How to Read Your Experience Rating Statement
Below is a sample of what an Experience Rating Statement looks like. Your appropriate dates and amounts would replace the sample information in the document below.
Section A takes your basic industry rate, adds or subtracts your experience rating, adds a poor safety performance surcharge, if applicable, and your industry levy, if applicable (some industries collect a levy for safety programming).
Section B shows your SIC code and industry group.
Section C shows your assessable payroll and your individual injury costs over a 3-year period.
Section D takes your information and compares it to your rate group to determine your experience rating adjustment.
Section E will only show if there are claim costs within the applicable period. For instance, new employers will not see this section.