Workers Compensation Audit & Recovery

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1 Workers Compensation Audit & Recovery Workers' Compensation Program specializes in recovering Workers' Compensation premium overcharges with no upfront fees involved. We will perform a free and expert analysis of your company's workers comp policies for errors in past and current charges, with the goal of locating errors and finding refunds. Our expert auditors have a track record of recovering millions for satisfied clients. With over 70% of companies overpaying for Worker's Compensation Insurance, our free audit will also give you the piece of mind that your policy is accurate. Unlike most companies that only audit your current policy, we go back as far as seven years to recoup the greatest amount of refund. "Your extensive knowledge of the NCCI rules and regulations was instrumental in recovering roughly $65,000 from Kemper Insurance Company, Virginia Surety Company and Insurance Company of the West, Inc. (ICW)." - Executive Assistant Insurance Coordinator, Phoenix, AZ "The over $55,000 you ve saved our company is only a drop in the bucket of the future savings Central States Roofing, Inc. will realize due to your expertise, knowledge, and recommendations." - Controller, Colorado Springs, CO "Thank you for recovering over $40,000 in overpaid workers compensation premiums from ACE USA and Liberty Mutual Insurance Company. Needless to say, we are very pleased with your results-oriented process." - VP of Operations, Rockport, ME "Thank you for your work in obtaining refunds in excess of $40,000 for our company. If it was not for your guidance and persistence, we never would have received the refunds from State Compensation Insurance Fund and Seabright Insurance." - President, Gardena, CA "Thank you for your efforts in recovering over $31,000 from Pinnacol Assurance on behalf of The Castle Pines Golf Club, Inc. We now know the Importance of having an independent review of our workers compensation premium calculations and would recommend your service to anyone concerned about the proper assessment of premiums under their workers compensation policies." - Controller, Castle Rock, CO "We had no idea we had overpaid on our workers compensation premiums or that premiums could be recovered from previous years audits. Nonetheless, we are extremely happy to say that you recovered over $70,000 for us!" - Controller, Chatsworth, CA Why overpay? Let us help you save! NormAndy Financial Services x 102 [email protected]

2 NormAndy Financial Services Expense Reduction Cost Recovery Energy Procurement Specialized Tax Incentives No Recovery, No Fee! Frequently asked questions about work comp audits I don t have time for another project. How much of my time will this review take? Once the available information from your files is provided or online access is granted, we will prepare the necessary letters to your agent and/or insurance company. Your time commitment only involves executing the requests we provide to you. How will my agent handle the news that his/her work will be reviewed? Most insurance agents recognize that what is good for the client is what matters. Most agents do not have the time or the resources to conduct the detailed retrospective review that they will receive from us. Why do we need your services when my agent already does that for us? It is impossible for your agent to verify all of the details involved in your premium calculations or conduct the 5 to 7 year retrospective review that we do. Often times, agents do not receive copies of your experience rating worksheets or auditor worksheets to review their accuracy. In fact, after the insurance company s annual audit is completed, agents send a letter to the client requesting that the client review the audit for accuracy. Without these documents, it is impossible to verify whether or not you were charged the correct premiums. My insurance company just performed an audit. Why do I need your services? Insurance companies perform an annual audit to determine the actual payrolls for the past policy year. The auditor, who works for the insurance company, is not there to locate overcharges. What will my insurance company think? Insurance companies want to be sure that the rules and regulations are mandated by the state s Department of Insurance or the state s workers compensation laws are followed. Our review will confirm compliance with these rules and regulations. In which industries do you find the most overcharges? Through our experience, we have found that our recoveries are not industry dependent. We have been successful in recovering overcharges in many industries including but not limited to auto dealerships, construction, health care, restaurants, temporary labor services and manufacturing. What happens if you find an error in our favor? We contract with you and look out for your best interest. If we find an error in your favor, we will indicate the error to you, but will not request any corrections that are not to your benefit. We are concerned with confidential nature of the information involved. Who will see the information? Privacy is the highest of importance to us. We have a confidentiality clause in our Agreement and will be happy to execute a separate Disclose Agreement. Your only contact will be with WorkComp Premium Recovery Group. Once the audit is complete, all documents are shredded. We are happy with our insurance company and get money back each year. Typically when you get money back each year it is only because your final premium is lower than your estimated premium. Thus, you most likely made insurance payments based on higher estimated payroll as compared with your actual payroll, and are getting back only the money that you previously paid your insurance company. We guarantee you to receive premium refunds or the peace of mind that you have been charged the correct premiums by your insurance carrier(s). It s a win/win situation! Why overpay? Let us help you save! NormAndy Financial Services x 102 [email protected]

3 NormAndy Financial Services Expense Reduction Cost Recovery Energy Insurance Government Stimulus No Recovery, No Fee! Aircraft Amusement Park & Ski Areas Asbestos Contractors Assisted Living Automobile Dealerships Beverage Dealers - Wholesale Bottlers Box Manufacturers Building Operators Cable Installation Casinos Carpentry Clothing Manufacturers Concrete Contractors Electrical Contractors Excavating Contractors Food Processing Ideal Clients... Foundry Forklift Operations Framing Contractors Garbage Collection Grocery Stores Home Builders Home Health Care Hospitals HVAC Contractors Labor Services Landscaping Contractors Lumber Yards Machinery Dealers Meat Processors Mining Operations Municipalities Nursing Homes Oil & Gas Exploration Painting Contractors Paving & Street Contractors Plastering & Stucco Plastics Manufactures Plumbing Contractors Restaurants Sand & Gravel Scaffolding Scrap Dealers Sewer Contractors Sheet Metal Tile & Floor Installation Trucking Wallboard Installation Warehousing Wrecking & Demolition Some warning signs The following are some signals that your company may have been overcharged and be entitled to a refund: An insurance company has changed a company s basic classification A company s experience rating has increased during the policy period Various credits or discounts are missing from a company s policy Workers compensation claims that include subrogation The final audit was conducted by mail or by telephone A rate change was implemented during the policy period Policy s ex-mod is indicated as contingent or preliminary The premium was increased mid-term Employees are paid a significant amount of overtime Previously open claims have been denied by official rulings Involved in a merger or acquisition A contractor involved in Wrap-up Construction Projects Why overpay? Let us help you save! NormAndy Financial Services 3470 Olney - Laytonsvlle Road, Suite 187 Olney, Maryland Phone: NormAndy Fax: [email protected] Andy Shuman cell x 102 [email protected]

4 AGREEMENT FOR SERVICES This agreement is made and dated the day of, 2013 by and between WORKERS' COMPENSATION SERVICES INC., a Colorado corporation ("WCS ), d/b/a WorkComp Premium Recovery Group, and undersigned Client. In consideration of the mutual promises and undertakings stated herein, the parties agree as follows: 1. Services. WCS will provide the following services to Client in connection with Client's workers' compensation insurance policies now or previously in effect: [a] determine whether Client may be entitled to any past, or current reduction, credit, rebate or refund on its workers' compensation premiums, or to a reduction of any monetary obligation to Client's insurance carrier or agent (all of the foregoing individually and collectively referred to herein as "Savings ); [b] recommend means by which Client may be able to obtain Savings; and [c] assist Client, to the extent reasonably necessary, in realizing the Savings. 2. Compensation. Client will pay WCS the following compensation for Savings that arise or result in whole or in part from WCS's recommendation(s) or from any direct or indirect benefit, advantage or assistance rendered by WCS under this agreement: [a] 50% of Savings realized in connection with the policy period in effect on the date of this Agreement ("Current Policy Period ); [b] 50% of Savings realized in connection with each policy period in effect before the Current Policy Period. Client understands that WCS's recommendations are the result of WCS's specialized experience and knowledge. WCS shall be entitled to full payment of its fees regardless of any participation, cooperation or assistance of Client or Client's employees or agents. 3. Payment; Interest on Delinquent Payments. WCS's fees shall be due and payable immediately when any Savings is realized. Savings shall be considered "realized on the date that Client receives the reduction, credit, rebate, refund or other Savings from its insurance carrier or agent. WCS may also invoice for its fee when WCS deems the fee due and payable. Any fee or portion thereof not timely paid will accrue interest at the rate of 1.5% per month, compounded monthly from the date Savings are realized. 4. Cooperation. Client understands and agrees that it must and will cooperate with WCS to obtain the Savings and to administer this agreement. Client will: provide WCS with any and all pertinent information and records within Client's knowledge, possession, custody or control; assist WCS in obtaining any pertinent records or information not within Client's possession or knowledge; sign and deliver such letters and other documents that WCS may reasonably request including but not limited to requests for documents and requests for audit revisions; and diligently comply with all reasonable requests of WCS to perform services per paragraph 1. Client's failure to cooperate as required hereunder would cause material harm to WCS of unknown proportions, in that WCS will have expended substantial time and effort without full compensation therefor. Such failure to cooperate will entitle WCS to liquidated damages equal to the greater of $2,500 or the fees actually known or proven to be owed to WCS under this Agreement. Client authorizes WCS to obtain records and information from Client's insurance carrier and agent for the purpose of obtaining policy documents and determining the compensation owed to WCS. 5. Confidentiality. WCS and Client agree to keep all information (including but not limited to WCS's reports and recommendations) in strictest confidence, except that each of the parties authorizes the other to discuss in general terms, but not in detail, such information and recommendations whenever necessary to effectuate the purposes of this agreement. If Client agrees to provide WCS a letter of reference, Client grants permission to WCS to use such reference letter or any part of such letter in its marketing efforts. 6. Miscellaneous. All notices under this agreement shall be in writing. Client shall not have the right to terminate this agreement after Client's execution of this Agreement unless WCS is in material breach of this agreement and fails to cure its breach within a reasonable time. WCS's services shall terminate upon completion of its review, recommendation(s) and assistance under paragraph 1 above. Client's obligation to pay WCS as provided in this agreement shall continue until WCS is paid in full. If it becomes necessary for WCS to engage the services of an attorney or collection agency to collect its fees or other compensation due under this agreement, Client shall also be liable to WCS for reasonable collection costs (including but not limited to attorney's fees and expert witness fees). The services provided hereunder are being provided by WCS in the State of Colorado. The exclusive jurisdiction and venue for the adjudication of any disputes between the parties arising under or in connection with this agreement, or any breach thereof, shall be the county, state or federal courts located within the city and county of Denver, Colorado. Client hereby irrevocably submits to the personal jurisdiction of such courts upon service of process, and waives any objection to such venue. Each party waives the right to a jury trial. The laws of the State of Colorado shall govern this agreement and the interpretation of its provisions. Each person signing this agreement represents that s/he has full authority to bind the party on whose behalf it is signing. This agreement contains the entire agreement between the parties concerning its subject matter, and supersedes all proposals or other agreements, oral or written. This agreement shall be binding upon, inure to the benefit of, each party and its successors and assigns. WORKERS' COMPENSATION SERVICES, INC. BY: CLIENT: BY: Printed Name: Printed Name: Title: Title:

5 Date: WPRG PO Box Denver, Colorado Re: Letter of Authority To Whom It May Concern: This letter authorizes Workers Compensation Services, Inc. d/b/a WPRG to request and receive copies of any information and pertinent data from employees and associates of our workers compensation carrier(s) insurance agent(s) and rating bureaus regarding any and all aspects of our workers compensation policies and to receive copies of such information as deemed necessary. Such information shall include, but not be limited to, bureau inspection reports, administrative rulings, correspondence, policies, loss reports, experience rating worksheets, billing statements, and audit reports/auditor worksheets pertaining to our company. This letter authorizes Workers Compensation Services, Inc. to consult with any employee or agent of your organization regarding all aspects of our workers compensation policies and to request policy or rating revisions on our behalf. We appreciate your cooperation in this important matter. Please extend every courtesy to the employees or agents of Workers Compensation Services, Inc. Sincerely, Company Name Signature Title

6 Client Interview Checklist and Submittal Form Company Name: Contact Person: Address: Title: City, State, Zip: Phone: Fax: Description of Operations: Year Business Started: Any Divestitures or Purchases within the last 5 years? Yes No Any Severance paid within the last 5 years? Yes No Estimate Paid? Any Overtime paid within the last 5 years? Yes No Any type of Allowances included in gross pay paid within the last 5 years? Yes No If so, what type of Allowance is included in gross pay? Any third party sick pay, options, or relocation benefits included in gross pay? Yes No If so, what benefits indicated above are included in gross pay? Participation in any OCIP/Wrap-up projects in the last 5 years?(construction) Yes No Any Davis Bacon Wages paid into a 3rd Party Trust (Construction) Yes No Any Health & Welfare Benefits paid under a Collective Bargaining Agreement? Yes No Any Subrogated losses in the last 5 years? Yes No Are detailed payroll records and tax reports available if requested? Yes No Please submit as much information as possible Dec. Pages/Information pages of Policy Client Information Operational Questions Paperwork Submitted Final Audit Billing Statements N/A Experience Rating Worksheets Loss History Summaries N/A Auditor Worksheets N/A Single Use Letters of Authority Agreement for Services Marketing Brochure/Materials Business Card and Blank Letterhead Agent & Insurance Company Information If there are additional Agents or Insurance Companies, please list information on an additional copy of this checklist Agency: Contact Person: Address: Phone: City, State, Zip: Fax: Effective Date: Policy Number: Agent Insurance Carrier: Contact Person: Address: Phone: City, State, Zip: Fax: Effective Date: Policy Number: Advisor/Consultant: Date Submitted: