Effective Date The desired coverage effective date.
FEIN (Optional) – Federal Employer Identification Number. Used with effective date to determine experience/merit modification.
Employer Name Used for identification purposes on the printed report.
Experience Modification If the current experience/merit modification effective date differs more than 3 months from the desired coverage effective date no modification factor will populate. You may call Customer Service at 734-462-9600 for assistance.
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Assigned Risk Premium Calculator

The premium estimate is based on the class code and payroll information provided. The experience modification and surcharge shown, if any, are tentative factors based on information in CAOM’s system for this FEIN and requested coverage effective date. Changes in modification effective date could result in a recalculation of the modification/surcharge factors.


Entry of a valid FEIN will populate the experience modification if the desired effective date is within 3 months of the current modification effective date.

Class Code Description USLHW No of
Total Payroll Rate Premium
Manual Premium:  
Increased Limits:
Experience Modification:  
Standard Premium:  
Premium Discount:
Expense Constant:  
Plan A Surcharge:
Terrorism (Payroll ÷ 100 X .01)
Total Estimated Premium:  
Deposit Premium Percent:
Your Deposit Premium: