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152
AASCIF StatBook Summary Statistics 2012-2013 US or Canada Dividend Ratio AZ* US Statutory 12/31/2013 1.21 0.89 0.78 1.01 1.84 0.18 0.30 0.41 0.02 0.04 8.50 BC Canada GAAP 12/31/2009 1.45 1.45 0.23 1.29 10.80 1.17 0.00 1.22 0.00 1.67 0.92 CA* US Statutory 12/31/2013 1.28 1.02 0.67 0.75 1.90 0.17 0.26 0.62 0.08 0.06 13.58 CO* US Statutory 12/31/2013 1.11 0.88 0.94 0.84 1.40 0.77 0.23 0.20 0.00 0.04 8.81 HI US Statutory 12/31/2011 1.05 0.71 0.68 0.83 0.46 0.17 0.32 0.36 0.05 0.06 30.61 KY US Statutory 12/31/2010 1.14 0.92 0.88 0.71 2.95 0.73 0.23 0.29 0.28 0.09 5.86 LA* US Statutory 12/31/2013 0.78 0.53 0.32 0.59 0.57 0.20 0.37 0.46 0.39 0.14 28.08 MB* Canada IFRS 12/31/2013 1.30 1.06 0.71 0.66 2.72 0.70 0.24 0.16 0.00 0.24 NA MD* US Statutory 12/31/2013 1.13 0.89 0.91 0.89 3.79 0.64 0.23 0.31 0.00 0.06 4.82 ME* US Statutory 12/31/2012 0.85 0.61 0.66 0.64 0.96 0.38 0.25 0.18 0.10 0.11 15.23 MN* US Statutory 12/31/2013 0.98 0.79 0.89 0.90 2.70 1.38 0.19 0.09 0.03 0.13 6.85 MO US Statutory 12/31/2010 1.05 0.73 0.91 0.56 0.97 0.66 0.33 0.15 0.00 0.06 13.33 MT US Statutory 6/30/2012 1.11 0.95 0.80 0.71 2.80 0.47 0.15 0.31 0.04 0.10 6.42 NB Canada IFRS 12/31/2011 0.84 0.63 0.71 0.92 5.80 1.07 0.25 0.15 0.00 0.37 NA ND* US GAAP 6/30/2014 1.01 0.93 0.43 0.99 2.40 0.71 0.11 0.53 (0.28) (0.03) NA NM* US Statutory 12/31/2013 1.01 0.73 0.91 0.53 1.75 0.78 0.26 0.10 0.00 0.08 7.21 NS Canada GAAP 12/31/2012 2.46 2.46 (0.67) 0.83 (2.90) (0.06) 0.00 0.40 0.00 (0.10) n.a. NY US Statutory 12/31/2012 1.14 1.01 0.73 1.02 3.07 0.60 0.16 0.38 0.10 0.17 NA OH US GAAP/GASB 6/30/2010 1.36 1.29 0.38 0.85 5.18 0.55 0.06 0.97 0.00 0.41 NA OK US Statutory 12/31/2010 1.23 1.06 1.03 0.93 4.06 1.05 0.18 0.21 0.00 (0.03) 4.15 OR US Statutory 12/31/2011 1.12 0.92 0.58 1.11 3.31 0.39 0.19 0.54 0.43 0.16 6.64 PA* US Statutory 12/31/2013 1.24 1.13 0.96 0.90 (8.81) (1.16) 0.11 0.35 0.00 (0.05) -4.89 PE Canada IFRS 12/31/2012 0.99 0.98 0.49 0.60 0.40 0.25 0.03 0.51 0.00 0.58 NA RI* US Statutory 12/31/2013 1.13 0.76 0.96 0.63 0.93 0.65 0.35 0.17 0.02 0.03 9.71 SC US GAAP 6/30/2011 0.85 0.85 0.80 NA NA NA NA 0.05 0.00 (0.25) NA SK Canada IFRS 12/31/2011 0.91 0.79 1.02 0.62 3.55 0.97 0.12 0.17 0.00 (0.02) NA TX* US Statutory 12/31/2013 0.82 0.57 0.57 0.67 1.11 0.42 0.24 0.26 0.19 0.20 11.08 UT US Statutory 12/31/2010 1.07 0.79 0.67 0.92 1.39 0.26 0.29 0.42 0.11 0.09 11.52 WY US NA 6/30/2009 0.69 0.69 0.46 0.60 3.08 0.68 0.00 0.19 0.00 0.45 0.00 Average 1.11 0.93 0.67 0.80 2.08 0.53 0.19 0.35 0.05 0.17 NA All Submissions: 29 Members Average 1.11 0.93 0.67 0.80 2.08 0.53 0.19 0.35 0.05 0.17 9.42 Median 1.11 0.89 0.71 0.83 2.15 0.62 0.23 0.31 0.00 0.09 7.85 Statutory Submissions Only: 19 Members Average 1.07 0.82 0.77 0.79 2.00 0.55 0.25 0.30 0.10 0.09 11.32 Median 1.11 0.84 0.79 0.79 1.79 0.54 0.24 0.30 0.04 0.08 8.81 NA Indicates anamolous/missing values suppressed for purposes of this display Jurisdiction of Participating AASCIF Members Accounting Basis Data from fiscal year ended Calendar Year Combined Ratio (prior to dividends & taxes) Calendar Year Loss & LAE Ratio Calendar Year Operating Ratio Accident Year Direct Loss Ratio Loss & LAE Reserve: Surplus Ratio Premium: Surplus Ratio Expense Ratio (to WP)--new formula for 2009 Investment Yield Ratio Return on Policyholder Surplus Risk Based Capital Ratio--new statistic for 2011--2012 * data updated through latest reporting date Graph Graph Graph Graph Graph Graph Graph Graph Graph Graph Graph

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Page 1: files/2013_A… · XLS file · Web view · 2016-03-16O Detail N Detail M Detail L Detail K Detail J Detail I Detail H Detail G Detail F detail E detail O N M L K J I H G F E WY

AASCIF StatBook Summary Statistics 2012-2013

US or Canada Dividend Ratio

AZ* US Statutory 12/31/2013 1.21 0.89 0.78 1.01 1.84 0.18 0.30 0.41 0.02 0.04 8.50BC Canada GAAP 12/31/2009 1.45 1.45 0.23 1.29 10.80 1.17 0.00 1.22 0.00 1.67 0.92CA* US Statutory 12/31/2013 1.28 1.02 0.67 0.75 1.90 0.17 0.26 0.62 0.08 0.06 13.58CO* US Statutory 12/31/2013 1.11 0.88 0.94 0.84 1.40 0.77 0.23 0.20 0.00 0.04 8.81HI US Statutory 12/31/2011 1.05 0.71 0.68 0.83 0.46 0.17 0.32 0.36 0.05 0.06 30.61KY US Statutory 12/31/2010 1.14 0.92 0.88 0.71 2.95 0.73 0.23 0.29 0.28 0.09 5.86 LA* US Statutory 12/31/2013 0.78 0.53 0.32 0.59 0.57 0.20 0.37 0.46 0.39 0.14 28.08MB* Canada IFRS 12/31/2013 1.30 1.06 0.71 0.66 2.72 0.70 0.24 0.16 0.00 0.24 NAMD* US Statutory 12/31/2013 1.13 0.89 0.91 0.89 3.79 0.64 0.23 0.31 0.00 0.06 4.82ME* US Statutory 12/31/2012 0.85 0.61 0.66 0.64 0.96 0.38 0.25 0.18 0.10 0.11 15.23MN* US Statutory 12/31/2013 0.98 0.79 0.89 0.90 2.70 1.38 0.19 0.09 0.03 0.13 6.85MO US Statutory 12/31/2010 1.05 0.73 0.91 0.56 0.97 0.66 0.33 0.15 0.00 0.06 13.33MT US Statutory 6/30/2012 1.11 0.95 0.80 0.71 2.80 0.47 0.15 0.31 0.04 0.10 6.42NB Canada IFRS 12/31/2011 0.84 0.63 0.71 0.92 5.80 1.07 0.25 0.15 0.00 0.37 NAND* US GAAP 6/30/2014 1.01 0.93 0.43 0.99 2.40 0.71 0.11 0.53 (0.28) (0.03) NANM* US Statutory 12/31/2013 1.01 0.73 0.91 0.53 1.75 0.78 0.26 0.10 0.00 0.08 7.21 NS Canada GAAP 12/31/2012 2.46 2.46 (0.67) 0.83 (2.90) (0.06) 0.00 0.40 0.00 (0.10) n.a.NY US Statutory 12/31/2012 1.14 1.01 0.73 1.02 3.07 0.60 0.16 0.38 0.10 0.17 NAOH US GAAP/GASB 6/30/2010 1.36 1.29 0.38 0.85 5.18 0.55 0.06 0.97 0.00 0.41 NAOK US Statutory 12/31/2010 1.23 1.06 1.03 0.93 4.06 1.05 0.18 0.21 0.00 (0.03) 4.15OR US Statutory 12/31/2011 1.12 0.92 0.58 1.11 3.31 0.39 0.19 0.54 0.43 0.16 6.64PA* US Statutory 12/31/2013 1.24 1.13 0.96 0.90 (8.81) (1.16) 0.11 0.35 0.00 (0.05) -4.89PE Canada IFRS 12/31/2012 0.99 0.98 0.49 0.60 0.40 0.25 0.03 0.51 0.00 0.58 NARI* US Statutory 12/31/2013 1.13 0.76 0.96 0.63 0.93 0.65 0.35 0.17 0.02 0.03 9.71SC US GAAP 6/30/2011 0.85 0.85 0.80 NA NA NA NA 0.05 0.00 (0.25) NASK Canada IFRS 12/31/2011 0.91 0.79 1.02 0.62 3.55 0.97 0.12 0.17 0.00 (0.02) NATX* US Statutory 12/31/2013 0.82 0.57 0.57 0.67 1.11 0.42 0.24 0.26 0.19 0.20 11.08UT US Statutory 12/31/2010 1.07 0.79 0.67 0.92 1.39 0.26 0.29 0.42 0.11 0.09 11.52WY US NA 6/30/2009 0.69 0.69 0.46 0.60 3.08 0.68 0.00 0.19 0.00 0.45 0.00

Average 1.11 0.93 0.67 0.80 2.08 0.53 0.19 0.35 0.05 0.17 NA

All Submissions: 29 MembersAverage 1.11 0.93 0.67 0.80 2.08 0.53 0.19 0.35 0.05 0.17 9.42Median 1.11 0.89 0.71 0.83 2.15 0.62 0.23 0.31 0.00 0.09 7.85

Statutory Submissions Only: 19 MembersAverage 1.07 0.82 0.77 0.79 2.00 0.55 0.25 0.30 0.10 0.09 11.32Median 1.11 0.84 0.79 0.79 1.79 0.54 0.24 0.30 0.04 0.08 8.81

NA Indicates anamolous/missing values suppressed for purposes of this display

Jurisdiction of Participating

AASCIF Members

Accounting Basis

Data from fiscal year

ended

Calendar Year Combined Ratio

(prior to dividends & taxes)

Calendar Year Loss & LAE Ratio

Calendar Year Operating Ratio

Accident Year Direct Loss Ratio

Loss & LAE Reserve: Surplus

RatioPremium: Surplus

RatioExpense Ratio (to WP)--new formula

for 2009 Investment Yield

Ratio Return on

Policyholder Surplus

Risk Based Capital Ratio--new statistic

for 2011--2012

* data updated through latest reporting dateGraph Graph Graph Graph Graph Graph Graph Graph Graph Graph Graph

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StatBook Statistics Menu

Ratios included on the Summary Stats Page

1 Calendar Year Combined Ratio (prior to dividends & taxes)

2 Calendar Year Loss & LAE Ratio

3 Calendar Year Operating Ratio

4 Accident Year Loss Ratio

5 Loss & LAE Reserve: Surplus Ratio

6 Premium: Surplus Ratio

7 Expense Ratio (to Written Premium)

8 Investment Yield Ratio (to Earned Premium)

9 Dividend Ratio (to Earned Premium)

10 Return on Policyholder Surplus

11 Risk Based Capital Ratio

Additional example ratios that could be produced using existing information in this Workbook

1 Return on Revenue

2 Yield on Invested Assets

3 Net Leverage

4 Net Premium Written to Surplus

5 Loss & LAE Reserves to Surplus

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Definition

Losses + Loss Expense + Underwriting ExpenseNet Earned Premium

Losses and loss adjustment expensesNet Earned Premium

Net Earned Premium - Net Income pre dividend and taxesNet Earned Premium

Accident Year LossesDirect Earned Premium

Losses and loss adjustment expensesPolicyholder Surplus

Earned PremiumPolicyholder Surplus

Underwriting ExpenseNet Written Premium

Net Investment IncomeDirect Earned Premium

DividendsDirect Earned Premium

Net Income pre-Dividends and TaxesPolicyholder Surplus

Total Adjusted CapitalAuthorized Control Level Risk Based Capital

Additional example ratios that could be produced using existing information in this Workbook

Pretax Operating Income Net Premium Earned

Annual Net Investment Income after Expenses(CY Invested Assets + PY Invested Assets) / 2

Net Premiums Written+

Net LiabilitiesPolicyholder Surplus Policyholder Surplus

Net Premiums WrittenPolicyholder Surplus

Loss & LAE ReservesPolicyholder Surplus

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AASCIF Member Name CopperPoint Mutual Insurance Company ConsolidatedJurisdiction ArizonaWeb Address

Brent McClean602-631-2231 / [email protected]

Last Reporting Period (ended) 12/31/2013Statutory

Accounting Year Year-1 Year-2 Year-3 Year-4 Year-5

Year Designation 2013 2012 2011 2010 2009 2008

OPERATING STATEMENT ($000)1 Net Premiums Earned 209,618 180,162 175,656 191,973 275,217 408,344 2 Net Losses Incurred 150,722 151,474 140,642 200,102 298,489 460,001 3 Loss Expense Incurred 36,246 31,949 39,598 38,906 37,577 43,525 4 Underwriting Expense Incurred 67,173 54,952 54,543 63,608 73,072 79,578 5 Net UW Gain / (Loss) (44,523) (58,213) (59,127) (110,644) (133,921) (174,760)6 Income From Bond Investments 60,284 79,621 113,118 124,913 126,689 122,223 7 Income From Stock Investments 9,047 8,751 7,936 6,573 4,292 9,314 8 Income From Mortgage Investments 11,176 12,405 14,235 15,938 18,323 17,786 9 Income From All Other Investments 5,025 7,792 5,639 3,792 5,878 10,365

10 Net Realized Capital Gain/(Loss) 6,867 240,318 61,459 21,260 17,187 55,336 11 Investment Expense Incurred (6,968) (13,281) (12,298) (11,410) (11,904) (7,897)12 Other Income 4,373 11,597 (3,941) 847 (8,144) 4,143 13 Net Income Prior to Dividends/Taxes 45,281 288,990 127,021 51,270 18,400 36,510 14 Dividends to Policyholders 3,568 3,500 3,912 7,500 7,781 21,441 15 Federal Income Tax 21 (203) (159) - - - 16 Net Income After Dividends/Taxes 41,692 285,693 123,268 43,770 10,619 15,069

ASSETS ($000)1 Cash & Bank Deposits 87,834 200,055 77,474 46,014 95,614 414,112 2 Bonds @ Amortized Value 2,648,092 2,802,168 2,669,459 2,609,113 2,534,372 2,406,011 3 Stocks @ Market Value 402,134 374,189 335,642 349,898 305,390 234,601 4 Mortgage Loans On Real Estate @ Amortized Value 192,649 201,289 229,911 252,992 272,967 283,506 5 Real Estate 43,116 42,298 65,302 68,958 67,391 65,407 6 Other Invested Assets & Loans 12,673 11,094 11,508 28,267 18,890 17,796 7 Cash & Invested Assets 3,386,498 3,631,093 3,389,296 3,355,242 3,294,624 3,421,433 8 Funds Held Or Deposited With Ceding Reinsurers - - 9 Premium Due But Not Collected 73,919 66,260 60,526 70,859 112,246 152,206

10 Reinsurance Recoverable On Loss Payments 1,731 1,986 1,173 2,486 1,923 1,823 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 14,645 14,894 20,447 23,161 25,911 24,145 12 Other Non-Invested Assets 62,180 15,702 7,770 8,763 8,382 5,168 13 Total Assets 3,538,973 3,729,935 3,479,212 3,460,511 3,443,086 3,604,775

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 2,007,936 2,356,478 2,416,784 2,495,264 2,508,797 2,466,402 2 Loss Adjustment Expense 178,126 184,611 184,201 178,826 175,202 174,569 3 19,204 14,235 12,108 11,288 10,169 9,510 4 Taxes, Licenses, & Fees 2,249 2,564 2,391 2,082 2,131 282 5 Borrowed Money - - - - - - 6 Unearned Premiums 79,070 66,173 62,790 68,738 93,011 125,801 7 Dividends Declared & Unpaid 638 696 693 1,274 1,575 4,986 8 Other Liabilities 65,509 38,545 38,222 46,719 93,297 344,940 9 Total Liabilities 2,352,732 2,663,302 2,717,189 2,804,191 2,884,182 3,126,490

10 Restricted Surplus/Equity Funds11 Unrestricted Surplus 1,186,241 1,066,633 762,023 656,320 558,904 478,285 12 Policyholder Surplus 1,186,241 1,066,633 762,023 656,320 558,904 478,285 13 Total Liabilities & Policyholder Surplus 3,538,973 3,729,935 3,479,212 3,460,511 3,443,086 3,604,775

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 1,066,633 762,023 656,320 558,904 478,285 648,725 2 Net Income/(Loss) After Policyholder Dividend & Taxes 41,692 285,693 123,268 43,770 10,619 15,069 3 Net Unrealized Capital Gains/(Losses) 19,321 9,821 (21,689) 44,932 141,298 (194,467)4 Change in Nonadmitted Assets (52,714) (8,852) 5,484 7,642 16,647 18,606 5 Other Adjustments To Surplus/Equity 111,309 17,948 (1,360) 1,072 (87,945) (9,648)6 Policyholder Surplus At Close of Accounting Period 1,186,241 1,066,633 762,023 656,320 558,904 478,285

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 209,060 184,605 172,550 189,329 276,314 412,657 2 Approximate Direct Market Share (Insured Market Only) 29% 29% 31% 31% 40% 45%3 Direct Policies Written 20,359 21,719 25,596 29,705 35,316 42,294 4 Direct Written Payroll ($000) 9,765,342 9,439,797 9,706,712 10,695,869 13,744,569 16,977,873 5 Accident Year Direct Loss Incurred ($000) 211,984 191,375 195,890 205,102 244,461 379,084 6 Accident Year Direct Claims Incurred 15,546 15,978 16,409 18,229 23,145 34,171 7 Open Direct Claims @ End of Period 17,427 18,148 19,034 18,961 21,840 27,446 8 Direct Claim Management Employees (FTE) 76.09 80.96 90.68 113.73 141.00 145.60 9 Other Claim Management Employees (FTE) 60.62 63.27 73.88 99.08 107.49 106.01

10 Direct Policy Service Employees (FTE) 83.81 86.31 105.73 115.99 122.00 131.43 11 All Other Employees (FTE) 160.48 148.46 151.71 191.53 190.76 181.10 12 Total Employees (FTE) 381.00 379.00 422.00 520.33 561.25 564.14 13 Net Premiums Written 222,515 183,545 169,707 166,961 241,743 380,085 14 Total Adjusted Capital 1,186,241 1,066,633 762,023 656,320 558,904 478,285 15 Authorized Control Level Risk-based Capital 139,587 137,278 139,373 141,594 128,400 121,603

BENCHMARK STATISTICS1 1.212 1.323 1.337 1.576 1.487 1.4282 Calendar Year Loss & LAE Ratio 0.892 1.018 1.026 1.245 1.221 1.2333 Calendar Year Operating Ratio 0.784 -0.604 0.277 0.733 0.933 0.9114 Accident Year Direct Loss Ratio 1.014 1.037 1.135 1.083 0.885 0.9195 Loss & LAE Reserve:Surplus Ratio 1.843 2.382 3.413 4.074 4.802 5.5226 Premium:Surplus Ratio 0.177 0.169 0.231 0.292 0.492 0.8547 Expense Ratio 0.302 0.299 0.321 0.381 0.000 0.2098 Investment Yield Ratio (to EP) 0.409 1.818 1.102 0.851 0.581 0.5029 Dividend Ratio 0.017 0.019 0.023 0.040 0.028 0.052

10 Return on Policyholder Surplus 0.040 0.316 0.179 0.084 0.035 0.065

www.copperpoint.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

Calendar Year Combined Ratio (prior to dividends & taxes)

B41
Less private accounts over 90 days since billing
B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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AASCIF Member Name WorkSafe BCJurisdiction British Columbia, CanadaWeb Address worksafebc.com

Terrry Bogyo Director Corporate Planning & Development(604) 276-3202 [email protected]

Last Reporting Period (ended) 12/31/2009GAAP

Accounting YearYear Designation 2009

OPERATING STATEMENT ($000)1 Net Premiums Earned 1,024,500 2 Net Losses Incurred 1,321,928 3 Loss Expense Incurred 167,835 4 Underwriting Expense incurred - 5 Net UW Gain / (Loss) (465,263)6 Income From Bond Investments 240,392 7 Income From Stock Investments 1,295,304 8 Income From Mortgage Investments 29,188 9 Income From All Other Investments (95,411)

10 Net Realized Capital Gain/(Loss) (188,110)11 Investment Expense Incurred (28,065)12 Other Income 5,483 13 Net Income Prior to Dividends/Taxes 793,518 15 Dividends to Policyholders - 16 Federal Income Tax - 17 Net Income After Dividends/Taxes 793,518

ASSETS ($000)1 Cash & Bank Deposits 20,438 2 Bonds @ Amortized Value 3,695,284 3 5,465,284 4 Mortgage Loans On Real Estate @ Amortized Value 522,133 5 1,601,427 6 Other Invested Assets & Loans 8,329 7 Cash & Invested Assets 11,312,895 8 Funds Held Or Deposited With Ceding Reinsurers9 Premium Due But Not Collected 414,587

10 Reinsurance Recoverable On Loss Payments - 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 1,511 12 Other Non-Invested Assets 240,933 13 Total Assets 11,969,926

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 9,424,103 2 Loss Adjustment Expense - 3 - 4 Taxes, Licenses, & Fees - 5 Borrowed Money - 6 Unearned Premiums -

StatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Stocks @ Market Value and Private placement at cost

Real Estate (Real pool at market + Stopper Corps at cost)

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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7 Dividends Declared & Unpaid - 8 Other Liabilities 1,673,396 9 Total Liabilities 11,097,499

10 Restricted Surplus/Equity Funds 872,427 11 Unrestricted Surplus - 12 Policyholder Surplus 872,427 13 Total Liabilities & Policyholder Surplus 11,969,926

CHANGE IN POLICYHOLDER SURPLUS ($000)

1 78,909 2 Net Income/(Loss) After Policyholder Dividend & Taxes 793,518 3 Net Unrealized Capital Gains/(Losses)4 Change in Nonadmitted Assets5 Other Adjustments To Surplus/Equity - 6 Policyholder Surplus At Close of Accounting Period 872,427

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 1,024,500 2 Approximate Direct Market Share (Insured Market Only) 100%3 Direct Policies Written 202,390 4 Direct Written Payroll ($000) 69,931,000 5 Accident Year Direct Loss Incurred ($000) 1,321,928 6 Accident Year Direct Claims Incurred 94,252 7 Open Direct Claims @ End of Period 7,434 8 Direct Claim Management Employees (FTE)9 Other Claim Management Employees (FTE)

10 Direct Policy Service Employees (FTE)11 All Other Employees (FTE)12 Total Employees (FTE) - 13 Net Premiums Written 1,024,500 14 Total Adjusted Capital 11,970,000,000 15 Authorized Control Level Risk-based Capital 12,960,000,000

BENCHMARK STATISTICS1 1.4542 Calendar Year Loss & LAE Ratio 1.4543 Calendar Year Operating Ratio 0.2254 Accident Year Direct Loss Ratio 1.2905 Loss & LAE Reserve:Surplus Ratio 10.8026 Premium:Surplus Ratio 1.1747 Expense Ratio 0.0008 Investment Yield Ratio 1.2239 Dividend Ratio 0.000

10 Return on Policyholder Surplus 1.66811 Risk Based Capital 0.924

Policyholder Surplus @ Begin of Accounting Period-Includes prior year adjustments

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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WorkSafe BCBritish Columbia, Canada

worksafebc.comTerrry Bogyo Director Corporate Planning & Development

(604) 276-3202 [email protected]/31/2009

GAAP

Year-1 Year-2 Year-3 Year-4 Year-5

2008 2007 2006 2005 2004

1,141,319 1,081,896 1,267,238 1,239,777 1,239,777 1,363,076 1,116,741 1,124,593 1,266,058 1,266,058 167,409 160,485 148,325 131,404 131,404 487,364 36,514 185,269 - - (876,530) (231,844) (190,949) (157,685) (157,685) 96,927 120,390 80,683 320,664 320,664 (1,176,553) (608,689) (1,666) 425,583 425,583 15,584 12,971 11,399 11,067 11,067 (1,154) 224,266 184,912 14,917 14,917 (139,514) 787,088 907,793 411,138 411,138 (25,850) (28,031) (22,746) (21,207) (21,207) 12,391 7,040 1,355 (37,760) (37,760) (2,094,699) 283,191 970,781 966,717 966,717 - - - - - - - - - - (2,094,699) 283,191 970,781 966,717 966,717

80,033 213,276 585,100 392,202 392,202 4,371,716 4,451,208 4,258,966 3,724,364 3,724,364 3,744,421 5,234,623 5,368,646 5,279,778 5,279,778 455,047 239,895 191,915 182,526 182,526 1,696,625 1,668,653 1,043,977 772,401 772,401 51,128 77,588 47,353 - - 10,398,970 11,885,243 11,495,957 10,351,271 10,351,271

451,086 454,731 489,461 498,443 498,443 - - - - - 1,467 1,446 1,480 6,126 6,126 230,799 226,127 201,599 188,746 188,746 11,082,322 12,567,547 12,188,497 11,044,586 11,044,586

9,347,925 8,751,988 8,765,301 8,576,574 8,576,574 - - - - - - - - - - - - - - - - - - - - - - - - -

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- - - - - 1,655,488 1,662,951 1,055,476 671,073 671,073 11,003,413 10,414,939 9,820,777 9,247,647 9,247,647 78,909 2,152,608 2,367,720 1,796,939 1,796,939 - - - - - 78,909 2,152,608 2,367,720 1,796,939 1,796,939 11,082,322 12,567,547 12,188,497 11,044,586 11,044,586

2,152,608 2,459,417 1,796,939 1,010,222 1,010,222 (2,094,699) 283,191 970,781 966,717 966,717

21,000 (590,000) (400,000) (180,000) (180,000) 78,909 2,152,608 2,367,720 1,796,939 1,796,939

1,141,319 1,081,896 1,267,238 1,239,777 1,239,777 100% 100% 100% 100% 100%

200,959 197,190 188,164 184,239 184,239 71,827,000 68,417,000 64,375,000 59,318,000 59,318,000 1,850,440 1,153,255 1,309,862 1,266,058 1,266,058 128,442 135,453 131,118 127,810 127,810 8,288 8,112 7,486 7,268 7,268

- - - - - 1,141,319 1,081,896 1,267,238 1,239,777 1,239,777 11,082,000,000 12,568,000,000 n/a n/a n/a 12,579,000,000 12,180,000,000 n/a n/a n/a

1.768 1.214 1.151 1.127 1.1271.341 1.181 1.004 1.127 1.1272.835 0.738 0.234 0.220 0.2201.621 1.066 1.034 1.021 1.021

118.465 4.066 3.702 4.773 4.77314.464 0.503 0.535 0.690 0.6900.427 0.034 0.146 0.000 0.000-1.078 0.470 0.916 0.937 0.9370.000 0.000 0.000 0.000 0.000-1.877 0.123 0.466 0.689 0.6890.881 1.032 #VALUE! #VALUE! #VALUE!

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AASCIF Member Name State Compensation Insurance FundJurisdiction CaliforniaWeb Address

Marie N. Barrios415-263-5801 / [email protected]

Last Reporting Period (ended) 12/31/2013Statutory

Accounting Year

Year Designation2013

OPERATING STATEMENT ($000)1 Net Premiums Earned 1,093,782 2 Net Losses Incurred 820,337 3 Loss Expense Incurred 295,321 4 Underwriting Expense Incurred 279,674 5 Net UW Gain / (Loss) (301,550)6 Income From Bond Investments 682,555 7 Income From Stock Investments 10,410 8 Income From Mortgage Investments - 9 Income From All Other Investments (8,997)

10 Net Realized Capital Gain/(Loss) 3,867 11 Investment Expense Incurred - 12 Other Income (22,088)13 Net Income Prior to Dividends/Taxes 364,197 14 Dividends to Policyholders 85,323 15 Federal Income Tax - 16 Net Income After Dividends/Taxes 278,874

ASSETS ($000)1 Cash & Bank Deposits 155,161 2 Bonds @ Amortized Value 17,459,326 3 Stocks @ Market Value 917,328 4 Mortgage Loans On Real Estate @ Amortized Value - 5 Real Estate 319,241 6 Other Invested Assets & Loans 191 7 Cash & Invested Assets 18,851,247 8 Funds Held Or Deposited With Ceding Reinsurers 600 9 Premium Due But Not Collected 115,507

10 Reinsurance Recoverable On Loss Payments 1,935 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 141,475 12 Other Non-Invested Assets 118,261 13 Total Assets 19,229,025

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 10,502,660 2 Loss Adjustment Expense 1,598,389 3 30,723 4 Taxes, Licenses, & Fees 15,485 5 Borrowed Money 97,133 6 Unearned Premiums 55,072 7 Dividends Declared & Unpaid 172,120 8 Other Liabilities 403,983 9 Total Liabilities 12,875,565

www.scif.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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10 Restricted Surplus/Equity Funds - 11 Unrestricted Surplus 6,353,460 12 Policyholder Surplus 6,353,460 13 Total Liabilities & Policyholder Surplus 19,229,025

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 6,011,869 2 Net Income/(Loss) After Policyholder Dividend & Taxes 278,874 3 Net Unrealized Capital Gains/(Losses) 98,583 4 Change in Nonadmitted Assets 16,412 5 Other Adjustments To Surplus/Equity (52,278)6 Policyholder Surplus At Close of Accounting Period 6,353,460

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 1,109,994 2 Approximate Direct Market Share (Insured Market Only) 0 3 Direct Policies Written 13545500%4 Direct Written Payroll ($000) 20,118,920 5 Accident Year Direct Loss Incurred ($000) 837,073 6 Accident Year Direct Claims Incurred 15,366 7 Open Direct Claims @ End of Period 7,647 8 Direct Claim Management Employees (FTE) 1,426 9 Other Claim Management Employees (FTE) 670.00

10 Direct Policy Service Employees (FTE) 630.00 11 All Other Employees (FTE) 1,739.00 12 Total Employees (FTE) 4,465.00 13 Net Premiums Written 1,096,322.00 14 Total Adjusted Capital 6,353,460 15 Authorized Control Level Risk-based Capital 467,956

BENCHMARK STATISTICS1 1.2762 Calendar Year Loss & LAE Ratio 1.0203 Calendar Year Operating Ratio 0.6674 Accident Year Direct Loss Ratio 0.7545 Loss & LAE Reserve:Surplus Ratio 1.9056 Premium:Surplus Ratio 0.1727 Expense Ratio 0.2558 Investment Yield Ratio 0.6209 Dividend Ratio 0.077

10 Return on Policyholder Surplus 0.05911 Risk Based Capital 13.577

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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State Compensation Insurance FundCalifornia

Marie N. Barrios415-263-5801 / [email protected]

12/31/2013Statutory

Year-1 Year-2 Year-3 Year-4 Year-5

2012 2011 2010 2009 2008

922,635 1,001,628 1,135,645 1,247,737 1,663,669 691,975 252,381 850,290 939,826 1,251,950 207,593 928,300 520,832 574,330 609,735 356,588 401,079 409,149 456,432 537,747 (333,521) (580,132) (644,626) (722,851) (735,763) 769,632 841,105 870,494 896,005 954,262 - - - - - - - - - - (10,022) (11,929) (9,511) 11,748 28,633 42,821 27,945 34,303 4,322 (86,668) - - - - - (10,733) (97,857) (79,638) (46,208) (87,502) 458,177 179,132 171,022 143,016 72,962 99,500 49,501 - 15 (2,101) - - - - - 358,677 129,631 171,022 143,001 75,063

430,904 130,128 1,027,286 466,914 1,540,210 18,232,852 18,940,254 18,381,870 19,274,652 18,523,828 - - - - - - - - - - 353,544 360,189 384,349 384,878 378,387 2,035 598 2,839 3,109 1,850 19,019,335 19,431,169 19,796,344 20,129,553 20,444,275 600 - - 91,641 60,484 63,848 71,576 92,863 3,122 5,319 8,397 2,902 1,968 151,213 166,707 161,382 173,443 189,929 168,206 209,226 241,883 295,494 375,806 19,434,117 19,872,905 20,271,854 20,672,968 21,104,841

11,193,896 11,996,218 13,164,864 13,839,355 14,488,903 1,732,627 2,307,604 1,887,911 1,889,486 1,890,593 32,086 166,361 138,067 117,695 95,870 11,699 11,476 12,619 13,765 14,549 - - - - - 47,026 60,051 68,630 83,919 90,659 131,182 50,500 1,000 1,000 1,000 273,732 (381,997) (467,600) (521,142) (565,654) 13,422,248 14,210,213 14,805,491 15,424,078 16,015,920

www.scif.com

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- - - - - 6,011,869 5,662,692 5,466,363 5,248,890 5,088,921 6,011,869 5,662,692 5,466,363 5,248,890 5,088,921 19,434,117 19,872,905 20,271,854 20,672,968 21,104,841

5,662,692 5,466,363 5,248,890 5,088,921 4,908,725 358,677 129,631 171,022 143,001 75,063 - - (4,276) 4,276 - (11,329) 61,043 55,057 16,233 86,746 1,829 5,655 (4,330) (3,541) 18,387 6,011,869 5,662,692 5,466,363 5,248,890 5,088,921

938,795 1,017,429 1,154,354 1,282,537 1,722,411 0 0 0 0 0

13467100% 14761300% 16109100% 16160600% 20571700% 12,945,771 24,571,214 67,789,070 100,498,769 36,842,022 692,950 753,587 888,764 1,001,604 1,249,137 12,931 15,539 21,330 29,937 43,170 6,447 7,305 9,918 13,199 19,362 1,363 1,356 1,596 1,724 2,115 642.00 1,169.00 1,745.00 1,840.00 1,794.00 679.00 1,204.00 1,072.00 1,023.00 1,231.00 1,899.00 1,924.00 2,886.00 3,074.00 2,769.00 4,583.00 5,653.00 7,299.00 7,661.00 7,909.00 887,629.00 995,346.00 1,121,494.00 1,252,241.00 1,666,490.00 6,011,869 5,662,692 5,466,363 5,248,890 5,088,921 497,281 618,653 705,319 728,180 781,522

1.361 1.579 1.568 1.579 1.4420.975 1.179 1.207 1.214 1.1190.503 0.821 0.849 0.885 0.9560.738 0.741 0.770 0.781 0.7252.150 2.526 2.754 2.997 3.2190.153 0.177 0.208 0.238 0.3270.402 0.403 0.365 0.364 0.3230.855 0.842 0.776 0.711 0.5200.106 0.049 0.000 0.000 -0.0010.078 0.032 0.032 0.028 0.015

12.089 9.153 7.750 7.208 6.512

D71
mnb3aqb: Source: Yellow Book - Schd P, Col. 1 as advised by Ethel Wang.
E71
mnb3aqb: Source: Yellow Book - Schd P, Col. 1 as advised by Ethel Wang.
F71
mnb3aqb: Source: Yellow Book - Schd P, Col. 1 as advised by Ethel Wang.
G71
Lawrence Lu: Source: Yellow Book - Schd P, Col. 1 as advised by Ethel Wang.
D72
mnb3aqb: CDI Market Share Reports
E72
mnb3aqb: CDI Market Share Reports
F72
mnb3aqb: CDI Market Share Reports
G72
pmd2485: CDI Market Share Reports
G75
Ethel Wang: Sch P, Column 4-Column 5 + Column 13-Column 14+Column 15-Column 16
G76
Lawrence Lu: Source: Yellow Book - Schd P, Col. 12. Confirmed by Ethel Wang.
G77
Lawrence Lu: Source: Yellow Book - Schd P, Col. 25. Confirmed by Ethel Wang.
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AASCIF Member Name Pinnacol AssuranceJurisdiction ColoradoWeb Address

Alicia Miller

Last Reporting Period (ended) 12/31/2013Statutory

Accounting Year Year-1

Year Designation 2013 2012

OPERATING STATEMENT ($000)1 Net Premiums Earned 479,719 425,882 2 Net Losses Incurred 361,710 318,363 3 Loss Expense Incurred 62,695 43,592 4 Underwriting Expense Incurred 110,022 116,312 5 Net UW Gain / (Loss) (54,708) (52,385)6 Income From Bond Investments 64,525 72,966 7 Income From Stock Investments 8,408 7,855 8 Income From Mortgage Investments9 Income From All Other Investments 4,486 3,895

10 Net Realized Capital Gain/(Loss) 22,356 47,007 11 Investment Expense Incurred (5,571) (4,876)12 Other Income (11,680) (8,290)13 Net Income Prior to Dividends/Taxes 27,816 66,172 14 Dividends to Policyholders 1,720 38,922 15 Federal Income Tax - - 16 Net Income After Dividends/Taxes 26,096 27,250

ASSETS ($000)1 Cash & Bank Deposits 86,416 129,571 2 Bonds @ Amortized Value 1,454,706 1,397,763 3 Stocks @ Market Value 428,430 309,700 4 Mortgage Loans On Real Estate @ Amortized Value - - 5 Real Estate 18,139 19,209 6 Other Invested Assets & Loans 699 - 7 Cash & Invested Assets 1,988,390 1,856,243 8 Funds Held Or Deposited With Ceding Reinsurers - - 9 Premium Due But Not Collected 40,526 30,478

10 Reinsurance Recoverable On Loss Payments11 Interest,Dividends,&Real Estate Inc. Due & Accrued 14,123 14,901 12 Other Non-Invested Assets 514 866 13 Total Assets 2,043,553 1,902,488

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 768,516 676,347 2 Loss Adjustment Expense 109,081 112,431 3 27,245 24,049 4 Taxes, Licenses, & Fees 3,235 3,801 5 Borrowed Money - - 6 Unearned Premiums 81,294 71,081 7 Dividends Declared & Unpaid 13,265 12,748 8 Other Liabilities 415,356 385,929 9 Total Liabilities 1,417,992 1,286,386

www.pinnacol.comStatBook Contact (name)StatBook Contact (phone / email) 303-361-4889/[email protected]

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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10 Restricted Surplus/Equity Funds - - 11 Unrestricted Surplus 625,560 616,102 12 Policyholder Surplus 625,560 616,102 13 Total Liabilities & Policyholder Surplus 2,043,552 1,902,488

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 616,102 581,826 2 Net Income/(Loss) After Policyholder Dividend & Taxes 26,096 27,250 3 Net Unrealized Capital Gains/(Losses) 57,056 6,094 4 Change in Nonadmitted Assets (2,101) 955 5 Other Adjustments To Surplus/Equity (71,593) (23)6 Policyholder Surplus At Close of Accounting Period 625,560 616,102

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 469,203 409,326 2 Approximate Direct Market Share (Insured Market Only) 59% 58.5%3 Direct Policies Written 55,989 55,404 4 Direct Written Payroll ($000) 24,168 23,680 5 Accident Year Direct Loss Incurred ($000) 394,766 375,300 6 Accident Year Direct Claims Incurred 30,472 30,2137 Open Direct Claims @ End of Period 9,039 8,756 8 Direct Claim Management Employees (FTE) 128 1279 Other Claim Management Employees (FTE) 43 42

10 Direct Policy Service Employees (FTE) 226 22511 All Other Employees (FTE) 180 188 12 Total Employees (FTE) 576.00 582.00 13 Net Premiums Written 488,429 431,449 14 Total Adjusted Capital 625,560 616,102 15 Authorized Control Level Risk-based Capital 70,994 58,908

BENCHMARK STATISTICS1 1.114 1.1232 Calendar Year Loss & LAE Ratio 0.885 0.8503 Calendar Year Operating Ratio 0.942 0.8454 Accident Year Direct Loss Ratio 0.841 0.9175 Loss & LAE Reserve:Surplus Ratio 1.403 1.2806 Premium:Surplus Ratio 0.767 0.6917 Expense Ratio 0.225 0.2708 Investment Yield Ratio 0.201 0.3109 Dividend Ratio 0.004 0.095

10 Return on Policyholder Surplus 0.045 0.11011 Risk Based Capital 8.811 10.459

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Pinnacol AssuranceColorado

Alicia Miller

12/31/2013Statutory

Year-2 Year-3 Year-4 Year-5

2011 2010 2009 2008

385,795 344,612 398,502 521,082 300,554 243,642 255,523 274,076 58,929 16,136 34,542 66,841 99,246 145,518 113,958 124,041 (72,934) (60,684) (5,521) 56,124 82,225 85,253 89,915 91,987 7,298 4,573 4,570 4,102

- 3,874 3,888 4,232 6,523 28,226 21,187 (63,498) 11,744 (4,287) (4,218) (4,315) (4,179) (10,304) (130,756) 227 (1,725) 34,098 (80,757) 25,610 164,576 40,751 46,956 116,841 78,557 - - - - (6,653) (127,713) (91,231) 86,019

80,053 52,809 63,556 111,674 1,476,227 1,563,182 1,615,973 1,692,948 278,835 295,352 268,236 189,062 - - 20,061 21,116 21,589 22,344 - 531 - 1,855,176 1,932,990 1,969,354 2,016,027 - - 20,846 25,085 22,362 50,590 - - 16,320 17,958 18,328 18,559 1,299 2,731 6,622 4,924 1,893,641 1,978,764 2,016,666 2,090,101

703,488 722,346 954,394 1,006,494 136,670 143,727 194,744 216,666 17,298 13,676 22,446 29,282 3,185 2,799 5,870 8,367 - - 65,477 68,567 71,838 86,068 11,697 14,572 20,275 29,957 374,001 394,951 14,572 15,265 1,311,816 1,360,638 1,284,139 1,392,100

www.pinnacol.com

303-361-4889/[email protected]

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- - 581,826 618,126 732,527 698,001 581,826 618,126 732,527 698,001 1,893,642 1,978,764 2,016,666 2,090,101

618,126 732,527 698,001 722,072 (6,654) (127,713) (91,231) 86,019 (29,789) 30,125 123,156 (110,077) 620 (1,814) 2,601 (342) (477) (15,000) - 330 581,826 618,125 732,527 698,001

367,709 328,495 381,694 494,418 59% 50% 50% 50%

55,033 55,431 55,212 57,336 22,721 22,494,849 22,763,465 23,252,419

365,232 228,343 248,298 266,020 29,220 42,427 43,008 50,254

8,677 8,354 9,807 9,456 112 208 236 239

37 71 81 82 198 146 138 137

229 166 154 156 577.00 591.00 609.00 614.00 382,632 346,762 370,030 511,601 581,826 618,126 732,527 698,001 52,434 55,678 57,930 56,273

1.189 1.176 1.014 0.8920.932 0.754 0.728 0.6540.912 1.234 0.936 0.6840.993 0.695 0.651 0.5381.444 1.401 1.569 1.7520.663 0.558 0.544 0.7470.259 0.420 0.308 0.2420.319 0.337 0.081 0.2230.111 0.143 0.306 0.1590.057 -0.120 0.036 0.232

11.096 11.102 12.645 12.404

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AASCIF Member Name Hawaii Employers' Mutual Insurance Company, Inc.Jurisdiction Hawaii Web Address

Jason Yoshimi808-524-3642 ext. 206 / [email protected]

Last Reporting Period (ended) 12/31/2011Statutory

Accounting Year Year-1

Year Designation 2011 2010

OPERATING STATEMENT ($000)1 Net Premiums Earned 29,911 28,970 2 Net Losses Incurred 17,162 15,411 3 Loss Expense Incurred 4,066 4,910 4 Underwriting Expense Incurred 10,066 9,318 5 Net UW Gain / (Loss) (1,383) (669)6 Income From Bond Investments 9,586 10,388 7 Income From Stock Investments 767 680 8 Income From Mortgage Investments - - 9 Income From All Other Investments 137 74

10 Net Realized Capital Gain/(Loss) 1,261 176 11 Investment Expense Incurred - - 12 Other Income (648) 12 13 Net Income Prior to Dividends/Taxes 9,720 10,661 14 Dividends to Policyholders 1,500 2,000 15 Federal Income Tax - - 16 Net Income After Dividends/Taxes 8,220 8,661

ASSETS ($000)1 Cash & Bank Deposits 5,105 3,308 2 Bonds @ Amortized Value 207,490 208,570 3 Stocks @ Market Value 38,234 39,819 4 Mortgage Loans On Real Estate @ Amortized Value - - 5 Real Estate 5,100 2,235 6 Other Invested Assets & Loans 1,703 1,482 7 Cash & Invested Assets 257,632 255,414 8 Funds Held Or Deposited With Ceding Reinsurors9 Premium Due But Not Collected 11,533 9,857

10 Reinsurance Recoverable On Loss Payments 33 272 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 2,458 2,494 12 Other Non-Invested Assets 1,917 875 13 Total Assets 273,573 268,912

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 62,592 66,217 2 Loss Adjustment Expense 16,882 18,110 3 909 978 4 Taxes, Licenses, & Fees 2,202 1,554 5 Borrowed Money6 Unearned Premiums 14,942 13,708 7 Dividends Declared & Unpaid8 Other Liabilities 2,217 2,006 9 Total Liabilities 99,744 102,573

www.hemic.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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10 Restricted Surplus/Equity Funds11 Unrestricted Surplus 173,829 166,339 12 Policyholder Surplus 173,829 166,339 13 Total Liabilities & Policyholder Surplus 273,573 268,912

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 166,339 152,677 2 Net Income/(Loss) After Policyholder Dividend & Taxes 8,220 8,661 3 Net Unrealized Capital Gains/(Losses) (1,455) 5,728 4 Change in Nonadmitted Assets 725 (727)5 Other Adjustments To Surplus/Equity - - 6 Policyholder Surplus At Close of Accounting Period 173,829 166,339

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 32,623 32,853 2 Approximate Direct Market Share (Insured Market Only) 18% 18%3 Direct Policies Written 6,092 7,258 4 Direct Written Payroll ($000) 1,312,427 1,324,634 5 Accident Year Direct Loss Incurred ($000) 26,923 29,307 6 Accident Year Direct Claims Incurred 1,531 1,560 7 Open Direct Claims @ End of Period 1,349 1,290 8 Direct Claim Management Employees (FTE) 15.00 15.00 9 Other Claim Management Employees (FTE) 7.00 7.00

10 Direct Policy Service Employees (FTE) 21.00 23.00 11 All Other Employees (FTE) 20.00 22.00 12 Total Employees (FTE) 63.00 67.00 13 Net Premiums Written 31,145 27,789 14 Total Adjusted Capital 173,829 166,339 15 Authorized Control Level Risk-based Capital 5,678 5,580

BENCHMARK STATISTICS1 1.046 1.0232 Calendar Year Loss & LAE Ratio 0.710 0.7013 Calendar Year Operating Ratio 0.675 0.6324 Accident Year Direct Loss Ratio 0.825 0.8925 Loss & LAE Reserve:Surplus Ratio 0.457 0.5076 Premium:Surplus Ratio 0.172 0.1747 Expense Ratio 0.323 0.3358 Investment Yield Ratio 0.360 0.3459 Dividend Ratio 0.046 0.061

10 Return on Policyholder Surplus 0.057 0.06711 Risk Based Capital 30.614 29.810

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Hawaii Employers' Mutual Insurance Company, Inc.Hawaii

Jason Yoshimi808-524-3642 ext. 206 / [email protected]

12/31/2011Statutory

Year-2 Year-3 Year-4 Year-5

2009 2008 2007 2006 2005

37,323 50,560 64,544 75,254 76,257 21,519 17,711 21,230 15,537 27,708 3,364 3,968 11,616 3,512 14,549 11,482 10,751 12,723 13,276 12,532 958 18,130 18,975 42,929 21,468 10,743 10,145 9,302 7,596 5,231 634 654 652 412 319 - - - - - - - - - - (1,645) (5,083) 567 394 (225) - - - - - 256 259 (1,169) (1,143) (720) 10,946 24,105 28,327 50,188 26,073 3,250 4,999 5,000 - - - - - - - 7,696 19,106 23,327 50,188 26,073

6,427 8,366 12,789 5,031 8,593 210,238 205,531 195,723 178,609 144,867 34,174 21,939 28,197 28,759 14,175 - - - - - - - - - - 1,325 2,000 1 - - 252,164 237,836 236,710 212,399 167,635

- - - - 10,395 15,791 20,929 24,032 25,202 32 77 46 586 24

2,506 2,381 2,134 1,719 1,309 463 1,302 439 186 641 265,560 257,387 260,258 238,922 194,811

72,694 72,679 73,854 72,773 74,430 18,753 21,966 25,943 22,028 25,885 1,001 1,118 1,052 839 929 3,059 2,504 2,102 2,231 2,554

- - - - 14,888 20,153 26,018 31,189 32,550

- - - - 2,488 2,928 4,863 6,527 7,039 112,883 121,348 133,832 135,587 143,387

www.hemic.com

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- - - - 152,677 136,039 126,426 103,335 51,424 152,677 136,039 126,426 103,335 51,424 265,560 257,387 260,258 238,922 194,811

136,039 126,426 103,335 51,424 25,199 7,697 19,106 23,327 50,188 26,073 7,557 (9,181) (284) 2,154 735 1,384 (312) 48 (431) (583) - - - - - 152,677 136,039 126,426 103,335 51,424

42,481 58,990 75,145 88,802 87,849 20% 22% 22% 25% 24%

6,361 6,809 6,932 7,160 6,991 1,662,888 1,766,400 1,819,889 1,770,333 1,708,173 40,446 48,527 45,697 35,397 31,531 1,944 2,435 2,834 2,814 3,232 1,371 1,566 1,421 1,348 1,495 16.00 15.00 11.00 11.00 12.00 10.00 9.00 7.00 7.00 6.00 26.00 32.50 34.50 31.50 36.50 25.00 20.50 23.00 27.00 19.00 77.00 77.00 75.50 76.50 73.50 32,058 Underwriting and Investment Exhibit, Part 1B, col. 6, line 16 152,677 Five-Year Historical Data (page 17, line 28) 5,263 Five-Year Historical Data (page 17, line 29)

0.974 0.641 0.706 0.430 0.7180.667 0.429 0.509 0.253 0.5540.707 0.523 0.561 0.333 0.6580.952 0.823 0.608 0.399 0.3590.599 0.696 0.789 0.917 1.9510.244 0.372 0.511 0.728 1.4830.358 #DIV/0! #DIV/0! #DIV/0! #DIV/0!0.229 0.097 0.140 0.095 0.0610.077 0.085 0.067 0.000 0.0000.076 0.184 0.247 0.649 0.681

29.010 #DIV/0! #DIV/0! #DIV/0! #DIV/0!

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Underwriting and Investment Exhibit, Part 1B, col. 6, line 16Five-Year Historical Data (page 17, line 28)Five-Year Historical Data (page 17, line 29)

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AASCIF Member Name Kentucky Employers' Mutual Insurance AuthorityJurisdiction KentuckyWeb Address

Diane S. May, Finance Manager859-425-7800 / [email protected]

12/31/2010Statutory

Accounting YearYear Designation 2010

OPERATING STATEMENT ($000)1 Net Premiums Earned 105,465 2 Net Losses Incurred 77,269 3 Loss Expense Incurred 19,279 4 Underwriting Expense Incurred 24,016 5 Net UW Gain / (Loss) (15,099)6 Income From Bond Investments 28,766 7 Income From Stock Investments 505 8 Income From Mortgage Investments - 9 Income From All Other Investments 8

10 Net Realized Capital Gain/(Loss) 4,963 11 Investment Expense Incurred (2,378)12 Other Income (3,913)13 Net Income Prior to Dividends/Taxes 12,852 14 Dividends to Policyholders 30,800 15 Federal Income Tax - 16 Net Income After Dividends/Taxes (17,948)

ASSETS ($000)1 Cash & Bank Deposits 13,610 2 Bonds @ Amortized Value 574,799 3 Stocks @ Market Value 25,780 4 Mortgage Loans On Real Estate @ Amortized Value - 5 Real Estate - 6 Other Invested Assets & Loans - 7 Cash & Invested Assets 614,189 8 Funds Held Or Deposited With Ceding Reinsurers - 9 Premium Due But Not Collected 32,565

10 Reinsurance Recoverable On Loss Payments 328 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 6,168 12 Other Non-Invested Assets 63 13 Total Assets 653,313

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 389,945 2 Loss Adjustment Expense 33,968 3 7,602 4 Taxes, Licenses, & Fees - 5 Borrowed Money - 6 Unearned Premiums 49,914 7 Dividends Declared & Unpaid 2,351 8 Other Liabilities 25,853 9 Total Liabilities 509,633

10 Restricted Surplus/Equity Funds -

www.kemi.comStatBook Contact (name)StatBook Contact (phone / email)Last Reporting Period (ended)Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excluding fed inc tax, licenses, fees)

B40
Less private accounts over 90 days since billing
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11 Unrestricted Surplus 143,680 12 Policyholder Surplus 143,680 13 Total Liabilities & Policyholder Surplus 653,313

- CHANGE IN POLICYHOLDER SURPLUS ($000)

1 Policyholder Surplus @ Begin of Accounting Period 153,998 2 Net Income/(Loss) After Policyholder Dividend & Taxes (17,948)3 Net Unrealized Capital Gains/(Losses) 2,843 4 Change in Nonadmitted Assets 4,907 5 Other Adjustments To Surplus/Equity (120)6 Policyholder Surplus At Close of Accounting Period 143,680

- OTHER OPERATIONAL MEASURES

1 Direct Premiums Earned ($000) 108,722 2 22%3 Direct Policies Written 21,691 4 Direct Written Payroll ($000) 4,057,186 5 Accident Year Direct Loss Incurred ($000) 77,176 6 Accident Year Direct Claims Incurred 5,791 7 Open Direct Claims @ End of Period 4,499 8 Direct Claim Management Employees (FTE) 28.00 9 Other Claim Management Employees (FTE) 37.50

10 Direct Policy Service Employees (FTE) 66.25 11 All Other Employees (FTE) 70.75 12 Total Employees (FTE) 202.50 13 Net Premiums Written ($000) 102,921 14 Total Adjusted Capital ($000) 143,680 15 Authorized Control Level Risk-based Capital ($000) 24,517

BENCHMARK STATISTICS1 1.1432 Calendar Year Loss & LAE Ratio 0.9153 Calendar Year Operating Ratio 0.8784 Accident Year Direct Loss Ratio 0.7105 Loss & LAE Reserve:Surplus Ratio 2.9506 Premium:Surplus Ratio 0.7347 Expense Ratio 0.2338 Investment Yield Ratio 0.2939 Dividend Ratio 0.283

10 Return on Policyholder Surplus 0.08611 Risk Based Capital 5.860

Approximate Direct Market Share (Insured Market Only)

Calendar Year Combined Ratio (prior to dividends & taxes)

B70
From Statutory Pg 14, Col 2 (Grand Total)
B71
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B72
Insurance policies issued with coverage effective dates within accounting period.
B73
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B74
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B75
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B76
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B77
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B78
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B83
Statutory filings only
B84
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Kentucky Employers' Mutual Insurance AuthorityKentucky

Diane S. May, Finance Manager859-425-7800 / [email protected]

12/31/2010Statutory

Year-1 Year-2 Year-3 Year-4 Year-5

2009 2008 2007 2006 2005

113,668 109,804 111,386 129,261 124,979 81,214 70,983 80,042 91,447 87,676 18,658 16,599 17,000 14,633 18,238 18,164 15,293 12,974 11,179 17,270 (4,368) 6,929 1,370 12,002 1,795 28,808 25,610 21,881 17,382 13,095 475 604 593 497 441 - - - - - 3 265 581 552 175 (3,546) (7,524) 454 159 (34) (3,377) (4,079) (3,960) (2,887) (1,657) (1,862) (1,761) (2,332) (1,753) (1,443) 16,133 20,044 18,587 25,952 12,372 - - - - - - - - - - 16,133 20,044 18,587 25,952 12,372

9,508 21,946 14,389 15,535 8,491 566,498 515,515 464,172 389,844 323,721 23,025 18,886 30,734 27,625 24,552 - - - - - - - - - - - - - 2,000 38 599,031 556,347 509,295 435,004 356,802 - - - - - 42,264 49,057 57,063 67,273 67,470 270 223 150 1,395 1,264 6,391 5,377 4,808 3,968 3,307 213 227 310 444 1,683 648,169 611,231 571,626 508,084 430,526

357,271 317,813 284,208 246,642 205,913 32,143 29,842 28,154 25,779 25,673 6,946 7,277 6,642 7,766 8,119 - - - - - - - - - - 53,837 48,970 51,872 57,142 61,013 - - - - - 43,974 75,591 77,251 67,677 53,892 494,171 479,493 448,127 405,006 354,610 - - - - -

www.kemi.com

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153,998 131,738 123,499 103,078 75,916 153,998 131,738 123,499 103,078 75,916 648,169 611,231 571,626 508,084 430,526 - - - - -

131,738 123,499 103,078 75,916 65,396 16,133 20,044 18,587 25,952 12,372 5,537 (11,377) 149 3,421 423 619 (651) 1,737 (2,080) (2,235) (29) 223 (52) (131) (40) 153,998 131,738 123,499 103,078 75,916 - - - - -

131,824 149,958 156,062 182,370 177,730 23% 24% 23% 26% 29%

21,896 22,175 23,632 23,486 23,007 3,864,695 4,058,373 4,029,590 3,720,650 3,771,333 91,401 98,471 99,039 104,300 100,825 6,142 7,174 7,664 8,253 8,271 4,380 4,609 5,077 4,678 5,172 31.00 30.85 29.66 29.36 28.33 38.00 37.81 36.36 36.00 34.72 66.25 65.94 63.40 62.77 60.55 73.75 73.40 70.58 69.87 67.40 209.00 208.00 200.00 198.00 191.00 119,539 106,964 107,820 123,991 111,751 Five-Year Historical Data (page 17, line 7) 153,998 131,738 123,499 103,078 75,916 Five-Year Historical Data (page 17, line 28) 21,165 19,349 20,683 19,870 19,693 Five-Year Historical Data (page 17, line 29)

1.038 0.937 0.988 0.907 0.9860.879 0.798 0.871 0.821 0.8470.858 0.817 0.833 0.799 0.9010.693 0.657 0.635 0.572 0.5672.529 2.639 2.529 2.643 3.0510.738 0.834 0.902 1.254 1.6460.152 0.143 0.120 0.090 0.1550.170 0.099 0.125 0.086 0.0680.000 0.000 0.000 0.000 0.0000.113 0.157 0.164 0.290 0.1757.276 6.809 5.971 5.188 3.855

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Five-Year Historical Data (page 17, line 7)Five-Year Historical Data (page 17, line 28)Five-Year Historical Data (page 17, line 29)

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AASCIF Member Name Louisiana Workers' Compensation CorporationJurisdiction LouisianaWeb Address

Natalie Howell225-924-7788 / [email protected]

Last Reporting Period (ended) 12/31/2013Statutory

Accounting YearYear Designation 2013

OPERATING STATEMENT ($000)1 Net Premiums Earned 172,652 2 Net Losses Incurred 67,496 3 Loss Expense Incurred 23,701 4 Underwriting Expense Incurred 43,077 5 Net UW Gain / (Loss) 38,379 6 Income From Bond Investments 38,909 7 Income From Stock Investments 13,661 8 Income From Mortgage Investments - 9 Income From All Other Investments 2,412

10 Net Realized Capital Gain/(Loss) 29,008 11 Investment Expense Incurred (3,835)12 Other Income (1,154)13 Net Income Prior to Dividends/Taxes 117,380 14 Dividends to Policyholders 69,061 15 Federal Income Tax - 16 Net Income After Dividends/Taxes 48,319

ASSETS ($000)1 Cash & Bank Deposits 56,782 2 Bonds @ Amortized Value 1,172,857 3 Stocks @ Market Value 272,332 4 Mortgage Loans On Real Estate @ Amortized Value - 5 Real Estate 11,478 6 Other Invested Assets & Loans 1 7 Cash & Invested Assets 1,513,450 8 Funds Held Or Deposited With Ceding Reinsurers 1,583 9 Premium Due But Not Collected 76,730

10 Reinsurance Recoverable On Loss Payments 993 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 7,849 12 Other Non-Invested Assets 1,677 13 Total Assets 1,602,281

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 431,082 2 Loss Adjustment Expense 58,550 3 18,655 4 Taxes, Licenses, & Fees 48,437 5 Borrowed Money 282 6 Unearned Premiums 84,065 7 Dividends Declared & Unpaid 69,061 8 Other Liabilities 38,180 9 Total Liabilities 748,313

www.lwcc.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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10 Restricted Surplus/Equity Funds11 Unrestricted Surplus 853,968 12 Policyholder Surplus 853,968 13 Total Liabilities & Policyholder Surplus 1,602,280

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 789,512 2 Net Income/(Loss) After Policyholder Dividend & Taxes 48,319 3 Net Unrealized Capital Gains/(Losses) 14,197 4 Change in Nonadmitted Assets 2,858 5 Other Adjustments To Surplus/Equity (918)6 Policyholder Surplus At Close of Accounting Period 853,968

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 175,261 2 Approximate Direct Market Share (Insured Market Only) 23%3 Direct Policies Written 17,945 4 Direct Written Payroll ($000) 6,472,801 5 Accident Year Direct Loss Incurred ($000) 103,512 6 Accident Year Direct Claims Incurred 3,248 7 Open Direct Claims @ End of Period 1,768 8 Direct Claim Management Employees (FTE) 47.00 9 Other Claim Management Employees (FTE) 15.00

10 Direct Policy Service Employees (FTE) 74.00 11 All Other Employees (FTE) 108.50 12 Total Employees (FTE) 244.50 13 Net Premiums Written 182,729.00 14 Total Adjusted Capital 853,967.64 15 Authorized Control Level Risk-based Capital 30,414.00

BENCHMARK STATISTICS1 0.7782 Calendar Year Loss & LAE Ratio 0.5283 Calendar Year Operating Ratio 0.3204 Accident Year Direct Loss Ratio 0.5915 Loss & LAE Reserve:Surplus Ratio 0.5736 Premium:Surplus Ratio 0.2027 Expense Ratio 0.3658 Investment Yield Ratio 0.4579 Dividend Ratio 0.394

10 Return on Policyholder Surplus 0.14311 Risk Based Capital 28.08

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
State pg 19 -From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Louisiana Workers' Compensation CorporationLouisiana

Natalie Howell225-924-7788 / [email protected]

12/31/2013Statutory

Year-1 Year-2 Year-3 Year-4 Year-5

2012 2011 2010 2009 2008

155,825 150,570 142,775 183,590 221,100 67,398 79,322 95,027 97,444 77,812 19,771 19,731 26,099 18,590 24,351 40,482 44,858 44,167 51,056 54,083 28,173 6,659 (22,518) 16,500 64,854 41,608 46,490 45,870 45,493 45,945 8,808 5,722 3,580 5,480 4,468 - - - - - 2,441 2,098 2,158 2,277 4,085 13,225 4,217 36,058 (6,113) (76,904) (3,183) (3,433) (3,790) (3,569) (3,300) (3,223) (4,914) (6,945) (14,475) (8,439) 87,849 56,839 54,413 45,593 30,709 48,695 23,500 22,500 15,000 7,500 - - - - - 39,154 33,339 31,913 30,593 23,209

41,639 49,506 14,425 27,576 31,985 1,121,637 1,107,173 1,106,198 999,501 916,454 258,748 199,259 165,514 152,615 122,624 - - - - - 11,495 10,695 10,999 11,210 11,210 1 - 16,574 36,956 45,373

1,433,520 1,366,633 1,313,710 1,227,858 1,127,646 1,458 2,495 2,239 1,909 1,884 67,954 62,929 62,128 73,409 100,634 910 1,445 2,759 1,472 6,261 7,622 8,606 9,057 8,393 7,931 403 581 715 1,434 6,553 1,511,867 1,442,689 1,390,608 1,314,475 1,250,909

434,721 438,461 432,255 421,721 415,331 54,776 54,826 54,531 47,809 50,532 18,276 16,596 16,115 21,154 23,042 50,440 54,501 55,092 55,408 57,922 245 214 218 216 500 73,989 66,684 70,531 75,299 91,013 48,695 23,500 22,500 15,000 7,500 41,213 60,558 52,487 44,400 68,127 722,354 715,340 703,729 681,007 713,967

www.lwcc.com

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- - 789,512 727,349 686,879 633,469 536,942 789,512 727,349 686,879 633,469 536,942 1,511,867 1,442,689 1,390,608 1,314,476 1,250,909

727,348 686,879 633,469 536,942 547,857 39,154 33,336 31,914 30,593 23,209 22,018 (1,702) (2,679) 53,351 (15,302) 2,480 7,982 31,267 3,614 (18,861) (1,488) 853 (7,092) 8,969 39 789,512 727,348 686,879 633,469 536,942

159,948 162,539 156,031 196,069 234,060 21% 22% 22% 24% 26%

18,620 18,627 19,397 20,471 20,152 6,124,920 6,063,974 6,286,555 6,701,356 6,905,291 100,418 99,058 101,775 97,519 111,946 3,457 3,661 3,957 3,577 4,105 1,926 2,157 2,375 2,215 2,467 48.00 46.50 49.00 35.00 36.00 16.00 16.00 14.00 31.00 31.00 73.00 75.00 74.00 80.00 89.00 97.00 112.00 114.00 123.00 122.00 234.00 249.50 251.00 269.00 278.00 163,129.00 146,723.00 138,006.00 167,876.00 214,107.00 Underwriting and Investment Exhibit, Part 1B, col. 6, line 16 789,512.42 727,348.00 686,879.00 633,469.00 536,942.00 Five-Year Historical Data (page 17, line 28) 29,634.00 29,345.00 29,381.00 29,753.00 31,194.00 Five-Year Historical Data (page 17, line 29)

0.819 0.956 1.158 0.910 0.7070.559 0.658 0.848 0.632 0.4620.436 0.623 0.619 0.752 0.8610.628 0.609 0.652 0.497 0.4780.620 0.678 0.709 0.741 0.8680.197 0.207 0.208 0.290 0.4120.369 0.440 0.509 0.415 0.2530.393 0.339 0.538 0.222 -0.1100.304 0.145 0.144 0.077 0.0320.116 0.080 0.082 0.078 0.05726.64 24.79 23.38 21.29 17.213

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Underwriting and Investment Exhibit, Part 1B, col. 6, line 16Five-Year Historical Data (page 17, line 28)Five-Year Historical Data (page 17, line 29)

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AASCIF Member Name Manitoba Workers Compensation BoardJurisdiction ManitobaWeb Address

Michael Rohatynsky204-954-4741 /[email protected]

12/31/2013IFRS 2009 to current; Canadian GAAP prior to 2009

Accounting Year Year-1

Year Designation 2013 2012

OPERATING STATEMENT ($000)1 Net Premiums Earned 265,781 277,458 2 Net Losses Incurred 268,255 216,021 3 Loss Expense Incurred 12,405 11,936 4 Underwriting Expense Incurred 64,583 57,832 5 Net UW Gain / (Loss) (79,462) (8,331)6 Income From Bond Investments 19,629 19,552 7 Income From Stock Investments 13,346 11,552 8 Income From Mortgage Investments - - 9 Income From All Other Investments 14,110 20,222

10 Net Realized Capital Gain/(Loss) - - 11 Investment Expense Incurred (5,171) (4,609)12 Other Income 115,582 52,957 13 Net Income Prior to Dividends/Taxes 78,034 91,343 14 Dividends to Policyholders - - 15 Federal Income Tax - - 16 Net Income After Dividends/Taxes 78,034 91,343

ASSETS ($000)1 Cash & Bank Deposits 8,000 8,784 2 Bonds @ Amortized Value 555,775 540,939 3 Stocks @ Market Value 625,675 484,005 4 Mortgage Loans On Real Estate @ Amortized Value - - 5 Real Estate 184,052 168,204 6 Other Invested Assets & Loans - - 7 Cash & Invested Assets 1,373,502 1,201,932 8 Funds Held Or Deposited With Ceding Reinsurers - - 9 Premium Due But Not Collected 103,799 114,914

10 Reinsurance Recoverable On Loss Payments - - 11 Interest,Dividends,&Real Estate Inc. Due & Accrued - - 12 Other Non-Invested Assets 28,319 26,790 13 Total Assets 1,505,620 1,343,636

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 1,036,965 962,511 2 Loss Adjustment Expense - - 3 - - 4 Taxes, Licenses, & Fees - - 5 Borrowed Money - - 6 Unearned Premiums - - 7 Dividends Declared & Unpaid - - 8 Other Liabilities 86,981 99,121 9 Total Liabilities 1,123,946 1,061,632

www.wcb.mb.caStatBook Contact (name)StatBook Contact (phone / email)Last Update (date)Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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10 Restricted Surplus/Equity Funds - - 11 Unrestricted Surplus 381,674 282,004 12 Policyholder Surplus 381,674 282,004 13 Total Liabilities & Policyholder Surplus 1,505,620 1,343,636

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 282,004 213,545 2 Net Income/(Loss) After Policyholder Dividend & Taxes 99,670 68,459 3 Net Unrealized Capital Gains/(Losses) - - 4 Change in Nonadmitted Assets - - 5 Other Adjustments To Surplus/Equity - - 6 Policyholder Surplus At Close of Accounting Period 381,674 282,004

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 265,781 277,458 2 Approximate Market Share (Insured Market Only) 75% 72%3 Policies Written 33,352 32,548 4 Written Payroll ($000) 16,360,000 15,656,000 5 Accident Year Loss Incurred ($000) 175,953 175,797 6 Accident Year Claims Incurred 14,979 15,136 7 Open Claims @ End of Period - - 8 Direct Claim Management Employees (FTE) 240.92 240.61 9 Other Claim Management Employees (FTE) 87.81 88.48

10 Direct Policy Service Employees (FTE) 48.32 48.52 11 All Other Employees (FTE) 149.45 142.01 12 Total Employees (FTE) 526.50 519.62 13 Net Premiums Written 265,781.00 277,458.00 14 Total Adjusted Capital n.a. n.a. 15 Authorized Control Level Risk-based Capital n.a. n.a.

BENCHMARK STATISTICS1 1.299 1.0302 Calendar Year Loss & LAE Ratio 1.056 0.8223 Calendar Year Operating Ratio 0.706 0.6714 Accident Year Direct Loss Ratio 0.662 0.6345 Loss & LAE Reserve:Surplus Ratio 2.717 3.4136 Premium:Surplus Ratio 0.696 0.9847 Expense Ratio 0.243 0.2088 Investment Yield Ratio 0.158 0.1689 Dividend Ratio 0.000 0.000

10 Return on Policyholder Surplus 0.235 0.36911 Risk Based Capital * n.a. n.a.

Note:*This ratio is calculated only for U.S. jurisdictions.

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Manitoba Workers Compensation BoardManitoba

Michael Rohatynsky204-954-4741 /[email protected]

12/31/2013IFRS 2009 to current; Canadian GAAP prior to 2009

Year-2 Year-3 Year-4 Year-5

2011 2010 2009 2008

267,043 249,032 246,626 247,887 195,235 182,135 198,807 263,127 12,249 12,058 10,492 10,863 53,800 50,520 49,432 48,930 5,759 4,319 (12,105) (75,033) 21,764 16,960 17,055 17,121 9,171 10,132 8,284 11,325 - - - - 6,467 17,094 3,136 13,446 - - - - (4,576) (4,348) (4,065) (4,387) (18,308) 43,995 (30,642) 7,530 20,277 88,152 (18,337) (29,998) - - - - - - - - 20,277 88,152 (18,337) (29,998)

11,937 8,491 401 1,103 507,678 453,559 380,205 361,452 427,049 457,318 459,226 382,408 - - - - 139,424 144,535 133,170 141,199 - - - - 1,086,088 1,063,903 973,002 886,162 - - - - 107,264 95,448 99,337 100,366 - - - - - - - - 20,412 15,934 15,748 12,036 1,213,764 1,175,285 1,088,087 998,564

930,182 909,531 913,006 903,489 - - - - - - - - - - - - - - - - - - - - - - - - 70,037 57,566 46,026 33,492 1,000,219 967,097 959,032 936,981

www.wcb.mb.ca

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- - - - 213,545 208,188 129,055 61,583 213,545 208,188 129,055 61,583 1,213,764 1,175,285 1,088,087 998,564

208,188 129,055 61,583 257,900 5,357 79,133 67,472 (196,317) - - - - - - - - - - - - 213,545 208,188 129,055 61,583

267,043 249,032 246,626 247,887 74% 74% 73% 71%

31,532 30,762 29,970 28,479 14,726,000 13,986,896 13,420,350 12,628,000 167,644 167,291 172,935 184,798 15,144 15,039 15,508 17,109

- - - - 239.12 239.79 248.12 228.62 90.33 92.33 90.16 93.16 50.36 49.52 47.69 48.60 139.81 134.48 137.64 135.89 519.62 516.12 523.61 506.27 267,043.00 249,032.00 246,626.00 247,887.00

n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a.

0.978 0.983 1.049 1.3030.777 0.780 0.849 1.1050.924 0.646 1.074 1.1210.628 0.672 0.701 0.7454.356 4.369 7.075 14.6711.251 1.196 1.911 4.0250.201 0.203 0.200 0.1970.123 0.160 0.099 0.1510.000 0.000 0.000 0.0000.096 0.523 -0.192 -0.188 n.a. n.a. n.a. n.a.

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AASCIF Member Name Chesapeake Employers' Insurance CompanyJurisdiction MarylandWeb Address

Frank Linardi(410) 494-2096 / [email protected]

Last Reporting Period (ended) 12/31/2013Statutory

Accounting Year Year-1

Year Designation 2013 2012

OPERATING STATEMENT ($000)1 Net Premiums Earned 216,827 189,094 2 Net Losses Incurred 167,849 152,994 3 Loss Expense Incurred 25,837 32,559 4 Underwriting Expense Incurred 51,942 49,074 5 Net UW Gain / (Loss) (28,801) (45,533)6 Income From Bond Investments 48,226 53,005 7 Income From Stock Investments 3,246 2,131 8 Income From Mortgage Investments - - 9 Income From All Other Investments 2,837 1,778

10 Net Realized Capital Gain/(Loss) 16,056 23,031 11 Investment Expense Incurred (5,737) (4,873)12 Other Income (16,451) (21,771)13 Net Income Prior to Dividends/Taxes 19,376 7,768 14 Dividends to Policyholders - 51 15 Federal Income Tax - - 16 Net Income After Dividends/Taxes 19,376 7,717

ASSETS ($000)1 Cash & Bank Deposits 54,717 76,472 2 Bonds @ Amortized Value 1,389,642 1,434,692 3 Stocks @ Market Value 157,103 108,508 4 Mortgage Loans On Real Estate @ Amortized Value - - 5 Real Estate 9,417 9,654 6 Other Invested Assets & Loans 141,265 116,961 7 Cash & Invested Assets 1,752,144 1,746,287 8 Funds Held Or Deposited With Ceding Reinsurers 1,366 1,066 9 Premium Due But Not Collected 78,909 71,623

10 Reinsurance Recoverable On Loss Payments - - 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 11,250 11,764 12 Other Non-Invested Assets 25,231 14,031 13 Total Assets 1,868,900 1,844,771

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 1,195,116 1,196,125 2 Loss Adjustment Expense 96,204 97,195 3 6,754 7,001 4 Taxes, Licenses, & Fees 2,257 2,252 5 Borrowed Money - - 6 Unearned Premiums 105,650 96,901 7 Dividends Declared & Unpaid8 Other Liabilities 122,190 156,546 9 Total Liabilities 1,528,171 1,556,020

www.ceiwc.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

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10 Restricted Surplus/Equity Funds 2,000 2,000 11 Unrestricted Surplus 338,729 286,751 12 Policyholder Surplus 340,729 288,751 13 Total Liabilities & Policyholder Surplus 1,868,900 1,844,771

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 288,751 321,386 2 Net Income/(Loss) After Policyholder Dividend & Taxes 19,376 7,717 3 Net Unrealized Capital Gains/(Losses) 34,566 10,011 4 Change in Nonadmitted Assets (1,885) (652)5 Other Adjustments To Surplus/Equity (79) (49,711)6 Policyholder Surplus At Close of Accounting Period 340,729 288,751

OTHER OPERATIONAL MEASURES

1 Direct Premiums Earned ($000) 210,434 184,020 2 Approximate Direct Market Share (Insured Market Only) 23% 23%3 Direct Policies Written 23,615 22,719 4 Direct Written Payroll ($000) 7,009,019 6,831,987 5 Accident Year Direct Loss Incurred ($000) 186,255 181,846 6 Accident Year Direct Claims Incurred 10,482 10,464 7 Open Direct Claims @ End of Period 4,819 4,279 8 Direct Claim Management Employees (FTE) 99.20 95.60 9 Other Claim Management Employees (FTE) 31.00 30.00

10 Direct Policy Service Employees (FTE) 37.00 35.00 11 All Other Employees (FTE) 230.10 216.00 12 Total Employees (FTE) 397.30 376.60 13 Net Premiums Written 225,577 199,897 14 Total Adjusted Capital 340,729 288,751 15 Authorized Control Level Risk-based Capital 70,639 65,233

BENCHMARK STATISTICS1 1.133 1.2412 Calendar Year Loss & LAE Ratio 0.893 0.9813 Calendar Year Operating Ratio 0.911 0.9594 Accident Year Direct Loss Ratio 0.885 0.9885 Loss & LAE Reserve:Surplus Ratio 3.790 4.4796 Premium:Surplus Ratio 0.636 0.6557 Expense Ratio 0.230 0.2458 Investment Yield Ratio 0.307 0.4089 Dividend Ratio 0.000 0.000

10 Return on Policyholder Surplus 0.062 0.02511 Risk Based Capital 4.824 4.426

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Chesapeake Employers' Insurance CompanyMaryland

Frank Linardi(410) 494-2096 / [email protected]

12/31/2013Statutory

Year-2 Year-3 Year-4 Year-5

2011 2010 2009 2008

170,595 168,859 182,625 244,315 150,862 161,513 178,286 208,478 28,016 24,658 24,466 26,071 41,405 35,699 36,955 48,076 (49,688) (53,011) (57,082) (38,310) 51,062 54,559 61,669 67,001 523 281 227 87 - - - - 3,063 2,388 3,139 7,504 16,811 11,946 8,941 (8,908) (4,463) (4,038) (3,640) (3,202) 69 753 869 601 17,377 12,878 14,123 24,773 (275) 869 2,037 2,555 - - - - 17,652 12,009 12,086 22,218

137,205 379,982 286,978 188,164 1,388,741 1,172,256 1,255,373 1,364,289 79,897 57,005 49,887 21,008 - - - - 9,892 10,129 10,363 9,481 13,816 10,487 2,916 290 1,629,551 1,629,859 1,605,517 1,583,232 1,730 1,730 - - 63,483 56,247 55,507 74,186 - - - - 11,500 11,064 11,897 12,344 11,120 53,361 10,139 10,096 1,717,384 1,752,261 1,683,060 1,679,858

1,202,290 1,220,441 1,211,520 1,201,032 89,030 86,629 86,550 85,788 7,246 6,225 5,181 6,399 2,664 1,100 1,100 1,554 - - - - 86,097 80,171 82,210 97,601 391 1,692 2,740 3,800 8,280 49,212 6,209 14,153 1,395,998 1,445,470 1,395,510 1,410,327

www.ceiwc.com

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2,000 32,000 32,000 32,000 319,386 274,791 255,550 237,531 321,386 306,791 287,550 269,531 1,717,384 1,752,261 1,683,060 1,679,858

306,791 287,550 269,531 250,302 17,652 12,009 12,086 22,218 (3,573) 6,359 9,246 (8,755) 681 1,054 (3,481) 2,365 (165) (181) 168 3,402 321,386 306,791 287,550 269,532

171,167 161,203 174,159 234,879 23% 22% 23% 25%

22,683 23,914 25,969 28,402 6,693,919 6,644,850 7,429,138 7,546,825 181,926 171,295 179,255 221,187 10,525 10,810 11,689 12,457 4,366 4,533 4,518 4,963 92.70 86.70 96.70 92.20 27.60 25.50 24.50 27.50 34.00 35.00 36.00 37.00 223.00 225.00 218.10 221.10 377.30 372.20 375.30 377.80 176,521 166,820 167,234 225,915 321,386 306,791 287,550 269,532 62,977 61,613 59,051 58,716

1.291 1.314 1.313 1.1571.049 1.103 1.110 0.9600.898 0.924 0.923 0.8991.063 1.063 1.029 0.9424.018 4.260 4.514 4.7740.531 0.550 0.635 0.9060.235 0.214 0.221 0.2130.391 0.404 0.404 0.266-0.002 0.005 0.012 0.0110.055 0.043 0.051 0.0955.103 4.979 4.870 4.590

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Web Address memic.comDan McGarvey, CFO

207-791-3303, [email protected] Reporting Period (ended) 12/31/2012

Statutory

Accounting Year Year-1

Year Designation 2012 2011

OPERATING STATEMENT ($000)1 Net Premiums Earned 126,374,465 122,698,571 2 Net Losses Incurred 63,318,718 78,723,277 3 Loss Expense Incurred 13,419,240 12,298,740 4 Underwriting Expense Incurred 31,039,236 27,238,746 5 Net UW Gain / (Loss) 18,597,271 4,437,808 6 Income From Bond Investments 20,136,752 20,667,712 7 Income From Stock Investments 2,095,142 1,582,022 8 Income From Mortgage Investments - 9 Income From All Other Investments 306,953 329,655

10 Net Realized Capital Gain/(Loss) 3,188,512 7,015,131 11 Investment Expense Incurred (1,464,855) (1,376,172)12 Other Income 7,882 (154,957)13 Net Income Prior to Dividends/Taxes 42,867,657 32,501,199 14 Dividends to Policyholders 13,000,000 12,055,419 15 Federal Income Tax 6,527,065 2,444,293 16 Net Income After Dividends/Taxes 23,340,592 18,001,487

ASSETS ($000)1 Cash & Bank Deposits 13,407,498 10,520,911 2 Bonds @ Amortized Value 465,154,749 474,467,703 3 Stocks @ Market Value 185,703,857 144,763,438 4 Mortgage Loans On Real Estate @ Amortized Value - - 5 Real Estate - - 6 Other Invested Assets & Loans 19,824,451 17,240,258 7 Cash & Invested Assets 684,090,555 646,992,310 8 Funds Held Or Deposited With Ceding Reinsurers - 9 Premium Due But Not Collected 40,596,793 38,904,459

10 Reinsurance Recoverable On Loss Payments 590,379 1,244,633 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 5,180,869 5,474,101 12 Other Non-Invested Assets 18,798,812 23,810,348 13 Total Assets 749,257,408 716,425,851

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 287,330,381 298,440,251 2 Loss Adjustment Expense 34,495,446 33,453,824 3 18,330,745 13,886,522 4 Taxes, Licenses, & Fees 1,635,033 1,209,562 5 Borrowed Money - 6 Unearned Premiums 61,270,023 60,951,939

StatBook Contact (name)

StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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7 Dividends Declared & Unpaid - 8 Other Liabilities 10,147,891 7,366,479 9 Total Liabilities 413,209,519 415,308,577

10 Restricted Surplus/Equity Funds 3,196,888 3,207,180 11 Unrestricted Surplus 332,851,001 297,910,094 12 Policyholder Surplus 336,047,889 301,117,274 13 Total Liabilities & Policyholder Surplus 749,257,408 716,425,851

- CHANGE IN POLICYHOLDER SURPLUS ($000)

1 Policyholder Surplus @ Begin of Accounting Period 301,117,274 285,896,940 2 Net Income/(Loss) After Policyholder Dividend & Taxes 23,340,592 18,001,487 3 Net Unrealized Capital Gains/(Losses) 9,471,832 (4,627,790)4 Change in Nonadmitted Assets 2,414,296 4,640,631 5 Other Adjustments To Surplus/Equity (296,105) (2,793,994)6 Policyholder Surplus At Close of Accounting Period 336,047,889 301,117,274

-0.39OTHER OPERATIONAL MEASURES

1 Direct Premiums Earned ($000) 131,181,580 126,519,514 2 Approximate Direct Market Share (Insured Market Only) 62% 59%3 Direct Policies Written 20,108 20,299 4 Direct Written Payroll ($000) 5,880,325,554 5,369,217,210 5 Accident Year Direct Loss Incurred ($000) 83,887,536 80,071,997 6 Accident Year Direct Claims Incurred 11,131 11,241 7 Open Direct Claims @ End of Period 4,709 4,538 8 Direct Claim Management Employees (FTE) 46.00 48.00 9 Other Claim Management Employees (FTE) 41.00 32.00

10 Direct Policy Service Employees (FTE) 72.00 71.00 11 All Other Employees (FTE) 50.00 45.00 12 Total Employees (FTE) 209.00 196.00 13 Net Premiums Written 126,479,780 123,990,341 14 Total Adjusted Capital 336,047,889 301,117,274 15 Authorized Control Level Risk-based Capital 22,058,958 21,765,099

BENCHMARK STATISTICS1 0.853 0.9642 Calendar Year Loss & LAE Ratio 0.607 0.7423 Calendar Year Operating Ratio 0.661 0.7354 Accident Year Direct Loss Ratio 0.639 0.6335 Loss & LAE Reserve:Surplus Ratio 0.958 1.1026 Premium:Surplus Ratio 0.376 0.4077 Expense Ratio 0.245 0.2208 Investment Yield Ratio 0.185 0.2239 Dividend Ratio 0.099 0.095

10 Return on Policyholder Surplus 0.114 0.10211 Risk Based Capital 15.234 13.835

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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memic.comDan McGarvey, CFO

207-791-3303, [email protected]/31/2012Statutory

Year-2 Year-3 Year-4 Year-5

2010 2009 2008 2007

119,398,247 130,036,980 139,884,756 147,286,652 63,611,326 86,080,302 72,361,371 89,925,578 4,791,987 10,989,392 15,174,892 12,366,832 25,433,495 28,246,650 28,046,263 30,115,938 25,561,439 4,720,636 24,302,230 14,878,304 21,389,636 21,662,368 21,341,956 20,190,482 1,030,672 1,005,188 1,210,080 1,263,681 - - - - 257,010 278,746 780,048 804,860 (333,923) 2,519,377 (13,447,677) (448,141) (1,423,390) (1,919,115) (1,902,107) (1,672,522) (408,417) (533,420) (249,178) (345,574) 46,073,027 27,733,780 32,035,352 34,671,090 10,999,955 10,000,000 15,000,110 14,006,432 9,140,019 3,065,319 6,117,053 6,212,186 25,933,053 14,668,461 10,918,189 14,452,472

21,131,855 16,431,801 19,456,583 14,078,973 476,667,467 487,210,027 464,184,517 449,490,816 124,062,018 101,172,130 91,744,666 116,124,881 - - - - - 5,294,269 4,511,008 - 11,472,665 5,245,019 4,729,335 4,617,224 633,334,005 615,353,246 584,626,109 584,311,894

- - - 36,442,124 38,576,449 42,560,057 43,886,084 1,301,293 661,788 1,019,880 1,629,475 5,514,227 5,673,632 5,447,225 5,119,792 17,736,512 11,303,143 10,704,579 13,237,517 694,328,161 671,568,258 644,357,850 648,184,762

294,844,482 309,752,661 300,922,066 300,281,527 32,195,606 38,486,960 38,855,011 34,554,397 16,611,919 15,701,425 14,200,148 16,419,661 932,045 693,000 465,243 418,575 - - - - 58,434,910 60,343,419 65,324,885 69,846,978

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- - - 68,752 5,412,259 5,472,877 7,714,245 5,815,175 408,431,221 430,450,342 427,481,598 427,405,065 8,802,654 3,222,136 3,222,875 3,220,336 277,094,286 237,895,780 213,653,377 217,559,361 285,896,940 241,117,916 216,876,252 220,779,697 694,328,161 671,568,258 644,357,850 648,184,762 - - - -

241,117,916 216,876,252 220,779,697 197,165,437 25,933,053 14,668,461 10,918,189 14,452,472 10,719,858 5,992,122 (8,261,710) 6,407,099 2,735,010 3,609,620 (10,077,053) 524,799 5,391,103 (28,539) 3,517,129 2,229,890 285,896,940 241,117,916 216,876,252 220,779,697

0.00 0.00 0.00 0.00

123,253,216 133,704,579 143,125,272 150,189,914 62% 65% 64% 62%

21,027 20,315 21,528 23,022 5,292,593,240 5,551,628,873 5,372,749,778 5,146,455,969 77,671,525 81,092,272 87,901,341 87,482,120 11,344 11,696 12,632 12,975 4,457 4,784 4,181 4,494 48.00 46.00 48.60 55.20 31.00 33.00 37.00 37.00 71.00 72.40 81.04 79.85 41.00 41.45 44.60 44.12 191.00 192.85 211.24 216.17 117,471,545 125,077,751 135,421,537 145,877,907 Underwriting and Investment Exhibit, Part 1B, col. 6, line 16 285,896,940 241,117,916 216,876,252 220,779,697 Five-Year Historical Data (page 17, line 28) 20,578,512 20,384,500 19,391,390 22,164,652 Five-Year Historical Data (page 17, line 29)

0.786 0.964 0.826 0.8990.573 0.746 0.626 0.6950.614 0.787 0.771 0.7650.630 0.607 0.614 0.5821.144 1.444 1.567 1.5170.418 0.539 0.645 0.6670.217 0.226 0.207 0.2060.170 0.176 0.056 0.1340.089 0.075 0.105 0.0930.140 0.108 0.118 0.136

13.893 11.828 11.184 9.961

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Underwriting and Investment Exhibit, Part 1B, col. 6, line 16Five-Year Historical Data (page 17, line 28)Five-Year Historical Data (page 17, line 29)

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AASCIF Member Name SFM Mutual Insurance CompanyJurisdiction MinnesotaWeb Address

Terry Miller952-838-4210 / [email protected]

Last Reporting Period (ended) 12/31/2013Statutory

Accounting Year Year-1 Year-2

Year Designation 2013 2012 2011

OPERATING STATEMENT ($000)1 Net Premiums Earned 139,808 132,039 114,502 2 Net Losses Incurred 92,330 86,375 82,425 3 Loss Expense Incurred 17,649 16,203 15,083 4 Underwriting Expense Incurred 27,408 26,676 22,862 5 Net UW Gain / (Loss) 2,421 2,785 (5,868)6 Income From Bond Investments 11,121 11,446 12,324 7 Income From Stock Investments 467 389 264 8 Income From Mortgage Investments - - - 9 Income From All Other Investments 2 3 2

10 Net Realized Capital Gain/(Loss) 1,001 1,530 707 11 Investment Expense Incurred (773) (706) (668)12 Other Income 657 731 810 13 Net Income Prior to Dividends/Taxes 14,896 16,178 7,571 14 Dividends to Policyholders 3,315 2,758 3,143 15 Federal Income Tax 2,515 3,797 2,123 16 Net Income After Dividends/Taxes 9,066 9,623 2,305

ASSETS ($000)1 Cash & Bank Deposits 12,546 10,663 37,179 2 Bonds @ Amortized Value 348,793 325,731 291,576 3 Stocks @ Market Value 12,058 10,931 5,620 4 Mortgage Loans On Real Estate @ Amortized Value - - - 5 Real Estate - - - 6 Other Invested Assets & Loans 15,946 10,472 - 7 Cash & Invested Assets 389,343 357,797 334,375 8 Funds Held Or Deposited With Ceding Reinsurers - - 9 Premium Due But Not Collected 47,091 46,477 41,806

10 Reinsurance Recoverable On Loss Payments 2,195 2,152 - 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 3,073 2,856 2,589 12 Other Non-Invested Assets 35,343 32,909 32,942 13 Total Assets 477,045 442,191 411,712

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 237,654 218,610 205,511 2 Loss Adjustment Expense 35,274 34,073 32,875 3 9,973 8,434 6,308 4 Taxes, Licenses, & Fees 234 421 346 5 Borrowed Money - - - 6 Unearned Premiums 66,270 64,419 59,176 7 Dividends Declared & Unpaid 493 465 676 8 Other Liabilities 25,988 23,978 24,982 9 Total Liabilities 375,886 350,400 329,874

www.sfmic.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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10 Restricted Surplus/Equity Funds 600 600 600 11 Unrestricted Surplus 100,559 91,191 81,238 12 Policyholder Surplus 101,159 91,791 81,838 13 Total Liabilities & Policyholder Surplus 477,045 442,191 411,712

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 91,791 81,838 77,703 2 Net Income/(Loss) After Policyholder Dividend & Tax 9,066 9,623 2,305 3 Net Unrealized Capital Gains/(Losses) 1,149 715 110 4 Change in Nonadmitted Assets (478) (771) 78 5 Other Adjustments To Surplus/Equity (369) 386 1,642 6 Policyholder Surplus At Close of Accounting Period 101,159 91,791 81,838

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 132,179 136,661 118,318 2 Approximate Direct Market Share (Insured 12% 12% 12%3 Direct Policies Written 13,337 13,397 13,245 4 Direct Written Payroll ($000) 9,989,645 10,058,098 9,316,611 5 Accident Year Direct Loss Incurred ($000) 118,324 103,073 96,121 6 Accident Year Direct Claims Incurred 10,641 10,495 10,062 7 Open Direct Claims @ End of Period 6,259 6,339 6,474 8 Direct Claim Management Employees (FTE) 50.00 41.00 41.00 9 Other Claim Management Employees (FTE) 40.00 39.00 39.00

10 Direct Policy Service Employees (FTE) 49.00 49.00 48.00 11 All Other Employees (FTE) 53.00 49.00 49.00 12 Total Employees (FTE) 192.00 178.00 177.00 13 Net Premiums Written 141,184 135,117 119,516 14 Total Adjusted Capital 101,159 91,791 81,838 15 Authorized Control Level Risk-based Capital 14,767 14,640 12,233

BENCHMARK STATISTICS1 0.983 0.979 1.0512 Calendar Year Loss & LAE Ratio 0.787 0.777 0.8523 Calendar Year Operating Ratio 0.893 0.877 0.9344 Accident Year Direct Loss Ratio 0.895 0.754 0.8125 Loss & LAE Reserve:Surplus Ratio 2.698 2.753 2.9136 Premium:Surplus Ratio 1.382 1.438 1.3997 Expense Ratio 0.194 0.197 0.1918 Investment Yield Ratio 0.089 0.093 0.1079 Dividend Ratio 0.025 0.020 0.027

10 Return on Policyholder Surplus 0.128 0.143 0.06811 Risk Based Capital 6.850 6.270 6.690

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Year-3 Year-4 Year-5

2010 2009 2008

98,819 94,554 103,753 77,084 63,860 70,141 13,312 13,383 14,667 20,492 30,366 21,100 (12,069) (13,055) (2,155) 13,086 14,341 11,618 11 6 115 - - - 4 24 366 2,645 2,508 (2,251) (640) (668) (608) 848 828 311 3,885 3,984 7,396 2,226 2,775 2,244 750 (2,216) 1,364 909 3,425 3,788

15,021 16,041 10,795 291,902 283,674 274,672 5,480 5,318 5,475 - - - - - - - - - 312,403 305,033 290,942 - - - 36,383 35,023 36,342 - - - 2,652 2,731 2,753 27,129 29,198 21,801 378,567 371,985 351,838

190,299 179,390 176,848 31,198 30,734 30,382 5,989 6,104 5,138 151 105 25 - - - 52,921 47,369 46,500 233 716 764 20,073 30,226 20,592 300,864 294,644 280,249

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600 600 600 77,103 76,741 70,989 77,703 77,341 71,589 378,567 371,985 351,838

77,341 71,589 66,976 909 3,425 3,788 234 (301) 378 (1,271) (1,060) (528) 490 3,688 975 77,703 77,341 71,589

102,325 98,032 95,383 12% 12% 12%

12,934 12,336 11,873 9,048,849 8,292,604 7,722,107 89,080 80,837 83,546 9,764 9,289 10,820 6,428 5,671 5,375 40.00 41.00 43.00 37.00 39.00 41.00 46.00 47.00 49.00 47.00 44.00 40.00 170.00 171.00 173.00 105,301 96,461 101,762 77,703 77,341 71,589 11,312 10,808 10,829

1.122 1.138 1.0210.915 0.817 0.8170.961 0.958 0.9290.871 0.825 0.8762.851 2.717 2.8951.272 1.223 1.4490.195 0.000 0.2070.148 0.165 0.0970.022 0.028 0.0240.040 0.083 0.0876.869 7.156 6.611

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AASCIF Member Name Missouri Employers Mutual InsuranceJurisdiction MissouriWeb Address

Melissa Woodall573-499-4396 / [email protected]

12/31/2010Statutory

Accounting YearYear Designation 2010

OPERATING STATEMENT ($000)1 Net Premiums Earned 107,790 2 Net Losses Incurred 66,860 3 Loss Expense Incurred 11,465 4 Underwriting Expense Incurred 35,167 5 Net UW Gain / (Loss) (5,702)6 Income From Bond Investments 14,323 7 Income From Stock Investments - 8 Income From Mortgage Investments - 9 Income From All Other Investments -

10 Net Realized Capital Gain/(Loss) 2,109 11 Investment Expense Incurred - 12 Other Income (687)13 Net Income Prior to Dividends/Taxes 10,043 14 Dividends to Policyholders - 15 Federal Income Tax - 16 Net Income After Dividends/Taxes 10,043

ASSETS ($000)1 Cash & Bank Deposits 22,424 2 Bonds @ Amortized Value 284,546 3 Stocks @ Market Value 27,758 4 Mortgage Loans On Real Estate @ Amortized Value - 5 Real Estate 15,946 6 Other Invested Assets & Loans 29 7 Cash & Invested Assets 350,703 8 Funds Held Or Deposited With Ceding Reinsurers - 9 Premium Due But Not Collected 7,740

10 Reinsurance Recoverable On Loss Payments 1,853 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 3,157 12 Other Non-Invested Assets 547 13 Total Assets 364,000

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 144,640 2 Loss Adjustment Expense 13,844 3 7,862 4 Taxes, Licenses, & Fees 639 5 Borrowed Money - 6 Unearned Premiums 23,212 7 Dividends Declared & Unpaid - 8 Other Liabilities 10,706 9 Total Liabilities 200,903

10 Restricted Surplus/Equity Funds

www.mem-ins.comStatBook Contact (name)StatBook Contact (phone / email)

Last Reporting Period (ended)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excluding fed inc tax, licenses, fees)

B40
Less private accounts over 90 days since billing
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11 Unrestricted Surplus 163,097 12 Policyholder Surplus 163,097 13 Total Liabilities & Policyholder Surplus 364,000

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 154,350 2 Net Income/(Loss) After Policyholder Dividend & Taxes 10,043 3 Net Unrealized Capital Gains/(Losses) 3,714 4 Change in Nonadmitted Assets (4,919)5 Other Adjustments To Surplus/Equity (91)6 Policyholder Surplus At Close of Accounting Period 163,097

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 109,626 2 14%3 Direct Policies Written 12,419 4 Direct Written Payroll ($000) 4,486,000 5 Accident Year Direct Loss Incurred ($000) 61,454 6 Accident Year Direct Claims Incurred 2,318 7 Open Direct Claims @ End of Period 3,161 8 Direct Claim Management Employees (FTE) 49.00 9 Other Claim Management Employees (FTE) 9.00

10 Direct Policy Service Employees (FTE) 60.00 11 All Other Employees (FTE) 86.00 12 Total Employees (FTE) 204 13 Net Premiums Written 108,141 14 Total Adjusted Capital 163,097 15 Authorized Control Level Risk-based Capital 12,232

BENCHMARK STATISTICS1 1.0532 Calendar Year Loss & LAE Ratio 0.7273 Calendar Year Operating Ratio 0.9074 Accident Year Direct Loss Ratio 0.5615 Loss & LAE Reserve:Surplus Ratio 0.9726 Premium:Surplus Ratio 0.6617 Expense Ratio 0.3258 Investment Yield Ratio 0.1509 Dividend Ratio 0.000

10 Return on Policyholder Surplus 0.06311 Risk Based Capital 13.334

Approximate Direct Market Share (Insured Market Only)

Calendar Year Combined Ratio (prior to dividends & taxes)

B70
From Statutory Pg 14, Col 2 (Grand Total)
B71
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B72
Insurance policies issued with coverage effective dates within accounting period.
B73
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B74
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B75
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B76
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B77
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B78
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B83
Statutory filings only
B84
Statutory filings only
B86
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Missouri Employers Mutual InsuranceMissouri

Melissa Woodall573-499-4396 / [email protected]

12/31/2010Statutory

Year-1 Year-2 Year-3 Year-4 Year-5

2009 2008 2007 2006 2005

109,910 128,872 135,809 130,400 126,386 58,916 67,168 68,492 69,306 72,549 12,114 12,213 14,100 13,865 12,358 38,829 45,498 45,465 40,394 39,864 51 3,993 7,752 6,835 1,615 14,202 13,374 11,790 9,190 7,512 - - - - - - - - - - - - - - - (903) (2,625) 2,108 326 682 - - - - - (473) (817) (278) (212) (1,614) 12,877 13,925 21,372 16,139 8,195 - - - - - - - - - - 12,877 13,925 21,372 16,139 8,195

36,270 26,283 17,031 19,727 4,770 260,070 262,680 264,959 238,386 223,073 24,198 19,421 26,536 21,569 12,288 - - - - - 16,354 14,657 15,324 15,532 13,549 2 401 - - - 336,894 323,442 323,850 295,214 253,680 - - - - - 6,708 11,233 13,961 15,024 16,415 3,694 1,677 1,648 (205) 1,779 2,845 2,482 2,386 2,036 1,833 659 949 946 1,304 1,615 350,800 339,783 342,791 313,373 275,322

139,206 139,883 137,538 129,641 117,710 14,105 15,057 15,463 13,786 12,328 7,987 8,999 9,313 5,149 3,666 1,221 608 520 1,775 3,044 - - - - - 24,847 25,494 27,582 26,012 21,096 - - - - - 9,084 15,019 18,889 23,426 23,965 196,450 205,060 209,305 199,789 181,809

- - - -

www.mem-ins.com

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154,350 134,723 133,486 113,584 93,513 154,350 134,723 133,486 113,584 93,513 350,800 339,783 342,791 313,373 275,322

134,723 133,486 113,584 93,513 83,304 12,877 13,925 21,372 16,139 8,195 4,616 (11,467) (2,002) 1,994 (446) 2,134 (1,221) 532 1,938 2,460 - - - - - 154,350 134,723 133,486 113,584 93,513

112,085 131,220 140,337 139,735 138,132 15% 14% 14% 14% 14%

12,320 14,082 17,704 18,329 18,513 4,052,268 4,018,169 4,025,438 3,810,429 3,261,014 63,096 85,469 71,585 68,442 70,319 2,068 2,400 2,550 2,395 2,335 3,135 4,028 3,868 3,419 3,717 49.00 55.00 66.00 66.00 70.00 9.00 6.00 8.00 8.00 8.00 61.00 74.00 87.00 87.00 86.00 84.00 79.00 85.00 70.00 77.00 203 214 246 231 241 107,394 126,783 137,380 135,316 128,510 Five-Year Historical Data (page 17, line 7) 154,350 134,723 133,486 113,584 93,513 Five-Year Historical Data (page 17, line 28) 13,343 13,630 12,715 11,049 10,824 Five-Year Historical Data (page 17, line 29)

1.000 0.969 0.943 0.948 0.9870.646 0.616 0.608 0.638 0.6720.883 0.892 0.843 0.876 0.9350.563 0.651 0.510 0.490 0.5090.993 1.150 1.146 1.263 1.3910.712 0.957 1.017 1.148 1.3520.362 0.359 0.331 0.299 0.3100.119 0.082 0.099 0.068 0.0590.000 0.000 0.000 0.000 0.0000.089 0.104 0.173 0.156 0.093

11.568 9.884 10.498 10.280 8.639

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Five-Year Historical Data (page 17, line 7)Five-Year Historical Data (page 17, line 28)Five-Year Historical Data (page 17, line 29)

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AASCIF Member Name Montana State FundJurisdiction Montana Web Address

Dan Gengler406-495-5192 / [email protected]

Last Reporting Period (ended) 6/30/2012Statutory

Accounting Year Year-1

Year Designation 2012 2011

OPERATING STATEMENT ($000)1 Net Premiums Earned 150,482 173,605 2 Net Losses Incurred 119,494 130,505 3 Loss Expense Incurred 23,370 32,872 4 Underwriting Expense Incurred 23,518 30,480 5 Net UW Gain / (Loss) (15,900) (20,252)6 Income From Bond Investments 43,207 42,733 7 Income From Stock Investments - - 8 Income From Mortgage Investments - - 9 Income From All Other Investments 2,843 3,384

10 Net Realized Capital Gain/(Loss) 4,888 6,425 11 Investment Expense Incurred (1,506) (2,048)12 Other Income (3,729) (3,871)13 Net Income Prior to Dividends/Taxes 29,803 26,371 14 Dividends to Policyholders 6,001 4,004 15 Federal Income Tax - - 16 Net Income After Dividends/Taxes 23,802 22,367

ASSETS ($000)1 Cash & Bank Deposits 26,496 19,972 2 Bonds @ Amortized Value 1,035,226 1,001,287 3 Stocks @ Market Value 141,840 137,532 4 Mortgage Loans On Real Estate @ Amortized Value - - 5 Real Estate 27,975 28,508 6 Other Invested Assets & Loans 149,465 89,190 7 Cash & Invested Assets 1,381,002 1,276,489 8 Funds Held Or Deposited With Ceding Reinsurers 471 471 9 Premium Due But Not Collected 52,331 50,977

10 Reinsurance Recoverable On Loss Payments 44,523 43,523 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 11,901 11,239 12 Other Non-Invested Assets 1,573 2,207 13 Total Assets 1,491,801 1,384,906

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 784,233 775,390 2 Loss Adjustment Expense 105,707 99,413 3 19,183 21,689 4 Taxes, Licenses, & Fees - - 5 Borrowed Money - - 6 Unearned Premiums 42,469 37,369 7 Dividends Declared & Unpaid - - 8 Other Liabilities 222,541 154,702 9 Total Liabilities 1,174,133 1,088,563

www.montanastatefund.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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10 Restricted Surplus/Equity Funds - - 11 Unrestricted Surplus 317,668 296,343 12 Policyholder Surplus 317,668 296,343 13 Total Liabilities & Policyholder Surplus 1,491,801 1,384,906

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 296,343 241,546 2 Net Income/(Loss) After Policyholder Dividend & Taxes 23,802 22,367 3 Net Unrealized Capital Gains/(Losses) 3,252 30,412 4 Change in Nonadmitted Assets 1,296 2,018 5 Other Adjustments To Surplus/Equity (7,025) - 6 Policyholder Surplus At Close of Accounting Period 317,668 296,343

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 160,438 183,101 2 Approximate Direct Market Share (Insured Market Only) 62% 60%3 Direct Policies Written 26,121 26,486 4 Direct Written Payroll ($000) 4,454,821 4,449,073 5 Accident Year Direct Loss Incurred ($000) 113,175 140,075 6 Accident Year Direct Claims Incurred 7,602 7,845 7 Open Direct Claims @ End of Period 7,641 7,767 8 Direct Claim Management Employees (FTE) 56.00 58.00 9 Other Claim Management Employees (FTE) 54.50 49.50

10 Direct Policy Service Employees (FTE) 56.00 60.00 11 All Other Employees (FTE) 120.25 117.00 12 Total Employees (FTE) 286.75 284.50 13 Net Premiums Written 155,582 163,920 14 Total Adjusted Capital 317,668 296,343 15 Authorized Control Level Risk-based Capital 49,458 50,065

BENCHMARK STATISTICS1 1.106 1.1172 Calendar Year Loss & LAE Ratio 0.949 0.9413 Calendar Year Operating Ratio 0.802 0.8484 Accident Year Direct Loss Ratio 0.705 0.7655 Loss & LAE Reserve:Surplus Ratio 2.801 2.9526 Premium:Surplus Ratio 0.474 0.5867 Expense Ratio 0.151 0.1868 Investment Yield Ratio 0.308 0.2769 Dividend Ratio 0.037 0.022

10 Return on Policyholder Surplus 0.097 0.09811 Risk Based Capital 6.423 5.919

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Montana State FundMontana

Dan Gengler406-495-5192 / [email protected]

6/30/2012Statutory

Year-2 Year-3 Year-4 Year-5

2010 2009 2008 2007

166,265 203,976 230,965 238,203 143,523 178,246 194,250 187,821 22,832 20,961 18,688 35,428 18,861 20,498 26,946 24,277 (18,951) (15,729) (8,919) (9,323) 44,605 45,626 42,800 37,131 - - - - - - - - 846 2,755 1,934 1,048 2,183 (13,625) (113) (656) (508) (457) (387) (259) (4,944) (5,946) (3,221) (2,025) 23,231 12,624 32,094 25,916 2,001 3,997 - 7,001 - - - - 21,230 8,627 32,094 18,915

29,609 33,586 24,926 13,744 927,439 908,460 870,572 776,129 110,790 81,743 87,443 100,545 - - - - 28,933 12,733 2,390 1,139 167,515 175,758 143,711 146,413 1,264,286 1,212,280 1,129,042 1,037,970 75 43,310 - -

56,217 14,500 22,738 25,322 57,064 - - - 10,666 11,216 11,414 11,214 2,837 2,777 33,423 22,595 1,391,145 1,284,083 1,196,617 1,097,101

755,249 735,248 677,196 607,086 83,516 78,057 75,057 72,123 23,203 25,855 27,175 26,983 - - - - - - - - 47,054 - - - - - - - 240,576 243,891 200,623 191,741 1,149,598 1,083,051 980,051 897,933

www.montanastatefund.com

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- - - - 241,546 201,032 216,564 199,169 241,546 201,032 216,564 199,169 1,391,144 1,284,083 1,196,615 1,097,102

204,401 216,565 199,169 163,101 FY2009 restated 21,230 8,627 32,095 18,915 12,054 (22,978) (13,102) 17,168 3,861 (1,182) (1,597) (15) - - - (1) 241,546 201,032 216,565 199,168

166,265 214,966 243,317 250,707 64% 64% 72% 73% SNL market share report for MT

27,085 28,668 30,152 30,641 4,382,600 4,519,481 4,884,704 4,950,283 130,195 145,280 166,410 164,680 7,914 9,064 11,250 11,894 7,746 8,093 8,658 8,639 63.50 62.00 63.00 59.00 51.50 54.75 54.00 54.00 59.75 57.75 53.00 55.50 124.75 123.50 128.00 128.00 299.50 298.00 298.00 296.50 161,504 195,228 231,313 244,714 Underwriting and Investment Exhibit, Part 1B, col. 6, line 16 241,546 201,032 216,564 199,169 Five-Year Historical Data (page 17, line 28) 46,425 44,846 42,761 59,875 Five-Year Historical Data (page 17, line 29)

1.114 1.077 1.039 1.0391.001 0.977 0.922 0.9370.860 0.938 0.861 0.8910.783 0.676 0.684 0.6573.472 4.046 3.474 3.4100.688 1.015 1.066 1.1960.117 0.105 0.116 0.0990.283 0.160 0.182 0.1490.012 0.019 0.000 0.0280.104 0.060 0.154 0.1435.203 4.483 5.065 3.326

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Underwriting and Investment Exhibit, Part 1B, col. 6, line 16

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AASCIF Member Name WorkSafeNBJurisdiction New BrunswickWeb Address

Tim Petersen

Last Reporting Period (ended) 12/31/2011IFRS

Accounting Year Year-1 Year-2 Year-3 Year-4 Year-5

Year Designation 2011 2010 2009 2008 2007 2006

OPERATING STATEMENT ($000)1 Net Premiums Earned 189,914 200,836 190,659 199,481 194,168 172,828 2 Net Losses Incurred 119,263 148,747 154,366 186,001 203,483 159,864 3 Loss Expense Incurred 0 0 - - - - 4 Underwriting Expense Incurred 40,413 39,985 37,829 36,680 34,252 33,593 5 Net UW Gain / (Loss) 30,238 12,104 (1,536) (23,200) (43,567) (20,629)6 Income From Bond Investments 28,018 26,434 24,780 31,400 28,390 24,390 7 Income From Stock Investments 0 0 - - - - 8 Income From Mortgage Investments - - - - - - 9 Income From All Other Investments 0 0 - - - -

10 Net Realized Capital Gain/(Loss) 363 70,190 108,028 (191,159) (30,925) 80,256 11 Investment Expense Incurred (3,767) (3,290) (2,958) (2,659) (2,795) (2,787)12 Other Income 100 25 900 442 900 900 13 Net Income Prior to Dividends/Taxes 54,952 105,463 129,214 (185,176) (47,997) 82,130 14 Dividends to Policyholders - - - - 15 Federal Income Tax - - - - 16 Net Income After Dividends/Taxes 54,952 105,463 129,214 (185,176) (47,997) 82,130

ASSETS ($000)1 Cash & Bank Deposits 21,774 28,374 51,092 34,429 29,105 24,262 2 Bonds @ Amortized Value 346,126 291,880 287,797 270,659 319,455 296,632 3 Stocks @ Market Value 585,665 633,228 561,080 455,827 556,585 576,405 4 Mortgage Loans On Real Estate @ Amortized Value - - - - - - 5 Real Estate 110,262 64,271 - - - - 6 Other Invested Assets & Loans 3,360 5,001 3,116 (3,326) 3,088 - 7 Cash & Invested Assets 1,067,187 1,022,754 903,085 757,589 908,233 897,299 8 Funds Held Or Deposited With Ceding Reinsurors - - - 9 Premium Due But Not Collected 12,399 13,101 12,980 11,269 10,482 10,193

10 Reinsurance Recoverable On Loss Payments 136,495 140,989 140,236 151,534 137,048 117,791 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 1,245 891 1,454 1,126 845 904 12 Other Non-Invested Assets 10,376 8,635 8,211 9,019 8,905 9,516 13 Total Assets 1,227,702 1,186,370 1,065,966 930,537 1,065,513 1,035,703

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 1,030,463 1,047,824 1,035,943 1,048,917 997,455 920,973 2 Loss Adjustment Expense 0 0 - - - - 3 5,804 6,236 4,888 5,069 5,231 5,084 4 Taxes, Licenses, & Fees 0 0 - - - - 5 Borrowed Money - - - - - - 6 Unearned Premiums 7,797 6,237 4,757 3,577 4,996 4,152 7 Dividends Declared & Unpaid 0 0 - - - - 8 Other Liabilities 5,974 3,855 3,623 3,494 3,355 3,021 9 Total Liabilities 1,050,038 1,064,152 1,049,211 1,061,057 1,011,037 933,230

10 Restricted Surplus/Equity Funds 177,664 122,218 16,755 (130,700) 54,476 102,473 11 Unrestricted Surplus - - - - - - 12 Policyholder Surplus 177,664 122,218 16,755 (130,700) 54,476 102,473 13 Total Liabilities & Policyholder Surplus 1,227,702 1,186,370 1,065,966 930,357 1,065,513 1,035,703

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 122,712 16,755 (130,700) 54,476 102,473 20,343 2 Net Income/(Loss) After Policyholder Dividend & Taxes 54,952 105,463 129,214 (185,176) (47,997) 82,130 3 Net Unrealized Capital Gains/(Losses) - - - - - - 4 Change in Nonadmitted Assets - - - - - - 5 Other Adjustments To Surplus/Equity - - 18,241 - - - 6 Policyholder Surplus At Close of Accounting Period 177,664 122,218 16,755 (130,700) 54,476 102,473

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 162,428 168,427 155,608 153,442 148,690 144,858 2 Approximate Direct Market Share (Insured Market Only) 100% 100% 100% 100% 100% 100%3 Direct Policies Written 14,606 14,602 14,474 13,954 14,066 13,9944 Direct Written Payroll ($000) 8,180,671 7,991,929 7,755,931 7,655,941 7,286,496 6,951,103 5 Accident Year Direct Loss Incurred ($000) 149,697 146,210 143,050 142,633 131,870 138,582 6 Accident Year Direct Claims Incurred 7,822 8,511 8,781 9,478 9,668 9,8907 Open Direct Claims @ End of Period 625 185 140 122 128 1408 Direct Claim Management Employees (FTE) 47.80 48.80 48.80 48.80 46.50 46.50 9 Other Claim Management Employees (FTE) 133.00 130.00 129.00 119.00 118.00 117.00

10 Direct Policy Service Employees (FTE) 74.00 75.00 75.00 75.00 75.00 70.00 11 All Other Employees (FTE) 193.80 196.10 199.10 193.10 189.10 194.10 12 Total Employees (FTE) 448.60 449.90 451.90 435.90 428.60 427.60 13 Net Premiums Written 162,428 168,427 155,608 153,442 148,690 144,858 Underwriting and Investment Exhibit, Part 1B, col. 6, line 1614 Total Adjusted Capital NA NA NA NA NA NA Five-Year Historical Data (page 17, line 28)15 Authorized Control Level Risk-based Capital NA NA NA NA NA NA Five-Year Historical Data (page 17, line 29)

BENCHMARK STATISTICS1 0.841 0.940 1.008 1.116 1.224 1.1192 Calendar Year Loss & LAE Ratio 0.628 0.741 0.810 0.932 1.048 0.9253 Calendar Year Operating Ratio 0.711 0.475 0.322 1.928 1.247 0.5254 Accident Year Direct Loss Ratio 0.922 0.868 0.919 0.930 0.887 0.9575 Loss & LAE Reserve:Surplus Ratio 5.800 8.573 61.829 -8.025 18.310 8.9876 Premium:Surplus Ratio 1.069 1.643 11.379 -1.526 3.564 1.6877 Expense Ratio 0.249 0.237 0.243 0.239 0.230 0.2328 Investment Yield Ratio 0.152 0.554 0.834 -1.058 -0.036 0.7039 Dividend Ratio 0.000 0.000 0.000 0.000 0.000 0.000

10 Return on Policyholder Surplus 0.366 1.518 -2.268 4.859 -0.612 1.33711 Risk Based Capital 0.00 0.00 0.00 0.00 0.00 0.00

www.ws-ts.nb.caStatBook Contact (name)

StatBook Contact (phone / email) 506-633-3555/[email protected]

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

Calendar Year Combined Ratio (prior to dividends & taxes)

B41
Less private accounts over 90 days since billing
B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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AASCIF Member Name North Dakota Workforce Safety & InsuranceJurisdiction North Dakota Web Address

Cindy G. Ternes701-328-3837 / [email protected]

Last Reporting Period (ended) 6/30/2014GAAP

Accounting Year Year-1

Year Designation 2014 2013

OPERATING STATEMENT ($000)1 Net Premiums Earned 313,165 309,898 2 Net Losses Incurred 276,449 259,587 3 Loss Expense Incurred 15,599 12,702 4 Underwriting Expense Incurred 22,864 34,707 5 Net UW Gain / (Loss) (1,747) 2,902 6 Income From Bond Investments 32,843 43,309 7 Income From Stock Investments8 Income From Mortgage Investments9 Income From All Other Investments

10 Net Realized Capital Gain/(Loss) 147,114 75,121 11 Investment Expense Incurred - - 12 Other Income 1,717 6,409 13 Net Income Prior to Dividends/Taxes 179,927 127,741 14 Dividends to Policyholders (95,557) (147,585)15 Federal Income Tax16 Net Income After Dividends/Taxes 84,370 (19,844)

ASSETS ($000)1 Cash & Bank Deposits 3,083 2,263 2 Bonds @ Amortized Value - - 3 Stocks @ Market Value - - 4 Mortgage Loans On Real Estate @ Amortized Value - - 5 Real Estate - - 6 Other Invested Assets & Loans 1,704,038 1,557,777 7 Cash & Invested Assets 1,707,121 1,560,040 8 Funds Held Or Deposited With Ceding Reinsurors9 Premium Due But Not Collected 42,951 39,353

10 Reinsurance Recoverable On Loss Payments 79 39 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 11,576 8,374 12 Other Non-Invested Assets 11,006 11,645 13 Total Assets 1,772,733 1,619,451

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 1,037,207 946,007 2 Loss Adjustment Expense 15,599 12,702 34 Taxes, Licenses, & Fees5 Borrowed Money

www.workforcesafety.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B24
DGengler: Includes unrealized capital gain/(loss) per GAAP basis
B41
Less private accounts over 90 days since billing
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6 Unearned Premiums 152,954 141,891 7 Dividends Declared & Unpaid 121,733 162,000 8 Other Liabilities 6,112 5,978 9 Total Liabilities 1,333,605 1,268,578

10 Restricted Surplus/Equity Funds 210,561 191,742 11 Unrestricted Surplus 228,567 163,016 12 Policyholder Surplus 439,128 354,758 13 Total Liabilities & Policyholder Surplus 1,772,733 1,623,336

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 354,760 374,605 2 Net Income/(Loss) After Policyholder Dividend & Taxes 84,370 (19,845)3 Net Unrealized Capital Gains/(Losses)4 Change in Nonadmitted Assets5 Other Adjustments To Surplus/Equity6 Policyholder Surplus At Close of Accounting Period 439,130 354,760

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 341,836 333,992 2 Approximate Direct Market Share (Insured Market Only) 100% 100%3 Direct Policies Written 25,067 24,793 4 Direct Written Payroll ($000) * 15,321,732 17,572,233 5 Accident Year Direct Loss Incurred ($000) 337,537 299,882 6 Accident Year Direct Claims Incurred 26,395 25,835 7 Open Direct Claims @ End of Period 14,810 13,972 8 Direct Claim Management Employees (FTE) 99.00 99.00 9 Other Claim Management Employees (FTE) 59.00 59.00

10 Direct Policy Service Employees (FTE) 30.00 30.00 11 All Other Employees (FTE) 62.00 62.00 12 Total Employees (FTE) 250 250 13 Net Premiums Written 350,206 350,872 14 Total Adjusted Capital N/A N/A15 Authorized Control Level Risk-based Capital N/A N/A

BENCHMARK STATISTICS1 1.006 0.9912 Calendar Year Loss & LAE Ratio 0.933 0.8793 Calendar Year Operating Ratio 0.425 0.5884 Accident Year Direct Loss Ratio 0.987 0.8985 Loss & LAE Reserve:Surplus Ratio 2.397 2.7026 Premium:Surplus Ratio 0.713 0.8747 Expense Ratio 0.110 0.1358 Investment Yield Ratio 0.526 0.3559 Dividend Ratio -0.280 -0.442

10 Return on Policyholder Surplus -0.028 -0.45911 Risk Based Capital N/A N/A

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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North Dakota Workforce Safety & InsuranceNorth Dakota

Cindy G. Ternes701-328-3837 / [email protected]

6/30/2014GAAP

Year-2 Year-3 Year-4 Year-5

2012 2011 2010 2009

250,545 188,750 152,988 160,692 176,750 157,356 106,768 137,523 12,074 11,193 10,839 9,557 20,103 17,228 18,976 17,318 41,618 2,973 16,405 (3,706) 42,742 39,347 39,208 43,256

- - - - - -

39,445 119,652 86,825 (165,282) - - - - 2,048 2,951 3,088 1,994 125,853 164,923 145,526 (123,738) (144,376) (108,006) (74,868) (3,300) - - - - (18,523) 56,917 70,658 (120,438)

1,878 1,669 1,364 2,030 - - - - - - - - - - - - - - 1,434,766 1,350,959 1,211,945 1,136,489 1,436,644 1,352,628 1,213,309 1,138,519

- - - 41,255 33,179 33,114 17,095 97 69 55 39 9,983 7,142 9,575 9,191 18,379 14,771 19,852 17,680 1,506,358 1,407,789 1,275,905 1,182,524

853,571 802,830 755,109 755,251 12,074 11,193 16,987 16,649

- - - - - - - - -

www.workforcesafety.com

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117,488 91,587 78,320 77,004 142,388 102,000 76,500 1,645 6,231 7,051 12,778 66,423 1,131,752 1,014,661 939,694 916,972 170,756 189,279 184,593 154,380 203,850 203,849 151,618 111,172 374,606 393,128 336,211 265,552 1,506,358 1,407,789 1,275,905 1,182,524

393,128 336,211 (120,438) - (18,523) 56,917 70,658 (120,438) - - - -

374,605 393,128 (49,780) (120,438)

271,276 188,750 152,988 160,692 100% 100% 100% 100%

23,812 21,552 20,316 19,946 15,007,416 12,619,416 11,402,592 11,050,294 257,806 193,114 146,418 148,228 24,647 21,693 19,388 20,544 13,181 12,446 11,631 11,355 80.00 61 59 59 50.00 49 49 49 46.00 29 28 29 71.00 108 102 100 247 247 238 237 293,807 214,456 173,332 185,753

N/A N/A N/AN/A N/A N/A

0.834 0.984 0.893 1.0230.754 0.893 0.769 0.9150.498 0.126 0.049 1.7700.950 1.023 0.957 0.9222.311 2.071 2.296 2.9070.669 0.480 0.455 0.6050.110 0.080 0.109 0.0930.303 0.842 0.824 -0.759-0.532 -0.572 -0.489 -0.021-0.424 -0.140 0.049 2.055

N/A N/A N/A N/A

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AASCIF Member Name New Mexico Mutual GroupJurisdiction New MexicoWeb Address

Douglas Dunton505-343-2835 / [email protected]

Last Reporting Period (ended) 12/31/2013Statutory

Accounting YearYear Designation 2013

OPERATING STATEMENT ($000)1 Net Premiums Earned 84,638 2 Net Losses Incurred 49,681 3 Loss Expense Incurred 12,104 4 Underwriting Expense Incurred 24,022 5 Net UW Gain / (Loss) (1,169)6 Income From Bond Investments 7,029 7 Income From Stock Investments 1,241 8 Income From Mortgage Investments - 9 Income From All Other Investments -

10 Net Realized Capital Gain/(Loss) 1,815 11 Investment Expense Incurred (836)12 Other Income (112)13 Net Income Prior to Dividends/Taxes 7,968 14 Dividends to Policyholders - 15 Federal Income Tax 123 16 Net Income After Dividends/Taxes 7,845

ASSETS ($000)1 Cash & Bank Deposits 18,501 2 Bonds @ Amortized Value 264,053 3 Stocks @ Market Value 24,667 4 Mortgage Loans On Real Estate @ Amortized Value - 5 Real Estate 2,508 6 Other Invested Assets & Loans - 7 Cash & Invested Assets 309,729 8 Funds Held Or Deposited With Ceding Reinsurors9 Premium Due But Not Collected 11,242

10 Reinsurance Recoverable On Loss Payments 1,158 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 1,620 12 Other Non-Invested Assets 875 13 Total Assets 324,624

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 158,447 2 Loss Adjustment Expense 30,956 3 2,508 4 Taxes, Licenses, & Fees 2,112 5 Borrowed Money - 6 Unearned Premiums 10,141 7 Dividends Declared & Unpaid - 8 Other Liabilities 11,942 9 Total Liabilities 216,106

www.newmexicomutual.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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10 Restricted Surplus/Equity Funds11 Unrestricted Surplus 108,518 12 Policyholder Surplus 108,518 13 Total Liabilities & Policyholder Surplus 324,624

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 100,542 2 Net Income/(Loss) After Policyholder Dividend & Taxes 7,845 3 Net Unrealized Capital Gains/(Losses) (1,525)4 Change in Nonadmitted Assets 940 5 Other Adjustments To Surplus/Equity 716 6 Policyholder Surplus At Close of Accounting Period 108,518

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 92,928 2 Approximate Direct Market Share (Insured Market Only) 31.3%3 Direct Policies Written 7,217 4 Direct Written Payroll ($000) 3,148,000 5 Accident Year Direct Loss Incurred ($000) 49,681 6 Accident Year Direct Claims Incurred 3,791 7 Open Direct Claims @ End of Period 1,269 8 Direct Claim Management Employees (FTE) 15.00 9 Other Claim Management Employees (FTE) 5.00

10 Direct Policy Service Employees (FTE) 20.00 11 All Other Employees (FTE) 66.00 12 Total Employees (FTE) 106.00 13 Net Premiums Written 86,389 14 Total Adjusted Capital 108,518 15 Authorized Control Level Risk-based Capital 15,051

BENCHMARK STATISTICS1 1.0142 Calendar Year Loss & LAE Ratio 0.7303 Calendar Year Operating Ratio 0.9064 Accident Year Direct Loss Ratio 0.5355 Loss & LAE Reserve:Surplus Ratio 1.7456 Premium:Surplus Ratio 0.7807 Expense Ratio 0.2598 Investment Yield Ratio 0.1009 Dividend Ratio 0.000

10 Return on Policyholder Surplus 0.07511 Risk Based Capital 7.21

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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New Mexico Mutual GroupNew Mexico

Douglas Dunton505-343-2835 / [email protected]

12/31/2013Statutory

Year-1 Year-2 Year-3 Year-4 Year-5

2012 2011 2010 2009 2008

71,885 61,649 58,781 65,344 74,901 41,858 40,375 34,673 41,341 51,448 10,856 8,842 8,960 9,722 10,845 21,729 17,894 19,092 19,685 19,260 (2,558) (5,462) (3,944) (5,404) (6,652) 8,249 9,429 10,772 10,790 10,078 1,094 728 556 264 403 - - - - - - - - 25 156 743 900 831 228 (6,260) (874) (772) (904) (970) (818) (660) (75) (69) (341) (116) 5,994 4,748 7,242 4,592 (3,209)

- - (43) - 12 (21) - - 25 5,982 4,769 7,242 4,635 (3,234)

17,557 9,405 1,576 3,308 11,933 244,161 243,143 244,728 232,637 217,378 22,709 13,009 13,385 17,466 15,199 - - - - - 2,508 2,508 2,508 2,507 2,505 - - - - - 286,935 268,065 262,197 255,918 247,015

- - - - 8,163 8,215 7,566 9,015 9,702 1,295 817 1,422 1,384 1,396 1,697 1,778 1,911 1,658 1,466 611 901 1,022 743 848 298,701 279,776 274,118 268,718 260,427

146,944 144,203 141,612 141,699 137,613 28,599 26,882 26,770 27,475 27,721 2,239 1,779 2,632 2,904 1,664 1,127 110 145 3 623 - - - - - 8,390 7,187 7,386 9,821 11,829 - - - - - 10,860 7,249 7,342 7,271 8,240 198,159 187,410 185,887 189,173 187,690

www.newmexicomutual.com

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- - - 100,542 92,366 88,231 79,545 72,737 100,542 92,366 88,231 79,545 72,737 298,701 279,776 274,118 268,718 260,427

92,366 88,231 79,545 72,737 83,441 5,982 4,767 7,240 4,593 (3,191) 667 (179) 748 2,485 (6,538) 1,182 622 1,266 508 (680) 345 (1,075) (569) (778) (295) 100,542 92,366 88,230 79,545 72,737

78,258 66,257 61,630 68,933 82,440 29.6% 27.2% 27.1% 28.4% 29.4%

7,169 7,098 7,245 7,821 8,526 3,010,000 2,606,000 2,387,000 3,251,300 2,643,210 41,858 41,326 40,805 47,291 47,831 3,728 3,426 3,545 3,328 3,957 2,818 2,869 2,811 2,867 3,059 17.00 16.00 14.00 15.00 20.00 3.00 6.00 6.00 6.00 6.00 20.00 24.00 26.00 23.00 26.00 55.00 53.00 56.00 73.00 74.00 95.00 99.00 102.00 117.00 126.00 73,088 61,450 56,346 63,336 74,657 100,542 92,366 88,230 79,545 72,737 12,165 11,429 11,940 12,093 10,642

1.036 1.089 1.067 1.083 1.0890.733 0.798 0.742 0.781 0.8320.917 0.923 0.877 0.930 1.0430.535 0.624 0.662 0.686 0.5801.746 1.852 1.908 2.127 2.2730.715 0.667 0.666 0.821 1.0300.278 0.270 0.310 0.000 0.2580.118 0.155 0.183 0.150 0.0430.000 0.000 0.000 -0.001 0.0000.062 0.053 0.086 0.060 -0.0418.26 8.08 7.39 6.578 6.835

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AASCIF Member Name Workers Compensation Board of Nova ScotiaJurisdiction Nova ScotiaWeb Address

Sandra Keefe902-491-8405 /[email protected]

Last Reporting Period (ended) 12/31/2012GAAP

Accounting Year Year-1 Year-2 Year-3 Year-4 Year-5

Year Designation 2012 2011 2010 2009 2008 2007

OPERATING STATEMENT ($000)1 Net Premiums Earned 37,307 37,767 37,825 33,365 34,582 29,018 2 91,599 119,176 120,331 118,097 108,315 155,721 3 Loss Expense Incurred - - 4 Underwriting Expense Incurred - - - - - - 5 Net UW Gain / (Loss) (54,292) (81,409) (82,506) (84,732) (73,733) (126,702)6 Income From Bond Investments 36,665 33,600 24,448 13,403 15,452 17,638 7 Income From Stock Investments 83,355 (14,852) 61,771 86,301 (187,904) 8,260 8 Income From Mortgage Investments - - 9 Income From All Other Investments (30) 480 555

10 Net Realized Capital Gain/(Loss) - - 11 Investment Expense Incurred (3,510) (2,854) (2,646) (2,553) (2,862) (3,240)12 Other Income - - - - - - 13 Net Income Prior to Dividends/Taxes 62,218 (65,515) 1,067 12,389 (248,567) (103,489)14 Dividends to Policyholders - - 15 Federal Income Tax - - - - - - 16 Net Income After Dividends/Taxes 62,218 (65,515) 1,067 12,389 (248,567) (103,489)

ASSETS ($000)1 Cash & Bank Deposits - - - 5,756 15,940 - 2 Bonds @ Amortized Value 345,452 327,215 282,826 295,860 300,177 339,381 3 Stocks @ Market Value 681,299 604,843 649,636 563,840 460,024 611,481 4 Mortgage Loans On Real Estate @ Amortized Value - - - 5 Real Estate 139,202 117,293 101,437 97,582 96,781 126,715 6 Other Invested Assets & Loans 537 742 822 3,550 16,349 6,043 7 Cash & Invested Assets 1,166,489 1,050,093 1,034,721 966,588 889,271 1,083,620 8 Funds Held Or Deposited With Ceding Reinsurers - - 9 Premium Due But Not Collected 24,129 19,876 20,739 18,409 16,940 17,781

10 Reinsurance Recoverable On Loss Payments - - 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 402 517 176 616 722 593 12 Other Non-Invested Assets 4,991 5,475 5,771 8,122 7,816 8,747 13 Total Assets 1,196,011 1,075,961 1,061,407 993,735 914,749 1,110,741

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 1,752,308 1,705,957 1,631,449 1,561,003 1,497,616 1,448,965 2 Loss Adjustment Expense - - - - - - 3 - - - - - - 4 Taxes, Licenses, & Fees - - - - - - 5 Borrowed Money - - - - - - 6 Unearned Premiums - - - - - - 7 Dividends Declared & Unpaid - - - - - - 8 Other Liabilities 48,090 36,609 26,208 32,466 29,256 25,332 9 Total Liabilities 1,800,398 1,742,566 1,657,657 1,593,469 1,526,872 1,474,297

10 Restricted Surplus/Equity Funds - - 11 Unrestricted Surplus (604,387) (666,605) (596,250) (599,734) (612,123) (363,556)12 Policyholder Surplus (604,387) (666,605) (596,250) (599,734) (612,123) (363,556)13 Total Liabilities & Policyholder Surplus 1,196,011 1,075,961 1,061,407 993,735 914,749 1,110,741

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period (666,605) (601,090) (599,734) (612,123) (363,556) (260,067)2 Net Income/(Loss) After Policyholder Dividend & Taxes 62,218 (65,515) 1,067 12,389 (248,567) (103,489)3 Net Unrealized Capital Gains/(Losses) - - - - 4 Change in Nonadmitted Assets - - - 5 Other Adjustments To Surplus/Equity - - (2,423) - - - 6 Policyholder Surplus At Close of Accounting Period (604,387) (666,605) (601,090) (599,734) (612,123) (363,556)

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 291,806 289,956 282,587 272,762 273,098 190,622 2 71% 72% 72% 70% 72% 72%3 Direct Policies Written 26,422 27,786 28,002 28,541 20,856 29,531 4 Direct Written Payroll ($000) 9,480,000 9,350,000 907,000,000 8,559,820 8,590,000 4,246,159 5 Accident Year Direct Loss Incurred ($000) 242,304 236,116 236,707 238,640 243,370 136,100 6 Accident Year Direct Claims Incurred 20,081 21,170 21,081 19,504 22,270 11,148 7 Open Direct Claims @ End of Period 49,672 49,242 48,688 48,497 49,257 6,650 8 Direct Claim Management Employees (FTE) 183 189 192 128 124 51.00 9 Other Claim Management Employees (FTE) 80 83 89 124 96 26.00

10 Direct Policy Service Employees (FTE) 24 28 26 44 38 72.00 11 All Other Employees (FTE) 104 100 98 128 139 139.00 12 Total Employees (FTE) 391 400 405 424 397 288.00 13 Net Premiums Written14 Total Adjusted Capital15 Authorized Control Level Risk-based Capital

BENCHMARK STATISTICS1 2.455 3.156 3.181 3.540 3.132 5.3662 Calendar Year Loss & LAE Ratio 2.455 3.156 3.181 3.540 3.132 5.3663 Calendar Year Operating Ratio -0.668 2.735 0.972 0.629 8.188 4.5664 Accident Year Direct Loss Ratio 0.830 0.814 0.838 0.875 0.891 0.7145 Loss & LAE Reserve:Surplus Ratio -2.899 -2.559 -2.736 -2.603 -2.447 -3.9866 Premium:Surplus Ratio -0.062 -0.057 -0.063 -0.056 -0.056 -0.0807 Expense Ratio 0.000 0.000 0.000 0.000 0.000 0.0008 Investment Yield Ratio 0.399 0.055 0.296 0.356 -0.640 0.1229 Dividend Ratio 0.000 0.000 0.000 0.000 0.000 0.000

10 Return on Policyholder Surplus -0.098 0.103 -0.002 -0.020 0.510 0.33211 Risk Based Capital * n.a. n.a. n.a. n.a. n.a. n.a.

www.wcb.ns.caStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Net Losses Incurred (Growth & Experience Adjustments)

Other Expenses (excl. fed inc tax, licenses, fees)

Approximate Direct Market Share (% of Covered Workforce)

Calendar Year Combined Ratio (prior to dividends & taxes)

E15
macala00: total exp less growth + assmnt rev
F15
macala00: total exp less growth + assmnt rev
E21
macala00: Net invst inc from i/s and net change from i/s
F21
macala00: Net invst inc from i/s and net change from i/s
B41
Less private accounts over 90 days since billing
E41
macala00: Note 3 AR total assmnt rec less si deposits
F41
macala00: Note 3 AR total assmnt rec less si deposits
E43
macala00: from FS note 4
F43
macala00: from FS note 4
E44
macala00: note 3 AR - hst & other plus prop and eqpt
F44
macala00: note 3 AR - hst & other plus prop and eqpt
B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
E75
macala00: claims pyts made
F75
macala00: claims pyts made
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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AASCIF Member Name New York State Insurance FundJurisdiction New York/USWeb Address nysif.com

Mary Ellen Martin518-437-422812/31/2012Statutory

Accounting Year Year-1

Year Designation 2012 2011

OPERATING STATEMENT ($000)1 Net Premiums Earned 1,878,020 1,470,934 2 Net Losses Incurred 1,833,108 1,532,746 3 Loss Expense Incurred 62,254 249,306 4 Underwriting Expense Incurred 241,241 228,621 5 Net UW Gain / (Loss) (258,583) (539,739)6 Income From Bond Investments 426,455 456,329 7 Income From Stock Investments 31,720 24,386 8 Income From Mortgage Investments - 9 Income From All Other Investments 10,060 12,249

10 Net Realized Capital Gain/(Loss) 277,392 130,581 11 Investment Expense Incurred (25,570) (26,051)12 Other Income 40,592 26,270 13 Net Income Prior to Dividends/Taxes 502,066 84,025 14 Dividends to Policyholders 190,536 78,638 15 Federal Income Tax - - 16 Net Income After Dividends/Taxes 311,530 5,387

ASSETS ($000)1 Cash & Bank Deposits 197,054 295,104 2 Bonds @ Amortized Value 11,499,279 10,743,007 3 Stocks @ Market Value 1,413,436 1,300,197 4 Mortgage Loans On Real Estate @ Amortized Value - 5 Real Estate 16,998 16,936 6 Other Invested Assets & Loans 215,215 294,823 7 Cash & Invested Assets 13,341,982 12,650,067 8 Funds Held Or Deposited With Ceding Reinsurors - - 9 Premium Due But Not Collected 175,044 126,623

10 Reinsurance Recoverable On Loss Payments 158 56,683 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 79,319 83,710 12 Other Non-Invested Assets 1,360,752 1,350,537 13 Total Assets 14,957,255 14,267,620

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 8,732,897 8,287,852 2 Loss Adjustment Expense 855,925 952,850 3 72,735 64,265 4 Taxes, Licenses, & Fees - - 5 Borrowed Money - 6 Unearned Premiums 417,864 338,745 7 Dividends Declared & Unpaid - 8 Other Liabilities 1,749,839 1,827,908 9 Total Liabilities 11,829,260 11,471,620

StatBook Contact (name)StatBook Contact (phone / email)Last Update (date)Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

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10 Restricted Surplus/Equity Funds11 Unrestricted Surplus 3,127,996 2,796,001 12 Policyholder Surplus 3,127,996 2,796,001 13 Total Liabilities & Policyholder Surplus 14,957,256 14,267,621

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 2,796,001 2,816,161 2 Net Income/(Loss) After Policyholder Dividend & Taxes 311,531 5,387 3 Net Unrealized Capital Gains/(Losses) 55,890 (30,249)4 Change in Nonadmitted Assets (35,426) 4,702 5 Other Adjustments To Surplus/Equity - - 6 Policyholder Surplus At Close of Accounting Period 3,127,996 2,796,001

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 1,878,020 1,470,934 2 Approximate Direct Market Share (Insured Market Only)3 Direct Policies Written 165,907 166,096 4 Direct Written Payroll ($000) 79,158,000 72,355,000 5 Accident Year Direct Loss Incurred ($000) 1,923,487 1,523,849 6 Accident Year Direct Claims Incurred 46,091 44,482 7 Open Direct Claims @ End of Period 97,001 97,187 8 Direct Claim Management Employees (FTE) 1,039.00 1,038.00 9 Other Claim Management Employees (FTE) 76.00 76.00

10 Direct Policy Service Employees (FTE) 628.00 627.00 11 All Other Employees (FTE) 736.00 726.00 12 Total Employees (FTE) 2,479.00 2,467.00 13 Net Premiums Written 1,943,838 1,470,934 14 Total Adjusted Capital NA NA 15 Authorized Control Level Risk-based Capital NA NA

BENCHMARK STATISTICS1 1.138 1.3672 Calendar Year Loss & LAE Ratio 1.009 1.2123 Calendar Year Operating Ratio 0.733 0.9434 Accident Year Direct Loss Ratio 1.024 1.0365 Loss & LAE Reserve:Surplus Ratio 3.065 3.3056 Premium:Surplus Ratio 0.600 0.5267 Expense Ratio 0.156 0.3258 Investment Yield Ratio 0.383 0.4069 Dividend Ratio 0.101 0.053

10 Return on Policyholder Surplus 0.170 0.03011 Risk Based Capital NA NA

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Sch P Summary Line 11 Col 3.
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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New York State Insurance FundNew York/US

nysif.comMary Ellen Martin

518-437-422812/31/2012 Statutory

Year-2 Year-3 Year-4 Year-5

2010 2009 2008 2007

1,307,817 1,311,660 1,462,132 1,744,497 1,189,613 1,199,289 1,036,797 1,236,937 178,818 175,428 234,831 331,017 214,943 214,711 206,636 197,799 (275,557) (277,768) (16,132) (21,256) 484,762 510,465 538,868 519,063 23,102 23,812 27,167 24,715 - - - - 12,832 13,832 72,128 160,021 212,081 (369,662) (286,524) 134,843 (25,325) (23,272) (71,525) (153,970) 7,444 3,955 (31,590) 5,025 439,339 (118,638) 232,392 668,441 38,892 104,920 375,333 310,951 - - - - 400,447 (223,558) (142,941) 357,490

127,352 56,456 77,047 91,898 10,574,091 10,412,216 10,436,571 10,134,572 1,279,915 1,174,685 922,784 1,366,173 - - - - 17,706 13,711 14,319 13,509 368,646 490,013 1,196,191 2,636,996 12,367,710 12,147,081 12,646,912 14,243,148 - - - - 135,412 44,438 53,392 51,842 - 1,418 83 81 90,908 93,801 103,200 118,638 1,333,241 1,331,259 1,316,965 1,322,341 13,927,271 13,617,997 14,120,552 15,736,050

8,029,705 7,986,386 7,868,281 7,861,662 866,572 855,031 827,397 740,680 60,161 29,999 30,312 28,330 - (1,482) 2,266 113 - - - - 331,455 337,606 341,512 388,272 488 - - - 1,822,729 2,015,504 2,783,671 4,017,308 11,111,110 11,223,044 11,853,439 13,036,365

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- - - - 2,816,161 2,394,953 2,267,113 2,699,685 2,816,161 2,394,953 2,267,113 2,699,685 13,927,271 13,617,997 14,120,552 15,736,050

2,394,953 2,267,113 2,699,685 2,413,996 400,447 (223,558) (142,941) 357,490 22,164 362,684 (307,680) (56,019) 17,235 (11,286) 18,049 (10,960) (18,638) - - (4,822) 2,816,161 2,394,953 2,267,113 2,699,685

1,307,817 1,311,660 1,462,132 1,744,497 28% 31% 41% 39%

176,295 184,910 192,646 196,522 74,000,000 73,000,000 67,887,606 65,285,927 2,026,397 1,735,636 1,596,261 1,553,178 39,855 45,465 46,003 47,967 97,550 98,374 101,323 102,545 990.00 1,013.00 1,072.00 1,093.00 78.00 84.00 82.00 84.00 643.00 650.00 660.00 646.00 790.00 776.00 769.00 765.00 2,501.00 2,523.00 2,583.00 2,588.00 1,309,759 1,309,601 1,355,121 1,719,136 Underwriting and Investment Exhibit, Part 1B, col. 6, line 16

NA NA NA NA Five-Year Historical Data (page 17, line 28) NA NA NA NA Five-Year Historical Data (page 17, line 29)

1.211 1.212 1.011 1.0121.046 1.048 0.870 0.8990.664 1.090 0.841 0.6171.549 1.323 1.092 0.890 3.159 3.692 3.836 3.1860.464 0.548 0.645 0.6460.301 0.298 0.326 0.308 0.541 0.118 0.192 0.3920.030 0.080 0.257 0.1780.169 -0.051 0.094 0.261 NA NA NA NA

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Underwriting and Investment Exhibit, Part 1B, col. 6, line 16Five-Year Historical Data (page 17, line 28)Five-Year Historical Data (page 17, line 29)

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AASCIF Member Name Ohio Bureau of Workers' CompensationJurisdiction State of OhioWeb Address

Barbara J. Ingram, Director of Accounting614-466-6050 / [email protected]

Last Reporting Period (ended) 6/30/2010GAAP/GASB

Accounting Year Year-1

Year Designation 2010 2009

OPERATING STATEMENT ($000)1 Net Premiums Earned 2,118,421 2,360,930 2 Net Losses Incurred 2,254,613 1,667,092 3 Loss Expense Incurred 482,371 406,442 4 Underwriting Expense Incurred 136,161 97,585 5 Net UW Gain / (Loss) (754,724) 189,811 6 Income From Bond Investments 638,902 648,647 7 Income From Stock Investments 82,453 84,060 8 Income From Mortgage Investments - - 9 Income From All Other Investments 1,175 5,378

10 1,334,056 (928,239)11 Investment Expense Incurred (7,143) (4,801)12 Other Income 15,018 17,197 13 Net Income Prior to Dividends/Taxes 1,309,737 12,053 14 Dividends to Policyholders - - 15 Federal Income Tax - - 16 Net Income After Dividends/Taxes 1,309,737 12,053

ASSETS ($000)1 Cash & Bank Deposits 6,922 15,133 2 13,380,808 13,050,126 3 Stocks @ Market Value 5,149,644 3,516,207 4 Mortgage Loans On Real Estate @ Amortized Valu - - 5 Real Estate 99,383 103,737 6 Other Invested Assets & Loans 433,620 495,417 7 Cash & Invested Assets 19,070,377 17,180,620 8 Funds Held Or Deposited With Ceding Reinsurers - - 9 Premium Due But Not Collected 1,306,869 1,493,151

10 Reinsurance Recoverable On Loss Payments - - 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 161,171 186,206 12 Other Non-Invested Assets 3,557,491 3,560,372 13 Total Assets 24,095,908 22,420,349

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 17,903,737 17,458,744 2 Loss Adjustment Expense 1,926,200 1,819,999 3 - - 4 Taxes, Licenses, & Fees - - 5 Borrowed Money 64,200 80,657 6 Unearned Premiums 87,974 88,474 7 Dividends Declared & Unpaid - - 8 Other Liabilities 288,718 457,133

www.ohiobwc.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Net Realized Capital Gain/(Loss) NOTE 1

Bonds @ Market Value NOTE 2

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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9 Total Liabilities 20,270,829 19,905,007 10 Restricted Surplus/Equity Funds 154,197 (1,794,588)11 Unrestricted Surplus 3,670,882 4,309,930 12 Policyholder Surplus 3,825,079 2,515,342 13 Total Liabilities & Policyholder Surplus 24,095,908 22,420,349

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 2,515,342 2,503,289 2 Net Income/(Loss) After Policyholder Dividend & Taxes 1,309,737 12,053 3 Net Unrealized Capital Gains/(Losses) - - 4 Change in Nonadmitted Assets - - 5 Other Adjustments To Surplus/Equity - - 6 Policyholder Surplus At Close of Accounting Period 3,825,079 2,515,342

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 2,118,421 2,360,930 2 Approximate Direct Market Share (Insured Market Only) 100% 100%3 Direct Policies Written 255,066 261,063 4 113,356,499 116,691,162 5 Accident Year Direct Loss Incurred ($000) 1,802,000 2,064,000 6 Accident Year Direct Claims Incurred 104,151 118,855 7 259,068 289,417 8 Direct Claim Management Employees (FTE) 719 756 9 Other Claim Management Employees (FTE) 211 191

10 Direct Policy Service Employees (FTE) 352 387 11 All Other Employees (FTE) 962 1,007 12 Total Employees (FTE) 2,244 2,341 13 Net Premiums Written 2,360,93014 Total Adjusted Capital N/A GAAP filer15 Authorized Control Level Risk-based Capital N/A GAAP filer

BENCHMARK STATISTICS1 1.356 0.9202 Calendar Year Loss & LAE Ratio 1.292 0.8783 Calendar Year Operating Ratio 0.382 0.9954 Accident Year Direct Loss Ratio 0.851 0.8745 Loss & LAE Reserve:Surplus Ratio 5.184 7.6646 Premium:Surplus Ratio 0.554 0.9397 Expense Ratio 0.058 0.0008 Investment Yield Ratio 0.967 -0.0839 Dividend Ratio 0.000 0.000

10 Return on Policyholder Surplus 0.413 0.00511 Risk Based Capital N/A 0

Direct Written Payroll ($000) NOTE 3

Open Direct Claims @ End of Period NOTE 4

Calendar Year Combined Ratio (prior to dividends & taxes)

NOTE 1 - Net Realized Capital Gain/Loss includes BWC's Change in Fair Value of Investments.

NOTE 2 - Bonds are recorded using the average cost method and marked to market in BWC's Combined Financial Statements.

NOTE 3 - Written payroll includes Private, Public County, and Public State Employer Payroll. 2009 Public State payroll is projected.

NOTE 4 - Claims that have had a medical or indemnity payment within the past 13 calendar months.

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Ohio Bureau of Workers' CompensationState of Ohio

Barbara J. Ingram, Director of Accounting614-466-6050 / [email protected]

6/30/2010GAAP/GASB

Year-2 Year-3 Year-4

2008 2007 2006

2,138,402 4,270,933 2,095,060 2,180,823 2,030,596 1,609,421 406,660 636,552 324,392 94,364 100,527 85,452 (543,445) 1,503,258 75,795 791,152 741,292 563,860 63,525 26,434 60,177 - - - 22,114 44,033 119,536 (143,729) 108,936 105,007 (14,121) (9,489) (84,707) 22,247 17,703 15,326 197,743 2,432,167 854,994 - - (8,229) - - - 197,743 2,432,167 863,223

13,263 17,554 14,982 13,723,521 13,329,461 15,590,155 3,164,461 2,632,606 11,985 - - - 114,530 116,927 122,942 383,175 773,508 612,248 17,398,950 16,870,056 16,352,312 - - - 1,539,814 1,533,890 1,373,612 - - - 200,414 183,418 2,421 3,242,796 3,553,422 1,809,359 22,381,974 22,140,786 19,537,704

17,637,509 17,458,204 17,295,068 1,834,994 1,858,529 1,676,498 - - - - - - 97,286 113,076 128,052 88,918 87,808 460,540 - - - 219,978 317,623 104,167

www.ohiobwc.com

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19,878,685 19,835,240 19,664,325 (1,592,975) (1,431,677) (1,277,227) 4,096,264 3,737,223 1,150,606 2,503,289 2,305,546 (126,621) 22,381,974 22,140,786 19,537,704

2,305,546 (126,621) (989,844) 197,743 2,432,167 863,223 - - - - - - - - - 2,503,289 2,305,546 (126,621)

2,138,402 4,270,933 2,095,060 100% 100% 100%

268,936 274,540 287,062 121,472,808 121,518,252 119,436,489 2,219,000 2,282,000 2,270,000 143,199 154,677 167,053 323,726 338,986 350,917 816 891 891 226 246 252 422 449 467 943 963 969 2,407 2,549 2,579

Underwriting and Investment Exhibit, Part 1B, col. 6, line 16Five-Year Historical Data (page 17, line 28)Five-Year Historical Data (page 17, line 29)

1.254 0.648 0.9641.210 0.624 0.9230.908 0.431 0.5921.038 0.534 1.0847.779 8.378 -149.8300.854 1.852 -16.546

#DIV/0! #DIV/0! #DIV/0!0.336 0.213 0.3650.000 0.000 -0.0040.082 2.232 -1.532

#DIV/0! #DIV/0! #DIV/0!

Net Realized Capital Gain/Loss includes BWC's Change in Fair Value of Investments.

Bonds are recorded using the average cost method and marked to market in BWC's Combined Financial Statements.

Written payroll includes Private, Public County, and Public State Employer Payroll. 2009 Public State payroll is projected.

Claims that have had a medical or indemnity payment within the past 13 calendar months.

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Underwriting and Investment Exhibit, Part 1B, col. 6, line 16

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AASCIF Member Name CompSource OklahomaJurisdiction OklahomaWeb Address

Stan Anderson(405)962-3505/[email protected]

Last Reporting Period (ended) 12/31/2010Statutory

Accounting YearYear-1 Year-2

Year Designation 2010 2009 2008

OPERATING STATEMENT ($000)1 Net Premiums Earned 247,264 243,920 261,898 2 Net Losses Incurred 241,036 242,687 222,660 3 Loss Expense Incurred 21,063 21,957 17,899 4 Underwriting Expense Incurred 42,289 41,069 37,268 5 Net UW Gain / (Loss) (57,124) (61,793) (15,930)6 Income From Bond Investments 40,338 42,136 42,054 7 Income From Stock Investments 2,565 2,402 3,197 8 Income From Mortgage Investments 1,014 1,018 1,018 9 Income From All Other Investments 1,658 1,727 2,960

10 Net Realized Capital Gain/(Loss) 6,004 (627) (24,309)11 Investment Expense Incurred (1,789) (1,544) (5,589)12 Other Income 428 517 491 13 Net Income Prior to Dividends/Taxes (6,906) (16,164) 3,891 14 Dividends to Policyholders - - 20,007 15 Federal Income Tax - - - 16 Net Income After Dividends/Taxes (6,906) (16,164) (16,116)

ASSETS ($000)1 Cash & Bank Deposits 65,660 74,156 96,592 2 Bonds @ Amortized Value 916,757 894,229 848,353 3 Stocks @ Market Value 191,772 153,161 110,378 4 Mortgage Loans On Real Estate @ Amortized Value - - - 5 Real Estate - - - 6 Securities lending reinvested collateral assets 117,872 7 Other Invested Assets & Loans 29,767 30,864 32,077 8 Cash & Invested Assets 1,321,828 1,152,410 1,055,323 9 Funds Held Or Deposited With Ceding Reinsurers - -

10 Premium Due But Not Collected 46,981 39,523 41,544 11 Reinsurance Recoverable On Loss Payments - - 12 Interest,Dividends,&Real Estate Inc. Due & Accrued 9,773 9,690 9,466 13 Other Non-Invested Assets 22,213 21,918 22,897 14 Total Assets 1,400,795 1,223,541 1,161,307

LIABILITIES/SURPLUS/EQUITY ($000)

1 Unpaid Losses 883,560 852,676 824,150 2 Loss Adjustment Expense 72,911 71,583 68,922 3 - - - 4 Taxes, Licenses, & Fees - - - 5 Borrowed Money - - - 6 Unearned Premiums 32,699 30,699 29,271 7 Dividends Declared & Unpaid - -

www.compsourceok.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed

Year

Other Expenses (excl. fed inc tax, licenses, fees)

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8 Payable for securities lending 121,972 9 Other Liabilities 53,849 58,151 55,267

10 Total Liabilities 1,164,991 1,013,109 977,610 11 Restricted Surplus/Equity Funds 5,000 5,000 5,000 12 Unrestricted Surplus 230,804 205,432 178,697 13 Policyholder Surplus 235,804 210,432 183,697 14 Total Liabilities & Policyholder Surplus 1,400,795 1,223,541 1,161,307

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 210,432 183,697 258,953 2 Net Income/(Loss) After Policyholder Dividend & Taxes (6,906) (16,164) (16,116)3 Net Unrealized Capital Gains/(Losses) 33,579 42,942 (57,718)4 Change in Nonadmitted Assets (1,079) (1,983) (1,421)5 Other Adjustments To Surplus/Equity (222) 1,940 - 6 Policyholder Surplus At Close of Accounting Period 235,804 210,432 183,697

OTHER OPERATIONAL MEASURES (Std. Only)1 Direct Premiums Earned ($000) 236,938 234,445 261,898 2 Approximate Direct Market Share (Insured Market Only) 33% 34% 35%3 Direct Policies Written 23,385 23,819 25,076 4 Direct Written Payroll ($000) 6,531,934 6,571,594 6,568,039 5 Accident Year Direct Loss Incurred ($000) 220,170 244,628 215,313 6 Accident Year Direct Claims Incurred 11,200 11,978 10,540 7 Open Direct Claims @ End of Period 10,839 10,984 9,330 8 Direct Claim Management Employees (FTE) 69 72 86 9 Other Claim Management Employees (FTE) 60 62 69

10 Direct Policy Service Employees (FTE) 83 83 89 11 All Other Employees (FTE) 133 134 149 12 Total Employees (FTE) 345 351 393 13 Net Premiums Written 238,843 235,629 254,52214 Total Adjusted Capital 235,804 210,432 183,69715 Authorized Control Level Risk-based Capital 56,827 54,456 48,270

BENCHMARK STATISTICS1 1.231 1.253 1.0612 Calendar Year Loss & LAE Ratio 1.060 1.085 0.9193 Calendar Year Operating Ratio 1.028 1.066 0.9854 Accident Year Direct Loss Ratio 0.929 1.043 0.8225 Loss & LAE Reserve:Surplus Ratio 4.056 4.392 4.8626 Premium:Surplus Ratio 1.049 1.159 1.4267 Expense Ratio 0.177 0.174 0.1468 Investment Yield Ratio 0.210 0.192 0.0749 Dividend Ratio 0.000 0.000 0.076

10 Return on Policyholder Surplus -0.031 -0.082 0.01811 Risk Based Capital 4.150 3.864 3.806

Calendar Year Combined Ratio (prior to dividends & taxes)

B73
From Statutory Pg 14, Col 2 (Grand Total)
B74
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B75
Insurance policies issued with coverage effective dates within accounting period. See applicable tab on this excel worksheet.
B76
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material. See applicable tab on this worksheet.
B77
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B78
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B79
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B80
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B82
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B83
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B86
Statutory filings only
B87
Statutory filings only
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Year-3 Year-4

2007 2006

268,338 289,983 241,055 254,497 20,606 22,344 37,157 33,249 (30,480) (20,107) 40,868 36,208 3,133 3,449 1,018 1,022 3,250 3,304 14,313 3,002 (1,715) (1,501) 451 498 30,838 25,874 - - - - 30,838 25,874

60,223 38,315 849,416 788,787 185,761 196,473 - - - -

= Securities Lending Program 52,921 53,779 1,095,399 1,023,575 - - 40,368 42,840 - - 9,712 9,103 23,678 24,104 1,222,078 1,153,401

815,136 776,379 70,781 70,222 - - - - - - 27,779 26,833 - -

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= Securities Lending Program 49,428 51,416 963,125 924,850 5,000 5,000 253,953 223,550 258,953 228,550 1,222,078 1,153,401

228,550 181,129 30,838 25,874 (592) 21,442 157 105 - - 258,953 228,550

268,338 289,983 37% 40%

25,978 27,462 7,587,888 8,411,500 246,999 251,778 11,671 12,819 9,685 10,146 85 85 73 75 86 86 149 141 392 387

260,499 280,386258,953 228,550

60,170 56,640

1.114 1.0690.975 0.9550.885 0.9110.920 0.8683.421 3.7041.036 1.2690.143 0.1190.227 0.1570.000 0.0000.127 0.1264.304 4.035

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AASCIF Member Name SAIF CorporationJurisdiction OregonWeb Address

Jerry Dykes503.373.8728 / [email protected]

Last Reporting Period (ended) 12/31/2011Statutory

Accounting YearYear Designation 2011

OPERATING STATEMENT ($000)1 Net Premiums Earned 356,841 2 Net Losses Incurred 242,027 3 Loss Expense Incurred 85,517 4 Underwriting Expense Incurred 70,381 5 Net UW Gain / (Loss) (41,084)6 Income From Bond Investments 167,155 7 Income From Stock Investments 296 8 Income From Mortgage Investments - 9 Income From All Other Investments 4,908

10 Net Realized Capital Gain/(Loss) 26,091 11 Investment Expense Incurred (9,325)12 Other Income 101 13 Net Income Prior to Dividends/Taxes 148,142 14 Dividends to Policyholders 150,043 15 Federal Income Tax - 16 Net Income After Dividends/Taxes (1,901)

ASSETS ($000)1 Cash & Bank Deposits 33,320 2 Bonds @ Amortized Value 3,458,105 3 Stocks @ Market Value 378,852 4 Mortgage Loans On Real Estate @ Amortized Value - 5 Real Estate 14,941 6 Other Invested Assets & Loans 212,545 7 Cash & Invested Assets 4,097,763 8 Funds Held Or Deposited With Ceding Reinsurers - 9 Premium Due But Not Collected 283,235

10 Reinsurance Recoverable On Loss Payments 268 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 36,554 12 Other Non-Invested Assets 27,245 13 Total Assets 4,445,065

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 2,681,567 2 Loss Adjustment Expense 351,776 3 14,381 4 Taxes, Licenses, & Fees 20,493 5 Borrowed Money - 6 Unearned Premiums 180,244 7 Dividends Declared & Unpaid - 8 Other Liabilities 279,374 9 Total Liabilities 3,527,835

www.saif.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
C55
IS Division: rounding
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10 Restricted Surplus/Equity Funds - 11 Unrestricted Surplus 917,230 12 Policyholder Surplus 917,230 13 Total Liabilities & Policyholder Surplus 4,445,065

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 958,572 2 Net Income/(Loss) After Policyholder Dividend & Taxes (1,901)3 Net Unrealized Capital Gains/(Losses) (39,127)4 Change in Nonadmitted Assets (235)5 Other Adjustments To Surplus/Equity (79)6 Policyholder Surplus At Close of Accounting Period 917,230

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 351,950 2 Approximate Direct Market Share (Insured Market Only) 54%3 Direct Policies Written 47,507 4 Direct Written Payroll ($000) 22,800,000 5 Accident Year Direct Loss Incurred ($000) 389,816 6 Accident Year Direct Claims Incurred 23,118 7 Open Direct Claims @ End of Period 4,746 8 Direct Claim Management Employees (FTE) 161.65 9 Other Claim Management Employees (FTE) 204.05

10 Direct Policy Service Employees (FTE) 174.40 11 All Other Employees (FTE) 258.90 12 Total Employees (FTE) 799.00 13 Net Premiums Written 372,963 14 Total Adjusted Capital 917,230 15 Authorized Control Level Risk-based Capital 138,101

BENCHMARK STATISTICS1 1.1152 Calendar Year Loss & LAE Ratio 0.9183 Calendar Year Operating Ratio 0.5854 Accident Year Direct Loss Ratio 1.1085 Loss & LAE Reserve:Surplus Ratio 3.3076 Premium:Surplus Ratio 0.3897 Expense Ratio 0.1898 Investment Yield Ratio 0.5379 Dividend Ratio 0.426

10 Return on Policyholder Surplus 0.15811 Risk Based Capital 6.642

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
C78
denmmar: claims adjusters only
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
C79
denmmar: incl FID & RTN/EAIP claims supervisors, assistants, nurse consultants, medical programs
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
C80
denmmar: Incl U/W, C/S, billing, Loss Control
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
C81
denmmar: incl support staff all areas HR/Fin Svcs/ASD/IS/Legal/Corp Pol/Exec/Mktg
C82
IS Division: 799 is total at 12/31/11
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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SAIF CorporationOregon

Jerry Dykes503.373.8728 / [email protected]

12/31/2011Statutory

Year-1 Year-2 Year-3 Year-4 Year-5

2010 2009 2008 2007 2006

Source: 332,966 340,391 416,373 459,389 439,899 Annual Stmt page 4 334,071 309,973 358,424 395,116 402,326 Annual Stmt page 4 36,336 66,114 73,936 36,780 7,490 Annual Stmt page 4 64,788 65,501 67,317 76,687 92,614 Annual Stmt page 4 (102,229) (101,197) (83,304) (49,194) (62,531) Annual Stmt page 4 176,559 177,026 172,118 155,947 143,441 Annual Stmt page 12, col 2 - bonds 323 274 4,350 2,007 615 Annual Stmt page 12, col 2 - Stocks - - 1 4 9 Annual Stmt page 12, col 2 - Mtgs 5,724 6,669 13,285 12,916 10,285 Annual Stmt page 12, col 2 - all other 223,757 (19,069) (42,351) (7,886) 7,497 Annual Stmt page 4 (9,084) (9,505) (8,680) (9,000) (10,056) Annual Stmt page 12, col 2 - total deductions 164 (1,460) 436 772 23,993 Annual Stmt page 4 295,214 52,738 55,855 105,566 113,253 Annual Stmt page 4 200,541 - - 59,979 - Annual Stmt page 4

- - - - - Annual Stmt page 4 94,673 52,738 55,855 45,587 113,253 Annual Stmt page 4

22,962 26,552 23,373 26,575 49,897 Annual Stmt page 2 Cash & Cash Equiv 3,390,138 3,158,346 3,060,935 2,975,263 2,805,581 Annual Stmt page 2 - Bonds + ST Investments 472,753 643,966 430,704 611,395 581,403 Annual Stmt page 2 - Stocks - - 6 21 62 Annual Stmt page 2 - Mtg 15,682 16,424 17,165 17,759 17,950 Annual Stmt page 2 - Real Estate 240,063 11,991 4,925 5,549 13,504 Annual Stmt page 2 - Other Inv 4,141,598 3,857,279 3,537,108 3,636,562 3,468,397 Annual Stmt page 2 - - - - - Annual Stmt page 2 265,317 273,429 304,011 310,426 172,448 Annual Stmt page 2 138 129 129 136 108 Annual Stmt page 2 40,058 36,799 38,451 35,176 31,139 Annual Stmt page 2 26,712 27,262 28,785 29,804 25,817 Annual Stmt page 2 4,473,823 4,194,898 3,908,484 4,012,104 3,697,909 Annual Stmt page 2

2,703,377 2,642,111 2,612,177 2,534,443 2,413,322 Annual Stmt page 3 316,043 327,860 311,881 287,513 294,220 Annual Stmt page 3 13,121 12,800 12,714 12,229 11,759 Annual Stmt page 3 17,079 13,667 14,910 17,322 11,976 Annual Stmt page 3 - - - - - Annual Stmt page 3 164,122 168,027 194,943 202,993 70,866 Annual Stmt page 3 - - - - - Annual Stmt page 3 301,509 75,074 82,644 81,064 73,879 Annual Stmt page 3 3,515,251 3,239,539 3,229,269 3,135,564 2,876,022 Annual Stmt page 3

www.saif.com

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- - - - - Annual Stmt page 3 958,572 955,359 679,215 876,540 821,887 Annual Stmt page 3 958,572 955,359 679,215 876,540 821,887 Annual Stmt page 3 4,473,823 4,194,898 3,908,484 4,012,104 3,697,909 Annual Stmt page 3

955,359 679,215 876,540 821,887 633,275 Annual Stmt page 4 94,673 52,738 55,855 45,587 113,253 Annual Stmt page 4 (89,378) 224,143 (254,656) 11,072 75,724 Annual Stmt page 4 419 174 (362) (165) (365) Annual Stmt page 4 (2,501) (911) 1,838 (1,841) - Annual Stmt page 4 958,572 955,359 679,215 876,540 821,887 Annual Stmt page 4

331,674 341,705 414,685 453,757 438,517 Annual Stmt page 19 55% 51% 50% 49% 53% Peter Merck - R&A

46,561 47,530 50,151 51,288 49,524 Peter Merck - R&A 21,700,000 21,811,000 22,785,000 23,305,000 22,438,000 Peter Merck - R&A 365,820 358,617 414,098 388,143 391,009 Joe Nhem - Actuary 22,281 22,171 26,893 29,838 31,728 Joe Nhem - Actuary 2,240 1,230 970 715 588 Joe Nhem - Actuary 157.90 170.90 174.10 174.80 170.00 Denise - per HR data 200.25 209.30 222.55 219.40 212.50 Denise - per HR data 162.00 157.25 163.40 152.80 150.70 Denise - per HR data 287.70 304.45 311.35 319.20 304.80 Denise - per HR data 807.85 841.90 871.40 866.20 838.00 329,062 313,474 408,323 591,516 447,265 Underwriting and Investment Exhibit, Part 1B, col. 6, line 16 958,572 955,359 679,215 876,540 821,887 Five-Year Historical Data (page 17, line 28) 138,015 130,564 114,761 170,246 142,267 Five-Year Historical Data (page 17, line 29)

1.307 1.297 1.200 1.107 1.1421.112 1.105 1.038 0.940 0.9320.113 0.845 0.866 0.770 0.7431.103 1.049 0.999 0.855 0.8923.150 3.109 4.305 3.219 3.2940.347 0.356 0.613 0.524 0.5350.197 0.209 0.165 0.130 0.2071.198 0.455 0.335 0.339 0.3460.605 0.000 0.000 0.132 0.0000.308 0.065 0.072 0.124 0.1566.945 7.317 5.919 5.149 5.777

I78
IS Division: Request from Denise Derrick
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Annual Stmt page 4 Annual Stmt page 4 Annual Stmt page 4 Annual Stmt page 4 Annual Stmt page 4 Annual Stmt page 12, col 2 - bonds Annual Stmt page 12, col 2 - Stocks

Annual Stmt page 12, col 2 - Mtgs Annual Stmt page 12, col 2 - all other Annual Stmt page 4

Annual Stmt page 12, col 2 - total deductions Annual Stmt page 4 Annual Stmt page 4 Annual Stmt page 4

Annual Stmt page 4 Annual Stmt page 4

Annual Stmt page 2 Cash & Cash Equiv

Annual Stmt page 2 - Bonds + ST Investments Annual Stmt page 2 - Stocks Annual Stmt page 2 - Mtg

Annual Stmt page 2 - Real Estate Annual Stmt page 2 - Other Inv Annual Stmt page 2 Annual Stmt page 2 Annual Stmt page 2 Annual Stmt page 2 Annual Stmt page 2 Annual Stmt page 2

Annual Stmt page 2

Annual Stmt page 3 Annual Stmt page 3 Annual Stmt page 3 Annual Stmt page 3 Annual Stmt page 3 Annual Stmt page 3 Annual Stmt page 3 Annual Stmt page 3

Annual Stmt page 3

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Annual Stmt page 3 Annual Stmt page 3 Annual Stmt page 3 Annual Stmt page 3

Annual Stmt page 4 Annual Stmt page 4 Annual Stmt page 4 Annual Stmt page 4 Annual Stmt page 4 Annual Stmt page 4

Annual Stmt page 19

Peter Merck - R&A Peter Merck - R&A Peter Merck - R&A Joe Nhem - Actuary Joe Nhem - Actuary Joe Nhem - Actuary Denise - per HR data Denise - per HR data

Denise - per HR data Denise - per HR data

Underwriting and Investment Exhibit, Part 1B, col. 6, line 16Five-Year Historical Data (page 17, line 28)Five-Year Historical Data (page 17, line 29)

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OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 208,977 179,419 158,5692 Approximate Direct Market Share (Insured Market On N/A N/A N/A 3 Direct Policies Written 24,115 23,868 25,2424 Direct Written Payroll ($000) 3,825,043 3,748,292 3,434,370 5 Accident Year Direct Loss Incurred ($000) 188,985 169,322 155,5846 Accident Year Direct Claims Incurred 39,989 48,516 6,2807 Open Direct Claims @ End of Period 10,430 11,471 12,055 8 Direct Claim Management Employees (FTE) 37.00 41.00 56.00 9 Other Claim Management Employees (FTE) 104.00 116.00 128.00

10 Direct Policy Service Employees (FTE) 51.00 58.00 62.00 11 All Other Employees (FTE) 76.00 75.00 76.00 12 Total Employees (FTE) 268.00 290.00 322.00

B71
From Statutory Pg 19, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
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AASCIF Member Name Workers Compensation Board of Prince Edward IslandJurisdiction Prince Edward IslandWeb Address

Tammy Turner902-368-4102 / [email protected]

12/31/2012IFRS

Accounting YearYear Designation 2012

OPERATING STATEMENT ($000)1 Net Premiums Earned 34,295 2 Net Losses Incurred 26,624 3 Loss Expense Incurred 7,080 4 Underwriting Expense Incurred 412 5 Net UW Gain / (Loss) 179 6 Income From Bond Investments 4,816 7 Income From Stock Investments 8,263 8 Income From Mortgage Investments9 Income From All Other Investments

10 Net Realized Capital Gain/(Loss) 4,668 11 Investment Expense Incurred (779)12 Other Income 186 13 Net Income/(Loss) Prior to Dividends/Taxes 17,333 14 Dividends to Policyholders15 Federal Income Tax - 16 Net Income/(Loss) After Dividends/Taxes 17,333

ASSETS ($000)1 Cash & Bank Deposits 6,733 2 Bonds @ Amortized Value 53,346 3 Stocks @ Market Value 101,472 4 Mortgage Loans On Real Estate @ Amortized Value5 Real Estate 27,682 6 Other Invested Assets & Loans - 7 Cash & Invested Assets8 Funds Held Or Deposited With Ceding Reinsurors9 Premium Due But Not Collected 1,554

10 Reinsurance Recoverable On Loss Payments11 Interest,Dividends,&Real Estate Inc. Due & Accrued12 Other Non-Invested Assets 3,390 13 Total Assets

LIABILITIES/SURPLUS/EQUITY ($000)

1 Unpaid Losses 54,405 2 Loss Adjustment Expense3 4,115 4 Taxes, Licenses, & Fees5 Borrowed Money6 Unearned Premiums7 Dividends Declared & Unpaid8 Other Liabilities - 9 Total Liabilities 58,520

www.wcb.pe.caStatBook Contact (name)StatBook Contact (phone / email)Last Update (date)Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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10 Restricted Surplus/Equity Funds 97,252 11 Unrestricted Surplus 38,406 12 Policyholder Surplus 135,658 13 Total Liabilities & Policyholder Surplus 194,178

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 21,074 2 Net Income/(Loss) After Policyholder Dividend & Taxes 17,332 3 Net Unrealized Capital Gains/(Losses)4 Change in Nonadmitted Assets5 Other Adjustments To Surplus/Equity - 6 Policyholder Surplus At Close of Accounting Period 38,406

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 33,376 2 Approximate Direct Market Share (Insured Market Only) 100%3 Direct Policies Written 5,041 4 Direct Written Payroll ($000) 1,701,190 5 Accident Year Direct Loss Incurred ($000) 20,070 6 Accident Year Direct Claims Incurred 1,727 7 Open Direct Claims @ End of Period 1,860 8 Direct Claim Management Employees (FTE) 15.00 9 Other Claim Management Employees (FTE) 11.00

10 Direct Policy Service Employees (FTE) 5.00 11 All Other Employees (FTE) 42.00 12 Total Employees (FTE) 73.00 13 Net Premiums Written 14,22514 Total Adjusted Capital N/A 15 Authorized Control Level Risk-based Capital N/A

BENCHMARK STATISTICS1 0.9952 Calendar Year Loss & LAE Ratio 0.9833 Calendar Year Operating Ratio 0.4954 Accident Year Direct Loss Ratio 0.6015 Loss & LAE Reserve:Surplus Ratio 0.4016 Premium:Surplus Ratio 0.2537 Expense Ratio 0.0298 Investment Yield Ratio 0.5089 Dividend Ratio 0.000

10 Return on Policyholder Surplus 0.58311 Risk Based Capital * n.a.

Note:*This ratio is calculated only for U.S. jurisdictions.

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Workers Compensation Board of Prince Edward IslandPrince Edward Island

Tammy Turner902-368-4102 / [email protected]

12/31/2012IFRS

Year-1 Year-2 Restated Year-3 Year-4 Year-5

2011 2010 2009 2008 2007

33,656 32,652 31,591 27,963 28,684 F/S Statement of Operations (Current Assessments+ Self-Insured) 28,756 23,725 25,149 24,725 21,916 F/S Statement of Operations (Expenditures - Claims)

6,787 6,694 5,816 5,377 5,063 F/S Statement of Operations ( Administration - Recoverable Self-Insured) 416 447 430 451 390 F/S Statement of Operations ( Workers Advisor + Employers Advisor + Appeals Tribunal ) (2,303) 1,787 196 (2,590) 1,315

4,804 3,906 2,926 3,597 3,257 Note 5. Earned during the year -3,717 9,002 17,682 (16,730) (10,759) Note 5. Unrealized

- - - -

3,003 1,029 (2,551) (9,905) 6,477 Note 5. Realized (761) (605) - - 216 221 - - - 1,241 15,340 18,254 (25,628) 291

- - - - - - - 1,241 15,340 18,254 (25,628) 291

10,749 11,929 8,772 4,377 6,172 Note 5. Money Market 52,679 44,055 40,391 37,648 43,955 Note 5. Fixed Term 89,325 95,711 78,949 63,531 76,699 Note 5. Equities

- - 16,782 9,701 - -

- - 71 73 136 Note 4. Other 169,535 161,396 128,183 105,629 126,962

139 198 213 Note 4. Self-Insured 1,304 1,034 1,269 401 719 Note 4. Assessments + Accrued Assessments

- - - -

3,622 3,870 4,271 4,219 3,630 Note 6. Capital Assets 174,461 166,300 133,862 110,446 131,524

51,608 49,563 43,689 41,931 38,939 Note 10. Benefit Liabilities ( TWL + HealthCare + Rehab + Admin ) - -

3,577 2,906 1,861 1,748 1,651 B/S (Payables and accruals + Debenture Payable + Retirement pay) - - - - - - - -

- - - - - 55,185 52,469 45,550 43,679 40,590

www.wcb.pe.ca

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98,202 93,998 83,449 80,158 78,696 Note 10. Benefit Liabilities ( Pension and Extended Wage Loss) 21,074 19,833 4,863 (13,390) 12,238 119,276 113,831 88,312 66,768 90,934 174,461 166,300 133,862 110,446 131,524

19,833 4,493 (13,391) 12,238 11,947 1,241 15,340 18,254 (25,628) 291

- - - -

- - - - - 21,074 19,833 4,863 (13,390) 12,238

32,928 32,053 29,443 25,929 26,561 F/S Statement of Operations (Current Assessments) 100% 100% 100% 100% 100%5,011 4,991 4,922 4,995 5,018

1,639,100 1,599,160 1,342,920 1,266,195 1,219,772 18,454 17,093 15,512 14,933 13,641 Note 10. Benefit Liabilities ( Costs Incurred )

1,627 1,669 1,624 1,825 1,773 1,852 1,755 1,744 1,733 1,772 15.00 15.00 16.00 16.00 16.00 11.00 11.00 12.00 10.00 10.00

5.00 5.00 5.00 4.00 4.00 39.00 41.00 36.00 42.00 42.00

70.00 72.00 69.00 72.00 72.00 15,202 15,559 16,079 13,030 15,043 Premiums Earned less claim costs incurred

N/A N/A N/A N/A N/A Five-Year Historical Data (page 17, line 28) N/A N/A N/A N/A N/A Five-Year Historical Data (page 17, line 29)

1.068 0.945 0.994 1.093 0.9541.056 0.932 0.980 1.077 0.9410.963 0.530 0.422 1.917 0.9900.560 0.533 0.527 0.576 0.5140.433 0.435 0.495 0.628 0.4280.282 0.287 0.358 0.419 0.3150.027 0.029 0.027 0.035 0.0260.101 0.416 0.613 -0.889 -0.0390.000 0.000 0.000 0.000 0.0000.061 1.261 -4.281 44.485 0.024 n.a. n.a. n.a. n.a. n.a.

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F/S Statement of Operations (Current Assessments+ Self-Insured) F/S Statement of Operations (Expenditures - Claims) F/S Statement of Operations ( Administration - Recoverable Self-Insured) F/S Statement of Operations ( Workers Advisor + Employers Advisor + Appeals Tribunal )

Note 5. Earned during the year Note 5. Unrealized

Note 5. Realized

Note 5. Money Market Note 5. Fixed Term Note 5. Equities

Note 4. Other

Note 4. Self-Insured Note 4. Assessments + Accrued Assessments

Note 6. Capital Assets

Note 10. Benefit Liabilities ( TWL + HealthCare + Rehab + Admin )

B/S (Payables and accruals + Debenture Payable + Retirement pay)

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Note 10. Benefit Liabilities ( Pension and Extended Wage Loss)

F/S Statement of Operations (Current Assessments)

Note 10. Benefit Liabilities ( Costs Incurred )

Premiums Earned less claim costs incurredFive-Year Historical Data (page 17, line 28)Five-Year Historical Data (page 17, line 29)

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AASCIF Member Name The Beacon Mutual Insurance CompanyJurisdiction Rhode IslandWeb Address

Arthur Lariviere401-825-2629 /[email protected]

Last Reporting Period (ended) 12/31/2013Statutory

Accounting Year Year-1 Year-2 Year-3 Year-4 Year-5

Year Designation 2013 2012 2011 2010 2009 2008

OPERATING STATEMENT ($000)1 Net Premiums Earned 102,822 94,165 85,008 83,423 94,497 108,756 2 Net Losses Incurred 61,596 60,728 49,290 55,336 60,165 63,028 3 Loss Expense Incurred 16,905 16,324 16,404 14,939 17,772 15,696 4 Underwriting Expense Incurred 37,893 34,813 32,567 31,216 32,689 35,278 5 Net UW Gain / (Loss) (13,572) (17,700) (13,253) (18,068) (16,129) (5,246)6 Income From Bond Investments 11,895 12,454 13,032 14,195 15,102 15,313 7 Income From Stock Investments 566 6,791 748 777 890 831 8 Income From Mortgage Investments - - - - - - 9 Income From All Other Investments 1,546 1,543 1,542 1,547 1,691 2,548

10 Net Realized Capital Gain/(Loss) 5,727 5,718 4,665 11,070 6,694 (3,146)11 Investment Expense Incurred (2,048) (2,030) (1,945) (1,842) (1,902) (2,297)12 Other Income 210 17 211 447 165 2,207 13 Net Income Prior to Dividends/Taxes 4,324 6,793 5,000 8,126 6,511 10,210 14 Dividends to Policyholders 2,335 4,220 2,693 2,788 2,062 6,285 15 Federal Income Tax - - - - - - 16 Net Income After Dividends/Taxes 1,989 2,573 2,307 5,338 4,449 3,925

ASSETS ($000)

1 Cash & Bank Deposits 5,911 10,089 6,880 12,655 (1,322) 33,878 2 Bonds @ Amortized Value 317,825 305,103 291,611 316,246 334,161 311,258 3 Stocks @ Market Value 17,313 34,752 57,190 51,169 57,886 50,172 4 Mortgage Loans On Real Estate @ Amortized Value - - - - - - 5 Real Estate 12,113 12,483 12,837 13,207 13,577 13,922 6 Other Invested Assets & Loans 146 445 425 352 345 373 7 Cash & Invested Assets 353,308 362,872 368,943 393,629 404,647 409,603 8 Funds Held Or Deposited With Ceding Reinsurors - - - - - - 9 Premium Due But Not Collected 32,972 28,604 28,054 24,406 25,308 28,183

10 Reinsurance Recoverable On Loss Payments 551 510 423 208 834 549 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 3,029 3,438 3,643 3,898 3,664 4,227 12 Other Non-Invested Assets 1,387 2,189 1,375 1,708 1,505 1,129 13 Total Assets 391,247 397,613 402,438 423,849 435,958 443,691

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 123,562 135,847 147,590 169,873 181,688 192,595 2 Loss Adjustment Expense 23,629 25,235 27,826 30,064 33,007 32,875 3 8,249 6,502 6,686 6,964 7,806 6,933 4 Taxes, Licenses, & Fees 7,966 7,379 6,673 6,400 6,449 6,788 5 Borrowed Money - - - - - - 6 Unearned Premiums 57,708 50,884 47,721 46,163 46,634 53,944 7 Dividends Declared & Unpaid 3,966 5,278 3,564 2,788 - - 8 Other Liabilities 8,633 8,041 6,214 6,469 7,875 8,657 9 Total Liabilities 233,713 239,166 246,274 268,721 283,459 301,792

10 Restricted Surplus/Equity Funds 20,759 20,759 20,759 20,759 20,759 20,759 11 Unrestricted Surplus 136,775 136,718 135,401 135,661 131,740 121,140 12 Policyholder Surplus 157,534 157,477 156,160 156,420 152,499 141,899 13 Total Liabilities & Policyholder Surplus 391,247 396,643 402,434 425,141 435,958 443,691

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 157,477 156,160 156,419 152,498 141,899 144,067 2 Net Income/(Loss) After Policyholder Dividend & Taxes 1,989 2,573 2,307 5,337 4,449 3,925 3 Net Unrealized Capital Gains/(Losses) (1,166) (1,990) (2,719) (2,400) 6,841 (7,367)4 Change in Nonadmitted Assets (735) 734 153 984 (1,160) 1,274 5 Other Adjustments To Surplus/Equity (31) - - - - - 6 Policyholder Surplus At Close of Accounting Period 157,534 157,477 156,160 156,419 152,029 141,899

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 106,829 97,856 88,119 87,799 98,767 115,998 2 Approximate Direct Market Share (Insured Market Only) 60% 59% 57% 58% 60% 61%3 Direct Policies Written 11,848 11,625 11,391 11,468 12,022 12,827 4 Direct Written Payroll ($000) 6,164,725 5,847,300 5,669,508 5,454,456 5,617,183 6,392,829 5 Accident Year Direct Loss Incurred ($000) 66,901 72,241 68,999 69,361 72,897 70,780 6 Accident Year Direct Claims Incurred 7,606 7,894 7,770 7,778 8,232 9,695 7 Open Direct Claims @ End of Period 2,873 2,769 2,953 3,052 2,959 3,291 8 Direct Claim Management Employees (FTE) 27.00 24.00 23.00 25.00 29.00 60.00 9 Other Claim Management Employees (FTE) 6.00 6.00 6.00 6.00 6.00 8.00

10 Direct Policy Service Employees (FTE) 19.00 19.00 19.00 19.00 21.00 18.00 11 All Other Employees (FTE) 124.00 129.00 130.00 134.00 130.00 124.00 12 Total Employees (FTE) 176.00 178.00 178.00 184.00 186.00 210.00 13 Net Premiums Written ($000) 109,646 97,328 86,659 81,207 87,479 105,159 14 Total Adjusted Capital ($000) 159,034 157,477 156,160 156,419 152,498 141,899 15 Authorized Control Level Risk-based Capital ($000) 16,375 16,176 15,536 15,569 15,726 14,978

BENCHMARK STATISTICS1 1.132 1.188 1.156 1.217 1.171 1.0482 Calendar Year Loss & LAE Ratio 0.763 0.818 0.773 0.842 0.825 0.7243 Calendar Year Operating Ratio 0.958 0.928 0.941 0.903 0.931 0.9064 Accident Year Direct Loss Ratio 0.626 0.738 0.783 0.790 0.738 0.6105 Loss & LAE Reserve:Surplus Ratio 0.934 1.023 1.123 1.278 1.408 1.5896 Premium:Surplus Ratio 0.653 0.598 0.544 0.533 0.620 0.7667 Expense Ratio 0.346 0.358 0.376 0.384 0.374 0.3358 Investment Yield Ratio 0.166 0.250 0.205 0.293 0.228 0.1149 Dividend Ratio 0.022 0.043 0.031 0.032 0.021 0.054

10 Return on Policyholder Surplus 0.027 0.043 0.032 0.053 0.044 0.07111 Risk Based Capital Ratio 9.71 9.74 10.05 10.05 9.70 9.47

www.beaconmutual.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

Calendar Year Combined Ratio (prior to dividends & taxes)

B41
Less private accounts over 90 days since billing
B71
From Statutory Pg 19, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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AASCIF Member Name SC State Accident FundJurisdiction South CarolinaWeb Address

Harry Gregory803-896-5409

Last Reporting Period (ended) 6/30/2011GAAP

Accounting Year Year-1 Year-2 Year-3 Year-4 Year-5

Year Designation 2011 2010 2009 2008 2007 2006

OPERATING STATEMENT ($000)1 Net Premiums Earned 83,189,298 87,631,830 94,095,017 101,658,115 87,677,773 72,706,067 2 Net Losses Incurred 56,251,403 63,633,941 76,878,838 80,460,433 81,970,188 50,779,720 3 Loss Expense Incurred 14,684,930 16,438,072 15,354,151 17,688,999 16,807,530 22,740,071 4 Underwriting Expense Incurred - - - - 5 Net UW Gain / (Loss) 12,252,965 7,559,817 1,862,028 3,508,683 (11,099,945) (813,724)6 Income From Bond Investments - - - - - - 7 Income From Stock Investments - - - - - - 8 Income From Mortgage Investments - - - - - - 9 Income From All Other Investments 3,969,889 8,619,198 8,024,947 4,317,874 2,940,427 1,010,260 10 Net Realized Capital Gain/(Loss) - - - - - - 11 Investment Expense Incurred - - - - - - 12 Other Income - - 986 5,548 13,907,101 140 13 Net Income Prior to Dividends/Taxes 16,222,854 16,179,015 9,887,961 7,832,105 5,747,583 196,676 14 Dividends to Policyholders - - - - - - 15 Federal Income Tax - - - - - - 16 Net Income After Dividends/Taxes 16,222,854 16,179,015 9,887,961 7,832,105 5,747,583 196,676

ASSETS ($000)1 Cash & Bank Deposits 199,479,999 170,560,135 135,132,141 96,044,780 65,101,322 26,037,228 2 Bonds @ Amortized Value - - - - - - 3 Stocks @ Market Value - - - - - - 4 Mortgage Loans On Real Estate @ Amortized Value - - - - - - 5 Real Estate - - - - - - 6 Other Invested Assets & Loans - - - - - - 7 Cash & Invested Assets 199,479,999 170,560,135 135,132,141 96,044,780 65,101,322 26,037,228 8 Funds Held Or Deposited With Ceding Reinsurors - - - - 9 Premium Due But Not Collected 63,357,246 81,162,732 78,583,427 81,714,080 77,286,130 71,084,440 10 Reinsurance Recoverable On Loss Payments 42,088 42,088 37,620 120,364 120,364 120,364 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 888,843 1,132,707 1,149,881 771,596 510,321 234,326 12 Other Non-Invested Assets 845,930 996,323 1,231,006 1,256,593 1,768,339 1,669,601 13 Total Assets 264,614,106 253,893,985 216,134,075 179,907,413 144,786,476 99,145,959

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 237,790,000 228,145,000 214,750,000 188,810,000 159,191,568 127,509,000 2 Loss Adjustment Expense - - - - 3 - - - - 4 Taxes, Licenses, & Fees - - - 5 Borrowed Money - - - - 6 Unearned Premiums 72,692,640 88,115,788 86,087,517 87,170,978 84,758,236 77,654,364 7 Dividends Declared & Unpaid - - - - 8 Other Liabilities 11,019,788 10,744,373 4,586,849 3,104,587 7,846,929 6,740,435 9 Total Liabilities 321,502,428 327,005,161 305,424,366 279,085,565 251,796,733 211,903,799 10 Restricted Surplus/Equity Funds - - - - 11 Unrestricted Surplus - - - - - - 12 Policyholder Surplus - - - - - - 13 Total Liabilities & Policyholder Surplus 321,502,428 327,005,161 305,424,366 279,085,565 251,796,733 211,903,799

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period (73,111,176) (89,290,191) (99,178,152) (107,010,257) (112,757,840) (112,954,516)2 Net Income/(Loss) After Policyholder Dividend & Taxes 16,222,854 16,179,015 9,887,961 7,832,105 5,747,583 196,676 3 Net Unrealized Capital Gains/(Losses) - - - - - - 4 Change in Nonadmitted Assets - - - - - - 5 Other Adjustments To Surplus/Equity - - - - - - 6 Policyholder Surplus At Close of Accounting Period (56,888,322) (73,111,176) (89,290,191) (99,178,152) (107,010,257) (112,757,840)

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 83,189,298 87,631,830 94,095,017 101,658,115 87,677,773 72,706,067 2 Approximate Direct Market Share (Insured Market Only) 43% 43% 41% 41%3 Direct Policies Written 609 647 675 677 668 656 4 Direct Written Payroll ($000) - - - - - - 5 Accident Year Direct Loss Incurred ($000) - - - - - - 6 Accident Year Direct Claims Incurred 4,662 5,217 5,712 6,063 6,240 6,527 7 Open Direct Claims @ End of Period 3,206 3,297 3,535 4,078 4,507 4,618 8 Direct Claim Management Employees (FTE) 31.00 31.00 19.00 19.00 19.00 19.00 9 Other Claim Management Employees (FTE) 14.00 14.00 23.00 23.00 23.00 23.00 10 Direct Policy Service Employees (FTE) 6.00 6.00 3.00 3.00 3.00 3.00 11 All Other Employees (FTE) 34.00 35.00 41.00 41.00 41.00 45.00 12 Total Employees (FTE) 85.00 86.00 86.00 86.00 86.00 90.00 13 Net Premiums Written Underwriting and Investment Exhibit, Part 1B, col. 6, line 1614 Total Adjusted Capital Five-Year Historical Data (page 17, line 28)15 Authorized Control Level Risk-based Capital Five-Year Historical Data (page 17, line 29)

BENCHMARK STATISTICS1 0.853 0.914 0.980 0.965 1.127 1.0112 Calendar Year Loss & LAE Ratio 0.853 0.914 0.980 0.965 1.127 1.0113 Calendar Year Operating Ratio 0.805 0.815 0.895 0.923 0.934 0.9974 Accident Year Direct Loss Ratio 0.000 0.000 0.000 0.000 0.000 0.0005 Loss & LAE Reserve:Surplus Ratio #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!6 Premium:Surplus Ratio #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!7 Expense Ratio #DIV/0! #DIV/0! 0.000 #DIV/0! #DIV/0! #DIV/0!8 Investment Yield Ratio 0.048 0.098 0.085 0.042 0.034 0.0149 Dividend Ratio 0.000 0.000 0.000 0.000 0.000 0.00010 Return on Policyholder Surplus -0.250 -0.199 -0.105 -0.076 -0.052 -0.00211 Risk Based Capital #DIV/0! #DIV/0! 0 #DIV/0! #DIV/0! #DIV/0!

www.saf.sc.govStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

Calendar Year Combined Ratio (prior to dividends & taxes)

B41
Less private accounts over 90 days since billing
B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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AASCIF Member Name Saskatchewan Workers' Compensation BoardJurisdiction Saskatchewan, CanadaWeb Address

Gerald Martine(306) 787-8718 / [email protected]

Last Reporting Period (ended) 12/31/2011IFRS

Accounting Year Year-1 Year-2 Year-3 Year-4 Year-5

Year Designation 2011 2010 2009 2008 2007 2006

OPERATING STATEMENT ($000)1 Net Premiums Earned 281,983 250,959 255,164 239,014 235,951 221,240 2 Net Losses Incurred 199,663 228,335 222,754 205,798 202,003 241,112 3 Loss Expense Incurred 22,214 21,080 23,326 14,099 24,347 21,238 4 Underwriting Expense Incurred 33,640 33,343 32,542 30,191 28,786 27,527 5 Net UW Gain / (Loss) 26,466 (31,799) (23,458) (11,074) (19,185) (68,637)6 Income From Bond Investments 13,829 14,805 16,276 18,443 15,707 17,659 7 Income From Stock Investments 19,055 (18,573) 12,937 5,088 34,122 16,615 8 Income From Mortgage Investments 2,902 2,484 1,404 - - - 9 Income From All Other Investments 941 912 4,448 9,846 10,847 8,338 10 Net Realized Capital Gain/(Loss) 15,314 47,663 (5,192) (8,675) 91,301 47,206 11 Investment Expense Incurred (3,632) (3,381) (2,855) (2,741) (2,809) (2,293)12 Other Income (81,919) - - - - - 13 Net Income Prior to Dividends/Taxes (7,044) 12,111 3,560 10,887 129,983 18,888 14 Dividends to Policyholders - - - - 15 Federal Income Tax - - - - - 16 Net Income After Dividends/Taxes (7,044) 12,111 3,560 10,887 129,983 18,888

ASSETS ($000)1 Cash & Bank Deposits 46,430 45,082 61,195 56,343 51,288 62,956 2 Bonds @ Amortized Value 381,659 389,039 381,849 356,800 425,727 475,703 3 Stocks @ Market Value 701,583 791,380 683,578 589,169 699,886 614,472 4 Mortgage Loans On Real Estate @ Amortized Value 65,720 49,420 28,560 - - - 5 Real Estate 164,314 144,527 123,171 98,195 95,468 72,682 6 Other Invested Assets & Loans 64,970 37,777 29,581 18,627 56,928 28,280 7 Cash & Invested Assets 1,424,676 1,457,225 1,307,934 1,119,134 1,329,297 1,254,093 8 Funds Held Or Deposited With Ceding Reinsurers - - - - 9 Premium Due But Not Collected 16,117 11,295 15,634 16,885 14,582 14,075 10 Reinsurance Recoverable On Loss Payments - - - - - 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 3,698 3,675 3,565 4,270 4,773 4,876 12 Other Non-Invested Assets 53,008 44,347 37,686 30,434 28,808 39,047 13 Total Assets 1,497,499 1,516,542 1,364,819 1,170,723 1,377,460 1,312,091

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 1,013,946 1,021,265 995,658 969,545 955,262 933,200 2 Loss Adjustment Expense 15,460 14,800 15,062 14,081 11,554 10,840 3 - - - - - 4 Taxes, Licenses, & Fees - - - - - 5 Borrowed Money - - - - - 6 Unearned Premiums - - - - - 7 Dividends Declared & Unpaid - - - - - 8 Other Liabilities 177,940 178,988 177,033 166,450 163,059 156,379 9 Total Liabilities 1,207,346 1,215,053 1,187,753 1,150,076 1,129,875 1,100,419 10 Restricted Surplus/Equity Funds - - - - - 11 Unrestricted Surplus 290,153 301,489 177,066 20,647 247,585 211,672 12 Policyholder Surplus 290,153 301,489 177,066 20,647 247,585 211,672 13 Total Liabilities & Policyholder Surplus 1,497,499 1,516,542 1,364,819 1,170,723 1,377,460 1,312,091

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 297,197 177,066 20,647 247,585 211,672 135,198 2 Net Income/(Loss) After Policyholder Dividend & Taxes (7,044) 12,111 3,560 10,887 129,983 18,888 3 Net Unrealized Capital Gains/(Losses) - 115,467 122,665 (269,533) (9,427) 99,781 4 Change in Nonadmitted Assets - - - - - 5 Other Adjustments To Surplus/Equity - (3,155) 30,194 31,708 (84,643) (42,195)6 Policyholder Surplus At Close of Accounting Period 290,153 301,489 177,066 20,647 247,585 211,672

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 281,476 251,243 255,481 250,904 224,295 225,980 2 Approximate Direct Market Share (Insured Market Only) 100% 100% 100% 100% 100% 100%3 Direct Policies Written 39,689 38,773 38,354 35,946 34,364 33,438 4 Direct Written Payroll ($000) 16,910,000 15,660,000 14,910,000 13,910,000 12,870,000 11,990,000 5 Accident Year Direct Loss Incurred ($000) 173,351 168,670 169,103 168,461 151,106 149,634 6 Accident Year Direct Claims Incurred 11,516 11,574 12,167 13,451 13,504 13,754 7 Open Direct Claims @ End of Period 13,118 12,870 10,841 11,297 10,850 8 Direct Claim Management Employees (FTE) 164.00 173.00 172.00 169.00 167.00 9 Other Claim Management Employees (FTE) 73.00 64.00 56.00 40.00 34.00 10 Direct Policy Service Employees (FTE) 70.00 64.00 72.00 60.00 61.00 11 All Other Employees (FTE) 166.00 173.00 184.00 166.00 165.00 12 Total Employees (FTE) - 473.00 474.00 484.00 435.00 427.00 13 Net Premiums Written 282,633 251,590 255,366 246,076 242,950 226,162 Underwriting and Investment Exhibit, Part 1B, col. 6, line 1614 Total Adjusted Capital NA NA NA NA NA NA Five-Year Historical Data (page 17, line 28)15 Authorized Control Level Risk-based Capital NA NA NA NA NA NA Five-Year Historical Data (page 17, line 29)

BENCHMARK STATISTICS1 0.906 1.127 1.092 1.046 1.081 1.3102 Calendar Year Loss & LAE Ratio 0.787 0.994 0.964 0.920 0.959 1.1863 Calendar Year Operating Ratio 1.025 0.952 0.986 0.954 0.449 0.9154 Accident Year Direct Loss Ratio 0.616 0.671 0.662 0.671 0.674 0.6625 Loss & LAE Reserve:Surplus Ratio 3.548 3.436 5.708 47.640 3.905 4.4606 Premium:Surplus Ratio 0.972 0.832 1.441 11.576 0.953 1.0457 Expense Ratio 0.119 0.133 0.127 0.123 0.118 0.1228 Investment Yield Ratio 0.172 0.175 0.106 0.088 0.665 0.3879 Dividend Ratio 0.000 0.000 0.000 0.000 0.000 0.00010 Return on Policyholder Surplus -0.024 0.051 0.036 0.081 0.566 0.10911 Risk Based Capital #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! #VALUE!

www.wcbsask.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

Calendar Year Combined Ratio (prior to dividends & taxes)

B41
Less private accounts over 90 days since billing
B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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AASCIF Member Name Texas Mutual Insurance CompanyJurisdiction TexasWeb Address

Erica Sanchez512-224-7328 / [email protected]

Last Reporting Period (ended) 12/31/2013Statutory

Accounting YearYear Designation 2013

OPERATING STATEMENT ($000)1 Net Premiums Earned 989,336 2 Net Losses Incurred 520,971 3 Loss Expense Incurred 38,702 4 Underwriting Expense Incurred 251,457 5 Net UW Gain / (Loss) 178,206 6 Income From Bond Investments 114,128 7 Income From Stock Investments 30,001 8 Income From Mortgage Investments - 9 Income From All Other Investments 9,196

10 Net Realized Capital Gain/(Loss) 116,496 11 Investment Expense Incurred (17,169)12 Other Income (1,848)13 Net Income Prior to Dividends/Taxes 429,010 14 Dividends to Policyholders 183,182 15 Federal Income Tax - 16 Net Income After Dividends/Taxes 245,828

ASSETS ($000)1 Cash & Bank Deposits 108,8402 Bonds @ Amortized Value 3,480,5253 Stocks @ Market Value 1,274,6934 Mortgage Loans On Real Estate @ Amortized Value - 5 Real Estate 18,0886 Other Invested Assets & Loans 242,945 7 Cash & Invested Assets 5,125,091 8 Funds Held Or Deposited With Ceding Reinsurers 2,2769 Premium Due But Not Collected 356,238

10 Reinsurance Recoverable On Loss Payments 1,30311 Interest,Dividends,&Real Estate Inc. Due & Accrued 31,06912 Other Non-Invested Assets 1,200 13 Total Assets 5,517,177

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 2,363,7822 Loss Adjustment Expense 212,1043 28,1304 Taxes, Licenses, & Fees 16,1935 Borrowed Money 06 Unearned Premiums 501,1287 Dividends Declared & Unpaid 3428 Other Liabilities 65,016 9 Total Liabilities 3,186,695

www.texasmutual.comStatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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10 Restricted Surplus/Equity Funds - 11 Unrestricted Surplus 2,330,482 12 Policyholder Surplus 2,330,482 13 Total Liabilities & Policyholder Surplus 5,517,177

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 1,934,3892 Net Income/(Loss) After Policyholder Dividend & Taxes 245,8283 Net Unrealized Capital Gains/(Losses) 156,374 4 Change in Nonadmitted Assets (6,092)5 Other Adjustments To Surplus/Equity (17)6 Policyholder Surplus At Close of Accounting Period 2,330,482

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 961,1562 Approximate Direct Market Share (Insured Market Only) 38.4%3 Direct Policies Written 62,8944 Direct Written Payroll ($000) 47,190,9105 Accident Year Direct Loss Incurred ($000) 646,1836 Accident Year Direct Claims Incurred 44,7857 Open Direct Claims @ End of Period 11,4698 Direct Claim Management Employees (FTE) 146.009 Other Claim Management Employees (FTE) 154.00

10 Direct Policy Service Employees (FTE) 157.0011 All Other Employees (FTE) 400.00 12 Total Employees (FTE) 857.00 13 Net Premiums Written 1,062,191 14 Total Adjusted Capital 2,330,482 15 Authorized Control Level Risk-based Capital 210,288

BENCHMARK STATISTICS1 0.8202 Calendar Year Loss & LAE Ratio 0.5663 Calendar Year Operating Ratio 0.5664 Accident Year Direct Loss Ratio 0.6725 Loss & LAE Reserve:Surplus Ratio 1.1056 Premium:Surplus Ratio 0.4257 Expense Ratio 0.2378 Investment Yield Ratio 0.2639 Dividend Ratio 0.191

10 Return on Policyholder Surplus 0.20111 Risk Based Capital 11.082

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Texas Mutual Insurance CompanyTexas

Erica Sanchez512-224-7328 / [email protected]

12/31/2013Statutory

Year-1 Year-2 Year-3 Year-4 Year-5

2012 2011 2010 2009 2008

844,843 707,485 623,063 648,194 755,954 451,343 354,761 343,545 297,558 413,426 70,639 78,857 37,782 76,568 76,490 222,078 194,407 168,871 179,129 192,085 100,783 79,460 72,865 94,939 73,953 124,181 134,555 145,850 149,277 141,913 26,012 18,998 15,380 14,160 19,926 - - - - - 6,536 4,479 4,855 5,640 10,370 92,862 86,074 84,774 8,466 (125,638) (17,383) (15,056) (12,011) (9,324) (9,110) (785) (275) (1,271) (1,218) (364) 332,206 308,235 310,442 261,940 111,050 163,532 169,164 115,974 93,114 166,239 - - - - - 168,674 139,071 194,468 168,826 (55,189)

148,883 142,001 100,465 97,633 147,457 3,193,680 3,097,179 2,920,429 2,736,213 2,440,836 1,036,718 791,497 826,154 695,114 518,883

- - - - - 19,513 20,878 21,911 23,264 24,356

164,037 67,738 630,083 45,681 38,760 4,562,831 4,119,293 4,499,042 3,597,905 3,170,292

1,982 1,270 1,270 750 750 293,632 227,075 187,468 193,229 197,498

1,246 1,223 882 763 882 29,367 28,925 28,891 29,557 27,760

1,236 2,174 3,334 5,049 6,376 4,890,294 4,379,960 4,720,887 3,827,253 3,403,558

2,192,869 2,060,677 1,997,541 1,916,967 1,888,194 229,891 210,968 183,450 194,775 170,854 24,452 22,093 21,347 25,476 27,576 20,337 12,235 8,894 9,184 8,435

0 0 0 0 - 428,276 346,110 311,849 332,949 344,275

2,301 747 1,071 257 1,270 57,779 49,913 586,556 33,973 38,065 2,955,905 2,702,743 3,110,708 2,513,581 2,478,669

www.texasmutual.com

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- - - - - 1,934,389 1,677,217 1,610,179 1,313,672 924,889 1,934,389 1,677,217 1,610,179 1,313,672 924,889 4,890,294 4,379,960 4,720,887 3,827,253 3,403,558

1,677,217 1,610,179 1,313,671 924,889 1,306,020 168,674 139,071 194,468 168,826 (55,189)92,535 (69,868) 100,668 221,416 (327,935)(2,521) (2,137) 1,383 (1,465) 1,958

(1,516) (28) (11) 6 35 1,934,389 1,677,217 1,610,179 1,313,672 924,889

829,190 698,359 618,714 645,639 755,203 37.1% 33.8% 31.1% 29.0% 29.3%58,235 54,640 52,565 51,057 51,046

43,319,477 36,898,397 32,752,148 30,810,854 31,068,902 575,778 504,852 427,365 376,683 436,654 45,081 40,823 36,552 33,938 39,338 11,073 10,947 10,740 9,817 10,378 135.00 123.00 119.00 115.00 124.00 139.00 128.00 126.00 138.00 149.00 147.00 148.00 156.00 161.00 169.00

387.00 393.00 392.00 392.00 404.00 808.00 792.00 793.00 806.00 846.00

927,005 741,746 601,963 636,868 758,796 Underwriting and Investment Exhibit, Part 1B, col. 6, line 161,934,389 1,677,217 1,610,179 1,313,672 924,889 Five-Year Historical Data (page 17, line 28)

155,097 109,516 116,794 111,246 102,728 Five-Year Historical Data (page 17, line 29)

0.881 0.888 0.883 0.854 0.9020.618 0.613 0.612 0.577 0.6480.607 0.564 0.502 0.596 0.8530.694 0.723 0.691 0.583 0.5781.252 1.354 1.355 1.608 2.2260.437 0.422 0.387 0.493 0.8170.240 0.262 0.000 0.281 0.2530.280 0.328 0.386 0.261 0.0500.197 0.242 0.187 0.144 0.2200.184 0.188 0.212 0.234 0.100

12.472 15.315 13.786 11.809 9.003

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Underwriting and Investment Exhibit, Part 1B, col. 6, line 16Five-Year Historical Data (page 17, line 28)Five-Year Historical Data (page 17, line 29)

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AASCIF Member Name Workers Compensation FundJurisdiction UtahWeb Address

Richard Hill

Last Reporting Period (ended) 12/31/2010Statutory

Accounting Year Year-1

Year Designation 2010 2009

OPERATING STATEMENT ($000)1 Net Premiums Earned 155,167 188,466 2 Net Losses Incurred 90,477 115,148 3 Loss Expense Incurred 32,213 14,713 4 Underwriting Expense Incurred 44,112 45,457 5 Net UW Gain / (Loss) (11,635) 13,148 6 Income From Bond Investments 55,414 57,060 7 Income From Stock Investments - - 8 Income From Mortgage Investments - - 9 Income From All Other Investments - -

10 Net Realized Capital Gain/(Loss) 6,902 (10,319)11 Investment Expense Incurred - - 12 Other Income (10) 267 13 Net Income Prior to Dividends/Taxes 50,671 60,156 14 Dividends to Policyholders 16,819 9,844 15 Federal Income Tax - - 16 Net Income After Dividends/Taxes 33,852 50,312

ASSETS ($000)1 Cash & Bank Deposits 14,621 44,649 2 Bonds @ Amortized Value 1,055,967 1,013,450 3 Stocks @ Market Value 262,396 267,542 4 Mortgage Loans On Real Estate @ Amortized Value 33,840 35,352 5 Real Estate 87,312 62,440 6 Other Invested Assets & Loans 16,747 11,406 7 Cash & Invested Assets 1,470,883 1,434,839 8 Funds Held Or Deposited With Ceding Reinsurers - 9 Premium Due But Not Collected 11,864 11,955

10 Reinsurance Recoverable On Loss Payments 1,150 1,533 11 Interest,Dividends,&Real Estate Inc. Due & Accrued 13,752 14,588 12 Other Non-Invested Assets 11,637 2,938 13 Total Assets 1,509,286 1,465,853

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 754,224 777,188 2 Loss Adjustment Expense 84,302 77,954 3 8,384 9,169 4 Taxes, Licenses, & Fees (2,037) (1,393)5 Borrowed Money - - 6 Unearned Premiums 32,092 34,622 7 Dividends Declared & Unpaid - - 8 Other Liabilities 3,738 5,343 9 Total Liabilities 880,703 902,883

www.wcfgroup.comStatBook Contact (name)StatBook Contact (phone / email) 801-288-8574/[email protected]

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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10 Restricted Surplus/Equity Funds - - 11 Unrestricted Surplus 601,128 562,971 12 Policyholder Surplus 601,128 562,971 13 Total Liabilities & Policyholder Surplus 1,481,831 1,465,854

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 562,971 460,507 2 Net Income/(Loss) After Policyholder Dividend & Taxes 33,852 50,312 3 Net Unrealized Capital Gains/(Losses) 16,454 52,992 4 Change in Nonadmitted Assets (10,946) (841)5 Other Adjustments To Surplus/Equity (1,203) 1 6 Policyholder Surplus At Close of Accounting Period 601,128 562,971

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 146,945 178,941 2 Approximate Direct Market Share (Insured Market Only) 50% 49%3 Direct Policies Written 20,826 23,386 4 Direct Written Payroll ($000) 13,334,926 12,624,000 5 Accident Year Direct Loss Incurred ($000) 134,545 141,765 6 Accident Year Direct Claims Incurred 16,269 18,196 7 Open Direct Claims @ End of Period 9,027 8,858 8 Direct Claim Management Employees (FTE) 48.00 64.00 9 Other Claim Management Employees (FTE) 62.00 79.00

10 Direct Policy Service Employees (FTE) 89.00 98.00 11 All Other Employees (FTE) 124.00 95.00 12 Total Employees (FTE) 323.00 336.00 13 Net Premiums Written 151,518 182,657 14 Total Adjusted Capital 601,128 526,971 15 Authorized Control Level Risk-based Capital 52,194 52,512

BENCHMARK STATISTICS1 1.075 0.9302 Calendar Year Loss & LAE Ratio 0.791 0.6893 Calendar Year Operating Ratio 0.673 0.6814 Accident Year Direct Loss Ratio 0.916 0.7925 Loss & LAE Reserve:Surplus Ratio 1.395 1.5196 Premium:Surplus Ratio 0.258 0.3357 Expense Ratio 0.291 0.2498 Investment Yield Ratio 0.424 0.2619 Dividend Ratio 0.114 0.055

10 Return on Policyholder Surplus 0.087 0.11811 Risk Based Capital 11.51718588343 10.03524908592

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Workers Compensation FundUtah

Richard Hill

12/31/2010Statutory

Year-2 Year-3 Year-4 Year-5

2008 2007 2006 2005

244,845 297,632 296,940 258,898 147,075 163,715 184,762 174,753 29,499 40,767 22,427 27,825 55,435 59,503 58,057 51,479 12,836 33,647 31,694 4,841 59,445 57,376 51,429 47,216 - - - - - - - - - - - - (77,211) 39,412 11,250 12,496 - - - - 87 36 345 (1,057) (4,843) 130,471 94,718 63,496 14,767 46,709 41,812 19,501 - - - - (19,610) 83,762 52,906 43,995

38,525 81,880 40,132 22,952 1,018,056 915,846 872,102 795,023 209,692 296,131 258,407 220,354 44,952 42,319 24,754 22,757 23,675 11,609 42,745 37,724 9,639 6,866 6,871 - 1,344,539 1,354,651 1,245,011 1,098,810 - - - - 14,854 16,619 15,473 15,046 1,109 1,314 1,090 1,231 15,324 14,447 13,996 12,137 3,256 4,978 4,872 6,516 1,379,082 1,392,009 1,280,442 1,133,740

774,609 748,373 706,836 639,245 88,085 83,095 65,657 65,789 8,991 9,834 10,808 10,046 304 5,210 5,789 4,992 - - - - 40,282 45,417 53,255 45,962 - - - - 6,304 2,363 6,320 2,429 918,575 894,292 848,665 768,463

www.wcfgroup.com

801-288-8574/[email protected]

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- - - - 460,507 497,717 431,777 365,277 460,507 497,717 431,777 365,277 1,379,082 1,392,009 1,280,442 1,133,740

497,717 431,777 365,277 326,651 (19,610) 83,763 52,906 43,995 (20,411) (15,777) 10,014 (1,903) 2,810 (2,045) 3,580 (3,466) 1 (1) - - 460,507 497,717 431,777 365,277

235,521 287,298 286,664 248,889 52% 55% 60% 59%

26,077 25,605 26,603 26,412 13,522,000 13,279,000 12,746,000 12,800,000 174,378 184,022 182,066 175,343 23,322 27,017 29,513 29,598 9,884 10,387 11,648 11,393 68.00 66.00 66.00 63.00 79.00 79.00 80.00 82.00 113.00 112.00 106.00 107.00 100.00 100.00 100.00 98.00 360.00 357.00 352.00 350.00 241,260 289,728 303,964 262,586 Underwriting and Investment Exhibit, Part 1B, col. 6, line 16 460,507 497,717 431,777 365,277 Five-Year Historical Data (page 17, line 28) 48,551 55,490 57,581 54,570 Five-Year Historical Data (page 17, line 29)

0.948 0.887 0.893 0.9810.721 0.687 0.698 0.7821.020 0.562 0.681 0.7550.740 0.641 0.635 0.7051.873 1.671 1.789 1.9300.532 0.598 0.688 0.7090.230 0.205 0.191 0.196-0.075 0.337 0.219 0.2400.063 0.163 0.146 0.078-0.010 0.281 0.238 0.184

9.485015756627 8.969489998198 7.4986019694 6.693732820231

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Underwriting and Investment Exhibit, Part 1B, col. 6, line 16Five-Year Historical Data (page 17, line 28)Five-Year Historical Data (page 17, line 29)

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AASCIF Member Name Worker's Safety and Compensation DivisionJurisdiction WyomingWeb Address doe.state.wy.us

Bob Curtis307-777-6761 [email protected]

Last Reporting Period (ended) 6/30/2009NA

Accounting Year Year-1

Year Designation 2009 2008

OPERATING STATEMENT ($000)1 Net Premiums Earned 240,636 265,398 2 Net Losses Incurred 143,804 140,278 3 Loss Expense Incurred 21,358 17,038 4 Underwriting Expense Incurred - - 5 Net UW Gain / (Loss) 75,474 108,082 6 Income From Bond Investments - - 7 Income From Stock Investments - - 8 Income From Mortgage Investments - - 9 Income From All Other Investments 45,410 54,983

10 Net Realized Capital Gain/(Loss) - - 11 Investment Expense Incurred - - 12 Other Income 7,870 4,066 13 Net Income Prior to Dividends/Taxes 128,754 167,131 14 Dividends to Policyholders - - 15 Federal Income Tax - - 16 Net Income After Dividends/Taxes 128,754 167,131

ASSETS ($000)1 Cash & Bank Deposits 110,933 115,545 2 Bonds @ Amortized Value - - 3 Stocks @ Market Value - - 4 Mortgage Loans On Real Estate @ Amortized Value - - 5 Real Estate - - 6 Other Invested Assets & Loans 1,024,368 903,628 7 Cash & Invested Assets 1,135,301 1,019,173 8 Funds Held Or Deposited With Ceding Reinsurers - - 9 Premium Due But Not Collected - -

10 Reinsurance Recoverable On Loss Payments - - 11 Interest,Dividends,&Real Estate Inc. Due & Accrued - - 12 Other Non-Invested Assets - - 13 Total Assets 1,135,301 1,019,173

LIABILITIES/SURPLUS/EQUITY ($000)1 Unpaid Losses 992,684 852,761 2 Loss Adjustment Expense 95,705 79,185 3 - - 4 Taxes, Licenses, & Fees - - 5 Borrowed Money - - 6 Unearned Premiums - - 7 Dividends Declared & Unpaid - - 8 Other Liabilities - - 9 Total Liabilities 1,088,389 931,946

StatBook Contact (name)StatBook Contact (phone / email)

Accounting Basis (statutory, GASB, GAAP, etc.)

Most Recent Completed Year

Other Expenses (excl. fed inc tax, licenses, fees)

B41
Less private accounts over 90 days since billing
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10 Restricted Surplus/Equity Funds - - 11 Unrestricted Surplus 353,664 392,041 12 Policyholder Surplus 353,664 392,041 13 Total Liabilities & Policyholder Surplus 1,442,053 1,323,987

CHANGE IN POLICYHOLDER SURPLUS ($000)1 Policyholder Surplus @ Begin of Accounting Period 224,910 224,910 2 Net Income/(Loss) After Policyholder Dividend & Taxes 128,754 167,131 3 Net Unrealized Capital Gains/(Losses) - - 4 Change in Nonadmitted Assets - - 5 Other Adjustments To Surplus/Equity - - 6 Policyholder Surplus At Close of Accounting Period 353,664 392,041

OTHER OPERATIONAL MEASURES1 Direct Premiums Earned ($000) 240,636 265,398 2 Approximate Direct Market Share (Insured Market Only) 90% 90%3 Direct Policies Written 18,068 17,815 4 Direct Written Payroll ($000) 9,101,959 8,839,738 5 Accident Year Direct Loss Incurred ($000) 143,804 140,278 6 Accident Year Direct Claims Incurred 14,771 16,359 7 Open Direct Claims @ End of Period 11,041 13,726 8 Direct Claim Management Employees (FTE) 54.00 54.00 9 Other Claim Management Employees (FTE) 33.00 33.00

10 Direct Policy Service Employees (FTE) 23.00 23.00 11 All Other Employees (FTE) 37.00 37.00 12 Total Employees (FTE) 147.00 147.00 13 Net Premiums Written14 Total Adjusted Capital15 Authorized Control Level Risk-based Capital

BENCHMARK STATISTICS1 0.686 0.5932 Calendar Year Loss & LAE Ratio 0.686 0.5933 Calendar Year Operating Ratio 0.465 0.3704 Accident Year Direct Loss Ratio 0.598 0.5295 Loss & LAE Reserve:Surplus Ratio 3.077 2.3776 Premium:Surplus Ratio 0.680 0.6777 Expense Ratio 0.000 #DIV/0!8 Investment Yield Ratio 0.189 0.2079 Dividend Ratio 0.000 0.000

10 Return on Policyholder Surplus 0.445 0.54211 Risk Based Capital 0 0

Calendar Year Combined Ratio (prior to dividends & taxes)

B71
From Statutory Pg 14, Col 2 (Grand Total)
B72
Please provide a reasonable estimate (in percent) of your share of the insured market (ie. excluding self-insurance) in your jurisdiction (exclude extra-terratorial coverage).
B73
Insurance policies issued with coverage effective dates within accounting period.
B74
Covered payroll on payroll-based policies in Line 3. Restate prior periods as payroll develops, if material.
B75
Gross loss (developed to ultimate) incurred during accident period. Update prior AYs for subsequent development.
B76
Claims with date of injury within accident period, developed to ultimate, claims with nonzero liabilities only (ie. exclude incident reports). Update prior AYs for subsequent development.
B77
Active claims deemed "administratively open" (irrespective of whether state laws allow full and final resolution)
B78
Employees with direct contact with injured employees/claims and decisionmaking authority. Apply reasonable definitions at discretion of AASCIF member. Generally claims examiners/adjustors. Do not include TPAs. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B79
Other employees with claim management duties but do not generally have direct contact with injured employees or decisionmaking authority as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally claims supervisors, claims related subject matter experts, and customer service representatives. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B80
Employees with direct contact with policyholders or the insurance policy as their primary job description. Apply reasonable definitions at discretion of AASCIF member. Generally underwriters, customer service representatives, and safety professionals. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B81
All other employees providing management or support services not included in claim management or policy services categories. Apply reasonable definitions at discretion of AASCIF member. FTE can be split among categories but do not double count. Count positions established at end of accounting period whether filled or unfilled.
B84
Statutory filings only
B85
Statutory filings only
B87
Standard industry benchmark measures, not exhaustive. A variety of other measures are obtainable from StatBook statistics.
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Worker's Safety and Compensation DivisionWyoming

doe.state.wy.usBob Curtis

307-777-6761 [email protected]/30/2009

NA

Year-2 Year-3

2007 2006

262,107 226,522 127,178 120,153 17,638 14,817 - - 117,291 91,552 - - - - - - 30,979 27,554 - - - - 4,069 4,191 152,339 123,297 - - - - 152,339 123,297

67,685 63,675 - - - - - - - - 784,244 556,299 851,929 619,974 - - - - - - - - - - 851,929 619,974

786,305 764,031 73,388 68,175 - - - - - - - - - - - - 859,693 832,206

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- - 224,910 72,571 224,910 72,571 1,084,603 904,777

72,571 (50,726) 152,339 123,297 - - - - - - 224,910 72,571

262,107 226,522 90% 90%

17,554 17,169 7,941,096 6,928,965 127,178 120,153 16,275 16,469 13,536 12,803 54.00 52.00 33.00 32.00 23.00 23.00 37.00 37.00 147.00 144.00

0.553 0.5960.553 0.5960.419 0.4560.485 0.5303.822 11.4671.165 3.121

#DIV/0! #DIV/0!0.118 0.1220.000 0.0001.024 11.288

0 0

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2122

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25 2627

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AASCIF State FundsCalendar Year Combined Ratio (prior to dividends & taxes)

Jurisdiction of Participating AASCIF Members

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AASCIF State FundsCalendar Year Loss & LAE Ratio

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(2)

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AASCIF State FundsAccident Year Direct Loss Ratio

Jurisdiction of Participating AASCIF Members

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Rat

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AASCIF State FundsLoss & LAE Reserve: Surplus Ratio

Jurisdiction of Participating AASCIF Members

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lus

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(1.5)

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AASCIF State FundsPremium: Surplus Ratio

Jurisdiction of Participating AASCIF Members

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AASCIF State FundsExpense Ratio (to WP)

Jurisdication of Participating AASCIF Members

Expe

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AASCIF State FundsInvestment Yield Ratio (to Earned Premium)

Jurisdiction of Participating AASCIF Members

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d R

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(0.40)

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6

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AASCIF State FundsDividend Ratio

Jurisdiction of Participating AASCIF Members

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(1)

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9 10 11 12 13

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AASCIF State FundsReturn on Policyholder Surplus

Jurisdiction of Participating AASCIF Members

Retu

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-10.00

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AASCIF State FundsRisk Based Capital Ratio

Jurisdiction of Participating AASCIF Members

Ris

k B

ased

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Jurisdiction of Participating AASCIF Members

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AASCIF State FundsAccident Year Loss Ratio

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AASCIF State FundsLoss & LAE Reserve: Surplus Ratio

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20

21

22

23

24

25

2627

28

AASCIF State FundsInvestment Yield Ratio (to Earned Premium)

Jurisdiction of Participating AASCIF Members

Yiel

d R

atio

Val

ueBack to

Summary StatsBack to Complete

Graph

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(0.30)

(0.25)

(0.20)

(0.15)

(0.10)

(0.05)

0.00

0.05

0.10

12

3

4

5

8 9

10

11

12

13

14

15

16 17 19 20 22 2324

25 26

AASCIF State FundsDividend Ratio

Jurisdiction of Participating AASCIF Members

Div

iden

d R

atio

Val

ueBack to

Summary StatsBack to

Complete Graph

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(0.6)

(0.4)

(0.2)

0.0

0.2

0.4

0.6

1 3 4 56

7

8

910 11

1213

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

AASCIF State FundsReturn on Policyholder Surplus

Jurisdiction of Participating AASCIF Members

Retu

rn o

n PH

Sur

plus

Val

ueBack to

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Complete Graph

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-5.50

-3.50

-1.50

0.50

2.50

4.50

2

9

20

22

29

AASCIF State FundsRisk Based Capital Ratio

Jurisdiction of Participating AASCIF Members

Ris

k B

ased

Cap

ital R

atio

Back to Summary Stats

Back to Complete Graph