New, Simplified Formula
 

The first $250 of every claim is excluded

Reporting the cost of minor workplace injuries helps everybody.

Summary of Changes

The Insurance Commissioner recently adopted changes to experience rating. These changes make it easier for employers to understand:

• How reducing workplace injuries will reduce their premium cost
• The importance of reporting all claims

The new formula excludes the first $250 of each claim from the X-Mod computation. This change removes any experience rating incentive to not report the cost of small or “first aid” type claims to your insurer. The new simplified formula also places a clear and direct emphasis on reducing the occurrence and cost of workplace injuries as reflected in the actual primary losses.

Download the 2019 Experience Rating Changes Brochure to share this information with your clients>

Definition of Terms

• Actual primary losses
  Equal to the cost of losses incurred with each loss limited to a policyholder’s primary threshold
   
• Expected excess losses
  Equal to the average losses expected for businesses of similar size and industry in excess of the primary threshold
   
• Expected losses
  Equal the total losses expected for businesses of similar size and industry

Frequently Asked Questions

How does the $250 loss exclusion work?
Under California’s Experience Rating Plan only the amount of each of your claims, up to your primary threshold, is used in the X-Mod computation. With the $250 loss exclusion, that amount is reduced by $250. For example, if you have a $10,000 primary threshold and a single claim of $5,000, the amount used in the X-Mod computation is $4,750. If you have a single claim of $15,000, the amount used in the X-Mod is your primary threshold ($10,000) less $250, or $9,750.

Is the first $250 excluded from all claims?
Yes, any claim incurred against policies incepting during the experience period for your 2019 experience modification, which includes 2015, 2016 and 2017 policies, will be used in the X-Mod computation at $250 less than its reported value.

What if I file a claim that’s valued at $250 or less?
A claim with a reported cost of $250 or less will continue to be shown on the experience rating worksheet, but will not be used in any way in the X-Mod calculation.

If I only have one claim over $250 during the experience period, do claims valued at $250 or less affect the 25 point cap to my lossfree X-Mod?
Any claim of $250 or less will not be considered in the determination of whether the single claim cap of 25% applies. In other words, if you have two claims during the experience period and one is reported at $250 or less, the single claim X-Mod cap of 25% will still apply.

Does the simplification of the formula affect my X-Mod?
No. It does not change the X-Mod value.

Webinars

Register to our WCIRB Mod Talk webinars to learn more about the 2019 Experience Rating Plan changes. Each 30-minute webinar consists of a brief presentation and status updates, followed by a question and answer session.

Effects of the New 2019 X-Mods
Wednesday, May 29, 2019, 10:00 – 10:30 AM PT
A new X-Mod formula was introduced in 2019. WCIRB experts Rod Libbe and Dave Bellusci will discuss how the new formula is working and the tools available to help understand how the changes can affect a policyholder's X-Mod.
View the video recording
Download the presentation

How to Read a Ratesheet
Thursday, July 25, 2019, 10:00 – 10:30 AM PT
Learn how to navigate the experience rating form, where to find the footnotes and notations and how to interpret their meaning. 
View the video recording
Download the presentation

How to Access an X-Mod
Wednesday, August 21, 2019, 10:00 – 10:30 AM PT
Whether you are an insurer, agent or broker, learn how to request access to experience rating worksheets, inspection reports, and Comprehensive Risk Summary (CRS) Reports for your policyholder clients. We will also preview the 2020 Experience Modification (X-Mod) Estimator. 
REGISTER NOW

Why Did the X-Mod Change?
Wednesday, October 23, 2019, 10:00 – 10:30 AM PT
Explore the factors, values, and variables that can change from year-to-year, resulting in changes to an experience modification. 
REGISTER NOW

More Resources

Experience Rating
Experience Modification Estimator
WCIRB Mod Talks
2019 Experience Rating Changes Brochure
Video: First Aid Claim Reporting and Potential Experience Rating Changes