如何阅读经验修改工作表

经验修改工作表, 通常被称为经验评级工作表或经验模型工作表, 在工伤赔偿保险中重要吗. When a company receives an experience rating, it is accompanied by an experience modifier.

这个经验修正器是应用于年保费的数字乘数, 哪些可以增加或减少保险金额. 其主要功能是计算企业的体验修改评级(EMR)。, a numeric factor used to adjust insurance premiums based on the company’s historical record of workplace injuries and claims.

The experience modification worksheet allows both employers and insurers to evaluate and manage workplace safety, ultimately leading to fair and appropriate insurance premiums and safer working environments. This article provides an overview of the experience modification worksheet and delves into its elements.

经验修改工作表概述

经验修改工作表 serves as a repository of crucial workers’ compensation claims data, 提供受伤日期的详细信息, types, 索赔款项和估计的未来费用. 

这些数据是对公司安全记录和索赔经验评估的基础. 根据评级机构对雇主的评价，工作表可能会有所不同.

It is important to understand that the state a company is located in will determine how the modifier will be calculated. 一些州使用国家赔偿保险委员会(NCCI), 其他州使用由州法规创建的独立评级机构. NCCI状态的修饰符将由NCCI计算. States that are not NCCI states will have their modifier calculated by the rating bureau the state appoints to do so.

通过比较实际损失和根据行业标准得出的预期损失, the worksheet helps determine whether a business’s claims history is better or worse than the industry average. 这种电子病历一旦计算出来，就会直接影响到工人赔偿覆盖的成本. EMR是1.0作为基线, 电子病历记录较低的企业可以享受较低的保费, 而那些电子病历较高的人可能面临更高的成本, 为安全改进提供财政激励.

Furthermore, the worksheet aids in risk management and budget planning and provides a basis for consultation and appeals if discrepancies or inaccuracies are identified. In essence, 经验修改工作表是企业理解的关键工具, manage and optimize their workers’ compensation insurance costs while promoting a safer workplace.

工作表具有特定的布局，其中分类代码, 工资单细节和预期损失数据显示在左侧, 而与索赔相关的信息显示在右侧. 该表的初始六列提供了各种类型的信息. The first column, labeled as “Code,” denotes the classification codes assigned to a company.

经验修改工作表的要素

经验修改工作表通常包含几个组件. These components provide a comprehensive view of a company’s claims history and are essential for determining workers’ compensation insurance premiums. 以下是经验修改工作表的主要组成部分:

• 基本信息-这部分包括有关被保险业务的基本细节, 比如公司的名字, address, 保单编号及评级期的生效日期. It also contains a risk identification number that is assigned to the employer by the NCCI. In addition, the worksheet will show “interstate” if the business operates in more than one state; it will list the state if it operates in only one state. 确保这些信息的准确性对雇主来说至关重要.
• 政策周期-工作表指定计算EMR的时间范围. This period typically spans three years but excludes the most recent policy year to ensure accurate historical data. The oldest policy period is at the top of the page, and the most recent is at the bottom of the page. Each policy period has a section for payroll that includes classification codes that identify the nature of the business. 雇主可以有一个或多个适用的类代码.
• Claims data-工作表的核心在于索赔数据部分. This part includes comprehensive details about each workers’ compensation claim made by employees during the calculation period. 每个索赔条目通常包括索赔编号, 受伤日期, 伤害类型, 已付金额及预留金额.
• 预期损失—The expected loss ratio (ELR) column typically provides information about the 预期损失 for the insured business. 每个类代码都有一个ELR，以美元和美分表示. These 预期损失 are calculated based on industry standards and actuarial data and a state-by-state basis representing what an average business in the same industry would typically experience in terms of workers’ compensation claims. It serves as an indicator of the expected dollar amount that an insurer is likely to expend on losses for every $100 of payroll.
• 经验修正值计算—The EMR is calculated using a specific formula that compares the actual losses incurred by the business to the 预期损失. 虽然确切的公式可能略有不同，但它通常遵循类似于以下格式:
• 对保费的影响—The calculation’s resulting EMR is a numerical factor applied to the company’s workers’ compensation insurance premium. An EMR of 1.0为平均, with values below indicating lower risk (leading to reduced premiums) and values above suggesting higher risk (increasing premiums). 风险分类-一些工作表可能包括NCCI所说的贴现率， 

Experience Modifier = (Actual Primary Losses + Expected Primary Losses) / Expected Primary Losses

• 实际主要损失—This is the total amount paid for all primary losses (direct claim costs) during the experience period.
• 预期初级损失-这是基于行业标准的主要损失的预期金额.

• 对保费的影响—The calculation’s resulting EMR is a numerical factor applied to the company’s workers’ compensation insurance premium. An EMR of 1.0为平均, with values below indicating lower risk (leading to reduced premiums) and values above suggesting higher risk (increasing premiums). 风险分类-一些工作表可能包括NCCI所说的贴现率，或d比率. 这决定了预计将成为主要损失的那部分损失.
• 经验等级调整—This section may outline any additional adjustments or factors that affect the experience modifier. 这些调整可能是针对特定州的，与折扣有关或基于其他因素.
• 损失数据汇总-一些工作表包括提供实际损失概览的汇总表, 预期损失, 以及由此产生的经验修正器. 此摘要可以帮助利益相关者快速评估公司的索赔历史和EMR.
• 上诉及争议—There may be information about the process for appealing or disputing the calculated EMR or claims data if a business believes there are inaccuracies or errors.

Conclusion

Understanding the components on the experience modification worksheet is crucial for businesses to manage their workers’ compensation insurance costs effectively and implement strategies to improve workplace safety and reduce claims. It is also essential to ensure that the EMR accurately reflects the company’s claims history, which, in turn, 影响保费.

This Work Comp Insights is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. 读者应联系法律顾问或保险专业人士以获得适当的建议. ©2023 Zywave, Inc. 版权所有.