Workers' Compensation Premium Audit - ICW Group

1 Maximum Payroll_rev011822 Insurance Company of the West | Explorer Insurance Company | ICW Premier Insurance CompanyICW National Insurance Company | ICW Casualty Insurance Company | Verterra Insurance Premium AuditOfficers & Partners Annual Maximum Payrolls* FL Construction MIN 26,000; NY Construction codes MAX: 82, ** NV Sole proprietor or partner electing higher benefits: 21,600. ** TN Construction codes MAX: 75,920. ** NH Officers of unincorporated assc. MIN 15,600, MAX 130,000. ** State requires a signed waiver for officers to be excluded from **ColoradoConnecticutDelawareDistrict of ColumbiaFlorida*GeorgiaGeorgiaHawaiiIdah oIllinoisIndianaIowaKansasKentuckyLouisi ana Maine**MarylandMassachusettsMichiganMinn esotaMississippiMissouriMontanaNebraskaN evada **New Hampshire**New JerseyNew MexicoNew York*North CarolinaOklahomaOregonPennsylvania**Rhod e IslandSouth CarolinaSouth DakotaTennessee **TexasUtahVermontVirginiaWest VirginiaWisconsinPolicy EFF.

2 After3/1/20211/1/20211/1/20227/1/20219/1 /20211/1/20211/1/202112/1/202111/1/20211 /1/20213/1/20213/1/20221/1/20211/1/20221 /1/20221/1/20221/1/20221/1/20221/1/20225 /1/20214/1/20211/1/202210/1/20211/1/2022 1/1/20223/1/20201/1/20227/1/20212/1/2021 7/1/19991/1/20221/1/20221/1/202210/1/202 14/1/20211/1/20221/1/20224/1/20218/1/202 14/1/20217/1/20213/1/202110/1/20201/1/20 224/1/20214/1/202111/1/202110/1/2021192, 400109,200239,200182,000144,30061,400 Flat140,400249,600322,400150,800223,6002 39,200192,400176,800249,600208,000208,00 0202,800192,400145,600187,200218,40070,2 00114,400256,256130,00048,200 Flat71,500182,00036,000 Max260,000158,600197,600127,40098,800192 ,400260,000140,400218,400182,000176,8002 08,00062,400218,400192,400119,600192,400 85,332 Officer Max46,80026,00059,80044,20055,90061,400 Flat70,20062,24480,60049,40057,20059,800 49,40044,20062,40044,20026,00052,00046,8 0049,40046,80054,60014,04028,18464,06439 ,00048,200 Flat10,40046,8006,00031,20039,52049,4004 2,90049,40046,80065,00056,21254,60023,40 044,20052,0007,80054,60023,40028,60046,8 0017,056 Officer Min47,80034,800 Flat261, Max45,000 Flat144,30061.

3 400 Flat71,400 Flat249,600 Max80,800 Flat50,50056,000 Flat59,700 Flat48,100 Flat21,900 Flat62,900 Flat208,000 Max208,000 Max51,100 Flat47,700 Flat48,900 Flat46,200 Flat54,600 Flat61,700 Flat22,200 Flat256,256 Max39,400 Flat48,200 Flat71,500 Max45,900 Flat3,600 Flat32,300 Flat158,600 Max49,100 Flat127,400 Max50,400 Flat48,000 Flat64,900 Flat140,400 MaxNot covered45,100 Flat44,600 Flat51,700 Flat65,400 Flat54,000 Flat24,300 Flat59,100 Flat47,700 Flat56,888 FlatPartner Max