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Designed to Address the Needs of the Chamber of Commerce Type Businesses such as Retail, Service, Light Manufacturing, Hospitality, Habitation, Light-Medium Trade Contractors, and Transportation/Distribution Offered and Underwritten Through:

Arrowhead General Insurance Agency, Inc.

2365 Northside Drive, Suite 450, San Diego, CA 92108 Tel: 619.681.0560 | Fax: 866.650.2747


SPARTA Insurance Company

Rated A- IX

Claims Administration: Gallagher Basset Services

Workers’ Compensation Claims Reporting Number: Toll Free:800.563.1080


General Information

Arrowhead General Insurance Agency, Inc. has designed this program to attract Chamber of Commerce type business such as Retail, Service, Light Manufacturing, Hospitality, Habitation, Light-Medium Trade Contractors, and Transportation/Distribution. This manual is designed to give basic information to the producer to determine risk eligibility in this program: however, each risk is evaluated on it's own merit. This is not a rating or quoting tool, but as a reference. All completed submissions must be sent to for evaluation and pricing. For San Diego County, this program is exclusive to San Diego Regional Chambers of Commerce.


• Risks over $100,000 modified standard premium are required to be referred to SPARTA Insurance

• Risk must have a loss ratio 40% or less over the past 3 years, excluding the current year. • Applicable schedule credit shall not exceed the authorized limits below, unless approved in

writing through referral to SPARTA.

o CA Chamber of Commerce – 20% Maximum Credit

• Risk should have no more than 100 employees on duty, per location at any given time.

• Risk must be in business for a minimum of three years unless there is written verification of prior management experience in similar business.

• Risk must not have any individual incurred losses exceeding $100,000 in the last five years, including current term.

• Risk must provide written description of any individual loss greater than $50,000, including nature of injury, cause and current status. Data provided should be valued within 90 days prior to the policy’s effective date.

• Risk must have an Experience Rating Modification of 1.25 or less but not less than 0.70. • Risk over $100,000 in premium must provide financial data within 30 days prior to binding. • Pricing and rating of accounts must be performed using currently filed rates, premium discounts,

documented schedule credits or debits and appropriate experience modification factors.

• Physical Loss Control Survey must be conducted of all accounts generating annual premium of: o $100,000 or more on rollover business

o $50,000 on any new risk to the program

o All accounts are required to return a “satisfactory” survey rating or better. • Risk Management must be:

o Stable for the past three years with no material change in operations. o Experienced in operation’s industry.

o Safety-conscious and compliant with any and all loss control recommendations.

• Risks with two or more cancellations in a single policy term for non-payment of premium should be considered for non-renewal.



The following risks do not qualify and are not to be submitted for consideration as a part of the program: • Any risk requesting coverage under the following rating plans:

- Retrospective Rating Plan - Retention Plan

- Deductible Rating Plan - Dividend Plans

• NCCI Hazard Group IV or equivalent new hazard group mapping of G, and in California hazard group IV, or equivalent new hazard group mapping of J and K. The only exception to this guideline is if a class code falling in to Hazard Group IV is on the eligible class list, these class codes will be allowed.

• Any risk with greater than 15% payroll exposure outside the program territory. • Any risk that does not require certificates of insurance from all subcontractors. • Any exposure involving pollution, asbestos, benzene, lead, radon or silica. • Nuclear Risk

• Risks with known exposures to explosions, collapse, underground work and work over 15 ft. • Any risk with blasting operations or exposures.

• Manufacturing, handling, packaging, shipping, transportation or storage of explosives, substances intended for use as explosives, ammunition, fuses, arms, magnesium, propellant charges,

detonating devices, fireworks, or nitroglycerine. • Any risk with known Occupational Disease exposures.

• Any risk with operations falling under the jurisdiction of the following federal acts: - Defense Base Acts

- Outer Continental Shelf Act

- USL&H Act/Jones Act/Admiralty Act - Federal Employers Liability Act (FELA)

- Migrant and Seasonal Agricultural Worker Protection Act

- Civilian Employees of Non-Appropriated Fund Instrumentalities Act - Federal Coal Mine Health & Safety Act

• Any Risk with operations or exposures identified in the sections titled Workers Compensation Exposure Exclusions.


Additional Workers’ Compensation Exclusions

Acetylene Gas Mfg. Airline/Aircraft Operations Marine Salvage Operations

All Vessels Including NOC Marine Wrecking

Ambulance Operations Mining Operations – all

Amusement Park/Carnival/Circus/Fairs/Exhibitions Asbestos

Exposures Mobile Crane and Hoisting Service

Asphalt Works Municipalities and Governmental Bodies

Blasting Exposures Nuclear Risk

Boat Livery Ocean Marine, when written as such

Boiler Installation and Repair Professional Sports Teams

Bridge Work, including painting caisson, Dam, Dike, Lock,

Jetty or Breakwater Corm or repair Public Utilities – Electric, Gas, Telephone, Etc.

Carbonic Acid Quarries

Chemical Manufacturing Radiator or Heating Mfg.

Chimney Construction or Smoke Stack Lining Railroad Operation or Construction Cleaning/Renovating Outside Surfaces of Buildings Refractory Products Mfg.

Cofferdam Work (except earth filled dams) Rigging NOC

Concrete Construction with Bridges and Culverts Rocket Missile Testing or Launching

Cumulative Trauma Exposures Rolling Mill NOC

Detective, Patrol Agencies Roofing Exposures

Diving Salvage Operations

Drilling NOC Scaffolding Exposures

Dredging Security Guard Services

Electric Light, Power Line Construction Serum, Antitoxin or Virus Mfg. Electric Light Power Line Cooperatives

Sewer Construction, excluding contractors doing household connections only

Employee Leasing/Temporary Services Ship /Boat building

Excavation in excess of 15 ft. Shoring Buildings

Explosive or Ammunition Mfg. Offshore Exposures

F.E.LA, Exposures Oil/Gas Pipeline Operations

Firefighters Oil Pipe, Telephone, or Electrical Conduit Laying Oil/Gas Well Exposures

Foundry Operations – Any Type Occupational Disease Exposures

Gas Main or Connection Construction Painting Metal Structures over two stories

Grain Elevator Operation Painting Steel Structures or Bridges

Hazard Group IV Exposures Participation in any Insolvency Pool

Hazardous Waste Haulers Pile Driving

Height Exposure – Any operations performed in excess of

15ft Police Officers

Healthcare-related business including but not limited to

Hospitals, nursing homes or visiting nurses Silica, Flint, Spar Grinding Slate Miller or Splitting Soapstone Products Mfg. Stevedoring

Hone or Oil Stone Mfg. Stone Cutting or Polishing or Crushing

Industrial Chemicals and Petrochemicals Subway Construction or Shaft Sinking

Iron or Steel Erection Sulfur Production

Iron or Steel Rolling Mill Synthetic rubber or Intermediate Mfg.

Levee Construction Tank Erection or Repair


Trucking Operations – Any Type - Including Courier Delivery Operations


Wrecking and Demolition Twenty-four (24) Hour Operations

Wrap-Ups War Risk

Wrecking and Demolition Window Cleaning


The Classification that most accurately describes the Insured’s operations is to be used. In the case of multiple operations, the classification for each operation will be used. Only those governing classes listed in the Eligible Classifications section below qualify. A “governing class” is determined by the largest payroll amount assigned. Risks with incidental exposures from classifications not on the eligible list may be considered.

5 Nurseries-propagation and cultivation of nursery stock 16 Orchards

35 Florists-cultivating or gardening 42 Landscape Gardening

2501 Clothing Mfg.-including embroidery manufacturing 2570 Mattress or Box Springs Mfg.

2571 Pillow, Quilt, Comforter or Cushion Mfg. 2585 Laundries-N.O.C

2586 Dry Cleaning or Dyeing-N.O.C 2589 Dry Cleaning or Laundry-retail

2683 Bag Mfg.-traveling bags or hand luggage 2790 Pattern or Model Mfg.-metal, plastic or wood 2806 Door, Sash or Window Mfg.-wood

2812 Cabinet Mfg.-wood

2842 Wood Products Mfg.-N.O.C.

2852 Window Blind Mfg. or Assembly-all types

2881 Furniture Assembling-other than metal including finishing 2883 Furniture Mfg.-wood-including assembling or finishing 2915 Veneer or Veneer Products Mfg.-N.O.C.

2923 Musical Instrument Mfg.-other than metal- N.O.C. 3040 Iron Works-non-structural-shop

3060 Door or Window Mfg.-metal or combined metal and glass 3066 Sheet Metal Products Mfg.-N.O.C.

3076 Furniture Mfg.-metal 3099 Tool Mfg.-N.O.C.

3131 Tag, Button or Fastener Mfg. 3146 Hardware Mfg.-N.O.C.

3152 Nail, Tack or Rivet Mfg.-cold or hot work

3165 Air-Conditioning and Refrigeration Equipment Mfg. 3178 Electronic Element Mfg.-N.O.C.

3179 Electrical Apparatus Mfg.-N.O.C.

3180 Fixtures or Lamp Mfg. or Assembly-metal-- electric or gas 3383 Jewelry Mfg.-including foundry operations

3400 Metal Goods Mfg.-N.O.C.

3401 Tube or Pipe Products Mfg.-N.O.C.

3501 Machinery Mfg.-portable tools and lawn care 3507 Machinery Mfg.-agricultural, construction

3560 Machinery Mfg.-commercial food processing equipment 3569 Electric Motor Mfg. or Repair

3570 Electric Appliance Mfg.-N.O.C.

3572 Medical Instrument Mfg.-electronicdiagnostic or treatment 3573 Power Supply Mfg.

3574 Machine Mfg.-office or sewing-N.O.C. 3632 Machine Shops-N.O.C.


3643 Electric Power or Transmission Equipment Mfg.-N.O.C. 3681 Instrument Mfg.-professional or scientific- N.O.C. 3682 Instrument Mfg.-non electronic-scientific or medical 3805 Aircraft Engine Mfg. or Rebuilding

3828 Automobile or Automobile Truck Parts Rebuilding 3831 Machine Shops-aircraft components

3840 Automobile, Automobile Truck or Motorcycle Parts Mfg.-N.O.C. 4038 Plaster Statuary or Ornament Mfg.

4049 Potteries-glazed or porcelain, earthenware 4150 Optical Goods Mfg.-N.O.C.

4250 Paper Coating or Laminating

4295 Printing Operation-screen printing-all other employees 4299 Printing Operation-all other employees

4312 Newspaper Delivery

4361 Photographers-all employees-including receptionists 4432 Pen or Mechanical Pencil Mfg.

4478 Plastic Goods Mfg.-N.O.C.

4494 Plastics-blow molded products mfg.-N.O.C. 4495 Plastics-extrusion molded products mfg.- N.O.C. 4496 Plastics-fabricated products mfg.-no molding-N.O.C. 4497 Plastics-fiber reinforced plastic products mfg.-N.O.C. 4498 Plastics-injection molded products mfg.- N.O.C. 4499 Plastics-thermoformed products mfg.- N.O.C. 4511 Analytical or Testing Laboratories

4611 Drug, Medicine or Pharmaceutical Mfg 4623 Cosmetic Mfg.

4691 Orthotic or Prosthetic Device Mfg. 4720 Soap or Synthetic Detergent Mfg. 4831 Vitamin or Food Supplement Mfg. 5192 Vending or Coin Operated Machines 7198 Parcel Delivery Companies

7232 Mail Delivery Service Companies

7382 Bus or Limousine Operations – all employees 7610 Radio Station

8001 Stores-florists-including service away from premises 8004 Stores-garden supplies-N.O.C.

8006 Stores-groceries and provisions-retail 8008 Stores-clothing 8013 Stores-jewelry-wholesale or retail 8015 Stores-furniture-wholesale or retail 8017 Stores-retail-N.O.C. 8018 Stores-wholesale-N.O.C. 8019 Printing-quick printing

8021 Stores-meat, fish or poultry-wholesale

8032 Stores-clothing, wearing apparel or dry goods-wholesale 8039 Stores-department stores

8046 Stores-automobile accessories

8063 Stores-lighting fixtures-wholesale or retail 8064 Stores-office supplies

8065 Stores-paint or paint supplies-wholesale or retail 8070 Stores-video media-rental-retail

8071 Book Stores

8078 Sandwich Shops-not restaurants-N.O.C. 8106 Iron or Steel Merchants

8110 Stores – Welding Supplies 8111 Plumbers Supplies Dealers


8215 Hay, Grain, or Feed Dealers 8290 Warehouses-self-storage 8293 Warehouse – furniture 8324 Automobile Gasoline Stations 8387 Automobile Service Stations 8388 Rubber Tire Dealers 8389 Automobile Repair Shops 8391 Automobile Dealers

8392 Automobile Storage Garages

8393 Automobile Body and Fender Repairing 8397 Automobile Transmission Repairing 8601 Engineers-consulting

8720 Inspection for Insurance

8740 Apartment Operation-supervisors 8741 Real Estate Agencies

8742 Salespersons-Outside 8743 Mortgage Brokers

8745 News Agents or Distributors

8748 Automobile or Automobile Truck Salespersons 8800 Mailing or Addressing Companies

8803 Auditors, Accountants

8807 Newspaper, Magazine or Book Publishing 8808 Banks

8810 Clerical Office Employees-N.O.C. 8813 Printing Operation-editing

8818 Newspaper Publishing or Newspaper Printing-editing 8820 Attorneys

8827 Homemaker Services – all employees 8829 Nursing Homes – all employees

8831 Hospitals-veterinary-all employees including receptionists 8834 Physicians-all employees-including Clerical Office Employees 8839 Dentists and Dental Surgeons

8840 Churches

8846 Printing Operation-screen printing-editing 8859 Computer Programming

8868 Colleges or Schools-Private - Professional Employees 8875 Public Colleges or Schools

9007 Apartment Operation for Seniors 9008 Janitorial Service – by Contractors

9009 Building Operations – Commercial Properties – All other employees 9033 Housing Authorities

9043 Hospitals 9048 Camps 9059 Day Care 9069 Clubs - Gaming

9070 Residential Care Facilities for the Elderly 9079 Restaurants or Taverns

9096 Residential Cleaning Services – by Contractors 9101 Schools Other

9011 Apartment Operation-N.O.C. 9015 Building Ops – N.O.C. 9050 Hotels-all employees 9053 Baths-N.O.C. 9060 Clubs-country or golf 9061 Clubs-N.O.C.


9092 Bowling Centers

9101 Colleges or Schools-Private - other than professional employees 9154 Theaters-not motion picture

9516 Television and Radio Equipment Installation 9586 Barber Shops or Beauty Parlors


Policy and endorsement forms are carrier filed with the eligible states. Eligible States

CA, CO, HI, NY, NJ, NM**, NV, OK**, TX**

**Based upon SPARTA Insurance Company availability in state.

Policy Term

All policies are issued as guaranteed cost for a 12-month term. Short-term policies may be available to coincide with a Normal Anniversary Date or as an accommodation to replace business midterm. Retrospective or Deductible programs are not currently available.

New Business & Renewal Submission Requirements

• Complete Acord application (Include Agent and Insured signature on application) • 4 years minimum of legible loss runs valued within the past 120 days

• Thorough description of operations

• Completed supplemental application (Include premium and payroll history) • Experience mod worksheet (If Applicable)

• Narrative on any large loss exceeding $50,000 • Bureau inspection report (If available) Binding of Coverage

Arrowhead General Insurance Agency will retain full binding authority. Producers authorized to market this program do not have binding authority. The producer may request to bind coverage upon receiving a written certified quotation. No verbal representations by any employee of Arrowhead General Insurance Agency are valid. No backdating is permitted.

The producer is responsible for collection of the down payment amount as stipulated on the quotation for new business and renewals. A copy of the deposit check or confirmation of check by fax/email must accompany the binding request. The down payment must be received within 5 business days after the date the request to bind was made or prior to the inception date of coverage if there is enough lead-time. If the down payment is not received within this timeframe, a Rescinding Bind Notice will be issued and the risk will not be re-bound without the underwriter approval.

Please note that upon binding coverage all down payment checks must be made payable to Sparta Insurance Company.


NOTE: If rescinded, no contract of insurance will be recognized, as the insured is deemed unable to perform and consummate the contract.

Certificates of Insurance

Certificates may be issued by the producer on ACORD certificate forms only with a copy to be forwarded to Arrowhead General Insurance Agency for approval. Please do not strike any wording from the

approved ACORD certificate form as it will be rejected. Dept. of Motor Vehicle filings will be generated by Arrowhead General Insurance Agency.

Waiver of Subrogation

Subrogation entitles an insurance company to recover the amount due an insured from a third party who caused the loss. When these rights are waived the Company gives up this opportunity. Because the right of subrogation is important, we want to protect that right, however, we recognize that there are instances where contracts require the Insured to waive their subrogation rights as a condition of the contract award.

˚ Certificates Of Insurance that include request for waiver of subrogation will need to include the following information:

• Length of Job, start to finish, if applicable • Detailed description of work being performed

• Detailed description of Job Name/Job Number/Contract Number, Job Location, etc. • Name and address of party requesting the Waiver Of Subrogation

• Class codes applicable to the job, class descriptions and applicable payroll. Be sure that payroll is consistent with the description of job, insured’s operation and size of risk respectively.

All Waiver of Subrogation endorsements are subject to the following charges: Specific Waiver: 5% of the specific job premium.

Blanket Waiver: 2% of the standard total premium.

˚ Backdating is not allowed. If back dating is to be considered then we must first obtain a “No Loss Letter” signed and dated by the named insured warranting that there have been no known or reported losses or occurrences that may give rise to a claim covering the period of time between the start date of the job and the date that waiver request is submitted.


Rates quoted and issued will be in accordance with the issuing company’s rate filing. Other modifiers may apply that will deviate the company’s base rate. Contact your underwriter for further details.


As quoted by the underwriter and varies by state.


Pro Rata Cancellation: The policy is cancelled pro rata and the return or additional premium is rounded to the next higher whole dollar when cancelled for any of the following:


• Non-report of payroll, failure to permit the Insurer to audit payroll • Material misrepresentation

• Failure to cooperate with the investigation of a claim • Non-Compliance with loss control recommendations • Material change in ownership and/or operations

Short Rate Cancellation: The policy is cancelled short rate when cancellation is at the Insured’s request.

Premium Accounting

All payments will be applied in the following order: 1. Past due premium on inactive policies

2. Past due fees, surcharges, taxes on inactive policies 3. Past due premium on active policies

4. Current charges

*Please note that alternative payment instructions included with the check will not be honored.

Experience Modifications and Normal Anniversary Rating

If the risk has an established experience modification factor, it will be applied. If the effective date of a policy is different than their normal anniversary date, Company and/or Bureau rules will apply concerning rates and the experience mod.

Customer Service

Arrowhead General Insurance Agency has dedicated Customer Service Representatives, staffed from 8:00 a.m. to 5:00 p.m. Monday through Friday. They are available to answer questions for producers and customers on a wide range of operational units including Premium Accounting, Claims, Audit and

Operations, etc. To utilize this customer service option, please call our main phone line at 866-671-5046 and follow the appropriate menu options.

Owners/Officers of Company

• All owners/officers of the insured will be considered included for coverage unless specifically excluded by the application.

• All owner/officer information contained on the application will be considered factual. It will be the Producer’s and/or the Insured’s responsibility should an error or omission regarding owners/officers be found at final audit.


Loss Control inspections are the key to determining improvement and success for a risk as well as identifying hazards that may exist which may eventually lead to the declination of a risk with Arrowhead


General Insurance Agency, Inc.. As previously mentioned in the eligibility section, the following is a guideline for submitted risks:

• All accounts over $350,000 in premium will have a pre-inspection conducted • Any account over $50,000 will have a post binding inspection performed

• Telephone inspections may be conducted at any time on any account at the discretion of Arrowhead General Insurance Agency.

Payment Plans

Premium Threshold Allowed Payment Plans Less than $2,000 Full Pay

$2,000 to $5,000 Full Pay

15% down, 3 equal monthly installments 15% down, 7 equal monthly installments Greater than $5,000 Full pay


15% down, 3 equal monthly installments 15% down, 7 equal monthly installments 15% down, 9 equal monthly installments Short term polices Full Pay


When the Named Insured sub-contracts work, a certificate of insurance naming the named insured as the certificate holder must be provided or payroll for the sub-contractor will be charged as an employee at final audit.

Minimum Premium

Targeting accounts over $5,000 in premium. Premium Audits

Every insurance policy that cancels mid-term or expires must have a final audit conducted, reconciling actual payrolls/exposure to the estimated amounts used on the policy when incepted. The results will


determine if the premium paid by the Insured over the policy period is in excess or additional pay is needed.


The following guidelines determine what type of audit is to be conducted pursuant to the premium size of the account:

• Estimated Annual Premium (EAP) between $0 and $9,999 are subject to a mail-in voluntary audit to be completed by the Insured.

• EAP of $10,000 and greater will be subject to a physical audit.

• Final Audits for expiring policies will be requested no less than 15 days prior to expiration. • Final audits for policies cancelled by request of the insured or by request of the carrier will be

ordered upon the effective date of cancellation.

• Final audits for policies cancelled for non-payment will be ordered 30 plus 5 days after the effective date of cancellation.

Final Audit Billing

Final audits with additional premiums will be due in 20 days. If the final audit additional premium is not paid within 25 days, a second notice will be sent with a due date of 10 days. If the premium is not paid after the second request, a third and final notice will be sent with a due date of 10 days. Uncollectible accounts may be sent to Collections if the premium is not received by the 61st day from the original

premium due date.

Final Audit Disputes

When an audit is disputed by an Insured, the Premium Audit department is notified immediately. Premium Auditing will review and determine what part of the audit is being disputed, why it is being disputed, and the insured’s recommendations for resolving the dispute. If the audit is being partially disputed, the undisputed portion of the audit must be paid by the insured based on the above final audit billing time frames. If the audit is disputed over the accuracy of the figures, then copies of the records should accompany the dispute notification with clear explanation. Disputes regarding classifications will need to be quantified by the insured. Disputes should include a detailed narrative outlining why they feel the classification is erroneous.




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