89 insurance afforded by this endorsement applies only to Employer Endorsement - WC 00 Vote work you perform under the contract or at the project 03 01A named in the Schedule". Proposes that the current retrospective rating plan Tax Revised Retrospective Rating Tax Board R-1244 01/01/89 Multiplier be updated to include a new provision for Multiplier Vote assigned risk subsidy. Employers Liability Increased Establish statistical code 9840 to be used when coding Board U-1248 Limits-Admiralty or FELA over 01/01/89 Employers Liability Increased Limits-Admiralty or FELA Vote $5,000-Statistical Code 9840 over $5,000. Total Filings 241 Total Assigned Risk Filings 55 Percent Assigned Risk Filings of Total 23% Notes: 1. Column titled "Board Vote or DOI" indicates if a filing was first reviewed by the the ICRB Governing Board for a vote prior to the ICRB submitting a filing to the Indiana Department of Insurance (DOI). Typically, filings that are rate sensitive go straight to the DOI without a mail vote. This is done to assure compliance with anti-trust law. 2. Column titled "Assigned Risk" indicates if the filing dealt with assigned risk plans or rules. 3. Notice additional tabs in spreadsheet (please see below). 11/18/2010 26 1f4cc652-8371-454e-9dce-450abf69c40b.xls New Code Description Previous Code Filing Effective 1/1/1996 9082 Restaurant NOC 9079 B-1328 9083 Fast Food - no alcohol or servers 9079 B-1328 Bar - greater than 50% alcohol receipts 9084 9079 B-1328 note: code 9058, Hotel Restaurant still in use Effective 7/1/1996 8869 Child Day Care Centers & Camps-Professionals 8868 B-1330 9059 Child Day Care Centers & Camps-Others & D 9101 B-1330 7611 Telephone & Cable TV Line Install - Underground 6325 & 7601 B-1330 7612 Telephone & Cable TV Line Install - Overhead 7601 B-1330 7613 Telephone & Cable TV Line Install - Service 7600 B-1330 8871 Clerical Telecommuter 8810 B-1330 Buildings - Pros, Mgrs, Lease Agents & CS 9012 9015 B-1330 note: code 9015 still applies to all other employees 9062 Casino Gambling & CSD 9061 B-1330 9044 Casino - Hotel & CSD 9052 B-1330 Chemical & 4828 Chemical Mixing or Blending NOC & D Dyestuff Rating B-1334 Plan 4829 Chemical Mfg. NOC & D B-1334 Effective 10/1/1996 9093 Roller-Skating Rink 9016 B-1331 Trucking Local hauling only-all employees & D 7228 7219 B-1331 within radius of 200 miles of base terminal Trucking Long distance hauling-all employees & D 7229 7219 B-1331 outside radius of 200 miles of base terminal Effective 1/1/1997 (combination of admiralty codes: maintained 3, deleted 18) B-1333 7019 Vessels, Admiralty Law, Program I Various B-1333 7027 Vessels, Admiralty Law, Program II - State Act Benefits Various B-1333 7062 Vessels, Admiralty Law, Program III - LHWCA Benefits Various B-1333 Effective 7/1/1997 Store Drug - Retail (at least 40% prescription receipts; 8045 8017 B-1335 less than 50% food service receipts) Store: Book, Record, CD, Software, Video or Audio Cassette - Retail 8072 (not for stores with more than 50% receipts in food service, musical 8017 B-1335 instruments, computers, hardware, or household/electronic equipment) Effective 10/1/1997 Store: Automobile Parts & Accessories NOC & D 8046 8010 B-1345 (wholesale was 8010, now 8046) Effective 1/1/1998 5478 Carpet, Linoleum, Vinyl, Asphalt, or Rubber Floor Tile Installation 9521 B-1346 Effective 7/1/1998 4771 Explosives or Ammunition Mfg NOC & D Various B-1347 8006 Grocery - Retail (eliminate 8061 Grocery Convenience; combine w/ 8006) 8061 B-1348 Effective 1/1/1999 7422 Patrol photography, mapping or survey work: Flying Crew 7418 2172 Cigar Mfg 2177 4279 Wallpaper Mfg 4301 Effective 7/1/2000 Sign installation, maintenance, repair, removal, or replacement NOC 9554 9545, 9549 & 9552 away from shop & D (Item B-1335) 9516 Television, Video, Audio & Radio Equipment-installation, service or repair Effective 1/1/2006 5537 Heating, Ventilation, A/C & refrig system install, service & repair & D Various B-1391 Automobile Recycling & D 3821 None B-1391 Note: National rule allows code 8046 for store employees. Indiana will not adopt this change consistent with Basis Manual Rule 1.A.2. See Item B-1391 Effective 7/1/2007 7710 Firefighters & Drivers 7704 B-1397 Firefighters & Drivers - Volunteer 7711 7704 B-1397 Note: 7699 Fighters - Med Only & D continues as an Indiana special code 7705 Ambulance Service & EMS (Emergency Medical Service) Providers & Drivers 7370 B-1397 2709 Logging or Tree Removal - Mechanized Equipment Operators B-1397 2701 Logging or Tree Removal - Log Hauling & D B-1397 Effective 1/1/2008 8864 Social Services Organization 8861 & 9110 B-1387 8842 Group Home 8861 & 9110 B-1387 7720 Juvenile Detention Center 8861 & 9110 B-1387 2157 Bottling 2156 B-1387 Effective 1/1/2010 8869 Child Care Services 9059 B-1408 8602 Surveyors 8601 B-1408 8603 Architectural or Engineering Firm—Clerical 8810 B-1408 8725 Inventory Counters 8803 B-1408 7402 Air Traffic Controllers 7402 B-1418 Effective 1/1/2011 6503 Potato Chip, Popcorn & Snack Chip Mfg. NOC 6504 B-1409 Manufactured, Modular, or Prefabricated Home Manufacturing —Shop Work & 2797 B-1410 Drivers 2797 state special Manufactured, Modular, or Prefabricated Home Setup, Hookup, or Installation 2799 B-1410 at Building Site 7228, 7229 & 8380 8037 Store—Superstores and Warehouse Clubs 8017 or 8039 B-1412 4109 Integrated Circuit Mfg 4150 B-1413 Legend: C = Clerical; S = Salesperson; D = Driver Notes Source: ICRB files as of 10/23/09 Also see "Class Code Changes" tab Also see CompClues document "New Class Codes" 11/18/2010 1f4cc652-8371-454e-9dce-450abf69c40b.xls Indiana Class Code Changes Effective 1/1/06 and after Code General Category Action Filing Effective 2576 Bag or sack mfg Eliminate & merge into 2501 B-1391 1/1/2006 2578 4308 Linotype printing Eliminate & merge into 4299 B-1391 1/1/2006 2150 Ice mfg Eliminate & merge into 8203 B-1391 1/1/2006 8050 Five & dime store Eliminate & merge into 8017 B-1391 1/1/2006 9083 Restaurant Update phraseology to include alcohol B-1391 1/1/2006 8721 Stop use of code 8742 as not applicable to Real estate appraisal B-1391 1/1/2006 8742 appraisal company 5191 Commercial restaurant equip installation Update phraseologies, delete old phrases B-1391 1/1/2006 9519 Update phraseology, add Indiana exception that 3821 Auto recycling B-1391 1/1/2006 8046 not available for store employees 5536 Eliminate & merge into 5537 5537 Heating a/c contractor (HVACR) New "Heating, Ventilation, A/C & refrig system B-1391 1/1/2006 install, service & repair & drivers" 4360 4431 Audio or visual recording media mfg Update phraseologies, delete old phrases B-1394 1/1/2006 4923 5703 Building raising or moving Update phraseologies, delete old phrases B-1394 1/1/2006 2041 Candy, chocolate & confection mfg Update phraseologies, delete old phrases B-1394 1/1/2006 6003 Dock & seawall construction Update phraseologies, delete old phrases B-1394 1/1/2006 6005 5606 Contractor executive supervisor Update conditions for use of code B-1394 1/1/2006 5221 5348 Floor coverings installation Update phraseologies, delete old phrases B-1394 1/1/2006 5437 5478 2014 Grain milling mfg Update phraseologies, delete old phrases B-1394 1/1/2006 2016 8835 Home health care Update phraseologies, delete old phrases B-1394 1/1/2006 2105 2112 Juice mfg Update phraseologies, delete old phrases B-1394 1/1/2006 2143 7380 Messenger/courier service Update phraseologies, delete old phrases B-1394 1/1/2006 8742 4239 4250 Newsprint mills Update phraseologies, delete old phrases B-1394 1/1/2006 11/18/2010 1f4cc652-8371-454e-9dce-450abf69c40b.xls Indiana Class Code Changes Effective 1/1/06 and after Code General Category Action Filing Effective Newsprint mills Update phraseologies, delete old phrases B-1394 1/1/2006 4279 8264 8392 Parking lots Update phraseologies, delete old phrases B-1394 1/1/2006 8017 8018 Pet stores Update phraseologies, delete old phrases B-1394 1/1/2006 8031 2211 2286 2501 2600 Tanning & fur mfg Update phraseologies, delete old phrases B-1394 1/1/2006 2623 2688 4493 8103 0106 5183 Tree pruning Update phraseologies, delete old phrases B-1394 1/1/2006 5507 9102 7710 New "Firefighters" 7711 New "Firefighters & Drivers - Volunteers" Firefighters Note: 7699 Fighters - Med Only & D continues B-1397 7/1/2007 as an Indiana special code Eliminate 7704 eff 7/1/07 New "Ambulance Service & EMS & D" 7705 Ambulance Service & EMS B-1397 7/1/2007 Eliminate cross reference to 7370 7720 New "Juvenile Detention Center" 8842 New "Group Homes" Charitable welfare organizations B-1387 1/1/2008 8864 New "Social Services Org" Eliminate 8861 & 9110 eff 1/1/08 2156 Bottling Eliminate & merge into 2157 B-1387 1/1/2008 0005 0016 0035 Farms Update phraseologies, delete old phrases B-1406 1/1/2010 0050 0079 2021 Sugar mfg Update phraseologies, delete old phrases B-1406 1/1/2010 2172 Tobacco mfg Update phraseologies, delete old phrases B-1406 1/1/2010 11/18/2010 1f4cc652-8371-454e-9dce-450abf69c40b.xls Indiana Class Code Changes Effective 1/1/06 and after Code General Category Action Filing Effective Tobacco mfg Update phraseologies, delete old phrases B-1406 1/1/2010 2174 8869 Child day care services Eliminate 9059 & reassign to 8869 B-1408 1/1/2010 8601 Revise phraselogy & cross references New "Surveyors, Timber Cruisers, Oil or Gas 8602 Geologists or Scouts, & Drivers" New "Architectural or Engineering Firm —Clerical 8603 Engineering & research B-1408 1/1/2010 Staff" 8810 Remove "drafting" function, reassign to 8603 New "Inventory Counters —Traveling —Including 8725 Salespersons & Clerical" 2001 Eliminate 2001 & reassign to 2003 Bakery & food New "Potato Chip, Popcorn & Snack Chip Mfg B-1409 1/1/2011 6503 NOC" 2812 Carpentry Eliminate 2812 & reassign to 2883 B-1410 1/1/2011 New national "Manufactured, Modular, or Prefabricated Home Manufacturing —Shop Work 2797 B-1410 1/1/2011 & Drivers" to replace IN state special "Mobile or Manufactured housing Trailer Home Mfg. & Drivers" New national "Manufactured, Modular, or 2799 Prefabricated Home Setup, Hookup, or B-1410 1/1/2011 Installation at Building Site" 4362 Film Eliminate 4362 & reassign to 4360 B-1412 1/1/2011 4561 Varnish & paint mfg Eliminate 4561 & reassign to 4439 B-1412 1/1/2011 8037 Superstores & warehouse clubs New "Store - Superstores & Warehouse Clubs" B-1412 1/1/2011 4112 Eliminate 4112 & reassign to 4110 4150 Fiber optics & semiconductors Eliminate 4150 & reassign to 4149 B-1413 1/1/2011 4109 New "Integrated Circuit Mfg" 7601 Eliminate 7601 & reassign to 7600 7611 Eliminate 7611 & reassign to 7600 Telecommunications & electronics B-1413 1/1/2011 7612 Eliminate 7612 & reassign to 7600 7613 Eliminate 7613 & reassign to 7600 Eliminate 5651 & reassign to 5645 5651 Carpentry B-1415 1/1/2011 Update phraseologies, delete old phrases New ―Aviation —Air Traffic Controllers Under 7402 Aviation (changes B-1399) B-1418 1/1/2010 Contract with the FAA‖ Notes 11/18/2010 1f4cc652-8371-454e-9dce-450abf69c40b.xls Indiana Class Code Changes Effective 1/1/06 and after Code General Category Action Filing Effective Source: ICRB files as of 10/23/09 Also see "New Codes" tab Also see CompClues document "New Class Codes" 11/18/2010 1f4cc652-8371-454e-9dce-450abf69c40b.xls
"Statute of Limitations Indiana"