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CALIFORNIA WORKERS' COMPENSATION INSURANCE <br />NOTICE OF NONRENEWAL <br />Section 11664 of the California Insurance Code requires <br />us, in most instances, to provide you with a notice of <br />nonrenewal. Except as specified in paragraphs 1 <br />through 6 below, if we elect to nonrenew your policy, we <br />are required to deliver or mail to you a written notice <br />stating the reason or reasons for the nonrenewal of the <br />policy. The notice is required to be sent to you no <br />earlier than 120 days before the end of the policy period <br />and no later than 30 days before the end of the policy <br />period. If we fail to provide you the required notice, we <br />are required to continue the coverage under the policy <br />with no change in the premium rate until 60 days after <br />we provide you with the required notice. <br />We are not required to provide you with a notice of <br />nonrenewal in any of the following situations: <br />Your policy was transferred or renewed without a <br />change in its terms or conditions or the rate on <br />which the premium is based to another insurer or <br />other insurers who are members of the same <br />insurance group as us. <br />2. The policy was extended for 90 days or less and the <br />required notice was given prior to the extension. <br />3. You obtained replacement coverage or agreed, in <br />writing, within 60 days of the termination of the <br />policy, to obtain that coverage. <br />Form PN 04 99 02 B (Ed. 5-02) Printed in U.S.A. <br />4. The policy is for a period of no more than 60 days <br />and you were notified at the time of issuance that it <br />may not be renewed. <br />5. You requested a change in the terms or conditions <br />or risks covered by the policy within 60 days prior to <br />the end of the policy period. <br />6. We made a written offer to you to renew the policy <br />at a premium rate increase of less than 25 percent. <br />(A) If the premium rate in your governing <br />classification is to be increased 25 percent or <br />greater and we intend to renew the policy, we <br />shall provide a written notice of a renewal offer <br />not less than 30 days prior to the policy renewal <br />date. The governing classification shall be <br />determined by the rules and regulations <br />established in accordance with California <br />Insurance Code 11750.3(c). <br />(B) For purposes of this Notice, "premium rate" <br />means the cost of insurance per unit of <br />exposure prior to the application of individual <br />risk variations based on loss or expense <br />considerations such as scheduled rating and <br />experience rating. <br />This notice does not change the policy to which it is <br />attached. <br />Rime Mattagement DMsion <br />REVIEWED&APPROVED BY: <br />'� Risk Management Analyst <br />