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POLICYHOLDER NOTICE <br />SHORT RATE CANCELATION <br />CALIFORNIA INSURANCE CODE SECTION 481 <br />CA Insurance Code Section 481 requires that where an insurance policy includes a provision to refund premium <br />on anything other than a pro rata basis, including the assessment of cancellation fees, the insurer must disclose <br />that fact to the policyholder in writing prior to, or concurrent with, the proposal or quote prior to each renewal. The <br />disclosure must include the actual or maximum fees or penalties to be applied. The WCIRB also created a Short <br />Rate Cancelation Endorsement which complements the disclosure requirement. This requirement applies to in- <br />surance policies issued or renewed on or after January 1, 2012. <br />In order to respond to this insurance code requirement we have created this Policyholder Notice to disclose our <br />use of short rate calculations as described in the California Short Rate Cancelation Endorsement included in the <br />policy. <br />W04N2H12 <br />-.1 MAMmuganmtotwe1m . <br />REVIEWED&APPROVF7]BY: <br />---� Risk Management Analyst <br />