Rhode Island. Advisory Loss Cost Filing Proposed Effective August 1, 2016

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1 RhodeIsland AdvisoryLossCostFiling ProposedEffectiveAugust1,2016

2 November 19, 2016 National Council on Compensation Insurance Laura Backus Hall State Relations Executive Regulatory Services Division (P) (F) The Honorable Macky McCleary Director State of Rhode Island and Providence Plantations Department of Business Regulation Insurance Division 1511 Pontiac Ave Cranston, RI Attention: Paula Pallozzi, SPIR, Associate Director Re: Rhode Island Workers Compensation Loss Cost Level Change including Loss Adjustment Expense (LAE) -- Effective August 1, 2016 Dear Director McCleary: In accordance with the applicable statutes and regulations of the state of Rhode Island, we are filing for your consideration and approval voluntary loss costs changes for Rhode Island. The voluntary loss costs, which are proposed to be effective August 1, 2016, reflect a decrease of 4.9% from the current voluntary loss costs which became effective August 1, Please note the following in connection with this filing: As a result of Items R-1410 and R-1411, the retrospective rating plan parameters were updated. As a result of Item B-1427, effective August 1, 2015, Class Code 3069 was discontinued, and Class Code 3076 reflects the combined experience of Class Codes 3069 and As a result of Item E-1402, the split point for experience rating was changed from $13,500 to the indexed value of $16,000. As always, if you should have any questions or need additional information, please do not hesitate to contact me at (802) or Angela McGhee at (561) Respectfully submitted, Laura Backus Hall, CPCU State Relations Executive 1493 Maple Hill Road Plainfield, VT

3 Actuarial Certification Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

4 Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved These materials are comprised of NCCI actuarial judgment and proprietary and confidential information which are valuable assets of NCCI and are protected by copyright and other intellectual property laws. The uses of these materials are governed by a separate contractual agreement between NCCI and its licensees such as an affiliation agreement between NCCI and an end user. Unless expressly authorized by NCCI, you may not copy, create derivative works (by way of example, create or supplement your own works or other materials), display, perform, or use the materials, in whole or in part, in any media. Such actions taken by you, or by your direction, may be in violation of federal copyright and other commercial laws. NCCI does not permit or agree to such use of its materials. In the event such use is contemplated or desired, please contact NCCI's Legal Department for permission. NCCI MAKES NO REPRESENTATIONS OR WARRANTIES RELATING TO THESE MATERIALS, INCLUDING ANY EXPRESS, STATUTORY OR IMPLIED WARRANTIES INCLUDING THE IMPLIED WARRANTY OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. ADDITIONALLY, AUTHORIZED END USERS ASSUME RESPONSIBILITY FOR THE USE OF, AND FOR ANY AND ALL RESULTS DERIVED OR OBTAINED THROUGH THE USE OF SUCH MATERIALS.

5 Table of Contents

6 Background and Filing Procedure

7 Proposed Overall Average Change in Voluntary Loss Cost Level Overall Change Requested -4.9%

8 Key Components Experience

9 Key Components (Continued) Trend Distribution of Rhode Island Benefit Costs

10 Rhode Island Claim Frequency Frequency per Million of On-Leveled, Wage-Adjusted Premium Policy Year

11 Rhode Island Indemnity Cost Per Case Average Cost Per Case Policy Year

12 Rhode Island Indemnity Cost Per Case Adjusted to Current Wage Level Average Cost Per Case Policy Year

13 Rhode Island Indemnity Loss Ratio History Indemnity Loss Ratio Policy Year

14 Rhode Island Medical Cost Per Case Average Cost Per Case Policy Year

15 Rhode Island Medical Cost Per Case Adjusted to Current Wage Level Average Cost Per Case Policy Year

16 Rhode Island Medical Loss Ratio History Medical Loss Ratio Policy Year

17 Benefits Key Components (Continued) Loss Adjustment Expense

18 Conclusion

19 EXHIBIT I Rhode Island Historical Loss Cost Changes Approved Change Effective Date

20 EXHIBIT II Rhode Island Written Premium Written Premium ($ millions) Calendar Year

21 EXHIBIT III Rhode Island Largest Workers Compensation Writers Calendar Year 2014

22 ADVISORY LOSS COSTS - NOT RATES Advisory loss costs exclude all expense provisions except loss adjustment expense. RHODE ISLAND Exhibit IV Effective August 1, 2016 Page S1 CLASS LOSS D CLASS LOSS D CLASS LOSS D CODE COST ELR RATIO CODE COST ELR RATIO CODE COST ELR RATIO D D D D N P P X X D D D D D D D D D D D * Refer to the Footnotes Page for additional information on this class code. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

23 ADVISORY LOSS COSTS - NOT RATES Advisory loss costs exclude all expense provisions except loss adjustment expense. RHODE ISLAND Exhibit IV Effective August 1, 2016 Page S2 CLASS LOSS D CLASS LOSS D CLASS LOSS D CODE COST ELR RATIO CODE COST ELR RATIO CODE COST ELR RATIO D X N X X X * Refer to the Footnotes Page for additional information on this class code. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

24 ADVISORY LOSS COSTS - NOT RATES Advisory loss costs exclude all expense provisions except loss adjustment expense. RHODE ISLAND Exhibit IV Effective August 1, 2016 Page S3 CLASS LOSS D CLASS LOSS D CLASS LOSS D CODE COST ELR RATIO CODE COST ELR RATIO CODE COST ELR RATIO F F M M M M M D M M M M M M M F F F F M M M X F D D D M M M N M* M* M* F N N F N F F F * Refer to the Footnotes Page for additional information on this class code. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

25 ADVISORY LOSS COSTS - NOT RATES Advisory loss costs exclude all expense provisions except loss adjustment expense. RHODE ISLAND Exhibit IV Effective August 1, 2016 Page S4 CLASS LOSS D CLASS LOSS D CLASS LOSS D CODE COST ELR RATIO CODE COST ELR RATIO CODE COST ELR RATIO X X X X X X X F F a a a a F M M M X M M M X * Refer to the Footnotes Page for additional information on this class code. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

26 WORKERS COMPENSATION AND EMPLOYERS LIABILITY Effective August 1, 2016 RHODE ISLAND Exhibit IV Page S5 FOOTNOTES a D Advisory loss cost for each individual risk must be obtained from NCCI Customer Service or the Rating Organization having jurisdiction. Advisory loss cost for classification already includes the specific disease loading shown in the table below. See Basic Manual Rule 3-A-7. Code No. Disease Loading Symbol Code No. Disease Loading Symbol Code No. Disease Loading Symbol 0059D 0.26 S 1710D 0.02 S 3175D 0.04 S 0065D 0.05 S 1741D 0.31 S 4024D 0.02 S 0066D 0.05 S 1803D 0.29 S 5508D 0.04 S 0067D 0.05 S 1852D 0.06 Asb 6251D 0.07 S 1164D 0.04 S 3081D 0.07 S 6252D 0.02 S 1165D 0.02 S 3082D 0.07 S 6260D 0.05 S 1624D 0.01 S 3085D 0.07 S Asb=Asbestos, S=Silica F M N Advisory loss cost provides for coverage under the United States Longshore and Harbor Workers Compensation Act and its extensions. Loss cost contains a provision for the USL&HW Assessment. Risks are subject to Admiralty Law or Federal Employers Liability Act (FELA). However, the published loss cost is for risks that voluntarily purchase standard workers compensation and employers liability coverage. A provision for the USL&HW Assessment is included for those classifications under Program II USL Act. This code is part of a ratable / non-ratable group shown below. The statistical non-ratable code and corresponding advisory loss cost are applied in addition to the basic classification when determining premium. Class Non-Ratable Code Element Code P X Classification is computed on a per capita basis. Refer to special classification phraseology in these pages which is applicable in this state. * Class Codes with Specific Footnotes 6702 Loss cost and rating values only appropriate for laying or relaying of tracks or maintenance of way - no work on elevated railroads. Otherwise, assign appropriate construction or erection code loss cost and elr each x Loss cost and rating values only appropriate for laying or relaying of tracks or maintenance of way - no work on elevated railroads. Otherwise, assign appropriate construction or erection class loss cost x and elr x Loss cost and rating values only appropriate for laying or relaying of tracks or maintenance of way - no work on elevated railroads. Otherwise, assign appropriate construction or erection class loss cost and elr each x Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

27 WORKERS COMPENSATION AND EMPLOYERS LIABILITY Effective August 1, 2016 RHODE ISLAND Exhibit IV Page S6 ADVISORY MISCELLANEOUS VALUES Advisory Loss Elimination Ratios - The following percentages represent the portion of total loss eliminated per claim and are applicable by hazard group: Advisory Loss Elimination Ratios Deductible HAZARD GROUP Amount A B C D E F G $ % 1.6% 1.4% 1.2% 0.9% 0.7% 0.7% $ % 2.9% 2.6% 2.2% 1.7% 1.4% 1.3% $1, % 5.0% 4.5% 3.7% 3.0% 2.4% 2.3% $2, % 9.3% 8.4% 7.0% 5.9% 4.9% 4.5% $5, % 14.4% 13.1% 11.1% 9.5% 8.0% 7.4% Note: These percentages do not include a safety factor and do not reflect the premium reductions to be applied to policy premium. Basis of premium applicable in accordance with Basic Manual footnote instructions for Code "Taxicab Co.": Employee operated vehicle $72,900 Leased or rented vehicle $48,600 Catastrophe (other than Certified Acts of Terrorism) - (Advisory Loss Cost) 0.01 Maximum Weekly Payroll applicable in accordance with Basic Manual Rule 2-E-1 -- "Executive Officers" and Basic Manual footnote instructions for Code "Athletic Sports or Park: Non-Contact Sports," and Code "Athletic Sports or Park: Contact Sports".. $3,700 Minimum Weekly Payroll applicable in accordance with Basic Manual Rule 2-E-1 -- "Executive Officers" $950 Terrorism - (Advisory Loss Cost) 0.01 United States Longshore and Harbor Workers' Compensation Coverage Percentage applicable only in connection with Basic Manual Rule 3-A % (Multiply a Non-F classification loss cost by a factor of 1.60 to adjust for differences in benefits and lossbased expenses. This factor is the product of the adjustment for differences in benefits (1.52) and the adjustment for differences in loss-based expenses (1.052).) Experience Rating Eligibility A risk is eligible for intrastate experience rating when the payrolls or other exposures developed in the last year or last two years of the experience period produced a premium of at least $10,000. If more than two years, an average annual premium of at least $5,000 is required. The Experience Rating Plan Manual should be referenced for the latest approved eligibility amounts by state. Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

28 EXPERIENCE RATING PLAN MANUAL RHODE ISLAND Exhibit IV Effective August 1, 2016 Page S7 TABLE OF WEIGHTING VALUES APPLICABLE TO ALL POLICIES Experience Rating Program - ERA Expected Weighting Expected Weighting Losses Values Losses Values , ,133, ,196, , , ,196, ,262, , , ,262, ,332, , , ,332, ,406, , , ,406, ,485, , , ,485, ,570, , , ,570, ,660, , , ,660, ,756, , , ,756, ,859, , , ,859, ,971, , , ,971, ,090, , , ,090, ,220, , , ,220, ,361, , , ,361, ,514, , , ,514, ,681, , , ,681, ,865, , , ,865, ,068, , , ,068, ,292, , , ,292, ,542, , , ,542, ,823, , , ,823, ,139, , , ,139, ,500, , , ,500, ,913, , , ,913, ,393, , , ,393, ,956, , , ,956, ,627, , , ,627, ,439, , , ,439, ,441, , , ,441, ,711, , , ,711, ,372, , , ,372, ,637, , , ,637, ,909, , , ,909, ,049, , , ,049, ,303, , , ,303, ,894, , , ,894, ,852, , , ,852,495 AND OVER , ,018, ,018, ,074, ,074, ,133, (a) G (b) State Per Claim Accident Limitation $240,000 (c) State Multiple Claim Accident Limitation $480,000 (d) USL&HW Per Claim Accident Limitation $469,500 (e) USL&HW Multiple Claim Accident Limitation $939,000 (f) Employers Liability Accident Limitation $55,000 (g) Primary/Excess Loss Split Point $16,000 (h) USL&HW Act -- Expected Loss Factor -- Non-F Classes (Multiply a Non-F classification ELR by the USL&HW Act - Expected Loss Factor of 1.52.) Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved. 10/15

29 EXPERIENCE RATING PLAN MANUAL RHODE ISLAND Exhibit IV Effective August 1, 2016 Page S8 TABLE OF BALLAST VALUES APPLICABLE TO ALL POLICIES Experience Rating Plan - ERA Expected Ballast Expected Ballast Expected Ballast Losses Values Losses Values Losses Values ,636 24,000 1,656, ,704, ,000 3,336, ,384, ,000 51, ,871 28,800 1,704, ,752, ,800 3,384, ,432, ,800 88, ,655 33,600 1,752, ,800, ,600 3,432, ,480, , , ,788 38,400 1,800, ,848, ,400 3,480, ,528, , , ,020 43,200 1,848, ,896, ,200 3,528, ,576, , , ,831 48,000 1,896, ,944, ,000 3,576, ,624, , , ,982 52,800 1,944, ,992, ,800 3,624, ,672, , , ,346 57,600 1,992, ,040, ,600 3,672, ,720, , , ,853 62,400 2,040, ,088, ,400 3,720, ,768, , , ,459 67,200 2,088, ,136, ,200 3,768, ,816, , , ,138 72,000 2,136, ,184, ,000 3,816, ,864, , , ,871 76,800 2,184, ,232, ,800 3,864, ,912, , , ,646 81,600 2,232, ,280, ,600 3,912, ,960, , , ,454 86,400 2,280, ,328, ,400 3,960, ,008, , , ,287 91,200 2,328, ,376, ,200 4,008, ,056, , , ,142 96,000 2,376, ,424, ,000 4,056, ,104, , , , ,800 2,424, ,472, ,800 4,104, ,152, , , , ,600 2,472, ,520, ,600 4,152, ,200, , , , ,400 2,520, ,568, ,400 4,200, ,248, , , , ,200 2,568, ,616, ,200 4,248, ,296, , , , ,000 2,616, ,664, ,000 4,296, ,344, , , ,033, ,800 2,664, ,712, ,800 4,344, ,392, ,800 1,033, ,081, ,600 2,712, ,760, ,600 4,392, ,440, ,600 1,081, ,129, ,400 2,760, ,808, ,400 4,440, ,488, ,400 1,129, ,177, ,200 2,808, ,856, ,200 4,488, ,536, ,200 1,177, ,225, ,000 2,856, ,904, ,000 4,536, ,584, ,000 1,225, ,273, ,800 2,904, ,952, ,800 1,273, ,321, ,600 2,952, ,000, ,600 1,321, ,369, ,400 3,000, ,048, ,400 1,369, ,417, ,200 3,048, ,096, ,200 1,417, ,465, ,000 3,096, ,144, ,000 1,465, ,513, ,800 3,144, ,192, ,800 1,513, ,561, ,600 3,192, ,240, ,600 1,561, ,608, ,400 3,240, ,288, ,400 1,608, ,656, ,200 3,288, ,336, ,200 For Expected Losses greater than $4,584,000, the Ballast Value can be calculated using the following formula (rounded to the nearest 1): Ballast = (0.10)(Expected Losses) (Expected Losses)(9.60) / (Expected Losses + (700)(9.60)) G = 9.60 Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved. 10/15

30 RETROSPECTIVE RATING PLAN MANUAL RHODE ISLAND STATE SPECIAL RATING VALUES RR 1 Effective August 1, 2016 Exhibit IV 1. Hazard Group Differentials A B C D E F G Table of Expected Loss Ranges Effective January 1, Excess Loss Pure Premium Factors (Applicable to New and Renewal Policies) Per Accident Hazard Groups Limitation A B C D E F G $10, $15, $20, $25, $30, $35, $40, $50, $75, $100, $125, $150, $175, $200, $225, $250, $275, $300, $325, $350, $375, $400, $425, $450, $475, $500, $600, $700, $800, $900, $1,000, $2,000, $3,000, $4,000, $5,000, $6,000, $7,000, $8,000, $9,000, $10,000, Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

31 RETROSPECTIVE RATING PLAN MANUAL RHODE ISLAND STATE SPECIAL RATING VALUES RR 2 Effective August 1, 2016 Exhibit IV Excess Loss and Allocated Expense Pure Premium Factors (Applicable to New and Renewal Policies) Per Accident Hazard Groups Limitation A B C D E F G $10, $15, $20, $25, $30, $35, $40, $50, $75, $100, $125, $150, $175, $200, $225, $250, $275, $300, $325, $350, $375, $400, $425, $450, $475, $500, $600, $700, $800, $900, $1,000, $2,000, $3,000, $4,000, $5,000, $6,000, $7,000, $8,000, $9,000, $10,000, Retrospective Pure Premium Development Factors With Loss Limit Without Loss Limit 1st 2nd 3rd 1st 2nd 3rd 4th & Subsequent Adj. Adj. Adj. Adj. Adj. Adj. Adjustment Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

32 NCCI KEY CONTACTS

33 RHODE ISLAND WORKERS COMPENSATION FILING - AUGUST 1, 2016 NCCI AFFILIATE LIST ACADIA INSURANCE COMPANY ACCIDENT FUND GENERAL INS CO ACCIDENT FUND INS CO OF AMERICA ACCIDENT FUND NATIONAL INS CO ACE AMERICAN INSURANCE COMPANY ACE FIRE UNDERWRITERS INSURANCE COMPANY ACE PROPERTY & CASUALTY INSURANCE COMPANY ACIG INS CO ADVANTAGE WC INSURANCE CO AIG ASSURANCE COMPANY AIG PROPERTY CASUALTY COMPANY AIU INSURANCE CO (NATIONAL UNION FIRE OF PITTS PA) ALLIED INSURANCE COMPANY OF AMERICA ALLMERICA FINANCIAL ALLIANCE INS CO ALLMERICA FINANCIAL BENEFIT INS CO AMERICAN ALTERNATIVE INSURANCE CORPORATION AMERICAN AUTOMOBILE INSURANCE CO AMERICAN CASUALTY COMPANY OF READING P A AMERICAN COMPENSATION INS CO AMERICAN FAMILY HOME INS CO AMERICAN FIRE AND CASUALTY CO AMERICAN GUARANTEE AND LIABILITY INS CO AMERICAN HOME ASSUR CO-NATIONAL UNION FIRE OF PIT AMERICAN INS CO AMERICAN INTERSTATE INS CO AMERICAN MINING INS CO AMERICAN MODERN HOME INS CO AMERICAN ZURICH INS CO AMERISURE INS CO AMERISURE MUTUAL INS CO AMERISURE PARTNERS INS CO AMGUARD INS CO ARBELLA INDEMNITY INS CO ARBELLA PROTECTION INS CO ARCH INSURANCE COMPANY ARGONAUT GREAT CENTRAL INS CO ARGONAUT INS CO ARGONAUT MIDWEST INS CO ARROW MUTUAL LIABILITY INS CO ASSOCIATED INDEMNITY CORP ATLANTIC SPECIALTY INS CO (ONEBEACON) BANKERS STANDARD INS CO BEACON MUTUAL INS CO BENCHMARK INSURANCE COMPANY BERKLEY NATIONAL INSURANCE COMPANY BERKLEY REGIONAL INS CO BERKSHIRE HATHAWAY DIRECT INSURANCE COMPANY BERKSHIRE HATHAWAY HOMESTATE INS CO BITCO GENERAL INSURANCE CORPORATION BROTHERHOOD MUTUAL INS CO CALIFORNIA INSURANCE COMPANY CAROLINA CASUALTY INS CO CHARTER OAK FIRE INS CO CHEROKEE INS CO CHUBB INDEMNITY INS CO CHUBB NATIONAL INS CO CHURCH MUTUAL INS CO CINCINNATI CASUALTY COMPANY CINCINNATI INDEMNITY COMPANY CINCINNATI INS CO CITIZENS INS CO OF AMERICA COLONIAL AMERICAN CASUALTY & SURETY CO COMMERCE AND INDUSTRY INS CO CONTINENTAL CASUALTY CO CONTINENTAL INDEMNITY CO CONTINENTAL INS CO CRUM AND FORSTER INDEMNITY CO DISCOVER PROPERTY & CASUALTY INS CO DORCHESTER MUTUAL INSURANCE COMPANY EASTGUARD INS CO ELECTRIC INS CO EMCASCO INS CO EMPLOYERS ASSURANCE COMPANY EMPLOYERS INS CO OF WAUSAU EMPLOYERS MUTUAL CASUALTY CO EMPLOYERS PREFERRED INS CO EVEREST NATIONAL INS CO EVEREST REINSURANCE CO DIRECT EXCELSIOR INSURANCE COMPANY EXECUTIVE RISK INDEMNITY INC FALLS LAKE NATIONAL INSURANCE CO FARMINGTON CASUALTY COMPANY FEDERAL INSURANCE COMPANY FEDERATED MUTUAL INS CO FIDELITY & DEPOSIT COMPANY OF MARYLAND FIDELITY & GUARANTY INS UNDERWRITERS FIDELITY & GUARANTY INSURANCE CO FIREMANS FUND INSURANCE CO FIREMENS INS CO OF WASHINGTON DC FIRST LIBERTY INS CORP FIRSTCOMP INSURANCE CO FITCHBURG MUTUAL INS CO FLORISTS MUTUAL INSURANCE CO FOREMOST INS CO GRAND RAPIDS MICHIGAN FOREMOST PROPERTY & CAS INS FOREMOST SIGNATURE INS CO FRANK WINSTON CRUM INSURANCE CO GENERAL CASUALTY COMPANY OF WISCONSIN GENERAL INS CO OF AMERICA GENESIS INS CO GRANITE STATE INSURANCE COMPANY GRAPHIC ARTS MUTUAL INS CO GREAT AMERICAN ALLIANCE INS CO GREAT AMERICAN ASSURANCE COMPANY GREAT AMERICAN INS CO OF NY GREAT AMERICAN INSURANCE COMPANY GREAT AMERICAN SPIRIT INS CO GREAT DIVIDE INSURANCE COMPANY GREAT MIDWEST INS CO GREAT NORTHERN INS CO GREAT WEST CASUALTY COMPANY GREATER NY MUTUAL INS CO GREENWICH INS CO GUIDEONE MUTUAL INS CO HANOVER AMERICAN INS CO HANOVER INS CO HARLEYSVILLE INSURANCE COMPANY HARLEYSVILLE PREFERRED INSURANCE CO HARLEYSVILLE WORCESTER INSURANCE CO HARTFORD ACCIDENT AND INDEMNITY CO Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

34 RHODE ISLAND WORKERS COMPENSATION FILING - AUGUST 1, 2016 NCCI AFFILIATE LIST HARTFORD CASUALTY INS CO HARTFORD FIRE INSURANCE CO HARTFORD INS CO OF IL HARTFORD INS CO OF MIDWEST HARTFORD INS CO OF THE SOUTHEAST HARTFORD UNDERWRITERS INS CO HDI GERLING AMERICA INSURANCE COMPANY ILLINOIS NATIONAL INSURANCE COMPANY IMPERIUM INSURANCE COMPANY INDEMNITY INS CO OF N AMERICA (INA INS) (CT GEN) INS CO OF GREATER NY INS CO OF NORTH AMERICA INS CO OF THE STATE PA INS CO OF THE WEST LIBERTY INS CORP LIBERTY INSURANCE UNDERWRITERS INC LIBERTY MUTUAL FIRE INS CO LIBERTY MUTUAL INS CO LM INS CORP MA BAY INS CO MAIN STREET AMERICA ASSURANCE CO MANUFACTURERS ALLIANCE INS CO MARKEL INSURANCE CO MEMIC INDEMNITY CO MERCHANTS MUTUAL INS CO MERCHANTS PREFERRED INSURANCE COMPANY MERIDIAN SECURITY INSURANCE COMPANY MIDDLESEX INS CO MIDWEST EMPLOYERS CASUALTY CO MILBANK INSURANCE COMPANY MITSUI SUMITOMO INS CO OF AMERICA MITSUI SUMITOMO INS USA INC MOTORISTS COMMERCIAL MUTUAL INSURANCE COMPANY NATIONAL AMERICAN INS CO NATIONAL CASUALTY CO NATIONAL FIRE INS CO OF HARTFORD NATIONAL INTERSTATE INS CO NATIONAL LIABILITY & FIRE INSURANCE CO NATIONAL SURETY CORP NATIONAL UNION FIRE INS CO OF PITTSBURG PA NATIONWIDE AGRIBUSINESS INS CO NATIONWIDE GENERAL INSURANCE CO NATIONWIDE MUTUAL FIRE INS CO NATIONWIDE MUTUAL INS CO NETHERLANDS INSURANCE COMPANY NEW HAMPSHIRE INSURANCE COMPANY NEW YORK MARINE AND GENERAL INSURANCE CO NGM INSURANCE COMPANY NORFOLK AND DEDHAM MUTUAL FIRE INS CO NORGUARD INS CO NORTH AMERICAN ELITE INSURANCE CO NORTH AMERICAN SPECIALTY INS CO NORTH POINTE INS CO NORTH RIVER INS CO NOVA CASUALTY COMPANY OAK RIVER INSURANCE COMPANY OBI NATIONAL INSURANCE COMPANY OH CASUALTY INS CO OHIO SECURITY INS CO OLD REPUBLIC GENERAL INSURANCE CORPORATION OLD REPUBLIC INS CO PA MANUFACTURERS ASSN INS CO PA MANUFACTURERS INDEMNITY CO PA NATIONAL MUTUAL CAS INS CO PACIFIC EMPLOYERS INS CO PACIFIC INDEMNITY CO PATRONS MUTUAL INS CO OF CT PEERLESS INDEMNITY INS CO PEERLESS INSURANCE COMPANY PENN MILLERS INS CO PENNSYLVANIA INSURANCE COMPANY PETROLEUM CASUALTY CO PHARMACISTS MUTUAL INS CO PHENIX MUTUAL FIRE INS CO PHOENIX INS CO PLAZA INSURANCE CO PRAETORIAN INSURANCE COMPANY PREFERRED PROFESSIONAL INSURANCE COMPANY PRIVILEGE UNDERWRITERS RECIPROCAL EXCHANGE PROPERTY AND CASUALTY INS CO OF HARTFORD PROTECTIVE INS CO PUBLIC SERVICE INSURANCE COMPANY QBE INSURANCE CORPORATION REDWOOD FIRE & CASUALTY INS CO REGENT INSURANCE COMPANY REPUBLIC FRANKLIN INS CO REPUBLIC INDEMNITY CO OF CA REPUBLIC INDEMNITY COMPANY OF AMERICA RIVERPORT INSURANCE COMPANY RLI INSURANCE COMPANY SAFECO INS CO OF AMERICA SAFETY FIRST INS CO SAFETY NATIONAL CASUALTY CORP SAGAMORE INSURANCE CO SAMSUNG FIRE AND MARINE INS CO LTD USB SAVERS PROPERTY & CASUALTY INS CO SELECTIVE INS CO OF SC SELECTIVE INS CO OF THE SOUTHEAST SELECTIVE INSURANCE COMPANY OF AMERICA SELECTIVE WAY INS CO SENECA INSURANCE CO SENTINEL INS CO SENTRY CASUALTY CO SENTRY INSURANCE A MUTUAL CO SENTRY SELECT INSURANCE COMPANY SOMPO JAPAN INSURANCE CO OF AMERICA ST PAUL FIRE AND MARINE INS CO ST PAUL GUARDIAN INS CO ST PAUL MERCURY INS CO ST PAUL PROTECTIVE INS CO STANDARD FIRE INSURANCE COMPANY STAR INS CO STARNET INSURANCE COMPANY STARR INDEMNITY AND LIABILITY CO STATE AUTO PROPERTY AND CASUALTY INS CO STATE AUTOMOBILE MUTUAL INS CO STATE NATIONAL INSURANCE COMPANY STONINGTON INS CO STRATHMORE INS CO SUNZ INSURANCE COMPANY Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

35 RHODE ISLAND WORKERS COMPENSATION FILING - AUGUST 1, 2016 NCCI AFFILIATE LIST SUSSEX INSURANCE COMPANY T H E INSURANCE COMPANY TECHNOLOGY INSURANCE CO THE TRAVELERS CASUALTY COMPANY TNUS INSURANCE CO TOKIO MARINE AMERICA INSURANCE CO TORUS NATIONAL INSURANCE COMPANY TRANS PACIFIC INS CO TRANSGUARD INS CO OF AMERICA INC TRANSPORTATION INS CO TRAVELERS CASUALTY AND SURETY CO TRAVELERS CASUALTY INS CO OF AMERICA TRAVELERS INDEMNITY CO TRAVELERS INDEMNITY CO OF AMERICA TRAVELERS INDEMNITY CO OF CT TRAVELERS INSURANCE CO TRAVELERS PROPERTY CASUALTY CO OF AMERICA TRI STATE INSURANCE COMPANY OF MINNESOTA TRUCK INSURANCE EXCHANGE TRUMBULL INS CO TWIN CITY FIRE INS CO UNITED STATES FIDELITY AND GUARANTY CO UNITED WI INS CO US FIRE INS CO UTICA MUTUAL INS CO VALLEY FORGE INS CO VANLINER INS CO VANTAPRO SPECIALTY INS CO VIGILANT INS CO WAUSAU UNDERWRITERS INSURANCE COMPANY WEST AMERICAN INS CO WESTCHESTER FIRE INSURANCE COMPANY WESTPORT INSURANCE CORPORATION WORK FIRST CASUALTY CO XL INS CO OF NY INC XL INSURANCE AMERICA INC XL SPECIALTY INS CO ZENITH INS CO ZURICH AMERICAN INS CO ZURICH AMERICAN INS CO OF IL Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

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