Residual Premium Algorithm
OVERVIEW | RESIDUAL MARKET DATA ENTRY (Algorithm PDF) | VOLUNTARY MARKET DATA ENTRY (Algorithm PDF) | WCRIBMA HOME


GO TO RESIDUAL MARKET DATA ENTRY BEFORE JULY 1,2016.
 
Residual Market Data Entry


Employer Name  
Effective Date
Expiration Date
Cancellation Date
Cancellation Type
Was policy issue short term to replace a binder or to establish concurrency with other policies?
Waiver of Subrogation
Employers Liability
   
Small Deductible Programs applicable to Workers' Compensation only and not Employers Liability  
MA Benefits Deductible Program:
MA Benefits Claim & Aggregate Deductible Program:
Experience Modification(x.xx): Merit Rating:
MA Construction Credit(xx): ARAP Surcharge(x.xx):
QLMP Credit(xx.xx): Former Self-Insurers Charge(whole dollar):
Admiralty Employers Liability Limit:
DIA Assessment:






Enter Class Codes


Class Code*Exposure(Not subject to waiver)Exposure(Subject to waiver)USL&H

* Refer to the algorithm Part I (1): enter class codes for the following: admiralty classes, non-admiralty payroll classes, per capita classes, supplemental rate disease classes, supplemental non-ratable classes, and/or the supplemental rate atomic energy exposure.