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POLICYHOLDER NOTICE CALIFORNIA WORKERS' COMPENSATION INSURANCE RATING LAWS PFIrsi—ant to Section 11 ❑2.8 of tip California Insi]'ance Code, we are promding yoi❑ wit❑ an e::planation of t—e California woriEOrs:Pompensation rating laws. We estadis❑ oEir own rates for worE0rs❑ compensation. OFT rates, rating plans, and related information are filed wit❑ tDe insFirance commissioner and are open for p❑dic inspection. 2. Ti❑e insEirance commissioner can disapproE0 oilr rates, rating plans, or classifications only if DO or sib ilas determined after p❑::Iic raring t0at oil rates migi t :eopardiEo o[]r ai�lity to pay claims or create a monopoly in tip mar::Ot. A monopoly is defined ❑y law as a mar::Ot wire one insFirer writes 20❑ or more of t-at part of tip California wor::Ors❑ compensation ins:1-ance tilat is not written ❑y tip State Compensation Instance F❑nd. If tip ins:1rance commissioner disappro::Os o[ir rates, rating plans, or classifications, 00 or sib may order an increase in t❑ e rates applicaiFle to of-tstanding policies. Rating organi:ations may de::Olop pi-i-e premi:jn rates ti-at are s❑❑act to tDa insi-irance commissioners approi❑al. A p0re premi7n rate reflects tie anticipated cost and e:])enses of claims per ❑100 of payroll for a gin classification. Pie premi::n rates are adElsory only, as we are not re❑iAred to ire tip p0re premi::n rates deiceloped ❑y any rating organii:ation in estaiFlis::Jng o0r own rates. 4. We mi—st admire to a single, iEniform ei[perience rating plan. If yo❑ are eligiiJe for e::perience rating ceder t❑e plan, we will ❑e re❑Elred to ad—st yo-r premi::n to reflect yoij claim iJstory. A utter claim Jstory generally resits in a lower eEperience rating modifications❑ more claims, or more e:])ensiL:e claims, generally resElt in a ::Jg:ler e:])erience rating modification. T❑e iEniform e:])erience rating plan, w::Jc❑ is deiFoloped ❑y tie instance rating organiL:8tion designated ❑y t❑e ins:1rance commissioner, is s❑i❑iect to approL:81 ❑y tip instance commissioner. El A standard classification system, de❑oloped ❑y to instance rating organiEAtion designated ❑y to instance commissioner, is s❑❑lect to approC81 y t❑e instance commissioner. Tile standard classification system is a met' od of recogniEJng and separating policy❑olders into indL8try or occEpational groEps according to t0eir similarities and/or differences. We can adopt and apply to standard classification system or deEolop and apply oil- own classification system, prouded we can report tip payroll, e::penses, and otter costs of claims in a way t0at is consistent wit❑ tija Eniform statistical plan or tie standard classification system. Oj rates and classifications may not Flolate tip ❑nr❑❑CiiFJl Rig Ets Act or i-le iEnfairly discriminatory. ❑ We will proiJde an appeal process for yo❑to appeal tFle way we rate yo:lr insi-i-ance policy. Ti❑e process re❑Fires .8 to respond to yo:lr written appeal witiAn 30 days. If yo❑ are not satisfied wit❑ tie res:]t of yo:1- appeal, yo❑ may appeal o0r decision to t-le insErance commissioner. Form PN 04 99 02 B (Ed. 5-02) Printed in ❑.S.A. Page 1 of 2