2023-24 Workers Comp EMOD CalculationJanuary 23, 2023
Costa Mesa Sanitary District
Mr. Scott Carroll
General Manager
290 Paularino Avenue
Costa Mesa, California 92626
Re: 2023-24 Workers’ Compensation Experience Modification Factor
Dear Mr. Carroll,
In preparation for the 2023-24 Workers’ Compensation Program renewal on July 1, 2023, we are providing your
agency’s 2023-24 Experience Modification Factor (EMOD) to help with budget planning. SDRMA follows the
Workers’ Compensation Insurance Rating Bureau (WCIRB) methodology for calculating EMODs. A detailed EMOD
Calculation Form and claims detail is attached to help you understand your EMOD.
Your agency’s 2023-24 EMOD is 146%
If you have questions regarding your agency’s EMOD, please contact us at memberplus@sdrma.org or 800-537-
7790.
The market for Workers’ Compensation coverage continues to remain stable. We anticipate only medical inflation
to cause minor rate increases for excess/reinsurance coverage for the 2023-24 program year. Thus, we anticipate
minimal rate changes for the 2023-24 program year.
The SDRMA Board of Directors will also discuss a potential Longevity Distribution in the coming months. Should the
board approve a distribution, every member that has completed its initial commitment of three full program years
and has an EMOD of 150% or lower is eligible to receive a longevity distribution credit when they renew coverage.
More information regarding a potential longevity distribution will be shared in March.
Members considering withdrawal from coverage with SDRMA for the 2023-24 program year are required to submit
a “Notice of Intent to Withdraw” by April 1, 2023 in accordance with SDRMA Bylaws and must have completed the
initial three full program year commitment period. If you have any questions about withdrawing from our program,
please contact Ellen Doughty at edoughty@sdrma.org or 800-537-7790.
On behalf of the SDRMA Board of Directors and our entire risk management team, we thank you for your continued
participation in our programs.
Sincerely,
Special District Risk Management Authority
Ellen Doughty, ARM
Chief Member Services Officer
Attachment: 2023-24 EMOD Calculation Form and claims detail
Special District Risk Management Authority
Workers' Compensation Program
Program Year 2023-24
Experience Modification (EMOD) Calculation Form
Costa Mesa Sanitary District
290 Paularino Avenue
Costa Mesa, California 92626
SummaryPY 2023-24 EMOD -
PY 2022-23 EMOD -
146%
165%
Detail Calculations for Program Year 2023-24
Expected Losses
Class
Codes
Total
Payroll
Expected
Loss Rate
Expected
Primary Losses
2019-20 Payroll2020-21 Payroll2021-22 Payroll Expected
Excess Losses
Total Expected
Losses
7580 $500,987 $505,078 $523,023 $1,529,088 0.0113 $13,736.56$3,542.13$17,278.69
8601 $0 $52,619 $143,846 $196,465 0.0009 $141.81$35.01$176.82
8742-D $94,047 $97,080 $89,975 $281,102 0.0011 $244.28$64.93$309.21
8742-M $20,746 $25,263 $46,842 $92,851 0.0011 $80.69$21.45$102.14
8810 $365,954 $489,920 $376,112 $1,231,986 0.0009 $837.14$271.65$1,108.79
9015 $39,920 $43,027 $0 $82,947 0.0182 $1,180.53$329.10$1,509.63
9410 $353,342 $360,758 $510,231 $1,224,331 0.0041 $3,513.83$1,505.93$5,019.76
$19,734.84$5,770.20$25,505.04$1,374,996 $1,573,745 $1,690,029 $4,638,770
Actual Losses valued as of 12/31/2022
Actual Losses*Actual Excess LossesActual Primary LossesClaims CountYear Actual Incurred Losses
3
0
1
$18,126.52
$0.00
$5,315.83
$0.00
$0.00
$12,321.28
$0.00
$5,065.83
2019-20
2020-21
2021-22
$17,376.52
$0.00
$5,065.83
$5,055.24
$5,055.24$17,387.11* Actual Losses are capped at $175,000 per claim for purposes of EMOD calculations.Totals $22,442.35
EMOD Calculation - Based on Workers' Compensation Insurance Rating Bureau's (WCIRB) rating model.
Total Adjusted Losses
/Total Expected
Losses =
$25,505.04 146%
2023-24 EMODExpected Excess
Losses
Actual Primary
Losses
(+$17,387.11 )$19,734.84
Special District Risk Management Authority
1112 I Street Suite 300, Sacramento, California 95814-2865
Tel 916.231.4141 or 800.537.7790 Fax 916.231.4111
www.sdrma.org
Printed 4/17/2023
Special District Risk Management Authority
Workers' Compensation EMOD Claims Detail
Program Year 2023-24
Costa Mesa Sanitary District
*ActualTotal Injury
Status CategoryNumberDate Losses IncurredType
Claim InjuryClaimInjury
09/05/2019 SDWA-560675 Indemnity Fall/Slip From a Different Level $14,305.24 $14,055.24C
10/10/2019 SDWA-560748 Medical Pushing or Pulling $1,590.57 $1,340.57C
06/09/2020 SDWA-561194 Medical Cut, Punctured, Scraped, NOC $2,230.71 $1,980.71C
2019-20 No. of Claims 3 $18,126.52 $17,376.52
No Claims All claims under $2,001 $.00 $.00
2020-21 No. of Claims 0 $.00 $.00
06/06/2022 4A2206J334H0001 Medical Motor Vehicle, NOC $5,315.83 $5,065.83C
2021-22 No. of Claims 1 $5,315.83 $5,065.83
No. of Claims 4 $22,442.35$23,442.35Total
* Actual Losses have the first $250 excluded and are capped at $175,000
Special District Risk Management Authority
1112 I Street Suite 300, Sacramento, California 95814-2865
Tel 916.231.4141 or 800.537.7790 Fax 916.231.4111
www.sdrma.org
Printed 4/17/2023