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First Amendment AdminSure, Inc.
<br />September 3, 2019
<br />Page 3
<br />Fee Structure Comparison:
<br />Oriainal Aareement., 91112018 - 8130-2019
<br />AdminSure, Inc. - Fee Structure
<br />Year 1 (Completed -No
<br />Adjustment)
<br />Year 2
<br />Year
<br />Optional Year
<br />Optional Year 5
<br />Optional Year 6
<br />Optional Year
<br />Workers'
<br />Compensation
<br />Monthly Fee
<br />Workers'
<br />Compensation
<br />Annual Fee
<br />General
<br />Liability
<br />Monthly Fee
<br />General
<br />Liability
<br />i Annual Fee
<br />$ 42,125
<br />$ 505,500
<br />$ 14,600
<br />$
<br />175,200
<br />$ 43,389
<br />$ 520,665
<br />$ 15,038
<br />$ 180,456
<br />$ 44,690
<br />$ 536,285
<br />$ 15,489
<br />$
<br />185,870
<br />$ 46,031
<br />$ 552,373
<br />$ 15,954
<br />$
<br />191,446
<br />$ 47,412
<br />$ 568,945
<br />$ 16,432
<br />$
<br />197,189
<br />$ 48,834
<br />$ 586,012
<br />$ 16,925
<br />$
<br />203,100
<br />$ 50,299
<br />$ 603,593
<br />$ 17,433
<br />$
<br />209,193
<br />PROPOSED: EFFECTIVE 91112019
<br />AdminSure, Inc. - Fee Structure
<br />Year 1 (Completed -No
<br />Adjustment)
<br />Year
<br />Year
<br />Optional Year
<br />Optional Year 5
<br />Optional Year 6
<br />Optional Year
<br />Workers'
<br />Compensation
<br />Monthly Fee
<br />$ 42,125
<br />$ 47,539
<br />$ 48,965
<br />$ 50,434
<br />$ 51,947
<br />$ 53,505
<br />$ 55,110
<br />Workers'
<br />Compensation
<br />Annual Fee
<br />General
<br />Liability
<br />Monthly Fee
<br />General
<br />Liability
<br />Annual Fee
<br />$ 505,500
<br />$ 14,600
<br />$
<br />175,200
<br />$ 570,465
<br />$ 22,818
<br />$
<br />273,816
<br />$ 587,579
<br />$ 23,503
<br />$
<br />282,030
<br />$ 605,206
<br />$ 24,208
<br />$
<br />290,491
<br />$ 623,363
<br />$ 24,934
<br />$ 299,206
<br />$ 642,063
<br />$ 25,682
<br />$
<br />308,182
<br />$ 661,325
<br />$ 26,452
<br />$ 317,428
<br />PROPOSED: EFFECTIVE 91112019
<br />Increase Difference Including Agreement
<br />AdminSure, Inc. - Fee Structure
<br />Year 1 (Completed -No
<br />Adjustment)
<br />Year
<br />Year
<br />Optional Year
<br />Optional Years
<br />Optional Year 6
<br />Optional Year
<br />Annual Increase
<br />and Additional
<br />Scope Increase
<br />Workers'
<br />Compensation
<br />Monthly Fee
<br />Workers'
<br />Compensation
<br />Annual Fee
<br />General
<br />Liability
<br />Monthly Fee
<br />General
<br />Liability
<br />Annual Fee
<br />$
<br />$
<br />$
<br />$
<br />$ 4,150
<br />$ 49,797
<br />$ 7,780
<br />$ 93,360
<br />$ 4,275
<br />$ 51,299
<br />$ 8,014
<br />$
<br />96,162
<br />$ 4,403
<br />$ 52,834
<br />$ 8,254
<br />$
<br />99,043
<br />$ 4,535
<br />$ 54,419
<br />$ 8,502
<br />$
<br />102,022
<br />$ 4,671
<br />$ 56,051
<br />$ 8,757
<br />$ 105,083
<br />$ 4,811
<br />$ 57,733
<br />$ %020
<br />$
<br />108,235
<br />25C-3
<br />
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