Forms

• Individual Retrospective Rating Plan Agreement  (F250-003-000)
• Application for Group Retrospective Rating  (F250-004-000)
• Application for Group Membership and Authorization for Release of Insurance Data  (F250-016-000)
     Español (Spanish) (F250-016-999)
• Retrospective Rating Adjustment Protest  (F250-024-000)

 Publications

• Is Retrospective Rating Right for You?  (F250-006-000)
    Español (Spanish)  (F250-006-999)
• Group vs. Individual Retrospective Rating Participation  (F225-016-000)
• Retrospective Rating Enrollment Decisions  (F225-017-000)
• Keys to Retro Success  (F225-018-000)
     Español (Spanish)  (F225-018-999)
• Evaluating Retro Groups  (F225-019-000)
     Español (Spanish)  (F225-019-999)
• Retrospective Rating Business & Industry Category Guide  (F250-025-000)
• Protesting Retro Adjustments  (F250-027-000)

Data field definitions for reports:

• Data fields for the adjustment report
• Data fields for the monthly report
• Data fields for the quarterly report
• How to download and import your Retro data files (for new users)

For use with downloadable data files and electronic reports:

• Column headers template for the adjustment report
• Column headers template for the monthly report
• Column headers master template for quarterly report and data files (includes data element definitions for factors & premium report)

• Current Retro Premium Calculator, updated October 2022; this applies to coverage periods beginning July 1, 2017 and later. This calculator assists in projecting future retro performance (though projections are not guaranteed). Please email us with any questions about the calculator.
• Retro Premium Calculator, updated July 2017. This premium calculator is meant to be used only for coverage periods from July 2014 through April 2017. Unlike the current premium calculator above, this calculator does not reflect subsequent changes to the Retro insurance tables and single loss limit program rules.

The rules governing Retrospective Rating can be found in the Washington Administrative Code (WAC):

• Chapter 296-17B: Retrospective rating for workers' compensation insurance.
• Section 296-17B-900: Retrospective rating plans standard premium size ranges.
• Section 296-17-901: Risk classification hazard grouping table.