Workers Comp derivation filings

Bulletin 10 WORKMEN'S COMPENSATION INSURANCE -- DEVIATION FILINGS November 25, 1963 In view of the increase of payrolls and premiums over the past several years, effective January 1, 1964 this Department will not permit individual deviations on Workmen's Compensation risks unless an average annual premium of at least $500.00 for each year of the three year period is developed. A deviation filing submitted to the Department must be accompanied by: 1. Experience rating data as promulgated by the Indiana Workmen's Compensation Rating Bureau. 2. Affidavit setting out the actual paid premiums and losses for 3 years if risk does not qualify for experience rating. The actual credit or debit applied for must be used on the risk. Deviation filings that apply to Premium Discounts only may be made in duplicate instead of quadruplicate. Please advise your Indiana Branch Offices of the contents of this letter. Harry E. McClain Insurance Commissioner