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Word Version - CAOMs Home Page

    COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN

    P.O. Box 3337 • Livonia, MI 48151-3337 • (734) 462-9600 • Fax (734) 462-9721

    Internet WEB Site: www.caom.com E-Mail: caom@caom.com

    February 1, 2002

    Addendum to Circular 170

    FINANCIAL CALLS FOR THE STATE OF MICHIGAN

On December 20, 2001 CAOM notified its members of the change in Michigan’s financial calls

    reporting process. CAOM will be collecting all MICHIGAN call data for the 2002 Annual Call

    for Experience reporting year. This addendum contains the complete forms and instructions for

    reporting Michigan’s aggregate financial experience. Please be advised that all data providers

    are encouraged to submit the calls electronically using the Excel spreadsheets available on our

    website www.caom.com.

Financial call data is collected annually, with the calls applicable to Michigan due in March,

    April and May. The data is valued as of December 31, 2001. The required financial calls

    are listed below. These calls are crucial for providing the source data that is used in the

    development of Michigan rate and loss cost filings.

2002 Call Year Reporting Schedule

    Call Number Financial Call Due Date # 3 Policy Year 3/15/02 # 3A Assigned Risk Policy Year 3/15/02 # 5 Calendar-Accident Year 4/1/02 #5A Assigned Risk Calendar-Accident Year 4/1/02 # 8 Reconciliation Report 4/15/02 # 10 Schedule Rating Premium Adjustments 5/15/02 # 11 F-Classification Policy Year 5/1/02 # 19 Countrywide Loss Adjustment Expense 5/1/02

Acknowledgement Form

The acknowledgement form enclosed in the packet provides verification that your

    company received this information. Additionally, the form lists all calls with the following

    columns to check off for each call: 1) you received the call, 2) you did not receive the call,

    and 3) no experience to report. Carriers should return the acknowledgement form to

    CAOM upon receipt. If you indicate “no experience to report” for any given call, you are

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    required to submit a No Experience to Report Verification Form. This acknowledgement form must be received by CAOM.

No Experience to Report Verification Form

    Complete a No Experience to Report Verification Form for each call in which you have no experience for Michigan and for all years as required on the call. This allows CAOM to positively verify those carriers who will not be submitting data for each particular call. A separate form is required for each call with no experience. The submission of this form with an “X” in the appropriate box and an authorized signature precludes the filing of the

    indicated call. Once the form is completed, attach the Acknowledgement Form and return to the CAOM, the No Experience to Report Verification Form is treated as compliance with the reporting requirements.

    If you have any questions, please contact Jon Heikkinen at (734) 462-9600 ext 225, or via e-mail at caom@caom.com

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    ANNUAL CALLS FOR EXPERIENCE ACKNOWLEDGEMENT FORM

    (Please sign and return immediately)

CAOM

    Jon Heikkinen

    P.O. Box 3337

    Livonia, MI 48151-3337

RE: Annual Calls For Compensation Experience

This form acknowledges receipt of your package dated February 1, 2002 for the 2002

    Annual Calls for Experience required by CAOM. Please indicate on the enclosed form by

    check mark (? or X) the disposition of each call for experience enclosed with the circular.

Carrier Name(s)* _______________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

    Submitted by_______________________________ Signature_______________________________

    Title______________________________________ Telephone Number_______________________

    Fax Number________________________________ Date Submitted__________________________

* If this acknowledgement is submitted on a group basis, list all carriers individually.

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    ANNUAL CALLS FOR EXPERIENCE - ACKNOWLEDGEMENT FORM

     No Call Not Experience Number Financial Call Received Received to Report 3 Policy Year Instructions

     Due Date: 03/15/02 Forms 3A Policy Year - Assigned Risk Instructions

     Due Date: 03/15/02 Forms 5 Calendar-Accident Year Instructions

     Due Date: 04/01/02 Forms 5A Calendar-Accident Year - Assigned Risk Instructions

     Due Date: 04/01/02 Forms 8 Reconciliation Instructions

     Due Date: 04/15/02 Forms 10 Supplemental Call for Schedule Rating Premium Adjustments Instructions

     Due Date: 05/15/02 Forms 11 F-Classification Policy Year Instructions

     Due Date: 05/01/02 Forms 19 Countrywide Loss Adjustment Expense Instructions

     Due Date: 05/01/02 Forms

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    COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN

    NO EXPERIENCE TO REPORT VERIFICATION FORM

This form is to provide CAOM with positive confirmation that a carrier has no experience

    to report under a given call(s). Return the form(s) with the “Acknowledgement Form”.

    Submit ONE of these forms for EACH call in which you indicate no experience to report

    on the “Acknowledgement Form”.

Only one box may be checked off on this form. For example, should a carrier have five

    calls with no experience to report, then five verification forms must be submitted to CAOM

    with the “Acknowledgement Form”.

Carrier(s)*_______________________________________________________________

Carrier Code_____________ Date____________________

Submitted by____________________________________________________________

Title_________________________________ Phone Number_____________________

Call

    Number Financial Call No Experience

    3 Policy Year 3A Assigned Risk Policy Year 5 Accident Year 5A Assigned Risk Accident Year 8 Reconciliation Report 10 Schedule Rating Premium Adjustments 11 F-Classification Policy Year 19 Countrywide Loss Adjustment Expense

* List all carrier names and carrier codes for group reporting

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    ANNUAL CALLS FOR EXPERIENCE

    There are five financial aggregate calls that are to be submitted to CAOM. These calls are used directly for ratemaking in determining the overall rate level. The Policy Year and Accident Year Calls are the major ratemaking calls. They provide historical information on earned premium and aggregate claim data enabling CAOM to analyze loss ratios and emerging claim patterns. Since rates for federal classes are calculated separately, this experience is not included in the two calls. By collecting historical data on both calls valued as of year-end, CAOM is able to compare the current call with calls from past years in order to calculate loss development factors and trend factors necessary in determining an overall rate level change.

General Edits

    Following are descriptions of basic edits for general reference. These descriptions are intended to assist you in identifying common types of edit failures. These edit descriptions are not all-inclusive.

1. A Transmittal Letter must be included with each submission.

    2. The Transmittal Letter must be complete. All required information must be provided. 3. Individual company name or names must appear in the space provided on each

    reporting form.

    4. A single five-digit NCCI carrier code number corresponding to the company must

    appear in the space provided on each call form. 5. The reported data must be legible.

    6. Amounts must be reported in whole dollars only.

    7. Negative amounts must be enclosed with parentheses.

    8. If company designed forms are going to be used, sample forms must be submitted

    and approved by CAOM.

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    Transmittal Letter

    Policy Year Call

    Valued as of 12-31-2001

1. STATE: MICHIGAN

    2. DUE DATE: March 15, 2002

    3. CARRIER NAME: ___________________________________________________

    4. FILING AS: GROUP INDIVIDUAL COMPANY 5. If filing as a group, list individual carrier names or NCCI carrier codes:

    _______________________________________________________________________

    _______________________________________________________________________

    _______________________________________________________________________

    _______________________________________________________________________

    6. SUBMISSION TYPE: ORIGINAL CORRECTION

    MAIL CALL AND TRANSMITTAL TO: CAOM USE ONLY

    DATE RECEIVED COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN ___________

    P.O. Box 3337

    Livonia, MI 48151-3337 RECEIPT MAILED ATTENTION: Jon Heikkinen ___________

    COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN

    RECEIPT OF CALL NOTIFICATION

    Policy Year Call

    Valued as of 12-31-2001

7. STATE: MICHIGAN

    8. DUE DATE: March 15, 2002

    9. SUBMISSION TYPE: ORIGINAL CORRECTION 10. DATE RECEIVED AT CAOM___________ BY_________________________

    11. MAIL RECEIPT TO (Indicate specific individual):

    __________________________________________________________________

    __________________________________________________________________

    __________________________________________________________________

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    Transmittal Letter

    Assigned Risk Policy Year Call

    Valued as of 12-31-2001

12. STATE: MICHIGAN

    13. DUE DATE: March 15, 2002

    14. CARRIER NAME: ___________________________________________________

    15. FILING AS: GROUP INDIVIDUAL COMPANY 16. If filing as a group, list individual carrier names or NCCI carrier codes:

    _______________________________________________________________________

    _______________________________________________________________________

    _______________________________________________________________________

    _______________________________________________________________________

    17. SUBMISSION TYPE: ORIGINAL CORRECTION

    MAIL CALL AND TRANSMITTAL TO: CAOM USE ONLY

    DATE RECEIVED COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN ___________

    P.O. Box 3337

    Livonia, MI 48151-3337 RECEIPT MAILED ATTENTION: Jon Heikkinen ___________

    COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN

    RECEIPT OF CALL NOTIFICATION

    Assigned Risk Policy Year Call

    Valued as of 12-31-2001

18. STATE: MICHIGAN

    19. DUE DATE: March 15, 2002

    20. SUBMISSION TYPE: ORIGINAL CORRECTION 21. DATE RECEIVED AT CAOM___________ BY_________________________

    22. MAIL RECEIPT TO (Indicate specific individual):

    __________________________________________________________________

    __________________________________________________________________

    __________________________________________________________________

     Page 8

    Transmittal Letter

    Accident Year Call

    Valued as of 12-31-2001

1. STATE: MICHIGAN

    2. DUE DATE: April 1, 2002

    3. CARRIER NAME: ___________________________________________________

    4. FILING AS: GROUP INDIVIDUAL COMPANY 5. If filing as a group, list individual carrier names or NCCI carrier codes:

    ____________________________________________________________________

    ____________________________________________________________________

    ____________________________________________________________________

    ____________________________________________________________________

    6. SUBMISSION TYPE: ORIGINAL CORRECTION

    MAIL CALL AND TRANSMITTAL TO: CAOM USE ONLY

     DATE RECEIVED COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN ___________

    P.O. Box 3337

    Livonia, MI 48151-3337 RECEIPT MAILED ATTENTION: Jon Heikkinen ___________

    COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN

    RECEIPT OF CALL NOTIFICATION

    Accident Year Call

    Valued as of 12-31-2001

7. STATE: MICHIGAN

    8. DUE DATE: April 1, 2002

    9. SUBMISSION TYPE: ORIGINAL CORRECTION 10. DATE RECEIVED AT CAOM___________ BY_________________________

    11. MAIL RECEIPT TO (Indicate specific individual):

    __________________________________________________________________

    __________________________________________________________________

    __________________________________________________________________

    __________________________________________________________________

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    Transmittal Letter

    Assigned Risk Accident Year Call

    Valued as of 12-31-2001

12. STATE: MICHIGAN

    13. DUE DATE: April 1, 2002

    14. CARRIER NAME: ___________________________________________________

    15. FILING AS: GROUP INDIVIDUAL COMPANY 16. If filing as a group, list individual carrier names or NCCI carrier codes:

    ____________________________________________________________________

    ____________________________________________________________________

    ____________________________________________________________________

    ____________________________________________________________________

    17. SUBMISSION TYPE: ORIGINAL CORRECTION

    MAIL CALL AND TRANSMITTAL TO: CAOM USE ONLY

     DATE RECEIVED COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN ___________

    P.O. Box 3337

    Livonia, MI 48151-3337 RECEIPT MAILED ATTENTION: Jon Heikkinen ___________

    COMPENSATION ADVISORY ORGANIZATION OF MICHIGAN

    RECEIPT OF CALL NOTIFICATION

    Assigned Risk Accident Year Call

    Valued as of 12-31-2001

18. STATE: MICHIGAN

    19. DUE DATE: April 1, 2002

    20. SUBMISSION TYPE: ORIGINAL CORRECTION 21. DATE RECEIVED AT CAOM___________ BY_________________________

    22. MAIL RECEIPT TO (Indicate specific individual):

    __________________________________________________________________

    __________________________________________________________________

    __________________________________________________________________

    __________________________________________________________________

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