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JiThe Hartford MAINTAINING YOUR RECORDS FOR AUDIT PURPOSES WHAT IS A PREMIUM ADJUSTMENT? Remuneration does not include: a. Employer contributions to a group insurance or When your Workers' Compensation policy was issued you pension plan other than statutory plans of insurance. paid a deposit premium based on the nature of your b. Special awards for individual inventions or business and estimates of your payroll. At the end of the discoveries. policy period, we conduct an audit to compare the c. Overtime.* estimates against the actual figures and operations. Based on this comparison an adjustment is made. If the Subcontractors. In the absence of other insurance, most actual premium is less than what you already have paid, a state laws hold a contractor responsible for injuries to refund will be made. If it's more, you will be billed for the employees of subcontractors. At the time of audit difference. These adjustments are subject to any minimum Certificates of Insurance must be available for premiums that apply. subcontractors with employees, in order to avoid payment of premium. HOW WILL THE PREMIUM ADJUSTMENT BE MADE? Independent Contractors, without employees, whose On smaller, less complex operations we may e-mail you, duties closely resemble those of an employee, will be call you, or mail you a request to ask you to provide the considered your employee with the appropriate premium information via our online web-based portal, mail or charged. telephone. if we require this information, we will provide an electronic link to, or a paper copy of, the necessary The actual working relationship between you and the forms for you to complete. Independent Contractor is examined. Items such as, but not limited to: whether the work performed is an integral On larger, more complex operations one of our Premium part of your operations, whether you have the right to Auditors will contact you for an appointment. You will be control the details of the work, the method of payment, contacted either by e-mail, telephone or mail. If directed, who supplied the materials used, does the person the auditor will contact your accountant to obtain as much regularly work for others, whose regulatory authority did information as possible and contact you at a later time for person operate under, whether the person is involved in a additional information that may be needed. separate and distinct business offering the same services to the public. BASIS OF PREMIUM Remuneration (Payroll) in most states, includes: RECORDS As part of the policy conditions, we are allowed to Payment of: Wages, bonuses, commissions, examine your financial books and records to determine overtime,* sick pay, vacation pay,* tool actual exposures and operations. We would appreciate allowances, contributions to individual your cooperation in making the needed records available retirement accounts, employee for the auditor's inspection. contributions to employee benefit plans. Payments on What Records Will Be Needed? basis of: Piece work, incentive plans, profit sharing. The records needed will vary. In most cases, the Premium The value of: Housing furnished to employees,* meals Auditor will be able to obtain the necessary audit data furnished to employees,* store certificates, from two or more of the following records: Journals, merchandise and other dollar substitutes. Ledgers, State and Federal Tax Reports, Individual Earning Cards, Checkbooks and Contracts. Form 98456 5th Rev. 12-13 Printed in U.S.A. Page 1 of 2