Radius Insurance Group LLC — Workers' Compensation Submission Packet Wholesale only. Tampa Bay, Florida. submissions@radiusinsurancegroup.com -------------------------------------------------------------------- 1. REQUIRED ITEMS -------------------------------------------------------------------- [ ] ACORD 130 (Workers' Compensation Application), signed and dated - List every named entity and FEIN to be covered - Include ownership percentages and officer inclusion/exclusion - Describe operations in plain language, not just class codes [ ] Loss runs, 3-5 years, valued within the last 90 days - Carrier-issued only - Include open reserves, claim status and date of loss [ ] Payroll by class code - Current estimated payroll and prior year actual - Split by state and by class code - Show officer payroll separately -------------------------------------------------------------------- 2. HELPFUL ITEMS (speed up market response) -------------------------------------------------------------------- [ ] Experience mod worksheet (NCCI or state bureau, current rating year) [ ] Currently expiring policy dec page [ ] Declination or non-renewal letter [ ] Safety program / corrective action narrative - What changed after the claims? Underwriters read this. [ ] Subcontractor usage and certificates of insurance [ ] Employee count by location -------------------------------------------------------------------- 3. PAYROLL WORKSHEET FORMAT -------------------------------------------------------------------- State | Class Code | Description | # Employees | Est. Annual Payroll ------+------------+-------------+-------------+-------------------- FL | 7380 | Drivers | 14 | $ 612,000 FL | 8810 | Clerical | 3 | $ 145,000 -------------------------------------------------------------------- 4. WHAT TO EXPECT -------------------------------------------------------------------- Same day - Receipt confirmed, appetite reviewed 24 hours - Missing items identified, markets selected 48 hours - Indications returned on most complete submissions -------------------------------------------------------------------- 5. APPETITE REMINDERS -------------------------------------------------------------------- - Experience mods of 2.00 and above are normal for us; there is no ceiling - All class codes considered, including codes other markets decline outright - Staffing and temporary labor is the core of the book - Premium range: $25,000 - $2,000,000 annual - Prior cancellations, lapses and open lost-time claims are expected The producing agent keeps the client relationship. Radius does not contact the insured directly without written authorization.