I. Instructions

• The rules of this Plan shall govern the WorkSafe^SM Credits plan procedure to be followed in connection with Workers Compensation and Employers' Liability Insurance. These rules have been prepared as applicable to all policies written or issued for a period that is one year but not more than one year and sixteen days. Such policies shall be considered as one year policies.
• The effective date of any change to this Plan is 12:01 a.m. on the date specified on the manual page. Any change will be issued on a reprinted page and will be designated by a (*).
• Unless specified otherwise, this Plan and any changes made hereafter apply only from the policy effective date which occurs on or after the effective date of the Plan or change, but shall not otherwise be available to outstanding policies.
• As provided in the Workers Compensation and Employers' Liability Policy, the Accident Fund Insurance Company of America has full authority to verify any or all practices of the insured for use in establishing the insureds qualification under the Plan.

II. Definitions

1. Entity
   The term "entity" shall mean an individual, partnership, limited liability company, corporation, association or fiduciary (e.g., trustee, receiver, executor or administrator), or other legal entity.
   
   
2. Risk
   The term "risk" as used in this Plan shall mean:
   1. A single entity.
   2. Two or more entities which qualify for combination under Rule III-A-4 of the "Rules" pages and the insurance is provided by one policy.
   
   
   
3. Practices
   For the purpose of this Plan, "practices" shall mean the procedures under which the risk is expected to perform during the policy period.
   
   
4. Standard Premium
   For the purpose of this Plan, "standard premium" means the premium determined on the basis of authorized rates, any experience rating modification, and minimum premiums. The Expense Constant and any scheduled rating credits or debits shall be excluded from determination of the standard premium.

III. General Provisions

1. Eligibility Requirements
   A policy may qualify for modification under this Plan if the manual premium is at least $5,000, effective March 1, 2002.
2. Change of Control, Management, Operations or Ownership
   A change of control, management, operations or ownership may change the Accident Fund Insurance Company of America evaluation of practices underlying the WorkSafe^SM credits, and the Accident Fund Insurance Company of America may accordingly discontinue the modification.
3. Evaluation of Practices
   The Accident Fund Insurance Company of America has the right to inspect or examine the insureds records to verify practices that allow the insured to qualify under this Plan.
   
   

IV. WorkSafe^SM Credits Schedule

The standard premium for a risk may be modified in accordance with the following schedule:

1. Minimum of 80% claims reported within 24 hours of notification.
   Insured agrees to report a minimum of 80% of claims to the Accident Fund Insurance Company of America within 24 hours after the employer receives notification of the claim. The Accident Fund Insurance Company of America’s 800 Express Claim Service telephone number should be utilized for speedy reporting. Credit 3% 
   
2. Utilization of a defined care provider program.
   Within the first 10 days of medical care following an injury, insured agrees to and exclusively utilizes the Accident Fund Insurance Company of America’s defined care provider program, where available. The insured also agrees to provide the Accident Fund Insurance Company of America with a copy of their procedure which states that they will utilize the Accident Fund Insurance Company of America’s care provider program. Credit  3% 
3. Minimum of 75% of employees with health care insurance.
   A 5% credit may be applied to a policy in which 75% or more of their employees have health care insurance. An employee may be counted in the 75% if they are covered in their spouses health care program. Health care is not limited to a specific health care provider.

The algebraic sum of the appropriate credits shall be applied to the standard premium in a multiplicative manner before the application of premium discount and expense constant. The Accident Fund Insurance Company of America reserves the right to withdraw the credit given under the WorkSafe^SM Credits Plan if it is determined that the policyholder is not complying with the loss containment practice for which the credit was given.