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COMMONWEALTH OF PENNSYLVANIA

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PA Bulletin, Doc. No. 12-313

NOTICES

Notice to Workers' Compensation Insurance Carriers

[42 Pa.B. 1018]
[Saturday, February 18, 2012]

 Insurance companies that write Workers' Compensation are required to report workers' compensation premium, loss and claim count information using 2011 Special Schedule ''W.'' Authority for this call is in section 655 of The Insurance Company Law of 1921 (40 P. S. § 815).

 Information to be reported by April 16, 2012, includes the following:

 For calendar year 2011:

 * Premiums—Written, Unearned, Earned

 * Losses—Indemnity vs. Medical for Paid, Reserves (Case vs. Bulk and IBNR), Incurred

 * Amounts added to premium to yield Standard Earned Premium at Designated Statistical Reporting Level

 * Deductible adjustments to yield first dollar premiums and losses

 For evaluations as of December 31, 2010, and December 31, 2011, policy year information for large deductible (that is, deductible > $100,000) policies vs. all other policies including small deductible policies on a first dollar basis:

 * Premiums—Earned

 * Losses—Indemnity vs. Medical for Paid, Reserves (Case vs. Bulk and IBNR), Incurred

 * Claim counts—Indemnity vs. Medical for Incurred, Closed with and without payments

 Information regarding the submission of 2011 Special Schedule ''W'' has been sent to carriers and has also been posted on the Insurance Department's web site at http://www.insurance.pa.gov.

 Persons who have not received this information or have questions concerning information in this notice should contact Bojan Zorkic, Actuarial Associate, 1311 Strawberry Square, Harrisburg, PA 17120, (717) 787-6968 or bzorkic@pa.gov.

MICHAEL F. CONSEDINE, 
Insurance Commissioner

[Pa.B. Doc. No. 12-313. Filed for public inspection February 17, 2012, 9:00 a.m.]



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