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MAINTAINING YOUR RECORDS <br />FOR AUDIT PURPOSES <br />Ml:l_\96'L\a:7:11dtl L11d�I91A11-1Idd:2l(t7 <br />When your Workers' Compensation policy was issued you <br />paid a deposit premium based on the nature of your <br />business and estimates of your payroll. At the end of the <br />policy period, we conduct an audit to compare the <br />estimates against the actual figures and operations. <br />Based on this comparison an adjustment is made. If the <br />actual premium is less than what you already have paid, a <br />refund will be made. If it's more, you will be billed for the <br />difference. These adjustments are subject to any minimum <br />premiums that apply. <br />HOW WILL THE PREMIUM ADJUSTMENT BE MADE? <br />On smaller, less complex operations we may e-mail you, <br />call you, or mail you a request to ask you to provide the <br />information via our online web -based portal, mail or <br />telephone. If we require this information, we will provide <br />an electronic link to, or a paper copy of, the necessary <br />forms for you to complete. <br />On larger, more complex operations one of our Premium <br />Auditors will contact you for an appointment. You will be <br />contacted either by e-mail, telephone or mail. If directed, <br />the auditor will contact your accountant to obtain as much <br />information as possible and contact you at a later time for <br />additional information that may be needed. <br />BASIS OF PREMIUM <br />Remuneration (Payroll) in most states, includes: <br />Payment of: <br />Wages, bonuses, commissions, <br />overtime,* sick pay, vacation pay,* tool <br />allowances, contributions to individual <br />retirement accounts, employee <br />contributions to employee benefit plans. <br />Payments on <br />basis of: <br />Piece work, incentive plans, profit sharing. <br />The value of: <br />Housing furnished to employees,* meals <br />furnished to employees,* store certificates, <br />merchandise and other dollar substitutes. <br />Form 98456 5th Rev. 12-13 Printed in U.S.A. <br />Remuneration does not include: <br />a. Employer contributions to a group insurance or <br />pension plan other than statutory plans of insurance. <br />b. Special awards for individual inventions or <br />discoveries. <br />c. Overtime.* <br />Subcontractors. In the absence of other insurance, most <br />state laws hold a contractor responsible for injuries to <br />employees of subcontractors. At the time of audit <br />Certificates of Insurance must be available for <br />subcontractors with employees, in order to avoid payment <br />of premium. <br />Independent Contractors, without employees, whose <br />duties closely resemble those of an employee, will be <br />considered your employee with the appropriate premium <br />charged. <br />The actual working relationship between you and the <br />Independent Contractor is examined. Items such as, but <br />not limited to: whether the work performed is an integral <br />part of your operations, whether you have the right to <br />control the details of the work, the method of payment, <br />who supplied the materials used, does the person <br />regularly work for others, whose regulatory authority did <br />person operate under, whether the person is involved in a <br />separate and distinct business offering the same services <br />to the public. <br />RECORDS <br />As part of the policy conditions, we are allowed to <br />examine your financial books and records to determine <br />actual exposures and operations. We would appreciate <br />your cooperation in making the needed records available <br />for the auditor's inspection. <br />What Records Will Be Needed? <br />The records needed will vary. In most cases, the Premium <br />Auditor will be able to obtain the necessary audit data <br />from two or more of the following records: Journals, <br />Ledgers, State and Federal Tax Reports, Individual <br />Earning Cards, Checkbooks and Contracts. <br />Rime Management DMsian <br />REV EWED & APPROVED BY: <br />'� Risk Management Analyst <br />