For reference, below are the proposals for gross and risk margin

Data based in Active, Completed and Abrogated OP through June 2025

Below is the summary of total price showing that the new margin scheme is revenue neutral over the 2020-2025 period

Total Revenue Before and After
Diagnosis Type Contract Price New Contract Price Count
ABI 976,998,862 986,521,317 664
Amputation 222,391,204 216,932,488 207
Burn Injury 343,324,558 340,992,626 178
Multiple Trauma 658,996,281 637,739,141 606
Other 10,515,637 9,487,366 8
SCI 675,066,557 698,424,615 315
Total 2,887,293,099 2,890,097,552 1,978

The charts below show the statistics on price changes for our largest clients had the changes been in effect for years 2020 to 2024. The 10th to 90th percentile are less than +-10% for all clients. The upper range increases to about +17% for the 95th percentile, while a few cases (mainly SCI), exceed that threshhold due to a higher allowed limit on risk margin, which calculates a margin of between 20 and 30% for some SCI cases. There were 47 such cases for the 10 largest carriers and 99 overall for the 5 year period.

Average Price Changes
Primary Payer Count Mean 5th Percentile 10th Percentile 90th Percentile 95th Percentile
AIG Technical Third Party Oversight 81 -1.71% -8.48% -7.38% 3.56% 6.95%
AXA XL 52 0.39% -8.89% -7.52% 10.38% 17.25%
Amerisure Mutual Insurance Company 55 -2.30% -8.21% -8.12% 2.49% 8.61%
CNA 44 1.50% -7.79% -6.84% 13.62% 14.63%
Chubb 274 0.43% -10.31% -7.98% 9.87% 13.14%
Old Republic Risk Management 42 -1.03% -10.12% -7.99% 6.89% 9.05%
Sentry Insurance 50 -0.23% -8.37% -6.91% 10.23% 10.78%
Starr Indemnity and Liability Company 40 -2.72% -10.44% -8.95% 2.84% 6.70%
Travelers 153 0.63% -8.91% -7.15% 9.73% 13.56%
Zurich North America 402 0.89% -7.53% -4.80% 8.56% 12.03%

The following charts show the dispersion of price changes about the mean

This table shows the ranges by diagnosis, which indicates the largest potential impact in SCI and ABI cases.

Average Price Changes by Diagnosis
Primary Payer Diagnosis Type Count Mean 5th Percentile 10th Percentile 90th Percentile 95th Percentile
AIG Technical Third Party Oversight ABI 33 0.52% -5.71% -4.58% 3.48% 7.11%
AIG Technical Third Party Oversight Amputation 5 -2.08% -5.18% -4.62% 0.06% 0.41%
AIG Technical Third Party Oversight Burn Injury 10 -2.25% -9.16% -7.90% 3.00% 3.66%
AIG Technical Third Party Oversight Multiple Trauma 21 -4.31% -8.12% -7.38% -1.50% 0.00%
AIG Technical Third Party Oversight Other 1 3.32% 3.32% 3.32% 3.32% 3.32%
AIG Technical Third Party Oversight SCI 11 -2.11% -12.22% -11.31% 5.48% 7.07%
AXA XL ABI 19 -0.51% -9.96% -8.05% 8.51% 11.53%
AXA XL Amputation 4 -1.79% -4.86% -4.78% 1.24% 1.34%
AXA XL Burn Injury 4 -3.01% -7.58% -6.91% 1.16% 2.04%
AXA XL Multiple Trauma 18 -1.24% -6.23% -5.89% 4.56% 6.78%
AXA XL SCI 7 4.48% -11.17% -9.25% 17.36% 17.81%
Amerisure Mutual Insurance Company ABI 19 -0.93% -8.53% -6.71% 8.46% 9.89%
Amerisure Mutual Insurance Company Amputation 8 -3.12% -5.41% -5.15% -1.05% -0.52%
Amerisure Mutual Insurance Company Burn Injury 3 1.70% -5.09% -4.86% 10.14% 11.78%
Amerisure Mutual Insurance Company Multiple Trauma 24 -4.58% -8.37% -8.12% -1.45% -0.56%
Amerisure Mutual Insurance Company SCI 1 -4.43% -4.43% -4.43% -4.43% -4.43%
CNA ABI 14 2.47% -5.72% -5.09% 13.53% 16.59%
CNA Amputation 5 0.35% -1.20% -0.90% 1.94% 2.58%
CNA Burn Injury 8 1.75% -6.41% -4.97% 14.35% 15.12%
CNA Multiple Trauma 8 -3.34% -7.86% -7.60% 2.59% 4.00%
CNA Other 1 -10.85% -10.85% -10.85% -10.85% -10.85%
CNA SCI 8 4.42% -5.84% -5.51% 13.73% 14.07%
Chubb ABI 89 1.60% -6.96% -5.03% 9.92% 11.30%
Chubb Amputation 40 -2.94% -7.09% -5.92% 0.67% 2.87%
Chubb Burn Injury 24 0.43% -6.39% -5.03% 12.10% 14.54%
Chubb Multiple Trauma 78 -4.54% -8.12% -8.12% -1.05% 0.11%
Chubb Other 1 -10.49% -10.49% -10.49% -10.49% -10.49%
Chubb SCI 42 1.30% -17.65% -13.87% 18.09% 22.74%
Old Republic Risk Management ABI 15 -2.29% -10.22% -9.30% 4.00% 5.34%
Old Republic Risk Management Amputation 2 -2.61% -3.61% -3.50% -1.72% -1.61%
Old Republic Risk Management Burn Injury 5 -3.52% -8.49% -7.80% 0.15% 0.20%
Old Republic Risk Management Multiple Trauma 12 -4.57% -7.99% -7.94% -2.22% 2.59%
Old Republic Risk Management SCI 8 0.86% -10.39% -8.02% 12.32% 13.14%
Sentry Insurance ABI 11 -0.64% -7.72% -6.86% 10.36% 11.61%
Sentry Insurance Amputation 7 -3.20% -6.34% -6.15% -0.65% -0.32%
Sentry Insurance Burn Injury 2 3.82% -1.93% -1.29% 8.94% 9.58%
Sentry Insurance Multiple Trauma 19 -3.98% -7.45% -6.87% -0.42% 3.45%
Sentry Insurance SCI 11 1.07% -14.33% -13.69% 11.01% 14.24%
Starr Indemnity and Liability Company ABI 11 -2.19% -7.86% -6.90% 3.11% 4.82%
Starr Indemnity and Liability Company Amputation 4 -2.57% -3.66% -3.66% -0.89% -0.44%
Starr Indemnity and Liability Company Burn Injury 8 -2.54% -8.50% -6.84% 1.33% 2.05%
Starr Indemnity and Liability Company Multiple Trauma 8 -4.93% -8.81% -7.29% -1.42% 0.44%
Starr Indemnity and Liability Company Other 1 -13.75% -13.75% -13.75% -13.75% -13.75%
Starr Indemnity and Liability Company SCI 8 0.65% -10.46% -8.37% 12.65% 15.91%
Travelers ABI 81 1.38% -7.07% -5.02% 9.80% 12.77%
Travelers Amputation 4 -4.72% -6.95% -6.51% -3.16% -2.90%
Travelers Burn Injury 14 -0.72% -7.78% -7.27% 3.88% 7.37%
Travelers Multiple Trauma 28 -3.03% -6.87% -6.26% -0.84% 0.04%
Travelers SCI 26 0.63% -12.92% -11.69% 16.60% 18.13%
Zurich North America ABI 103 3.15% -5.01% -4.12% 10.97% 12.50%
Zurich North America Amputation 62 1.93% -5.73% -4.42% 5.99% 8.43%
Zurich North America Burn Injury 36 2.31% -1.84% -1.41% 7.39% 9.82%
Zurich North America Multiple Trauma 152 -1.21% -4.57% -3.97% 1.54% 2.92%
Zurich North America Other 2 -7.07% -13.43% -12.72% -1.41% -0.71%
Zurich North America SCI 47 0.46% -15.50% -12.12% 18.38% 21.53%

Now we show the average price changes for Zurich if we hold the gross margin constant and only change risk margin, and vice versa

Zurich Price Change due to Risk and Gross
Diagnosis Type Count Risk Change Gross Change Total Change
ABI 103 1.01169 1.0205 1.03293
Amputation 62 0.97675 1.0237 1.00022
Burn Injury 36 0.98741 1.0312 1.01776
Multiple Trauma 152 0.95914 1.0235 0.98079
Other 2 0.86874 1.0333 0.89373
SCI 47 0.98318 1.0400 1.02203
Top 10 Price Change due to Risk and Gross
Diagnosis Type Count Risk Change Gross Change Total Change
ABI 395 1.00566 1.0103 1.01607
Amputation 141 0.97506 1.0088 0.98348
Burn Injury 114 0.97323 1.0181 0.99082
Multiple Trauma 368 0.96161 1.0113 0.97210
Other 6 0.87411 1.0356 0.89840
SCI 169 0.99564 1.0346 1.02935

Below is the price change per year for Zurich

Zurich Effective Year Price Change due to Risk and Gross
Effective Year Count Risk Change Gross Change Total Change
2020 51 0.96826 1.0288 0.99540
2021 66 1.00239 1.0289 1.03125
2022 63 1.00128 1.0322 1.03443
2023 75 0.97087 1.0183 0.98802
2024 106 0.97864 1.0244 1.00185
2025 41 0.96693 1.0305 0.99539

And for the Top 10

Top 10 Effective Year Price Change due to Risk and Gross
Diagnosis Type Count Risk Change Gross Change Total Change
2020 186 0.98050 1.0155 0.99500
2021 201 0.99469 1.0228 1.01740
2022 186 1.00596 1.0188 1.02582
2023 244 0.97253 1.0128 0.98444
2024 270 0.97909 1.0155 0.99370
2025 106 0.98610 1.0119 0.99644

The increase of price for Zurich is due to the higher proportion of sub-500K contracts compared to the average. The second table shows an average increase for Zurich of almost 6% in gross margin for sub-500K contracts, with a new gross margin of 30%

Claim Budget Breakdown Top 10 Payers
Budget/Payer Amerisure Mutual Insurance Company Starr Indemnity and Liability Company Old Republic Risk Management Sentry Insurance CNA AXA XL AIG Technical Third Party Oversight Travelers Chubb Zurich North America Total
A- 0-500K 16 (19.8%) 15 (27.3%) 12 (23.1%) 93 (33.9%) 2 (4.5%) 5 (11.9%) 10 (20.0%) 8 (20.0%) 18 (11.8%) 161 (40.0%) 340 (28.5%)
B- 500-750 14 (17.3%) 17 (30.9%) 9 (17.3%) 44 (16.1%) 7 (15.9%) 10 (23.8%) 14 (28.0%) 10 (25.0%) 27 (17.6%) 70 (17.4%) 222 (18.6%)
C- 750-1M 18 (22.2%) 8 (14.5%) 8 (15.4%) 48 (17.5%) 8 (18.2%) 12 (28.6%) 7 (14.0%) 4 (10.0%) 33 (21.6%) 71 (17.7%) 217 (18.2%)
D- 1M-1.25M 10 (12.3%) 4 (7.3%) 4 (7.7%) 31 (11.3%) 7 (15.9%) 3 (7.1%) 6 (12.0%) 7 (17.5%) 20 (13.1%) 30 (7.5%) 122 (10.2%)
E- 1.25M-1.5M 5 (6.2%) 8 (14.5%) 5 (9.6%) 18 (6.6%) 7 (15.9%) 3 (7.1%) 6 (12.0%) 2 (5.0%) 18 (11.8%) 19 (4.7%) 91 (7.6%)
F- 1.5M-1.75M 8 (9.9%) 1 (1.8%) 6 (11.5%) 11 (4.0%) 6 (13.6%) 2 (4.8%) 2 (4.0%) 2 (5.0%) 20 (13.1%) 26 (6.5%) 84 (7.0%)
G- 1.75M-2M 3 (3.7%) 1 (1.8%) 3 (5.8%) 9 (3.3%) 1 (2.3%) 2 (4.8%) 0 (0.0%) 3 (7.5%) 7 (4.6%) 10 (2.5%) 39 (3.3%)
H- 2M-2.5M 3 (3.7%) 1 (1.8%) 2 (3.8%) 14 (5.1%) 2 (4.5%) 4 (9.5%) 2 (4.0%) 2 (5.0%) 4 (2.6%) 9 (2.2%) 43 (3.6%)
I- 2.5M-3M 2 (2.5%) 0 (0.0%) 1 (1.9%) 4 (1.5%) 1 (2.3%) 1 (2.4%) 1 (2.0%) 0 (0.0%) 2 (1.3%) 1 (0.2%) 13 (1.1%)
J- Over 3M 2 (2.5%) 0 (0.0%) 2 (3.8%) 2 (0.7%) 3 (6.8%) 0 (0.0%) 2 (4.0%) 2 (5.0%) 4 (2.6%) 5 (1.2%) 22 (1.8%)
Total 81 (100.0%) 55 (100.0%) 52 (100.0%) 274 (100.0%) 44 (100.0%) 42 (100.0%) 50 (100.0%) 40 (100.0%) 153 (100.0%) 402 (100.0%) 1,193 (100.0%)

The chart below indicates the possible need for a favored nations gross margin to remain in place.

Zurich Price Change by Claim Budget
Claim Budget Count Risk Change Gross Change Total Change Current GM New GM
A- 0-500K 161 0.97362 1.0428 1.01421 26.2% 29.0%
B- 500-750 70 0.96486 1.0231 0.98623 26.5% 28.0%
C- 750-1M 71 0.98164 1.0202 1.00120 25.7% 27.0%
D- 1M-1.25M 30 0.97500 1.0057 0.98064 25.6% 26.0%
E- 1.25M-1.5M 19 0.98478 1.0247 1.00912 23.5% 25.0%
F- 1.5M-1.75M 26 1.01354 1.0268 1.04192 21.2% 23.0%
G- 1.75M-2M 10 0.98809 1.0438 1.02956 19.2% 22.0%
H- 2M-2.5M 9 0.97963 1.0261 1.00474 18.2% 20.0%
I- 2.5M-3M 1 1.12195 1.0000 1.12195 18.0% 18.0%
J- Over 3M 5 0.99010 1.0286 1.01990 14.7% 17.0%

Next we show the loss ratio based on the original contract price v the new contract price

Loss Ratio Comaprison
Payer Current Price New Price
AIG Technical Third Party Oversight 73.39% 74.67%
AXA XL 80.27% 79.96%
Amerisure Mutual Insurance Company 68.78% 70.39%
CNA 70.53% 69.49%
Chubb 73.71% 73.39%
Old Republic Risk Management 77.30% 78.11%
Sentry Insurance 64.40% 64.55%
Starr Indemnity and Liability Company 65.31% 67.14%
Travelers 74.02% 73.55%
Zurich North America 70.55% 69.93%
Loss Ratio by Effective Year
Payer Effective Year Current Price New Price
AIG Technical Third Party Oversight 2020 66.69% 66.26%
AIG Technical Third Party Oversight 2021 85.44% 88.55%
AIG Technical Third Party Oversight 2022 75.36% 75.62%
AIG Technical Third Party Oversight 2023 71.00% 71.41%
AIG Technical Third Party Oversight 2024 71.27% 74.06%
AIG Technical Third Party Oversight 2025 75.98% 76.34%
AXA XL 2020 92.39% 90.86%
AXA XL 2021 87.46% 84.19%
AXA XL 2022 79.71% 74.37%
AXA XL 2023 76.70% 79.51%
AXA XL 2024 69.49% 70.51%
AXA XL 2025 65.45% 70.47%
Amerisure Mutual Insurance Company 2020 75.66% 78.41%
Amerisure Mutual Insurance Company 2021 67.03% 67.19%
Amerisure Mutual Insurance Company 2022 73.62% 73.38%
Amerisure Mutual Insurance Company 2023 70.79% 73.77%
Amerisure Mutual Insurance Company 2024 62.90% 64.90%
Amerisure Mutual Insurance Company 2025 59.60% 63.44%
CNA 2020 64.26% 64.22%
CNA 2021 59.45% 60.42%
CNA 2022 77.63% 74.75%
CNA 2023 72.30% 70.95%
CNA 2024 75.02% 74.65%
CNA 2025 64.43% 61.54%
Chubb 2020 65.52% 65.98%
Chubb 2021 80.36% 79.24%
Chubb 2022 81.22% 78.59%
Chubb 2023 69.02% 70.79%
Chubb 2024 77.03% 76.93%
Chubb 2025 58.65% 57.93%
Old Republic Risk Management 2020 89.58% 88.73%
Old Republic Risk Management 2021 78.97% 77.26%
Old Republic Risk Management 2022 63.58% 63.73%
Old Republic Risk Management 2023 83.48% 83.59%
Old Republic Risk Management 2024 79.97% 82.70%
Old Republic Risk Management 2025 60.60% 63.73%
Sentry Insurance 2020 59.15% 63.58%
Sentry Insurance 2021 74.98% 75.04%
Sentry Insurance 2022 58.87% 58.40%
Sentry Insurance 2023 70.26% 72.17%
Sentry Insurance 2024 72.29% 71.21%
Sentry Insurance 2025 10.32% 10.42%
Starr Indemnity and Liability Company 2020 64.64% 66.68%
Starr Indemnity and Liability Company 2021 62.80% 63.42%
Starr Indemnity and Liability Company 2022 68.12% 67.87%
Starr Indemnity and Liability Company 2023 62.02% 67.71%
Starr Indemnity and Liability Company 2024 69.09% 70.58%
Starr Indemnity and Liability Company 2025 59.07% 60.76%
Travelers 2020 74.21% 74.20%
Travelers 2021 74.29% 72.48%
Travelers 2022 74.10% 72.77%
Travelers 2023 72.83% 72.82%
Travelers 2024 75.12% 75.76%
Travelers 2025 75.06% 74.26%
Zurich North America 2020 66.86% 67.17%
Zurich North America 2021 77.62% 75.27%
Zurich North America 2022 68.95% 66.66%
Zurich North America 2023 64.68% 65.46%
Zurich North America 2024 74.29% 74.15%
Zurich North America 2025 66.15% 66.45%

This methodology would have led to fewer bookends, both Windfalls and Losses.

Bookends Before and After
Bookend Current New
L 160 155
N 1501 1514
W 317 309

There is a slightly larger proportion of risk cap eligible contracts (loss ratio < 61%) in the general client population as opposed to the top ten payers. Note this includes Completed, Abrogated and Active at 6/30/2025.

Top Payers Risk Cap Exposure - Current Price
Risk Cap Cutoff Count Contract Price Percent Count Percent Price
Over 785 1,197,128,397 66.9% 71.7%
Under 388 473,634,656 33.1% 28.3%

And at the proposed new price

Top Payers Risk Cap Exposure - New Price
Risk Cap Cutoff Count New Contract Price Percent Count Percent Price
Over 803 1,220,170,996 68.5% 72.9%
Under 370 453,641,870 31.5% 27.1%

Below is the risk cap exposure for all other payers out of the top ten

Other Payers Risk Cap Exposure - Current Price
Risk Cap Cutoff Count Contract Price Percent Count Percent Price
Over 475 788,134,952 61.3% 67.0%
Under 300 388,273,096 38.7% 33.0%

And at the new proposed prices.

Other Payers Risk Cap Exposure - New Price
Risk Cap Cutoff Count New Contract Price Percent Count Percent Price
Over 499 808,628,939 64.4% 68.7%
Under 276 367,839,212 35.6% 31.3%