Payroll Capture Portal
HFL-2025-00182
Employer Payroll Submission
Annual payroll report by class code — Policy audit period
Payroll by Class Code
| Code | Job Description | Q1 ($) | Q2 ($) | Q3 ($) | Q4 ($) | Annual Total |
|---|---|---|---|---|---|---|
| 8810 | Clerical / Admin | 287,400 | 291,200 | 295,800 | 302,100 | 1,176,500 |
| 7380 | Truck Drivers — Long Haul | 698,200 | 712,400 | 741,300 | 755,100 | 2,907,000 |
| 7382 | Truck Drivers — Local | 342,600 | 348,900 | 361,200 | 371,300 | 1,424,000 |
| 8227 | Warehouse & Dock Workers | 223,100 | 228,400 | 241,700 | 253,800 | 947,000 |
| Total Payroll | 1,551,300 | 1,580,900 | 1,640,000 | 1,682,300 | 6,454,500 | |
By submitting this report, I certify that the payroll figures above are accurate and complete to the best of my knowledge for the audit period shown.
Last saved: 10/14/2024 11:42 AM
AI Document Extraction
Loss run analysis and structured data extraction
HFL_LossRun_2021-2024_CNA.pdf
Extraction Complete
Processed in 3.2 seconds • 11 fields extracted • High confidence
Extracted Policy Data
| Field | Extracted Value | Confidence |
|---|---|---|
| Policy Number | WC-CA-4482019-22 | 99% |
| Prior Carrier | CNA Financial Corporation | 98% |
| Coverage Period | 01/01/2021 – 01/01/2024 | 99% |
| Total Incurred | $482,310 | 97% |
| Total Paid | $391,450 | 97% |
| Outstanding Reserves | $90,860 | 95% |
| Open Claims | 3 | 99% |
| Closed Claims | 18 | 99% |
| Total Claims | 21 | 99% |
| Largest Single Claim | $147,200 (back injury, 2022) | 84% |
| Report Date | 10/01/2024 | 99% |
Note: 3 open claims flagged for underwriter review. Total incurred exceeds estimated prior-year level by 14%. Recommend requesting updated loss run within 30 days of binding.