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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31, 20212022 or
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from             to                         
Commission File Number: 0-16533
ProAssurance Corporation
(Exact name of registrant as specified in its charter)
Delaware63-1261433
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer Identification No.)
100 Brookwood Place,Birmingham,AL35209
(Address of principal executive offices)(Zip Code)
(205)877-4400
(Registrant’s telephone number,
including area code)
(Former name, former address and former
fiscal year, if changed since last report)
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, par value $0.01 per sharePRANew York Stock Exchange
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes      No  
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes      No  
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company, or an emerging growth company. See the definitions of "large accelerated filer," "accelerated filer," "smaller reporting company," and "emerging growth company" in Rule 12b-2 of the Exchange Act.
Large accelerated filer Accelerated filer 
Non-accelerated filerSmaller reporting company 
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ¨
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).     Yes     No  
As of April 30, 2021,May 4, 2022, there were 53,953,39954,047,919 shares of the registrant’s common stock outstanding.


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Glossary of Terms and Acronyms

When the following terms and acronyms appear in the text of this report, they have the meanings indicated below.
TermMeaning
AADAnnual aggregate deductible
AOCIAccumulated other comprehensive income (loss)
ASUAccounting Standards Update
BEATBase erosion anti-abuse tax
BoardBoard of Directors of ProAssurance Corporation
BOLIBusiness owned life insurance
CARES ActCoronavirus Aid, Relief and Economic Security Act
Council of Lloyd'sThe governing body for Lloyd's of London
CODMChief Operating Decision Maker
COVID-19Coronavirus Disease 2019
DDRDeath, disability and retirement
DPACDeferred policy acquisition costs
Eastern ReEastern Re, LTD, S.P.C.
EBUBEarned but unbilled premium
ECO/XPLExtra-contractual obligations/excess of policy limit claims
FALFunds at Lloyd's
FASBFinancial Accounting Standards Board
FHLBFederal Home Loan Bank
FHLMCFederal Home Loan Mortgage Corporation
FNMAFederal National Mortgage Association
GAAPGenerally accepted accounting principles in the United States of America
GNMAGovernment National Mortgage Association
HCPLHealthcare professional liability
IBNRIncurred but not reported
Inova ReInova Re, LTD, S.P.C.
IRSInternal Revenue Service
LIBORLondon Interbank Offered Rate
LLCLimited liability company
Lloyd'sLloyd's of London market
LPLimited partnership
Medical Technology LiabilityMedical technology and life sciences products liability
Mortgage LoansTwo ten-year mortgage loans collectively with an original borrowing amountamounts of approximately $40$18 million and approximately $23 million, each entered into by a subsidiary of ProAssurance
NAVNet asset value
NOLNet operating loss
NORCALNORCAL Insurance Company, formally known as NORCAL Mutual Insurance Company
NRSRONationally recognized statistical rating organization
NYSENew York Stock Exchange
OCIOther comprehensive income (loss)
PCAOBPublic Company Accounting Oversight Board
PDRPPM RRGPremium deficiency reservePreferred Physicians Medical Risk Retention Group, a Mutual Insurance Company
Revolving Credit AgreementProAssurance's $250 million revolving credit agreement
ROEReturn on equity
ROURight-of-use
SECSecurities and Exchange Commission
SPASpecial Purpose Arrangement
SPCSegregated portfolio cell
Specialty P&CSpecialty Property and Casualty
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TermMeaning
Syndicate 1729Lloyd's of London Syndicate 1729
Syndicate 6131Lloyd's of London Syndicate 6131, a Special Purpose Arrangement with Lloyd's of London Syndicate 1729
Syndicate Credit AgreementUnconditional revolving credit agreement with the Premium Trust Fund of Syndicate 1729
TCJATax Cuts and Jobs Act H.R.1 of 2017
U.K.United Kingdom of Great Britain and Northern Ireland
ULAEUnallocated loss adjustment expenseexpenses
VIEVariable interest entity
VOBAValue of business acquired

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Caution Regarding Forward-Looking Statements
Any statements in this Form 10-Q that are not historical facts are specifically identified as forward-looking statements. These statements are based upon our estimates and anticipation of future events and are subject to significant risks, assumptions and uncertainties that could cause actual results to vary materially from the expected results described in the forward-looking statements. Forward-looking statements are identified by words such as, but not limited to, "anticipate," "believe," "estimate," "expect," "hope," "hopeful," "intend," "likely," "may," "optimistic," "possible," "potential," "preliminary," "project," "should," "will" and other analogous expressions. There are numerous factors that could cause our actual results to differ materially from those in the forward-looking statements. Thus, sentences and phrases that we use to convey our view of future events and trends are expressly designated as forward-looking statements as are sections of this Form 10-Q that are identified as giving our outlook on future business.
Forward-looking statements relating to our business include among other things: statements concerning future liquidity and capital requirements, investment valuation and performance, return on equity, financial ratios, net income, premiums, losses and loss reserve, premium rates and retention of current business, competition and market conditions, the expansion of product lines, the development or acquisition of business in new geographical areas, the pricing or availability of acceptable reinsurance, actions by regulators and rating agencies, court actions, legislative actions, payment or performance of obligations under indebtedness, payment of dividends and other matters.
These forward-looking statements are subject to significant risks, assumptions and uncertainties, including, among other things, the following factors that could affect the actual outcome of future events:
lchanges in general economic conditions, including the impact of inflation or deflation and unemployment;
lour ability to maintain our dividend payments;
lregulatory, legislative and judicial actions or decisions that could affect our business plans or operations, including changes in interpretations of certain coverages as a result of COVID-19;
lthe enactment or repeal of tort reforms;
lformation or dissolution of state-sponsored insurance entities providing coverages now offered by ProAssurance which could remove or add sizable numbers of insureds from or to the private insurance market;
lchanges in the interest and tax rate environment, including the actions taken by the federal government and Federal Reserve in response to COVID-19;environment;
lresolution of uncertain tax matters and changes in tax laws, including the impact of the CARES Act;
lchanges in laws or government regulations regarding financial markets or market activity that may affect our business;
lchanges in the ability, or perception thereof, of the U.S. government to meet its obligations that may affect the U.S. economy and our business;
lperformance of financial markets affecting the fair value of our investments or making it difficult to determine the value of our investments;
lchanges in requirements or accounting policies and practices that may be adopted by our regulatory agencies, the FASB, the SEC, the PCAOB or the NYSE that may affect our business;
lchanges in laws or government regulations affecting the financial services industry, the property and casualty insurance industry or particular insurance lines underwritten by our subsidiaries or by Syndicates 1729 and 6131;Syndicate 1729;
lthe effect on our insureds, particularly the insurance needs of our insureds, and our loss costs, of changes in the healthcare delivery system and/or changes in the U.S. political climate that may affect healthcare policy or our business;
lconsolidation of our insureds into or under larger entities which may be insured by competitors, or may not have a risk profile that meets our underwriting criteria or which may not use external providers for insuring or otherwise managing substantial portions of their liability risk;
lthe effect of cyclical insurance industry trends on our underwriting, including demand and pricing in the
insurance and reinsurance markets in which we operate;
luncertainties inherent in the estimate of our loss and loss adjustment expense reserve and reinsurance recoverable;
lchanges in the availability, cost, quality or collectability of insurance/reinsurance;
lthe results of litigation, including pre- or post-trial motions, trials and/or appeals we undertake;
leffects on our claims costs from mass tort litigation that are different from that anticipated by us;
lallegations of bad faith which may arise from our handling of any particular claim, including failure to settle;
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lloss or consolidation of independent agents, agencies, brokers or brokerage firms;
lchanges in our organization, compensation and benefit plans;
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lchanges in the business or competitive environment may limit the effectiveness of our business strategy and impact our revenues;
lour ability to retain and recruit senior management and other qualified personnel;
lthe availability, integrity and security of our technology infrastructure orand that of our third-party providers, of technology infrastructure, including any susceptibility to cyber-attacks which might result in a loss of information, operating capability or operating capability;actual monetary loss;
lthe impact of a catastrophic event, including the recent COVID-19 pandemic, as it relates to our business and insurance operations, investment results, Lloyd's Syndicates and our insured risks;
lthe impact of the ongoing COVID-19 pandemic and related economic conditions on our premium volume, loss reserves, investment portfolio, asset valuations, business operations and workforce;
lthe impact of a catastrophic man-made event, such as acts of terrorism, acts of war and civil and political unrest;
lthe effects of terrorism-related insurance legislation and laws;
lguaranty funds and other state assessments;
lour ability to achieve continued growth through expansion into new markets or through acquisitions or business combinations;
lfailure to successfully integrate NORCAL to achieve expected results or synergies;
lchanges to the ratings assigned by rating agencies to our holding company or insurance subsidiaries, individually or as a group;
lprovisions in our charter documents, Delaware law and state insurance laws may impede attempts to replace or remove management or may impede a takeover;
lstate insurance restrictions may prohibit assets held by our insurance subsidiaries, including cash and investment securities, from being used for general corporate purposes;
ltaxing authorities can take exception to our tax positions and cause us to incur significant amounts of legal and accounting costs and, if our defense is not successful, additional tax costs, including interest and penalties; and
lexpected benefits from completed and proposed acquisitions may not be achieved or may be delayed longer than expected due to business disruption; loss of customers, employees or key agents; increased operating costs or inability to achieve cost savings and synergies; and assumption of greater than expected liabilities, among other reasons.
Additional risks, assumptions and uncertainties that could arise from our membership in the Lloyd's market and our participation in certain Lloyd's Syndicates include, but are not limited to, the following:
lmembers of Lloyd's are subject to levies by the Council of Lloyd's based on a percentage of the member's underwriting capacity, currently a maximum of 3%5%, but can be increased by Lloyd's;
lSyndicate results can be affected by decisions made by the Council of Lloyd's which the management of Syndicate 1729 and Syndicate 6131 havehas little ability to control, such as a decision to not approve the business plan of Syndicate 1729, or Syndicate 6131, or a decision to increase the capital required to continue operations, and by our obligation to pay levies to Lloyd's;
lLloyd's insurance and reinsurance relationships and distribution channels could be disrupted or Lloyd's trading licenses could be revoked, making it more difficult for a Lloyd's Syndicate to distribute and market its products;
lrating agencies could downgrade their ratings of Lloyd's as a whole; and
lSyndicate 1729 and Syndicate 6131 operations are dependent on a small, specialized management team, and the loss of their services could adversely affect the Syndicate’s business. The inability to identify, hire and retain other highly qualified personnel in the future could adversely affect the quality and profitability of Syndicate 1729’s or Syndicate 6131's business.
Our results may differ materially from those we expect and discuss in any forward-looking statements. The principal risk factors that may cause these differences are described in "Item 1A, Risk Factors" in our December 31, 20202021 report on Form 10-K and other documents we file with the SEC, such as our quarterly reports on Form 10-Q.
We caution readers not to place undue reliance on any such forward-looking statements, which are based upon conditions existing only as of the date made, and advise readers that these factors could affect our financial performance and could cause actual results for future periods to differ materially from any opinions or statements expressed with respect to future periods in any current statements. Except as required by law or regulations, we do not undertake and specifically decline any obligation to
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publicly release the result of any revisions that may be made to any forward-looking statements to reflect events or circumstances after the date of such statements or to reflect the occurrence of anticipated or unanticipated events.
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ProAssurance Corporation and Subsidiaries
Condensed Consolidated Balance Sheets (Unaudited)
(In thousands, except share data)
March 31,
2021
December 31,
2020
March 31,
2022
December 31,
2021
AssetsAssetsAssets
InvestmentsInvestmentsInvestments
Fixed maturities, available-for-sale, at fair value (amortized cost, $2,509,623 and $2,361,575, respectively; allowance for expected credit losses, NaN as of March 31, 2021 and $552 as of December 31, 2020)$2,563,273 $2,457,531 
Fixed maturities, trading, at fair value (cost, $44,819 and $47,907, respectively)45,151 48,456 
Equity investments, at fair value (cost, $74,083 and $113,709, respectively)77,537 120,101 
Fixed maturities, available-for-sale, at fair value (amortized cost, $3,861,574 and $3,814,847, respectively; allowance for expected credit losses, none as of each respective period end)Fixed maturities, available-for-sale, at fair value (amortized cost, $3,861,574 and $3,814,847, respectively; allowance for expected credit losses, none as of each respective period end)$3,700,821 $3,833,722 
Fixed maturities, trading, at fair value (cost, $49,986 and $43,914, respectively)Fixed maturities, trading, at fair value (cost, $49,986 and $43,914, respectively)49,421 43,670 
Equity investments, at fair value (cost, $211,962 and $211,356, respectively)Equity investments, at fair value (cost, $211,962 and $211,356, respectively)203,925 214,807 
Short-term investmentsShort-term investments280,993 337,813 Short-term investments233,345 216,987 
Business owned life insuranceBusiness owned life insurance66,932 67,847 Business owned life insurance80,879 81,767 
Investment in unconsolidated subsidiariesInvestment in unconsolidated subsidiaries299,360 310,529 Investment in unconsolidated subsidiaries321,402 335,576 
Other investments (at fair value, $69,251 and $44,116, respectively, otherwise at cost or amortized cost)71,621 47,068 
Other investments (at fair value, $100,678 and $98,611, respectively, otherwise at cost or amortized cost)Other investments (at fair value, $100,678 and $98,611, respectively, otherwise at cost or amortized cost)103,876 101,794 
Total InvestmentsTotal Investments3,404,867 3,389,345 Total Investments4,693,669 4,828,323 
Cash and cash equivalentsCash and cash equivalents214,835 215,782 Cash and cash equivalents72,101 143,602 
Premiums receivable, net210,560 201,395 
Premiums receivable (allowance for expected credit losses, $7,711 as of March 31, 2022 and $7,436 as of December 31, 2021)Premiums receivable (allowance for expected credit losses, $7,711 as of March 31, 2022 and $7,436 as of December 31, 2021)260,929 241,095 
Receivable from reinsurers on paid losses and loss adjustment expensesReceivable from reinsurers on paid losses and loss adjustment expenses10,451 14,370 Receivable from reinsurers on paid losses and loss adjustment expenses14,310 14,599 
Receivable from reinsurers on unpaid losses and loss adjustment expensesReceivable from reinsurers on unpaid losses and loss adjustment expenses393,420 385,087 Receivable from reinsurers on unpaid losses and loss adjustment expenses464,780 451,741 
Prepaid reinsurance premiumsPrepaid reinsurance premiums34,802 35,885 Prepaid reinsurance premiums32,198 24,571 
Deferred policy acquisition costsDeferred policy acquisition costs47,616 47,196 Deferred policy acquisition costs65,491 58,940 
Deferred tax asset, netDeferred tax asset, net67,699 57,105 Deferred tax asset, net157,214 117,613 
Real estate, netReal estate, net30,594 30,529 Real estate, net30,117 30,342 
Operating lease ROU assetsOperating lease ROU assets18,219 19,013 Operating lease ROU assets17,989 19,595 
Intangible assets, netIntangible assets, net64,173 65,720 Intangible assets, net71,717 73,336 
GoodwillGoodwill49,610 49,610 Goodwill49,610 49,610 
Other assetsOther assets127,692 143,766 Other assets128,473 138,110 
Total AssetsTotal Assets$4,674,538 $4,654,803 Total Assets$6,058,598 $6,191,477 
Liabilities and Shareholders' EquityLiabilities and Shareholders' EquityLiabilities and Shareholders' Equity
LiabilitiesLiabilitiesLiabilities
Policy liabilities and accrualsPolicy liabilities and accrualsPolicy liabilities and accruals
Reserve for losses and loss adjustment expensesReserve for losses and loss adjustment expenses$2,438,250 $2,417,179 Reserve for losses and loss adjustment expenses$3,603,246 $3,579,940 
Unearned premiumsUnearned premiums375,246 361,547 Unearned premiums486,693 433,961 
Reinsurance premiums payableReinsurance premiums payable31,039 39,998 Reinsurance premiums payable24,891 22,627 
Total Policy Liabilities2,844,535 2,818,725 
Total Policy Liabilities and AccrualsTotal Policy Liabilities and Accruals4,114,830 4,036,528 
Operating lease liabilitiesOperating lease liabilities19,168 20,116 Operating lease liabilities19,190 20,844 
Other liabilitiesOther liabilities205,097 182,039 Other liabilities217,280 280,732 
Debt less unamortized debt issuance costsDebt less unamortized debt issuance costs284,422 284,713 Debt less unamortized debt issuance costs425,530 424,986 
Total LiabilitiesTotal Liabilities3,353,222 3,305,593 Total Liabilities4,776,830 4,763,090 
Shareholders' EquityShareholders' EquityShareholders' Equity
Common shares (par value $0.01 per share, 100,000,000 shares authorized, 63,277,721 and 63,217,708 shares issued, respectively)633 632 
Common shares (par value $0.01 per share, 100,000,000 shares authorized, 63,371,520 and 63,308,741 shares issued, respectively)Common shares (par value $0.01 per share, 100,000,000 shares authorized, 63,371,520 and 63,308,741 shares issued, respectively)634 633 
Additional paid-in capitalAdditional paid-in capital388,924 388,150 Additional paid-in capital393,433 392,941 
Accumulated other comprehensive income (loss) (net of deferred tax expense (benefit) of $11,065 and $19,386, respectively)41,522 75,227 
Accumulated other comprehensive income (loss) (net of deferred tax expense (benefit) of ($33,755) and $4,423, respectively)Accumulated other comprehensive income (loss) (net of deferred tax expense (benefit) of ($33,755) and $4,423, respectively)(124,566)16,284 
Retained earningsRetained earnings1,306,199 1,301,163 Retained earnings1,428,229 1,434,491 
Treasury shares, at cost (9,325,180 shares as of each respective period end)Treasury shares, at cost (9,325,180 shares as of each respective period end)(415,962)(415,962)Treasury shares, at cost (9,325,180 shares as of each respective period end)(415,962)(415,962)
Total Shareholders' EquityTotal Shareholders' Equity1,321,316 1,349,210 Total Shareholders' Equity1,281,768 1,428,387 
Total Liabilities and Shareholders' EquityTotal Liabilities and Shareholders' Equity$4,674,538 $4,654,803 Total Liabilities and Shareholders' Equity$6,058,598 $6,191,477 
See accompanying notes.
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ProAssurance Corporation and Subsidiaries
Condensed Consolidated Statements of Changes in Capital (Unaudited)
(In thousands)

ProAssurance Shareholders' Equity
Common StockAdditional Paid-in CapitalAccumulated Other Comprehensive Income (Loss)Retained EarningsTreasury StockTotal
Balance at December 31, 2020$632 $388,150 $75,227 $1,301,163 $(415,962)$1,349,210 
Common shares issued for compensation and effect of shares reissued to stock purchase plan 8    8 
Share-based compensation 1,024    1,024 
Net effect of restricted and performance shares issued1 (258)   (257)
Dividends to shareholders   (2,699) (2,699)
Other comprehensive income (loss)  (33,705)  (33,705)
Net income (loss)   7,735  7,735 
Balance at March 31, 2021$633 $388,924 $41,522 $1,306,199 $(415,962)$1,321,316 
ProAssurance Shareholders' Equity
Common StockAdditional Paid-in CapitalAccumulated Other Comprehensive Income (Loss)Retained EarningsTreasury StockTotal
Balance at December 31, 2021$633 $392,941 $16,284 $1,434,491 $(415,962)$1,428,387 
Common shares issued for compensation and effect of shares reissued to stock purchase plan 7    7 
Share-based compensation 1,342    1,342 
Net effect of restricted and performance shares issued1 (857)   (856)
Dividends to shareholders   (2,702) (2,702)
Other comprehensive income (loss)  (140,850)  (140,850)
Net income (loss)   (3,560) (3,560)
Balance at March 31, 2022$634 $393,433 $(124,566)$1,428,229 $(415,962)$1,281,768 

Common StockAdditional Paid-in CapitalAccumulated Other Comprehensive Income (Loss)Retained EarningsTreasury StockTotalCommon StockAdditional Paid-in CapitalAccumulated Other Comprehensive Income (Loss)Retained EarningsTreasury StockTotal
Balance at December 31, 2019$631 $384,551 $36,955 $1,505,738 $(415,962)$1,511,913 
Cumulative-effect adjustment-
ASU 2016-13 adoption
— — — (4,076)— (4,076)
Balance at December 31, 2020Balance at December 31, 2020$632 $388,150 $75,227 $1,301,163 $(415,962)$1,349,210 
Common shares issued for compensation and effect of shares reissued to stock purchase planCommon shares issued for compensation and effect of shares reissued to stock purchase plan— 33 — — — 33 Common shares issued for compensation and effect of shares reissued to stock purchase plan— — — — 
Share-based compensationShare-based compensation— 1,017 — — — 1,017 Share-based compensation— 1,024 — — — 1,024 
Net effect of restricted and performance shares issuedNet effect of restricted and performance shares issued(869)— — — (868)Net effect of restricted and performance shares issued(258)— — — (257)
Dividends to shareholdersDividends to shareholders— — — (16,691)— (16,691)Dividends to shareholders— — — (2,699)— (2,699)
Other comprehensive income (loss)Other comprehensive income (loss)— — (41,865)— — (41,865)Other comprehensive income (loss)— — (33,705)— — (33,705)
Net income (loss)Net income (loss)— — — (21,954)— (21,954)Net income (loss)— — — 7,735 — 7,735 
Balance at March 31, 2020$632 $384,732 $(4,910)$1,463,017 $(415,962)$1,427,509 
Balance at March 31, 2021Balance at March 31, 2021$633 $388,924 $41,522 $1,306,199 $(415,962)$1,321,316 
See accompanying notes.
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ProAssurance Corporation and Subsidiaries
Condensed Consolidated Statements of Income and Comprehensive Income (Unaudited)
(In thousands, except per share data)
Three Months Ended March 31Three Months Ended March 31
20212020 20222021
RevenuesRevenuesRevenues
Net premiums earnedNet premiums earned$187,358 $203,855 Net premiums earned$265,711 $187,358 
Net investment incomeNet investment income15,017 20,830 Net investment income20,443 15,017 
Equity in earnings (loss) of unconsolidated subsidiariesEquity in earnings (loss) of unconsolidated subsidiaries6,788 (1,562)Equity in earnings (loss) of unconsolidated subsidiaries7,620 6,788 
Net realized investment gains (losses):
Impairment losses0 (1,817)
Portion of impairment losses recognized in other comprehensive income (loss) before taxes0 654 
Net impairment losses recognized in earnings0 (1,163)
Other net realized investment gains (losses)8,849 (27,510)
Total net realized investment gains (losses)8,849 (28,673)
Net investment gains (losses):Net investment gains (losses):
Other net investment gains (losses)Other net investment gains (losses)(13,506)8,849 
Total net investment gains (losses)Total net investment gains (losses)(13,506)8,849 
Other incomeOther income2,005 2,251 Other income2,804 2,005 
Total revenuesTotal revenues220,017 196,701 Total revenues283,072 220,017 
ExpensesExpensesExpenses
Net losses and loss adjustment expensesNet losses and loss adjustment expenses149,785 164,832 Net losses and loss adjustment expenses209,423 149,785 
Underwriting, policy acquisition and operating expenses:Underwriting, policy acquisition and operating expenses:Underwriting, policy acquisition and operating expenses:
Operating expenseOperating expense31,522 34,773 Operating expense38,810 31,522 
DPAC amortizationDPAC amortization24,929 27,283 DPAC amortization32,966 24,929 
SPC U.S. federal income tax expenseSPC U.S. federal income tax expense356 222 SPC U.S. federal income tax expense642 356 
SPC dividend expense (income)SPC dividend expense (income)1,742 (508)SPC dividend expense (income)2,367 1,742 
Interest expenseInterest expense3,212 4,129 Interest expense4,441 3,212 
Total expensesTotal expenses211,546 230,731 Total expenses288,649 211,546 
Income (loss) before income taxesIncome (loss) before income taxes8,471 (34,030)Income (loss) before income taxes(5,577)8,471 
Provision for income taxes:Provision for income taxes:Provision for income taxes:
Current expense (benefit)Current expense (benefit)3,008 (1,852)Current expense (benefit)(607)3,008 
Deferred expense (benefit)Deferred expense (benefit)(2,272)(10,224)Deferred expense (benefit)(1,410)(2,272)
Total income tax expense (benefit)Total income tax expense (benefit)736 (12,076)Total income tax expense (benefit)(2,017)736 
Net income (loss)Net income (loss)7,735 (21,954)Net income (loss)(3,560)7,735 
Other comprehensive income (loss), after tax, net of reclassification adjustmentsOther comprehensive income (loss), after tax, net of reclassification adjustments(33,705)(41,865)Other comprehensive income (loss), after tax, net of reclassification adjustments(140,850)(33,705)
Comprehensive income (loss)Comprehensive income (loss)$(25,970)$(63,819)Comprehensive income (loss)$(144,410)$(25,970)
Earnings (loss) per share
Earnings (loss) per share:Earnings (loss) per share:
BasicBasic$0.14 $(0.41)Basic$(0.07)$0.14 
DilutedDiluted$0.14 $(0.41)Diluted$(0.07)$0.14 
Weighted average number of common shares outstanding:Weighted average number of common shares outstanding:Weighted average number of common shares outstanding:
BasicBasic53,918 53,808 Basic54,012 53,918 
DilutedDiluted53,998 53,885 Diluted54,143 53,998 
Cash dividends declared per common shareCash dividends declared per common share$0.05 $0.31 Cash dividends declared per common share$0.05 $0.05 
See accompanying notes.
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ProAssurance Corporation and Subsidiaries
Condensed Consolidated Statements of Cash Flows (Unaudited)
(In thousands)
Three Months Ended March 31
 20212020
Operating Activities
Net income (loss)$7,735 $(21,954)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization, net of accretion6,722 4,734 
(Increase) decrease in cash surrender value of BOLI915 (457)
Net realized investment (gains) losses(8,849)28,673 
Share-based compensation1,031 1,011 
Deferred income tax expense (benefit)(2,272)(10,224)
Policy acquisition costs, net of amortization (net deferral)(420)(599)
Equity in (earnings) loss of unconsolidated subsidiaries(6,788)1,562 
Distributed earnings from unconsolidated subsidiaries5,658 1,585 
Other(661)(703)
Other changes in assets and liabilities:
Premiums receivable(9,165)(22,442)
Reinsurance related assets and liabilities(12,290)(4,623)
Other assets13,151 14,268 
Reserve for losses and loss adjustment expenses21,071 (15,478)
Unearned premiums13,699 30,202 
Other liabilities(837)(17,604)
Net cash provided (used) by operating activities28,700 (12,049)
Investing Activities
Purchases of:
Fixed maturities, available-for-sale(342,197)(227,503)
Equity investments(38,232)(23,136)
Other investments(33,252)(6,065)
Investment in unconsolidated subsidiaries(5,319)(17,180)
Proceeds from sales or maturities of:
Fixed maturities, available-for-sale195,266 180,698 
Equity investments82,048 157,652 
Other investments12,026 6,026 
Net sales or (purchases) of fixed maturities, trading3,163 (407)
Return of invested capital from unconsolidated subsidiaries17,618 1,481 
Net sales or maturities (purchases) of short-term investments56,836 (7,441)
Unsettled security transactions, net change27,025 12,656 
Purchases of capital assets(1,243)(2,750)
Other0 (2,206)
Net cash provided (used) by investing activities(26,261)71,825 
Continued on the following page.
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Three Months Ended March 31Three Months Ended March 31
20212020 20222021
Continued from the previous page.
Operating ActivitiesOperating Activities
Net income (loss)Net income (loss)$(3,560)$7,735 
Adjustments to reconcile net income (loss) to net cash provided by operating activities:Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization, net of accretionDepreciation and amortization, net of accretion10,350 6,722 
(Increase) decrease in cash surrender value of BOLI(Increase) decrease in cash surrender value of BOLI888 915 
Net investment (gains) lossesNet investment (gains) losses13,506 (8,849)
Share-based compensationShare-based compensation1,343 1,031 
Deferred income tax expense (benefit)Deferred income tax expense (benefit)(1,410)(2,272)
Policy acquisition costs, net of amortization (net deferral)Policy acquisition costs, net of amortization (net deferral)(6,551)(420)
Equity in (earnings) loss of unconsolidated subsidiariesEquity in (earnings) loss of unconsolidated subsidiaries(7,620)(6,788)
Distributed earnings from unconsolidated subsidiariesDistributed earnings from unconsolidated subsidiaries14,176 5,658 
Other, netOther, net(1,056)(661)
Change in:Change in:
Premiums receivablePremiums receivable(19,834)(9,165)
Reinsurance related assets and liabilitiesReinsurance related assets and liabilities(18,113)(12,290)
Other assetsOther assets12,367 13,151 
Reserve for losses and loss adjustment expensesReserve for losses and loss adjustment expenses23,306 21,071 
Unearned premiumsUnearned premiums52,732 13,699 
Other liabilitiesOther liabilities(56,259)(837)
Net cash provided (used) by operating activitiesNet cash provided (used) by operating activities14,265 28,700 
Investing ActivitiesInvesting Activities
Purchases of:Purchases of:
Fixed maturities, available-for-saleFixed maturities, available-for-sale(231,557)(342,197)
Equity investmentsEquity investments(28,129)(38,232)
Other investmentsOther investments(12,757)(33,252)
Investment in unconsolidated subsidiariesInvestment in unconsolidated subsidiaries(9,685)(5,319)
Proceeds from sales or maturities of:Proceeds from sales or maturities of:
Fixed maturities, available-for-saleFixed maturities, available-for-sale176,820 195,266 
Equity investmentsEquity investments27,305 82,048 
Other investmentsOther investments9,205 12,026 
Net sales or (purchases) of fixed maturities, tradingNet sales or (purchases) of fixed maturities, trading(6,119)3,163 
Return of invested capital from unconsolidated subsidiariesReturn of invested capital from unconsolidated subsidiaries17,302 17,618 
Net sales or maturities (purchases) of short-term investmentsNet sales or maturities (purchases) of short-term investments(16,632)56,836 
Unsettled security transactions, net changeUnsettled security transactions, net change(2,076)27,025 
Purchases of capital assetsPurchases of capital assets(811)(1,243)
Net cash provided (used) by investing activitiesNet cash provided (used) by investing activities(77,134)(26,261)
Financing ActivitiesFinancing ActivitiesFinancing Activities
Repayments of Mortgage LoansRepayments of Mortgage Loans(390)(376)Repayments of Mortgage Loans (390)
Dividends to shareholdersDividends to shareholders(2,686)(16,714)Dividends to shareholders(2,691)(2,686)
Capital contribution received from (return of capital to) external segregated portfolio cell participantsCapital contribution received from (return of capital to) external segregated portfolio cell participants(53)204 Capital contribution received from (return of capital to) external segregated portfolio cell participants(5,085)(53)
OtherOther(257)(1,090)Other(856)(257)
Net cash provided (used) by financing activitiesNet cash provided (used) by financing activities(3,386)(17,976)Net cash provided (used) by financing activities(8,632)(3,386)
Increase (decrease) in cash and cash equivalentsIncrease (decrease) in cash and cash equivalents(947)41,800 Increase (decrease) in cash and cash equivalents(71,501)(947)
Cash and cash equivalents at beginning of periodCash and cash equivalents at beginning of period215,782 175,369 Cash and cash equivalents at beginning of period143,602 215,782 
Cash and cash equivalents at end of periodCash and cash equivalents at end of period$214,835 $217,169 Cash and cash equivalents at end of period$72,101 $214,835 
Significant Non-Cash TransactionsSignificant Non-Cash TransactionsSignificant Non-Cash Transactions
Dividends declared and not yet paidDividends declared and not yet paid$2,699 $16,691 Dividends declared and not yet paid$2,702 $2,699 
See accompanying notes.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022

1. Basis of Presentation
The accompanying unaudited Condensed Consolidated Financial Statements include the accounts of ProAssurance Corporation, and its wholly owned subsidiaries and VIEs in which ProAssurance is the primary beneficiary (ProAssurance, PRA or the Company). See Note 9 for more information on ProAssurance's VIE interests. The financial statements have been prepared in accordance with GAAP for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation, consisting of normal recurring adjustments, have been included. ProAssurance’s results for the three months ended March 31, 20212022 are not necessarily indicative of the results that may be expected for the year ending December 31, 2021.2022. The accompanying Condensed Consolidated Financial Statements should be read in conjunction with the Consolidated Financial Statements and Notes contained in ProAssurance’s December 31, 20202021 report on Form 10-K. In connection with its preparation of the Condensed Consolidated Financial Statements, ProAssurance evaluated events that occurred subsequent to March 31, 2021 for recognition or disclosure in its financial statements and notes to financial statements. Please see Note 15 for additional information.
ProAssurance operates in 5 reportable segments as follows: Specialty P&C, Workers' Compensation Insurance, Segregated Portfolio Cell Reinsurance, Lloyd's Syndicates and Corporate. For more information on the Company's segment reporting, including the nature of products and services provided and financial information by segment, refer to Note 14.11.
Certain insignificant priorDuring the first quarter of 2022, ProAssurance revised its estimate of ULAE as a result of substantially integrating NORCAL into the Specialty P&C segment operations. ULAE are costs that cannot be attributed to processing a specific claim and are allocated to net losses and loss adjustment expenses on the Condensed Consolidated Statement of Income and Comprehensive Income. ProAssurance accounted for this change prospectively as a change in accounting estimate. Changes in accounting estimate are reflected prospectively beginning in the period the change in estimate occurs. The change in the Company's estimate of ULAE resulted in an increase of $7.3 million to underwriting, policy acquisition and operating expenses with an offsetting decrease of $7.3 million to net losses and loss adjustment expenses when compared to amounts that would have been reclassified to conform toestimated as ULAE under the current period presentation.Company's previous methodology. There was no impact on total expenses or net income (loss) in the Company's Condensed Consolidated Statement of Income and Comprehensive Income for the three months ended March 31, 2022 as a result of this change in the estimate.
Accounting Policies
The preparation of financial statements in conformity with GAAP requires the Company to make estimates and assumptions that affect the reported amounts of assets and liabilities, revenues and expenses, and disclosures related to these amounts at the date of the financial statements. The Company evaluates these estimates and assumptions on an ongoing basis based on current and historical developments, market conditions, industry trends and other information that the Company believes to be reasonable under the circumstances, including the potential impacts of the COVID-19 pandemic (see "Item 1A, Risk Factors" in ProAssurance's December 31, 20202021 report on Form 10-K for additional information). The Company can make no assurance that actual results will conform to its estimates and assumptions; reported results of operations may be materially affected by changes in these estimates and assumptions.
The significant accounting policies followed by ProAssurance in making estimates that materially affect financial reporting are summarized in Note 1 of the Notes to Consolidated Financial Statements in ProAssurance’s December 31, 20202021 report on Form 10-K.
Accounting Changes Adopted
ClarifyingProAssurance has not adopted any accounting changes during the Interactions between Investments - Equity Securities, Investments - Equity Method and Joint Ventures, and Derivatives and Hedging (ASU 2020-01)
Effective for fiscal years beginning after December 15, 2020 and interim periods within those fiscal years, the FASB amended guidancethree months ended March 31, 2022 that clarifies the accounting for the transition into and out of the equity method and measuring certain purchased options and forward contracts to acquire investments. ProAssurance adopted the guidance beginning January 1, 2021, and adoption had noa material effect on ProAssurance'sits results of operations, financial position or cash flows.
Accounting Changes Not Yet Adopted
ProAssurance is not aware of any accounting changes not yet adopted as of March 31, 20212022 that could have a material impact on its results of operations, financial position or cash flows.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2021
Credit Losses
ProAssurance's premiums receivable and reinsurance receivables are exposed to credit losses but to-date have not experienced any significant amount of credit losses. See Note 1 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 2020 report on Form 10-K for further information on how the Company estimates and measures expected credit losses on its premiums receivable and reinsurance receivables. ProAssurance's available-for-sale fixed maturity investments are also exposed to credit losses. See Note 3 for information on ProAssurance's allowance for expected credit losses on it's available-for-sale fixed maturities.
ProAssurance’s premiums receivable on its Condensed Consolidated Balance Sheets as of March 31, 2021 and December 31, 2020 is reported net of the related allowance for expected credit losses of $6.1 million in each period. The following tables present a roll forward of the allowance for expected credit losses related to the Company's premiums receivable for the three months ended March 31, 2021 and 2020.
(In thousands)Premiums Receivable, NetAllowance for Expected Credit Losses
Balance, December 31, 2020$201,395 $6,131 
Provision for expected credit losses105 
Write offs charged against the allowance(232)
Recoveries of amounts previously written off78 
Balance, March 31, 2021$210,560 $6,082 
(In thousands)Premiums Receivable, NetAllowance for Expected Credit Losses
Balance, December 31, 2019$249,540 $1,590 
Cumulative-effect adjustment, before tax*5,160 
Provision for expected credit losses88 
Write offs charged against the allowance(689)
Recoveries of amounts previously written off48 
Balance, March 31, 2020$266,822 $6,197 
*Due to the adoption of ASU 2016-13, ProAssurance recorded a cumulative-effect adjustment to beginning retained earnings as of January 1, 2020 to increase its consolidated allowance for expected credit losses related to its premiums receivable. See Note 1 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 2020 report on Form 10-K.
ProAssurance’s expected credit losses associated with its reinsurance receivables (related to both paid and unpaid losses) were nominal in amount as of March 31, 2021 and December 31, 2020. ProAssurance has other financial assets and off-balance-sheet commitments that are exposed to credit losses; however, expected credit losses associated with these assets and commitments were nominal in amount as of March 31, 2021 and December 31, 2020.
Other Liabilities
Other liabilities consisted of the following:

(In thousands)March 31, 2021December 31, 2020
SPC dividends payable$69,732 $68,865 
Unpaid shareholder dividends2,699 2,694 
All other132,666 110,480 
Total other liabilities$205,097 $182,039 
SPC dividends payable represents the undistributed equity contractually payable to the external cell participants of SPCs operated by ProAssurance's Cayman Islands subsidiaries, Inova Re and Eastern Re.
Unpaid shareholder dividends represent common stock dividends declared by ProAssurance's Board that had not yet been paid as of March 31, 2021.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
2. Fair Value Measurement
Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. A three level hierarchy has been established for valuing assets and liabilities based on how transparent (observable) the inputs are that are used to determine fair value, with the inputs considered most observable categorized as Level 1 and those that are the least observable categorized as Level 3. Hierarchy levels are defined as follows:
 Level 1:quoted (unadjusted) market prices in active markets for identical assets and liabilities. For ProAssurance, Level 1 inputs are generally quotes for securities actively traded in exchange or over-the-counter markets.
 Level 2:market data obtained from sources independent of the reporting entity (observable inputs). For ProAssurance, Level 2 inputs generally include quoted prices in markets that are not active, quoted prices for similar assets or liabilities, and results from pricing models that use observable inputs such as interest rates and yield curves that are generally available at commonly quoted intervals.
 Level 3:the reporting entity’s own assumptions about market participant assumptions based on the best information available in the circumstances (non-observable inputs). For ProAssurance, Level 3 inputs are used in situations where little or no Level 1 or 2 inputs are available or are inappropriate given the particular circumstances. Level 3 inputs include results from pricing models for which some or all of the inputs are not observable, discounted cash flow methodologies, single non-binding broker quotes and adjustments to externally quoted prices that are based on management judgment or estimation.
Fair values of assets measured at fair value on a recurring basis as of March 31, 20212022 and December 31, 20202021 are shown in the following tables. Where applicable, the tables also indicate the fair value hierarchy of the valuation techniques utilized to determine those fair values. For some assets, the inputs used to measure fair value may fall into different levels of the fair value hierarchy. When this is the case, the asset is categorized based on the level of the most significant input to the fair value measurement. Assessments of the significance of a particular input to the fair value measurement require judgment and consideration of factors specific to the assets being valued. For more information on the valuation methodologies used regarding securities in the Level 2 and Level 3 categories, see Note 3 of the Notes to Consolidated Financial Statements in ProAssurance’s December 31, 2021 report on Form 10-K.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
March 31, 2021March 31, 2022
Fair Value Measurements UsingTotalFair Value Measurements UsingTotal
(In thousands)(In thousands)Level 1Level 2Level 3Fair Value(In thousands)Level 1Level 2Level 3Fair Value
Assets:Assets:Assets:
Fixed maturities, available-for-saleFixed maturities, available-for-saleFixed maturities, available-for-sale
U.S. Treasury obligationsU.S. Treasury obligations$0 $102,877 $0 $102,877 U.S. Treasury obligations$ $225,676 $ $225,676 
U.S. Government-sponsored enterprise obligationsU.S. Government-sponsored enterprise obligations0 11,944 0 11,944 U.S. Government-sponsored enterprise obligations 16,733  16,733 
State and municipal bondsState and municipal bonds0 322,465 0 322,465 State and municipal bonds 492,291  492,291 
Corporate debt, multiple observable inputsCorporate debt, multiple observable inputs0 1,421,097 0 1,421,097 Corporate debt, multiple observable inputs 1,816,931  1,816,931 
Corporate debt, limited observable inputsCorporate debt, limited observable inputs0 0 7,769 7,769 Corporate debt, limited observable inputs  53,325 53,325 
Residential mortgage-backed securitiesResidential mortgage-backed securities0 270,059 1,489 271,548 Residential mortgage-backed securities 417,276 572 417,848 
Agency commercial mortgage-backed securitiesAgency commercial mortgage-backed securities0 13,718 0 13,718 Agency commercial mortgage-backed securities 12,847  12,847 
Other commercial mortgage-backed securitiesOther commercial mortgage-backed securities0 121,319 0 121,319 Other commercial mortgage-backed securities 222,800 582 223,382 
Other asset-backed securitiesOther asset-backed securities0 282,712 7,824 290,536 Other asset-backed securities 433,639 8,149 441,788 
Fixed maturities, tradingFixed maturities, trading0 45,151 0 45,151 Fixed maturities, trading 49,421  49,421 
Equity investmentsEquity investmentsEquity investments
FinancialFinancial12,074 2,289  14,363 
Utilities/EnergyUtilities/Energy1,099   1,099 
IndustrialIndustrial  2,500 2,500 
Bond fundsBond funds60,264 0 0 60,264 Bond funds170,338   170,338 
All otherAll other17,273 0 0 17,273 All other15,625   15,625 
Short-term investmentsShort-term investments259,075 21,918 0 280,993 Short-term investments210,122 23,223  233,345 
Other investmentsOther investments29 67,070 2,152 69,251 Other investments1,789 95,449 3,440 100,678 
Other assetsOther assets0 836 0 836 Other assets 1,663  1,663 
Total assets categorized within the fair value hierarchyTotal assets categorized within the fair value hierarchy$336,641 $2,681,166 $19,234 3,037,041 Total assets categorized within the fair value hierarchy$411,047 $3,810,238 $68,568 4,289,853 
Assets carried at NAV, which approximates fair value and which are not categorized within the fair value hierarchy, reported as a part of:Assets carried at NAV, which approximates fair value and which are not categorized within the fair value hierarchy, reported as a part of:Assets carried at NAV, which approximates fair value and which are not categorized within the fair value hierarchy, reported as a part of:
Investment in unconsolidated subsidiariesInvestment in unconsolidated subsidiaries226,898 Investment in unconsolidated subsidiaries267,125 
Total assets at fair valueTotal assets at fair value$3,263,939 Total assets at fair value$4,556,978 
Liabilities:Liabilities:
Other liabilitiesOther liabilities$ $ $24,000 $24,000 
Total liabilities categorized within the fair value hierarchyTotal liabilities categorized within the fair value hierarchy$ $ $24,000 $24,000 
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
December 31, 2020December 31, 2021
Fair Value Measurements UsingTotalFair Value Measurements UsingTotal
(In thousands)(In thousands)Level 1Level 2Level 3Fair Value(In thousands)Level 1Level 2Level 3Fair Value
Assets:Assets:Assets:
Fixed maturities, available-for-saleFixed maturities, available-for-saleFixed maturities, available-for-sale
U.S. Treasury obligationsU.S. Treasury obligations$$107,059 $$107,059 U.S. Treasury obligations$— $238,507 $— $238,507 
U.S. Government-sponsored enterprise obligationsU.S. Government-sponsored enterprise obligations12,261 12,261 U.S. Government-sponsored enterprise obligations— 20,234 — 20,234 
State and municipal bondsState and municipal bonds332,920 332,920 State and municipal bonds— 519,196 — 519,196 
Corporate debt, multiple observable inputsCorporate debt, multiple observable inputs1,326,077 1,326,077 Corporate debt, multiple observable inputs— 1,851,427 — 1,851,427 
Corporate debt, limited observable inputsCorporate debt, limited observable inputs3,265 3,265 Corporate debt, limited observable inputs— — 47,129 47,129 
Residential mortgage-backed securitiesResidential mortgage-backed securities274,509 2,032 276,541 Residential mortgage-backed securities— 453,644 297 453,941 
Agency commercial mortgage-backed securitiesAgency commercial mortgage-backed securities13,310 13,310 Agency commercial mortgage-backed securities— 14,141 — 14,141 
Other commercial mortgage-backed securitiesOther commercial mortgage-backed securities113,092 113,092 Other commercial mortgage-backed securities— 231,483 — 231,483 
Other asset-backed securitiesOther asset-backed securities266,345 6,661 273,006 Other asset-backed securities— 451,459 6,205 457,664 
Fixed maturities, tradingFixed maturities, trading48,456 48,456 Fixed maturities, trading— 43,670 — 43,670 
Equity investmentsEquity investmentsEquity investments
FinancialFinancial13,810 13,810 Financial6,615 855 — 7,470 
Utilities/Energy564 564 
Consumer oriented1,262 1,262 
IndustrialIndustrial2,240 2,240 Industrial— — 2,500 2,500 
Bond fundsBond funds69,475 69,475 Bond funds187,059 — — 187,059 
All otherAll other20,202 20,202 All other17,778 — — 17,778 
Short-term investmentsShort-term investments307,695 30,118 337,813 Short-term investments174,944 42,043 — 216,987 
Other investmentsOther investments1,509 42,607 44,116 Other investments1,889 95,288 1,434 98,611 
Other assetsOther assets329 329 Other assets— 649 — 649 
Total assets categorized within the fair value hierarchyTotal assets categorized within the fair value hierarchy$416,757 $2,567,083 $11,958 2,995,798 Total assets categorized within the fair value hierarchy$388,285 $3,962,596 $57,565 4,408,446 
Assets carried at NAV, which approximates fair value and which are not categorized within the fair value hierarchy, reported as a part of:Assets carried at NAV, which approximates fair value and which are not categorized within the fair value hierarchy, reported as a part of:Assets carried at NAV, which approximates fair value and which are not categorized within the fair value hierarchy, reported as a part of:
Equity investments12,548 
Investment in unconsolidated subsidiariesInvestment in unconsolidated subsidiaries233,711 Investment in unconsolidated subsidiaries270,816 
Total assets at fair valueTotal assets at fair value$3,242,057 Total assets at fair value$4,679,262 
Liabilities:Liabilities:
Other liabilitiesOther liabilities$— $— $24,000 $24,000 
Total liabilities categorized within the fair value hierarchyTotal liabilities categorized within the fair value hierarchy$— $— $24,000 $24,000 
The fair values for securities included in the Level 2 category, with the few exceptions described below, were developed by one of several third party, nationally recognized pricing services, including services that price only certain types of securities. Each service uses complex methodologies to determine values for securities and subject the values they develop to quality control reviews. Management selected a primary source for each type of security in the portfolio and reviewed the values provided for reasonableness by comparing data to alternate pricing services and to available market and trade data. Values that appeared inconsistent were further reviewed for appropriateness. Any value that did not appear reasonable was discussed with the service that provided the value and adjusted, if necessary. There were no material changes to the values supplied by the pricing services as of March 31, 2021 and December 31, 2020.

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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
Level 2 Valuations
Below is a summary description of the valuation methodologies primarily used by the pricing services for securities in the Level 2 category, by security type:
U.S. Treasury obligations were valued based on quoted prices for identical assets, or, in markets that are not active, quotes for similar assets, taking into consideration adjustments for variations in contractual cash flows and yields to maturity.
U.S. Government-sponsored enterprise obligations were valued using pricing models that consider current and historical market data, normal trading conventions, credit ratings and the particular structure and characteristics of the security being valued, such as yield to maturity, redemption options, and contractual cash flows. Adjustments to model inputs or model results were included in the valuation process when necessary to reflect recent regulatory, government or corporate actions or significant economic, industry or geographic events affecting the security’s fair value.
State and municipal bonds were valued using a series of matrices that considered credit ratings, the structure of the security, the sector in which the security falls, yields and contractual cash flows. Valuations were further adjusted, when necessary, to reflect the expected effect on fair value of recent significant economic or geographic events or ratings changes.
Corporate debt, multiple observable inputs consisted primarily of corporate bonds, but also included a small number of bank loans. The methodology used to value Level 2 corporate bonds was the same as the methodology previously described for U.S. Government-sponsored enterprise obligations. Bank loans were valued based on an average of broker quotes for the loans in question, if available. If quotes were not available, the loans were valued based on quoted prices for comparable loans or, if the loan was newly issued, by comparison to similar seasoned issues. Broker quotes were compared to actual trade prices to permit assessment of the reliability of the quotes; unreliable quotes were not considered in quoted averages.
Residential and commercial mortgage-backed securities were valued using a pricing matrix which considers the issuer type, coupon rate and longest cash flows outstanding. The matrix used was based on the most recently available market information. Agency and non-agency collateralized mortgage obligations were both valued using models that consider the structure of the security, current and historical information regarding prepayment speeds, ratings and ratings updates, and current and historical interest rate and interest rate spread data.
Other asset-backed securities were valued using models that consider the structure of the security, monthly payment information, current and historical information regarding prepayment speeds, ratings and ratings updates, and current and historical interest rate and interest rate spread data. Spreads and prepayment speeds consider collateral type.
Fixed maturities, trading, are held by the Lloyd's Syndicates segment and include U.S. Treasury obligations, corporate debt with multiple observable inputs and other asset-backed securities. These securities were valued using the respective valuation methodologies discussed above for each security type.
Short-term investments were securities maturing within one year, carried at fair value which approximated the cost of the securities due to their short-term nature.
Other investments consisted primarily of convertible bonds valued using a pricing model that incorporated selected dealer quotes as well as current market data regarding equity prices and risk free rates. If dealer quotes were unavailable for the security being valued, quotes for securities with similar terms and credit status were used in the pricing model. Dealer quotes selected for use were those considered most accurate based on parameters such as underwriter status and historical reliability.
Other assets consisted of an interest rate cap derivative instrument, valued using a model which considers the volatilities from other instruments with similar maturities, strike prices, durations and forward yield curves. Under the terms of the interest rate cap agreement, ProAssurance paid a premium of $2 million for the right to receive cash payments based upon a notional amount of $35 million if and when the three-month LIBOR rises above 2.35%. The Company's variable-rate Mortgage Loans bear an interest rate of three-month LIBOR plus 1.325%.
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Table of Contents
ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2021
Level 3 Valuations
Below isOther than as described below, see Note 3 of the Notes to Consolidated Financial Statements in ProAssurance’s December 31, 2021 report on Form 10-K for a summary description of the valuation methodologies used as well as quantitative information regarding securities in the Level 3 category, by security type:type.
Level 3 Valuation Methodologies
Corporate debt, limited observable inputs consisted of corporate bonds valued using dealer quotes for similar securities or discounted cash flow models using yields currently available for similar securities. Similar securities are defined as securities of comparable credit quality that have like terms and payment features. Assessments of credit quality were based on NRSRO ratings, if available, or were determined by management if not available. At March 31, 2021, 61% of the securities were rated and the average rating was BB+. At December 31, 2020, 100% of the securities were rated and the average rating was BB+.
Residential mortgage-backed, other commercial mortgage-backed securities and other asset-backed securities consisted of securitizations of receivables valued using dealer quotes for similar securities or discounted cash flow models using yields currently available for similar securities. Similar securities are defined as securities of comparable credit quality that have like terms and payment features. Assessments of credit quality were based on NRSRO ratings, if available, or were subjectively determined by management if not available. At March 31, 2021, 83%2022, 100% of the securities were rated and the average rating was AA+.A. At December 31, 2020, 51%2021, 100% of the securities were rated and the average rating was AA-.
Other investments consisted of convertible securities for which limited observable inputs were available at March 31, 2021. The securities were valued internally based on expected cash flows, including the expected final recovery, discounted at a yield that considered the lack of liquidity and the financial status of the issuer.BBB+.
Quantitative Information Regarding Level 3 Valuations
Fair Value at
($ in thousands)March 31, 2021December 31, 2020Valuation TechniqueUnobservable InputRange
(Weighted Average)
Assets:
Corporate debt, limited observable inputs$7,769$3,265Market Comparable
Securities
Comparability Adjustment0% - 5% (2.5%)
Discounted Cash FlowsComparability Adjustment0% - 5% (2.5%)
Residential mortgage-backed securities$1,489$2,032Market Comparable
Securities
Comparability Adjustment0% - 5% (2.5%)
Discounted Cash FlowsComparability Adjustment0% - 5% (2.5%)
Other asset-backed securities$7,824$6,661Market Comparable
Securities
Comparability Adjustment0% - 5% (2.5%)
Discounted Cash FlowsComparability Adjustment0% - 5% (2.5%)
Other investments$2,152$0Discounted Cash FlowsComparability Adjustment0% - 10% (5%)
Below is a quantitative information regarding securities in the Level 3 category, by security type:
Fair Value at
($ in thousands)March 31, 2022December 31, 2021Valuation TechniqueUnobservable InputRange
(Weighted Average)
Assets:
Corporate debt, limited observable inputs$53,325$47,129Market Comparable
Securities
Comparability Adjustment0% - 5% (2.5%)
Discounted Cash FlowsComparability Adjustment0% - 5% (2.5%)
Residential mortgage-backed securities$572$297Market Comparable
Securities
Comparability Adjustment0% - 5% (2.5%)
Discounted Cash FlowsComparability Adjustment0% - 5% (2.5%)
Other commercial mortgage-backed securities$582$—Market Comparable
Securities
Comparability Adjustment0% - 5% (2.5%)
Discounted Cash FlowsComparability Adjustment0% - 5% (2.5%)
Other asset-backed securities$8,149$6,205Market Comparable
Securities
Comparability Adjustment0% - 5% (2.5%)
Discounted Cash FlowsComparability Adjustment0% - 5% (2.5%)
Equity investments$2,500$2,500Discounted Cash FlowsComparability Adjustment0% - 10% (5%)
Other investments$3,440$1,434Discounted Cash FlowsComparability Adjustment0% - 10% (5%)
Liabilities:
Other liabilities$24,000$24,000Stochastic Model/Discounted Cash FlowsN/A0% - 10% (8%)
The significant unobservable inputs used in the fair value measurement of the above listed securities were the valuations of comparable securities with similar issuers, credit quality and maturity. Changes in the availability of comparable securities could result in changes in the fair value measurements.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
Fair Value Measurements - Level 3 Assets
The following tables (the Level 3 Tables) present summary information regarding changes in the fair value of assets measured at fair value using Level 3 inputs.
March 31, 2022
March 31, 2021 Level 3 Fair Value Measurements - Assets
Level 3 Fair Value Measurements – Assets
(In thousands)(In thousands)Corporate DebtAsset-backed SecuritiesOther InvestmentsTotal(In thousands)Corporate DebtAsset-backed SecuritiesEquity InvestmentsOther InvestmentsTotal
Balance December 31, 2020$3,265 $8,693 $0 $11,958 
Balance, December 31, 2021Balance, December 31, 2021$47,129 $6,502 $2,500 $1,434 $57,565 
Total gains (losses) realized and unrealized:Total gains (losses) realized and unrealized:Total gains (losses) realized and unrealized:
Included in earnings, as a part of:Included in earnings, as a part of:Included in earnings, as a part of:
Net investment incomeNet investment income1 (2)0 (1)Net investment income 1   1 
Net realized investment gains (losses)0 (11)0 (11)
Net investment gains (losses)Net investment gains (losses)   110 110 
Included in other comprehensive incomeIncluded in other comprehensive income20 (179)0 (159)Included in other comprehensive income(993)(260)  (1,253)
PurchasesPurchases4,875 7,357 0 12,232 Purchases9,711 5,585  1,483 16,779 
SalesSales(17)(304)0 (321)Sales(1,019)(5) (116)(1,140)
Transfers inTransfers in858 0 2,152 3,010 Transfers in1,000   529 1,529 
Transfers outTransfers out(1,233)(6,241)0 (7,474)Transfers out(2,503)(2,520)  (5,023)
Balance March 31, 2021$7,769 $9,313 $2,152 $19,234 
Balance, March 31, 2022Balance, March 31, 2022$53,325 $9,303 $2,500 $3,440 $68,568 
Change in unrealized gains (losses) included in earnings for the above period for Level 3 assets held at period-endChange in unrealized gains (losses) included in earnings for the above period for Level 3 assets held at period-end$0 $0 $0 $0 Change in unrealized gains (losses) included in earnings for the above period for Level 3 assets held at period-end$ $ $ $64 $64 
March 31, 2020 March 31, 2021
Level 3 Fair Value Measurements – Assets Level 3 Fair Value Measurements – Assets
(In thousands)(In thousands)Corporate DebtAsset-backed SecuritiesOther InvestmentsTotal(In thousands)Corporate DebtAsset-backed SecuritiesOther InvestmentsTotal
Balance December 31, 2019$5,079 $2,992 $3,086 $11,157 
Balance, December 31, 2020Balance, December 31, 2020$3,265 $8,693 $— $11,958 
Total gains (losses) realized and unrealized:Total gains (losses) realized and unrealized:Total gains (losses) realized and unrealized:
Included in earnings, as a part of:Included in earnings, as a part of:Included in earnings, as a part of:
Net investment incomeNet investment income(2)— (1)
Net realized investment gains (losses)(222)(222)
Net investment gains (losses)Net investment gains (losses)— (11)— (11)
Included in other comprehensive incomeIncluded in other comprehensive income(83)(122)(205)Included in other comprehensive income20 (179)— (159)
PurchasesPurchases3,422 3,422 Purchases4,875 7,357 — 12,232 
SalesSales(1,707)(1,707)Sales(17)(304)— (321)
Transfers inTransfers in945 605 1,550 Transfers in858 — 2,152 3,010 
Transfers outTransfers out(794)(1,526)(2,320)Transfers out(1,233)(6,241)— (7,474)
Balance March 31, 2020$3,440 $6,897 $1,338 $11,675 
Balance, March 31, 2021Balance, March 31, 2021$7,769 $9,313 $2,152 $19,234 
Change in unrealized gains (losses) included in earnings for the above period for Level 3 assets held at period-endChange in unrealized gains (losses) included in earnings for the above period for Level 3 assets held at period-end$$$(222)$(222)Change in unrealized gains (losses) included in earnings for the above period for Level 3 assets held at period-end$— $— $— $— 
Fair Value Measurements - Level 3 Liabilities
There was no change in the fair value of the contingent consideration from the date of the NORCAL acquisition on May 5, 2021 to December 31, 2021 or March 31, 2022.

Transfers
Transfers shown in the preceding Level 3 tables were as of the end of the period in which the transfer occurred. All transfers were to or from Level 2.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2022
All transfers in and out of Level 3 during the three months ended March 31, 20212022 and 20202021 related to securities held for which the level of market activity for identical or nearly identical securities varies from period to period. The securities were valued using multiple observable inputs when those inputs were available; otherwise the securities were valued using limited observable inputs.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2021
Fair Values Not Categorized
At March 31, 20212022 and December 31, 2020,2021, certain LPs/LLCs and investment funds measure fund assets at fair value on a recurring basis and provide a NAV for ProAssurance's interest. The carrying value of these interests is based on the NAV provided and was considered to approximate the fair value of the interests. For investment in unconsolidated subsidiaries, ProAssurance recognizes any changes in the NAV of its interests in equity in earnings (loss) of unconsolidated subsidiaries during the period of change. In accordance with GAAP, the fair value of these investments was not classified within the fair value hierarchy. The amount of ProAssurance's unfunded commitments related to these investments as of March 31, 20212022 and fair values of these investments as of March 31, 20212022 and December 31, 20202021 were as follows:
Unfunded
Commitments
Fair Value Unfunded
Commitments
Fair Value
(In thousands)(In thousands)March 31,
2021
March 31,
2021
December 31,
2020
(In thousands)March 31,
2022
March 31,
2022
December 31,
2021
Equity investments:
Mortgage fund (1)
NaN$0 $12,548 
Investment in unconsolidated subsidiaries:Investment in unconsolidated subsidiaries:Investment in unconsolidated subsidiaries:
Private debt funds (2)(1)
Private debt funds (2)(1)
$11,30816,317 16,387 
Private debt funds (2)(1)
$4,515$17,674 $18,465 
Long/short equity funds (3)(2)
Long/short equity funds (3)(2)
NaN632 596 
Long/short equity funds (3)(2)
None209 655 
Non-public equity funds (4)(3)
Non-public equity funds (4)(3)
$42,554137,648 138,357 
Non-public equity funds (4)(3)
$55,591158,286 160,219 
Credit funds (5)(4)
Credit funds (5)(4)
$1,65326,943 34,848 
Credit funds (5)(4)
$51,86845,174 47,300 
Strategy focused funds (6)(5)
Strategy focused funds (6)(5)
$36,92745,358 43,523 
Strategy focused funds (6)(5)
$28,24445,782 44,177 
226,898 233,711 
Total investments carried at NAVTotal investments carried at NAV$226,898 $246,259 Total investments carried at NAV$267,125 $270,816 
Below is additional information regarding each of the investments listed in the table above as of March 31, 2021.2022.
(1)This investment fund was focused on the structured mortgage market. The fund primarily invested in U.S. Agency mortgage-backed securities. Redemptions are allowed at the end of any calendar quarter with a prior notice requirement of 65 days and are paid within 45 days at the end of the redemption dealing day.
(2)This investment is comprised of interests in 2 unrelated LP funds that are structured to provide interest distributions primarily through diversified portfolios of private debt instruments. NaN LP allows redemption by special consent, while the other does not permit redemption. Income and capital are to be periodically distributed at the discretion of the LPs over an anticipated time frame that spans from three to eight years.
(3)(2)This investment holds primarily long and short North American equities and targets absolute returns using strategies designed to take advantage of market opportunities. Redemptions are permitted; however, redemptions above specified thresholds (lowest threshold is 90%) may be only partially payable until after a fund audit is completed and are then payable within 30 days.
(4)(3)This investment is comprised of interests in multiple unrelated LP funds, each structured to provide capital appreciation through diversified investments in private equity, which can include investments in buyout, venture capital, debt including senior, second lien and mezzanine, distressed debt, collateralized loan obligations and other private equity-oriented LPs. Two of the LPs allow redemption by terms set forth in the LP agreements; the others do not permit redemption. Income and capital are to be periodically distributed at the discretion of the LP over time frames that are anticipated to span up to ten years.
(5)(4)This investment is comprised of 4multiple unrelated LP funds. Two funds seek to obtain superior risk-adjusted absolute returns through a diversified portfolio of debt securities, including bonds, loans and other asset-backed instruments. A third fund focusesThe remaining funds focus on private middle market company mezzanine and senior secured loans, while the remaining fund seeks event driven opportunities across the corporate credit spectrum. Two funds are allowedspectrum, mortgage backed-loans, as well as various types of loan-backed investments. One fund allows redemptions at any quarter-end with a prior notice requirement of 90 days; one fund permits redemption at any quarter-end with a prior notice requirementrequirements of 180 days, and one fund doeswhile two other funds allow for redemptions with consent of the General Partner. The remaining funds do not allow redemptions. For the fundfunds that doesdo not allow redemptions, income and capital are to be periodically distributed at the discretion of the LP over time frames that are anticipated to span up to twelve years.throughout the remaining life of the funds.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
(6)(5)This investment is comprised of multiple unrelated LPs/LLCs funds. One fund is aan LLC focused on investing in North American consumer products companies, comprised of equity and equity-related securities, as well as debt instruments. A second fund is focused on aircraft investments, along with components and assets related to aircrafts. For both funds, redemptions are not permitted. Another fund is aan LP focused on North American energy infrastructure assets that allows redemption with consent of the General Partner. The remaining funds are real estate focused LPs, one of which allows for redemption with prior notice.
ProAssurance may not sell, transfer or assign its interest in any of the above LPs/LLCs without special consent from the LPs/LLCs.
Nonrecurring Fair Value Measurement
ProAssurance did 0tnot have any assets or liabilities that were measured at fair value on a nonrecurring basis at March 31, 2021or2022 or December 31, 2020.2021.
Financial Instruments - Methodologies Other Than Fair Value
The following table provides the estimated fair value of the Company's financial instruments that, in accordance with GAAP for the type of investment, are measured using a methodology other than fair value. Fair values provided primarily fall within the Level 3 fair value category.
March 31, 2021December 31, 2020 March 31, 2022December 31, 2021
(In thousands)(In thousands)Carrying
Value
Fair
Value
Carrying
Value
Fair
Value
(In thousands)Carrying
Value
Fair
Value
Carrying
Value
Fair
Value
Financial assets:Financial assets:Financial assets:
BOLIBOLI$66,932 $66,932 $67,847 $67,847 BOLI$80,879 $80,879 $81,767 $81,767 
Other investmentsOther investments$2,370 $2,370 $2,952 $2,952 Other investments$3,198 $3,198 $3,183 $3,183 
Other assetsOther assets$33,869 $33,885 $31,128 $31,141 Other assets$33,029 $33,016 $40,581 $40,583 
Financial liabilities:Financial liabilities:Financial liabilities:
Senior notes due 2023*Senior notes due 2023*$250,000 $271,105 $250,000 $269,160 Senior notes due 2023*$250,000 $255,913 $250,000 $264,000 
Mortgage Loans*$35,723 $35,723 $36,113 $36,113 
Contribution CertificatesContribution Certificates$176,351 $161,533 $175,900 $179,892 
Other liabilitiesOther liabilities$32,548 $32,548 $30,334 $30,334 Other liabilities$31,446 $31,446 $52,332 $52,332 
* Carrying value excludes unamortized debt issuance costs.
The fair value of the BOLI was equal to the cash surrender value associated with the policies on the valuation date.
Other investments listed in the table above include FHLB common stock carried at cost and an annuity investment carried at amortized cost. TwoThree of ProAssurance's insurance subsidiaries are members of an FHLB. The estimated fair value of the FHLB common stock was based on the amount the subsidiaries would receive if their memberships were canceled, as the memberships cannot be sold. The fair value of the annuity represents the present value of the expected future cash flows discounted using a rate available in active markets for similarly structured instruments.
Other assets and other liabilities primarily consisted of related investment assets and liabilities associated with funded deferred compensation agreements. The fair value of the funded deferred compensation assets was based upon quoted market prices, which is categorized as a Level 1 valuation, and had a fair value of $32.8$32.0 million and $30.6$39.5 million at March 31, 20212022 and December 31, 2020,2021, respectively. The deferred compensation liabilities are adjusted to match the fair value of the funded deferred compensation assets.assets at December 31, 2021 included assets from a rabbi trust plan acquired in the NORCAL acquisition that was terminated during the three months ended March 31, 2022. The rabbi trust assets consisted entirely of cash equivalents and mutual funds and had a total fair value of $5.2 million as of December 31, 2021 (see Note 2 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 2021 report on Form 10-K for additional information on the NORCAL acquisition). Other assets also included an unsecured note receivable under a separate line of credit agreement.receivable. The fair value of the note receivable was based on the present value of expected cash flows from the note receivable, discounted at market rates on the valuation date for receivables with similar credit standings and similar payment structures. Other liabilities primarily consisted of liabilities associated with funded deferred compensation agreements. The reported balance is determined based on the amount of elective deferrals and employer contributions adjusted for periodic changes in the fair value of the participant balances based on the performance of the funds selected by the participants and had a fair value of $31.4 million and $52.3 million at March 31, 2022 and December 31, 2021, respectively. The fair value of the funded deferred compensation liabilities at December 31, 2021 included liabilities from deferred compensation arrangements assumed in the NORCAL acquisition that were terminated during the three months ended March 31, 2022 using the associated
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2022
rabbit trust assets and cash; the termination of these deferred compensation arrangements did not result in a gain or loss during the current period. The funded deferred compensation liabilities had a total fair value of $18.4 million as of December 31, 2021 (see Note 2 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 2021 report on Form 10-K for additional information).
The fair value of the debt, excluding the Contribution Certificates, was estimated based on the present value of expected future cash outflows, discounted at rates available on the valuation date for similar debt issued by entities with a similar credit standing to ProAssurance.
The fair value of the Contribution Certificates was estimated based on a binomial option pricing model. The Contribution Certificates is a portion of the purchase consideration for the NORCAL acquisition and are issued to certain NORCAL policyholders in the conversion, and those instruments are an obligation of NORCAL Insurance Company, the successor of NORCAL Mutual Insurance Company (see Note 2 and Note 13 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 2021 report on Form 10-K for further discussion of the terms of the Contribution Certificates).
22
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
3. Investments
Available-for-sale fixed maturities at March 31, 20212022 and December 31, 20202021 included the following:
March 31, 2021March 31, 2022
(In thousands)(In thousands)Amortized
Cost
Gross Unrealized GainsGross Unrealized LossesEstimated Fair Value(In thousands)Amortized
Cost
Gross Unrealized GainsGross Unrealized LossesEstimated Fair Value
Fixed maturities, available-for-saleFixed maturities, available-for-saleFixed maturities, available-for-sale
U.S. Treasury obligationsU.S. Treasury obligations$101,045 $2,088 $256 $102,877 U.S. Treasury obligations$237,899 $240 $12,463 $225,676 
U.S. Government-sponsored enterprise obligationsU.S. Government-sponsored enterprise obligations11,959 106 121 11,944 U.S. Government-sponsored enterprise obligations17,650 15 932 16,733 
State and municipal bondsState and municipal bonds312,809 11,196 1,540 322,465 State and municipal bonds511,863 1,368 20,940 492,291 
Corporate debtCorporate debt1,395,466 42,572 9,172 1,428,866 Corporate debt1,955,390 4,593 89,727 1,870,256 
Residential mortgage-backed securitiesResidential mortgage-backed securities268,344 5,727 2,523 271,548 Residential mortgage-backed securities441,565 2,142 25,859 417,848 
Agency commercial mortgage-backed securitiesAgency commercial mortgage-backed securities13,196 537 15 13,718 Agency commercial mortgage-backed securities13,231 46 430 12,847 
Other commercial mortgage-backed securitiesOther commercial mortgage-backed securities119,145 3,254 1,080 121,319 Other commercial mortgage-backed securities232,924 471 10,013 223,382 
Other asset-backed securitiesOther asset-backed securities287,659 3,227 350 290,536 Other asset-backed securities451,052 2,065 11,329 441,788 
$2,509,623 $68,707 $15,057 $2,563,273 $3,861,574 $10,940 $171,693 $3,700,821 
December 31, 2020 December 31, 2021
(In thousands)(In thousands)Amortized
Cost
Allowance for Expected Credit LossesGross Unrealized GainsGross Unrealized LossesEstimated Fair Value(In thousands)Amortized
Cost
Gross Unrealized GainsGross Unrealized LossesEstimated Fair Value
Fixed maturities, available-for-saleFixed maturities, available-for-saleFixed maturities, available-for-sale
U.S. Treasury obligationsU.S. Treasury obligations$104,097 $$2,985 $23 $107,059 U.S. Treasury obligations$239,765 $1,166 $2,424 $238,507 
U.S. Government-sponsored enterprise obligationsU.S. Government-sponsored enterprise obligations12,103 158 12,261 U.S. Government-sponsored enterprise obligations20,467 29 262 20,234 
State and municipal bondsState and municipal bonds316,022 16,937 39 332,920 State and municipal bonds511,750 9,620 2,174 519,196 
Corporate debtCorporate debt1,267,992 552 63,204 1,302 1,329,342 Corporate debt1,884,455 29,050 14,949 1,898,556 
Residential mortgage-backed securitiesResidential mortgage-backed securities269,752 7,171 382 276,541 Residential mortgage-backed securities455,438 4,254 5,751 453,941 
Agency commercial mortgage-backed securitiesAgency commercial mortgage-backed securities12,623 687 — 13,310 Agency commercial mortgage-backed securities13,909 294 62 14,141 
Other commercial mortgage-backed securitiesOther commercial mortgage-backed securities109,244 4,788 940 113,092 Other commercial mortgage-backed securities231,226 2,530 2,273 231,483 
Other asset-backed securitiesOther asset-backed securities269,742 4,006 742 273,006 Other asset-backed securities457,837 2,747 2,920 457,664 
$2,361,575 $552 $99,936 $3,428 $2,457,531 $3,814,847 $49,690 $30,815 $3,833,722 

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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
The recorded cost basis and estimated fair value of available-for-sale fixed maturities at March 31, 2021,2022, by contractual maturity, are shown below. Actual maturities may differ from contractual maturities because borrowers may have the right to call or prepay obligations with or without call or prepayment penalties.
(In thousands)(In thousands)Amortized
Cost
Due in one
year or less
Due after
one year
through
five years
Due after
five years
through
ten years
Due after
ten years
Total Fair
Value
(In thousands)Amortized
Cost
Due in one
year or less
Due after
one year
through
five years
Due after
five years
through
ten years
Due after
ten years
Total Fair
Value
Fixed maturities, available-for-saleFixed maturities, available-for-saleFixed maturities, available-for-sale
U.S. Treasury obligationsU.S. Treasury obligations$101,045 $23,143 $70,919 $8,815 $0 $102,877 U.S. Treasury obligations$237,899 $21,181 $128,387 $74,586 $1,522 $225,676 
U.S. Government-sponsored enterprise obligationsU.S. Government-sponsored enterprise obligations11,959 3,870 5,044 2,887 143 11,944 U.S. Government-sponsored enterprise obligations17,650 1,798 11,029 3,774 132 16,733 
State and municipal bondsState and municipal bonds312,809 6,114 153,779 144,719 17,853 322,465 State and municipal bonds511,863 22,193 159,219 188,721 122,158 492,291 
Corporate debtCorporate debt1,395,466 140,572 755,625 481,431 51,238 1,428,866 Corporate debt1,955,390 141,092 848,525 774,223 106,416 1,870,256 
Residential mortgage-backed securitiesResidential mortgage-backed securities268,344 271,548 Residential mortgage-backed securities441,565 417,848 
Agency commercial mortgage-backed securitiesAgency commercial mortgage-backed securities13,196 13,718 Agency commercial mortgage-backed securities13,231 12,847 
Other commercial mortgage-backed securitiesOther commercial mortgage-backed securities119,145 121,319 Other commercial mortgage-backed securities232,924 223,382 
Other asset-backed securitiesOther asset-backed securities287,659 290,536 Other asset-backed securities451,052 441,788 
$2,509,623 $2,563,273 $3,861,574 $3,700,821 
Excluding obligations of the U.S. Government, U.S. Government-sponsored enterprises and a U.S. Government obligations money market fund, 0no investment in any entity or its affiliates exceeded 10% of shareholders’ equity at March 31, 2021.2022.
Cash and securities with a carrying value of $41.7$54.5 million at March 31, 20212022 were on deposit with various state insurance departments to meet regulatory requirements.
As a member of Lloyd's, ProAssurance is required to maintain capital at Lloyd's, referred to as FAL, to support underwriting by Syndicate 1729 and Syndicate 6131.1729. At March 31, 2021,2022, ProAssurance's FAL investments were comprised of available-for-sale fixed maturities with a fair value of $102.8$36.9 million and cash and cash equivalents of $4.0$0.1 million on deposit with Lloyd's in order to satisfy these FAL requirements.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
Investments Held in a Loss Position
The following tables provide summarized information with respect to investments held in an unrealized loss position at March 31, 20212022 and December 31, 2020,2021, including the length of time the investment had been held in a continuous unrealized loss position.
March 31, 2021March 31, 2022
TotalLess than 12 months12 months or longer TotalLess than 12 months12 months or longer
FairUnrealizedFairUnrealizedFairUnrealized FairUnrealizedFairUnrealizedFairUnrealized
(In thousands)(In thousands)ValueLossValueLossValueLoss(In thousands)ValueLossValueLossValueLoss
Fixed maturities, available-for-saleFixed maturities, available-for-saleFixed maturities, available-for-sale
U.S. Treasury obligationsU.S. Treasury obligations$26,250 $256 $26,250 $256 $0 $0 U.S. Treasury obligations$208,608 $12,463 $195,658 $11,629 $12,950 $834 
U.S. Government-sponsored enterprise obligationsU.S. Government-sponsored enterprise obligations5,714 121 5,714 121 0 0 U.S. Government-sponsored enterprise obligations16,601 932 12,835 599 3,766 333 
State and municipal bondsState and municipal bonds67,604 1,540 67,604 1,540 0 0 State and municipal bonds372,603 20,940 357,967 19,551 14,636 1,389 
Corporate debtCorporate debt397,470 9,172 370,642 8,704 26,828 468 Corporate debt1,437,296 89,727 1,292,183 75,597 145,113 14,130 
Residential mortgage-backed securitiesResidential mortgage-backed securities105,643 2,523 99,580 2,253 6,063 270 Residential mortgage-backed securities367,247 25,859 316,182 20,314 51,065 5,545 
Agency commercial mortgage-backed securitiesAgency commercial mortgage-backed securities1,276 15 1,276 15 0 0 Agency commercial mortgage-backed securities9,835 430 9,695 416 140 14 
Other commercial mortgage-backed securitiesOther commercial mortgage-backed securities41,832 1,080 35,400 437 6,432 643 Other commercial mortgage-backed securities204,736 10,013 194,654 9,310 10,082 703 
Other asset-backed securitiesOther asset-backed securities71,365 350 59,054 280 12,311 70 Other asset-backed securities375,684 11,329 360,024 10,477 15,660 852 
$717,154 $15,057 $665,520 $13,606 $51,634 $1,451 $2,992,610 $171,693 $2,739,198 $147,893 $253,412 $23,800 

December 31, 2020December 31, 2021
TotalLess than 12 months12 months or longer TotalLess than 12 months12 months or longer
FairUnrealizedFairUnrealizedFairUnrealized FairUnrealizedFairUnrealizedFairUnrealized
(In thousands)(In thousands)ValueLossValueLossValueLoss(In thousands)ValueLossValueLossValueLoss
Fixed maturities, available-for-saleFixed maturities, available-for-saleFixed maturities, available-for-sale
U.S. Treasury obligationsU.S. Treasury obligations$14,390 $23 $14,390 $23 $$U.S. Treasury obligations$190,054 $2,424 $181,689 $2,206 $8,365 $218 
U.S. Government-sponsored enterprise obligationsU.S. Government-sponsored enterprise obligations16,287 262 16,287 262 — — 
State and municipal bondsState and municipal bonds6,416 39 6,416 39 State and municipal bonds175,442 2,174 171,930 2,039 3,512 135 
Corporate debtCorporate debt94,695 1,302 79,436 1,020 15,259 282 Corporate debt945,196 14,949 866,731 11,828 78,465 3,121 
Residential mortgage-backed securitiesResidential mortgage-backed securities34,928 382 34,509 381 419 Residential mortgage-backed securities326,248 5,751 290,019 4,320 36,229 1,431 
Agency commercial mortgage-backed securitiesAgency commercial mortgage-backed securities4,529 62 4,355 54 174 
Other commercial mortgage-backed securitiesOther commercial mortgage-backed securities18,766 940 18,480 935 286 Other commercial mortgage-backed securities151,827 2,273 145,467 1,884 6,360 389 
Other asset-backed securitiesOther asset-backed securities43,739 742 37,850 701 5,889 41 Other asset-backed securities278,915 2,920 271,463 2,796 7,452 124 
$212,934 $3,428 $191,081 $3,099 $21,853 $329 $2,088,498 $30,815 $1,947,941 $25,389 $140,557 $5,426 
As of March 31, 2021,2022, excluding U.S. Government or U.S. Government-sponsored enterprise obligations, there were 7842,504 debt securities (28.5%(64.6% of all available-for-sale fixed maturity securities held) in an unrealized loss position representing 5141,288 issuers. The greatest and second greatest unrealized loss positions among those securities were approximately $2.3 million and $2.0 million, respectively. The securities were evaluated for impairment as of March 31, 2022.
As of December 31, 2021, excluding U.S. Government or U.S. Government-sponsored enterprise obligations, there were 1,766 debt securities (45.8% of all available-for-sale fixed maturity securities held) in an unrealized loss position representing 998 issuers. The greatest and second greatest unrealized loss positions among those securities were each approximately $0.5$0.4 million. The securities were evaluated for impairment as of March 31, 2021.
As of December 31, 2020, excluding U.S. Government or U.S. Government-sponsored enterprise obligations, there were 292 debt securities (11.1% of all available-for-sale fixed maturity securities held) in an unrealized loss position representing 229 issuers. The greatest and second greatest unrealized loss positions among those securities were approximately $0.4 million and $0.2 million, respectively. The securities were evaluated for impairment as of December 31, 2020.2021.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2022
Each quarter, ProAssurance performs a detailed analysis for the purpose of assessing whether any of the securities it holds in an unrealized loss position has suffered an impairment due to credit or non-credit factors. A detailed discussion of the factors considered in the assessment is included in Note 1 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 20202021 report on Form 10-K.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2021
Fixed maturity securities held in an unrealized loss position at March 31, 2021,2022, excluding asset-backed securities, have paid all scheduled contractual payments and are expected to continue doing so.continue. Expected future cash flows of asset-backed securities, excluding those issued by GNMA, FNMA and FHLMC, held in an unrealized loss position were estimated as part of the March 31, 20212022 impairment evaluation using the most recently available six-month historical performance data for the collateral (loans) underlying the security or, if historical data was not available, sector based assumptions, and equaled or exceeded the current amortized cost basis of the security.
There was no allowance for expected credit losses for the three months ended March 31, 2022.
The following tables presenttable presents a roll forward of the allowance for expected credit losses on available-for-sale fixed maturities for the three months ended March 31, 2021 and 2020.2021.
Three Months Ended March 31, 2021
(In thousands)Corporate DebtTotal
Balance at December 31, 2020$552 $552 
Reductions related to:
Securities sold during the period(552)(552)
Balance at March 31, 2021$0 $0 
Three Months Ended March 31, 2020
(In thousands)Corporate DebtTotal
Balance at December 31, 2019$$
Additional credit losses related to securities for which:
No allowance for credit losses has been previously recognized1,163 1,163 
Balance at March 31, 2020$1,163 $1,163 
Three Months Ended March 31, 2021
(In thousands)Corporate DebtTotal
Balance, at December 31, 2020$552 $552 
Reductions related to:
Securities sold during the period(552)(552)
Balance, at March 31, 2021$— $— 
Other information regarding sales and purchases of fixed maturity available-for-sale securities is as follows:
Three Months Ended March 31Three Months Ended March 31
(In millions)(In millions)20212020(In millions)20222021
Proceeds from sales (exclusive of maturities and paydowns)Proceeds from sales (exclusive of maturities and paydowns)$61.9 $64.9 Proceeds from sales (exclusive of maturities and paydowns)$63.5 $61.9 
PurchasesPurchases$342.2 $227.5 Purchases$231.6 $342.2 
Equity Investments
ProAssurance's equity investments are carried at fair value with changes in fair value recognized in income as a component of net realized investment gains (losses) during the period of change. Equity investments on the Condensed Consolidated Balance Sheets as of March 31, 20212022 and December 31, 20202021 primarily included stocks, bond funds and, to a lesser degree, stocks and investment funds.
Short-term Investments
ProAssurance's short-term investments, which have a maturity at purchase of one year or less, are primarily comprised of investments in U.S. treasury obligations, commercial paper and money market funds. Short-term investments are carried at fair value which approximates the cost of the securities due to their short-term nature.
BOLI
ProAssurance holds BOLI policies that are carried at the current cash surrender value of the policies (original cost $33$42 million), which includes the BOLI policies acquired from NORCAL (original cost $10 million). All insured individuals were members of ProAssurance or NORCAL management at the time the policies were acquired. The primary purpose of the program is to offset future employee benefit expenses through earnings on the cash value of the policies. ProAssurance is the owner and beneficiary of these policies.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
Net Investment Income
Net investment income (loss) by investment category was as follows:
Three Months Ended
March 31
Three Months Ended
March 31
(In thousands)(In thousands)20212020(In thousands)20222021
Fixed maturitiesFixed maturities$15,692 $18,285 Fixed maturities$21,544 $15,692 
EquitiesEquities694 1,909 Equities701 694 
Short-term investments, including OtherShort-term investments, including Other273 1,472 Short-term investments, including Other426 273 
BOLIBOLI444 456 BOLI(47)444 
Investment fees and expensesInvestment fees and expenses(2,086)(1,292)Investment fees and expenses(2,181)(2,086)
Net investment incomeNet investment income$15,017 $20,830 Net investment income$20,443 $15,017 
Investment in Unconsolidated Subsidiaries
ProAssurance's investment in unconsolidated subsidiaries were as follows:
March 31, 2021Carrying Value March 31, 2022Carrying Value
(In thousands)(In thousands)Percentage
Ownership
March 31,
2021
December 31,
2020
(In thousands)Percentage
Ownership
March 31,
2022
December 31,
2021
Qualified affordable housing project tax credit partnershipsQualified affordable housing project tax credit partnershipsSee below$24,351 $27,719 Qualified affordable housing project tax credit partnershipsSee below$10,036 $12,424 
All other investments, primarily investment fund LPs/LLCsAll other investments, primarily investment fund LPs/LLCsSee below275,009 282,810 All other investments, primarily investment fund LPs/LLCsSee below311,366 323,152 
$299,360 $310,529 $321,402 $335,576 
Qualified affordable housing project tax credit partnership interests held by ProAssurance generate investment returns by providing tax benefits to fund investors in the form of tax credits and project operating losses. The carrying value of these investments reflects ProAssurance's total commitments (both funded and unfunded) to the partnerships, less any amortization. At March 31, 2022, ProAssurance's ownership percentage relative to 1 of the tax credit partnership interests is almost 100%; this interest had a carrying value of $2.0 million. At December 31, 2021, ProAssurance's ownership percentage relative to 2 of the tax credit partnership interests iswas almost 100%; these interests had a carrying value of $8.1 million at March 31, 2021 and $9.4$3.2 million at December 31, 2020.2021. ProAssurance's ownership percentage relative to the remaining tax credit partnership interests is less than 20%; these interests had a carrying value of $16.3$8.0 million at March 31, 20212022 and $18.3$9.2 million at December 31, 2020.2021. Since ProAssurance has the ability to exert influence over the partnerships but does not control them, all are accounted for using the equity method. See further discussion of the entities in which ProAssurance holds passive interests in Note 12.9.
ProAssurance holds interests in investment fund LPs/LLCs and other equity method investments and LPs/LLCs which are not considered to be investment funds. ProAssurance's ownership percentage relative to 4 of the LPs/LLCs is greater than 25%, which is expected to be reduced as the funds mature and other investors participate in the funds; these investments had a carrying value of $47.0$49.3 million at March 31, 20212022 and $46.2$49.0 million at December 31, 2020.2021. ProAssurance's ownership percentage relative to the remaining investments and LPs/LLCs is less than 25%; these interests had a carrying value of $228.0$262.1 million at March 31, 20212022 and $236.6$274.2 million at December 31, 2020.2021. ProAssurance does not have the ability to exert control over any of these funds.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
Equity in Earnings (Loss) of Unconsolidated Subsidiaries
Equity in earnings (loss) of unconsolidated subsidiaries included losses from qualified affordable housing project tax credit partnerships and a historic tax credit partnership. Investment results recorded reflect ProAssurance's allocable portion of partnership operating results. Tax credits reduce income tax expense in the period they are recognized.utilized. The results recorded and tax credits recognized related to ProAssurance's tax credit partnership investments were as follows:
Three Months Ended
March 31
Three Months Ended
March 31
(In thousands)(In thousands)20212020(In thousands)20222021
Qualified affordable housing project tax credit partnershipsQualified affordable housing project tax credit partnershipsQualified affordable housing project tax credit partnerships
Losses recordedLosses recorded$3,368 $4,342 Losses recorded$2,388 $3,368 
Tax credits recognizedTax credits recognized$3,324 $4,369 Tax credits recognized$1,205 $3,324 
Historic tax credit partnership*Historic tax credit partnership*Historic tax credit partnership*
Losses (gains) recordedLosses (gains) recorded$(182)$323 Losses (gains) recorded$ $(182)
Tax credits recognizedTax credits recognized$50 $103 Tax credits recognized$ $50 
* ProAssurance holds a historic tax credit partnership which was fully amortized in 2020. ProAssurance received a distribution associated with this investment during the three months ended March 31, 2021 as a result of positive cash flows from a project recognizing an operating gain. See further discussion on this investment in Note 3 of the Notes to the Consolidated Financial Statements in ProAssurance’s December 31, 2020 report on Form 10-K.
*ProAssurance holds a historic tax credit partnership which was fully amortized in 2020. This partnership generated investment returns by providing benefits to fund investors in the form of tax credits, tax deductible project operating losses and positive cash flows. ProAssurance received a distribution associated with this investment during the first quarter of 2021, as a result of positive cash flows from a completed project, which was recognized as an operating gain.*ProAssurance holds a historic tax credit partnership which was fully amortized in 2020. This partnership generated investment returns by providing benefits to fund investors in the form of tax credits, tax deductible project operating losses and positive cash flows. ProAssurance received a distribution associated with this investment during the first quarter of 2021, as a result of positive cash flows from a completed project, which was recognized as an operating gain.
The tax credits generated from the Company's tax credit partnership investments of $3.4$1.2 million for the three months ended March 31, 2022 were deferred for use in future periods due to the Company's expected consolidated loss calculated on a tax basis. For the three months ended March 31, 2021 the tax credits generated from the Company's tax credit partnership investments of $3.4 million were deferred and are expected to be utilized in future periods. Not included in the table above is $2.0 million of tax credits recaptured from 2019 during the three months ended March 31, 2022 due to the carryback of the Company's estimated NOL for the three months ended March 31, 2022 to the 2021 tax year. The recaptured tax credits were earned in 2019 but not utilized until 2021 due to NOL's generated in both 2019 and 2020. As of March 31, 2022, the Company had approximately $49.9 million of available tax credit carryforwards generated from its investments in tax credit partnerships which they expect to utilize in future periods.
Tax credits provided by the underlying projects of the Company's historic tax credit partnership are typically available in the tax year in which the project is put into active service, whereas the tax credits provided by qualified affordable housing project tax credit partnerships are provided over approximately a ten year period.
Significant Equity Method InvesteeInvestees
As previously discussed, ProAssurance holds certain investments that are measured using the equity method of accounting, primarily investments in LPs/LLCs, which are carried as a part of Investment in Unconsolidated Subsidiaries on the Condensed Consolidated Balance Sheet.Sheets. Each quarter, ProAssurance assesses the significance of its equity method investees. As of March 31, 2022 ProAssurance determined one equity method investee, Prime Storage Fund II, LP, to be significant. This fund invests primarily in self-storage real estate. As of March 31, 2021, ProAssurance determined one equity method investee, NB Private Equity Credit Opportunities Fund LP, to be significant. ThisNB Private Equity Credit Opportunities Fund LP fund invests primarily in senior/junior debt instruments of private equity backed companies, including secured and unsecured loans, bonds and other instruments. The following table presents gross summarized financial information for this fund,significant funds, including the portion not attributable to ProAssurance, derived from the fund's financial statements which are prepared in accordance with GAAP. As the majority of ProAssurance's equity method investments report their results to the Company on a one quarter lag, the summarized financial information below represents this fund's resultsis for the three months ended December 31, 2020.2021 and 2020, respectively.
Three Months Ended March 31, 2021
(In thousands)
Net investment income$40,636
Net realized investment gains (losses)14,587
Net change in unrealized appreciation (depreciation)61,777
Net gain (loss)$117,000
Net gain (loss) attributable to ProAssurance*$2,056
*Represents ProAssurance's share of the fund's aggregate income or loss, which is included as a component of equity in earnings (loss) of unconsolidated subsidiaries in its Condensed Consolidated Statement of Income and Comprehensive Income for the three months ended March 31, 2021.
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Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
(In thousands)Three Months Ended March 31, 2022Three Months Ended March 31, 2021
Prime Storage Fund II LPNB Private Equity Credit Opportunities Fund LP
Net investment income$28,691 $40,636 
Net investment gains (losses)22,438 14,587 
Net change in unrealized appreciation (depreciation)235,525 61,777 
Net gain (loss)$286,654 $117,000 
Net gain (loss) attributable to ProAssurance*$1,457 $2,056 
*Represents ProAssurance's share of the fund's aggregate income or loss, which is included as a component of equity in earnings (loss) of unconsolidated subsidiaries in its Condensed Consolidated Statement of Income and Comprehensive Income for the three months ended March 31, 2022 and 2021.
Net Realized Investment Gains (Losses)
Realized investment gains and losses are recognized on the first-in, first-out basis. The following table provides detailed information regarding net realized investment gains (losses):
Three Months Ended
March 31
Three Months Ended
March 31
(In thousands)(In thousands)20212020(In thousands)20222021
Total impairment losses:
Corporate debt$0 $(1,817)
Portion of impairment losses recognized in other comprehensive income before taxes:
Corporate debt 654 
Net impairment losses recognized in earnings0 (1,163)
Gross realized gains, available-for-sale fixed maturitiesGross realized gains, available-for-sale fixed maturities4,294 2,427 Gross realized gains, available-for-sale fixed maturities$1,187 $4,294 
Gross realized (losses), available-for-sale fixed maturitiesGross realized (losses), available-for-sale fixed maturities(187)(1,403)Gross realized (losses), available-for-sale fixed maturities(1,124)(187)
Net realized gains (losses), trading fixed maturitiesNet realized gains (losses), trading fixed maturities72 103 Net realized gains (losses), trading fixed maturities(75)72 
Net realized gains (losses), equity investmentsNet realized gains (losses), equity investments4,189 15,190 Net realized gains (losses), equity investments(220)4,189 
Net realized gains (losses), other investmentsNet realized gains (losses), other investments3,196 48 Net realized gains (losses), other investments650 3,196 
Change in unrealized holding gains (losses), trading fixed maturitiesChange in unrealized holding gains (losses), trading fixed maturities(214)(118)Change in unrealized holding gains (losses), trading fixed maturities(326)(214)
Change in unrealized holding gains (losses), equity investmentsChange in unrealized holding gains (losses), equity investments(2,937)(38,477)Change in unrealized holding gains (losses), equity investments(11,485)(2,937)
Change in unrealized holding gains (losses), convertible securities, carried at fair valueChange in unrealized holding gains (losses), convertible securities, carried at fair value(190)(5,273)Change in unrealized holding gains (losses), convertible securities, carried at fair value(2,476)(190)
OtherOther626 (7)Other363 626 
Net realized investment gains (losses)$8,849 $(28,673)
Net investment gains (losses)Net investment gains (losses)$(13,506)$8,849 
For the three months ended March 31, 2022 and 2021, ProAssurance did not recognize any credit-related impairment losses in earnings or non-credit impairment losses in OCI. For the three months ended March 31, 2020, ProAssurance recognized credit-related impairment losses in earnings of $1.2 million and non-credit impairment losses in OCI of $0.7 million. The credit-related impairment losses related to four corporate bonds in the energy, consumer and entertainment sectors. The non-credit related impairment losses related to three corporate bonds in the energy and consumer sectors.
ProAssurance recognized $8.8 million of net realized investment gains during the three months ended March 31, 2021, driven primarily by realized gains on the sale of available-for-sale fixed maturities and equity investments. ProAssurance recognized $28.7 million of net realized investment losses during the three months ended March 31, 2020 driven by the impact of decreases in fair value on its equity portfolio of $38.5 million and convertible securities of $5.3 million attributable to disruptions in the global financial markets related to COVID-19 during the first quarter of 2020.
The following table presents a roll forward of cumulative credit losses recorded in earnings related to impaired debt securities for which a portion of the impairment was recorded in OCI.
Three Months Ended
March 31
Three Months Ended
March 31
(In thousands)(In thousands)20212020(In thousands)20222021
Balance beginning of periodBalance beginning of period$552 $470 Balance beginning of period$ $552 
Additional credit losses recognized during the period, related to securities for which:
No impairment has been previously recognized0 1,064 
Reductions due to:Reductions due to:Reductions due to:
Securities sold during the period (realized)Securities sold during the period (realized)(552)Securities sold during the period (realized) (552)
Balance March 31Balance March 31$0 $1,534 Balance March 31$ $— 
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Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
4. Retroactive Insurance Contracts
ProAssurance offers custom alternative risk solutions which includes assumed reinsurance. In the first quarter of 2021, ProAssurance entered into an assumed reinsurance arrangement with a regional hospital group. As the contract included both prospective coverage and retroactive coverage, ProAssurance bifurcated the provisions of the contract and accounted for each component separately. As of the contract effective date, ProAssurance recognized total net premiums written of $4.5 million, comprised of $2.2 million of prospective coverage and $2.3 million of retroactive coverage, total net premiums earned of $3.0 million, comprised of $0.7 million of prospective coverage and $2.3 million of retroactive coverage and total net losses and loss adjustment expenses of $2.9 million in the Condensed Consolidated Statement of Income and Comprehensive Income for the three months ended March 31, 2021. For additional information regarding ProAssurance's accounting policy for retroactive insurance contracts, see Note 1 of the Notes to Consolidated Financial Statements included in ProAssurance's December 31, 2020 report on Form 10-K.
5. Income Taxes
For interim periods, ProAssurance generally utilizes the estimated annual effective tax rate method under which the Company determines its provision (benefit) for income taxes based on the current estimate of its annual effective tax rate. For the three months ended March 31, 2022, ProAssurance utilized the discrete effective tax rate method for recording income taxes after the estimated annual effective tax rate method produced an unreliable estimated effective annual tax rate. The discrete method is applied when the application of the estimated annual effective tax rate method is impractical and does not provide a reliable estimate of the annual effective tax rate. The Company believes the use of the discrete effective tax rate method is more appropriate than the annual effective tax rate method for the three months ended March 31, 2022 as minor changes in the Company's estimated ordinary income would have a significant effect on the estimated annual effective tax rate and would result in sizable variations in the customary relationship between income tax expense (benefit) and pre-tax accounting income (loss). ProAssurance will reevaluate its use of this method each quarter until the Company believes a return to the estimated annual effective tax rate method is deemed appropriate. For the three months ended March 31, 2021, ProAssurance utilized the estimated annual effective tax rate method. Under the estimated annual effective tax rate method, items which are unusual, infrequent, or that cannot be reliably estimated are considered in the effective tax rate in the period in which the item is included in income, and are referred to as discrete items. In calculating the Company's year-to-date income tax expense (benefit) under the estimated annual effective tax rate method, it includes the estimated benefit of tax credits for the year-to-date period based on the most recently available information provided by the tax credit partnerships; the actual amounts of credits provided by the tax credit partnerships may prove to be different than our estimates. The effect of such a difference is recognized in the period identified.
For the three months ended March 31, 2022, the provision for income taxes is different from that which would be obtained by applying the statutory federal income tax rate to income before income taxes primarily because ProAssurance recognizes tax credit benefits transferred from tax credit partnership investments. In calculating the Company's year-to-date income tax expense (benefit), the Company includesincluded the estimated benefit of tax credits for the year-to-date period based on the most recently available information provided by the tax credit partnerships; the actual amounts of credits provided by the tax credit partnerships may prove to be different than the Company's estimates. The effect of such a difference is recognized in the period identified.
ProAssurance had a receivable for U.S. federal and U.K. income taxes carried as a part of other assets as of $6.6 million at March 31, 20212022 and $18.9 million at December 31, 2020. The2021 of $7.9 million in each period. At March 31, 2022 and December 31, 2021, the liability for unrecognized tax benefits, which is included in the total receivable for U.S. federal and U.K. income taxes, was $5.8$3.4 million and $5.7 million at March 31, 2021 and December 31, 2020, respectively,in each period which included an accrued liability for interest of approximately $0.6$0.4 million in each period.
NORCAL Acquisition
As a result of the NORCAL acquisition, ProAssurance has U.S. federal NOL carryforwards which as of March 31, 2022 were approximately $43.0 million and $0.5 million, respectively.will begin to expire in 2035. See Note 7 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 2021 report on Form 10-K for more information.
Coronavirus Aid, Relief and Economic Security Act
In response to COVID-19, the CARES Act was signed into law on March 27, 2020 and contains several provisions for corporations and easeseased certain deduction limitations originally imposed by the TCJA. See further discussion in Note 57 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 20202021 report on Form 10-K. As a result of the CARES Act, ProAssurance now has the abilitywas permitted to carryback NOLs generated in tax years 2018, 2019 and 2020 for up to five years. The Company hasProAssurance generated an NOL of approximately $45.3$33.3 million from the 2020 tax year that will bewas carried back to the 2015 tax year and is expected to generatewhich resulted in a taxclaim for a refund of approximately $15.9$11.7 million. Additionally, the Company had an NOL of approximately $25.6 million from the 2019 tax year which was carried back to the 2014 tax year and generated a tax refund of approximately $9.0 million which the Company received in February 2021.
American Rescue Plan Act of 2021
In response to economic concerns associated with COVID-19, the American Rescue Plan Act of 2021 was signed into law on March 11, 2021 and includes an expansion of the number of employees covered by the limitation on the deductibility of compensation in excess of $1 million. This provision is effective for tax years beginning after December 31, 2026. The Company has evaluated this provision as well as the other provisions of the American Rescue Plan Act of 2021 and concluded that they will not have a material impact on ProAssurance's financial position or results of operations as of March 31, 2021.
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Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
6. Goodwill
Goodwill is recognized in conjunction with business acquisitions as the excess of the purchase consideration for the business acquisition over the fair value of identifiable assets acquired and liabilities assumed. The fair value of identifiable assets and liabilities, and thus goodwill, is subject to redetermination within a measurement period of up to one year following completion of a business acquisition.
Goodwill is tested for impairment annually or more frequently if circumstances indicate an impairment may have occurred. The date of the Company's annual goodwill impairment test is October 1. Impairment of goodwill is tested at the reporting unit level, which is consistent with the Company's reportable segments identified in Note 14. See Note 1 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 2020 report on Form 10-K for further information on how the Company tests goodwill for impairment.
Of the Company's 5 reporting units, 2 have net goodwill: Workers' Compensation Insurance and Segregated Portfolio Cell Reinsurance. The table below presents the carrying amount of goodwill and accumulated impairment losses by reporting unit at March 31, 2021 and December 31, 2020:
Reporting Unit
(In thousands)Specialty P&CWorkers' Compensation InsuranceSegregated Portfolio Cell ReinsuranceTotal
Goodwill, gross as of January 1, 2020$161,115 $44,110 $5,500 $210,725 
Accumulated impairment losses*(161,115)(161,115)
Goodwill, net as of December 31, 202044,110 5,500 49,610 
Accumulated impairment losses
Goodwill, net as of March 31, 2021$0 $44,110 $5,500 $49,610 
*Accumulated impairment losses in 2020 represent the pre-tax impairment loss of $161.1 million recognized during the third quarter of 2020 in relation to the Specialty P&C reporting unit. There were no other impairment losses taken prior to 2020. For additional information regarding ProAssurance's goodwill impairment in 2020, see Note 1 and Note 6 of the Notes to Consolidated Financial Statements included in ProAssurance's December 31, 2020 report on Form 10-K.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2021
7.5. Reserve for Losses and Loss Adjustment Expenses
The reserve for losses is established based on estimates of individual claims and actuarially determined estimates of future losses based on ProAssurance’s past loss experience, available industry data and projections as to future claims frequency, severity, inflationary trends and settlement patterns. Estimating the reserve, particularly the reserve appropriate for liability exposures, is a complex process. For a high proportion of the risks insured or reinsured by ProAssurance, claims may be resolved over an extended period of time, often five years or more, and may be subject to litigation. Estimating losses requires ProAssurance to make and revise judgments and assessments regarding multiple uncertainties over an extended period of time. As a result, the reserve estimate may vary considerably from the eventual outcome. The assumptions used in establishing ProAssurance’s reserve are regularly reviewed and updated by management as new data becomes available. Changes to estimates of previously established reserves are included in earnings in the period in which the estimate is changed.
ProAssurance believes that the methods it uses to establish reserves are reasonable and appropriate. Each year, ProAssurance uses internal actuaries to review the For additional information regarding ProAssurance's reserve for losses, of each insurance subsidiary. ProAssurance also engages consulting actuaries to review ProAssurance claims data and provide observations regarding cost trends, rate adequacy and ultimate loss costs. The statutory filings of each insurance company with the insurance regulators must be accompanied by a consulting actuary's certification as to their respective reserves. ProAssurance considers the views of the actuaries as well as other factors, such as premium rates, historical paid and incurred loss development trends, and an evaluation of the current loss environment including frequency, severity, the expected effect of inflation, general economic and social trends, and the legal and political environment in establishing the amount of its reserve for losses. The Company expects there will be impacts to these factors as well as to the timing of loss emergence and ultimate loss ratios for certain coverages it underwrites as a result of COVID-19 and the related economic shutdown; however, the extent to which COVID-19 impacts these factors is highly uncertain and cannot be predicted (see "Item 1A, Risk Factors"see Note 1 and Note 810 of the Notes to Consolidated Financial Statements included in ProAssurance's December 31, 20202021 report on Form 10-K for additional information). The industry is experiencing new conditions, including the postponement of court cases, changes in settlement trends and a significant reduction in economic activity and insured exposure in some classes. ProAssurance's booked reserves as of March 31, 2021 include consideration of these factors, but the duration and degree to which these issues persist, along with potential legislative, regulatory or judicial actions, could result in significant changes to the Company's reserve estimates in future periods.
ProAssurance partitions its reserve by accident year, which is the year in which the claim becomes its liability. For claims-made policies, the insured event generally becomes a liability when the event is first reported to the Company. For occurrence policies, the insured event becomes a liability when the event takes place. For retroactive coverages, the insured event becomes a liability at inception of the underlying contract. As claims are incurred (reported) and claim payments are made, they are aggregated by accident year for analysis purposes. ProAssurance also partitions its reserve by reserve type: case reserves and IBNR reserves. Case reserves are established by the claims department based upon the particular circumstances of each reported claim and represent ProAssurance’s estimate of the future loss costs (often referred to as expected losses) that will be paid on reported claims. Case reserves are decremented as claim payments are made and are periodically adjusted upward or downward as estimates regarding the amount of future losses are revised; a reported loss for an individual claim equates to the case reserve at any point in time plus the claim payments that have been made to date. IBNR reserves represent an estimate, in the aggregate, of future development on losses that have been reported to ProAssurance plus an estimate of losses that have been incurred but not reported.
Development of Prior Accident Years
In addition to setting the initial reserve for the current accident year, each period ProAssurance reassesses the amount of reserve required for prior accident years. The foundation of ProAssurance’s reserve re-estimation process is an actuarial analysis that is performed by both the internal and consulting actuaries. This detailed analysis projects ultimate losses based on partitions which include line of business, geography, coverage layer and accident year. The procedure uses the most representative data for each partition, capturing its unique patterns of development and trends. ProAssurance believes that the use of consulting actuaries provides an independent view of the loss data as well as a broader perspective on industry loss trends.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2021
10-K.
Activity in the reserve for losses and loss adjustment expenses is summarized as follows:
(In thousands)(In thousands)Three Months Ended March 31, 2021Three Months Ended March 31, 2020Year Ended December 31, 2020(In thousands)Three Months Ended March 31, 2022Three Months Ended March 31, 2021Year Ended December 31, 2021
Balance, beginning of yearBalance, beginning of year$2,417,179 $2,346,526 $2,346,526 Balance, beginning of year$3,579,940 $2,417,179 $2,417,179 
Less reinsurance recoverables on unpaid losses and loss adjustment expensesLess reinsurance recoverables on unpaid losses and loss adjustment expenses385,087 390,708 390,708 Less reinsurance recoverables on unpaid losses and loss adjustment expenses451,741 385,087 385,087 
Net balance, beginning of yearNet balance, beginning of year2,032,092 1,955,818 1,955,818 Net balance, beginning of year3,128,199 2,032,092 2,032,092 
Net reserves acquired from NORCAL acquisitionNet reserves acquired from NORCAL acquisition — 1,089,103 
Net losses:Net losses:Net losses:
Current year(3)(1)
Current year(3)(1)
154,634 170,874 711,846 
Current year(3)(1)
214,753 154,634 797,732 
Favorable development of reserves established in prior years, net(2)Favorable development of reserves established in prior years, net(2)(4,849)(6,042)(50,399)Favorable development of reserves established in prior years, net(2)(5,330)(4,849)(45,483)
TotalTotal149,785 164,832 661,447 Total209,423 149,785 752,249 
Paid related to:Paid related to:Paid related to:
Current yearCurrent year(10,513)(15,876)(83,204)Current year(13,179)(10,513)(109,925)
Prior yearsPrior years(126,534)(163,518)(501,969)Prior years(185,977)(126,534)(635,320)
Total paidTotal paid(137,047)(179,394)(585,173)Total paid(199,156)(137,047)(745,245)
Net balance, end of periodNet balance, end of period2,044,830 1,941,256 2,032,092 Net balance, end of period3,138,466 2,044,830 3,128,199 
Plus reinsurance recoverables on unpaid losses and loss adjustment expensesPlus reinsurance recoverables on unpaid losses and loss adjustment expenses393,420 389,792 385,087 Plus reinsurance recoverables on unpaid losses and loss adjustment expenses464,780 393,420 451,741 
Balance, end of periodBalance, end of period$2,438,250 $2,331,048 $2,417,179 Balance, end of period$3,603,246 $2,438,250 $3,579,940 
(1) Current year net losses for the year ended December 31, 2020 included $9.2 million of amortization of a PDR which offsets the impact of the losses incurred associated with the premium earned related to a large national healthcare account's claims-made policy in the Specialty P&C segment. For additional information regarding the PDR, see Note 7 of the Notes to Consolidated Financial Statements included in ProAssurance's December 31, 2020 report on Form 10-K.
(2) During the second quarter of 2020, the aforementioned large national healthcare account did not renew on terms offered by the Company and exercised its contractual option to purchase extended reporting endorsement or "tail" coverage. As a result, ProAssurance recognized total current year losses of $60.0 million (assumes a full limit loss) within the Specialty P&C segment for the year ended December 31, 2020 (see Note 7 of the Notes to Consolidated Financial Statements included in ProAssurance's December 31, 2020 report on Form 10-K).
(3) Current year net losses for the three months ended March 31, 2022 and year ended December 31, 2021 included incurred$2.5 million and $6.7 million, respectively, of amortization of the negative VOBA associated with NORCAL's assumed unearned premium, which is being amortized over a period in proportion to the earn-out of the associated premium as a reduction to current accident year net losses (see Note 2 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 2021 report on Form 10-K).
(2) Net favorable prior year reserve development recognized for the three months ended March 31, 2022 and year ended December 31, 2021 included $2.9 million and $7.9 million, respectively, of amortization of the purchase accounting fair value adjustment on NORCAL's assumed net reserve and amortization of the negative VOBA associated with NORCAL's DDR reserve which is recorded as a reduction to prior accident year net losses and loss adjustment expenses (see Note 2 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 2021 report on Form 10-K). ProAssurance has not recognized any development related to an assumed reinsurance arrangement entered into duringNORCAL's prior accident year reserves since the first quarterdate of 2021 in the Specialty P&C segment (see Note 4).acquisition on May 5, 2021.
Estimating liability reserves is complex and requires the use of many assumptions. As time passes and ultimate losses for prior years are either known or become subject to a more precise estimation, ProAssurance increases or decreases the reserve estimates established in prior periods. The consolidatednet favorable loss development recognized in the three months ended March 31, 2022 primarily reflected overall favorable trends in claim closing patterns in the Workers' Compensation Insurance and Segregated Portfolio Cell Reinsurance segments. The net favorable loss development recognized in the Workers' Compensation
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2022
Insurance segment is primarily related to the 2019 accident year and prior. The net favorable loss development recognized in the Segregated Portfolio Cell Reinsurance segment is primarily related to the 2019 and 2020 accident years. Net favorable development recognized during the three months ended March 31, 2022 was net of an increase in the Company's reserve for potential ECO/XPL claims of $4.0 million in the Specialty P&C segment. Excluding the increase in the ECO/XPL reserve and amortization of purchase accounting adjustments (see footnote 2 in the table above), ProAssurance recognized net favorable prior accident year reserve development of $5.0 million in the Specialty P&C segment, principally related to accident years 2019 through 2021. Consolidated net favorable loss development recognized in the three months ended March 31, 2022 was partially offset by unfavorable reserve development recognized in the Lloyd's Syndicates segment driven by certain catastrophe related losses.
The net favorable loss development recognized in the three months ended March 31, 2021 primarily reflected a lower than anticipated claims severity trend (i.e., the average size of a claim) in the Specialty P&C segment, primarily related to the 2017 and 2018 accident years. The net favorable development also reflected overall favorable trends in claim closing patterns in the Workers' Compensation Insurance and Segregated Portfolio Cell Reinsurance segments. The net favorable loss development recognized in the Workers' Compensation Insurance segment is primarily related to the 2017 accident year and prior. The net favorable loss development recognized in the Segregated Portfolio Cell Reinsurance segment is primarily related to the 2018 and 2019 accident years. Consolidated net favorable loss development recognized in the three months ended March 31, 2021 was partially offset by unfavorable reserve development recognized in the Lloyd's Syndicates segment driven by certain property and catastrophe related losses.
The net favorable loss development recognized during the three months ended March 31, 2020 primarily reflected overall favorable trends in claim closing patterns in the Segregated Portfolio Cell Reinsurance and Workers' Compensation Insurance segments as well as a reduction in the reserve for potential ECO/XPL claims in the Specialty P&C segment. The net favorable loss development recognized in the Segregated Portfolio Cell Reinsurance segment primarily related to the 2016 through 2018 accident years and the net favorable loss development recognized in the Workers' Compensation Insurance segment primarily related to the 2015 and 2016 accident years.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2021
The net favorable loss development recognized for the year ended December 31, 20202021 primarily reflected a lower than anticipated claims severity trend (i.e., the average size of a claim)loss emergence in the Specialty P&C segment, primarily related to the 20142015 through 20172020 accident years. ProAssurance did not recognize any development related to NORCAL's prior accident year reserves in 2021. Net favorable prior accident year reserve development recognized in the Specialty P&C segment also included a $1.0 million reduction in our IBNR reserve for COVID-19 during the third quarter of 2021. The net favorable development also reflected overall favorable trends in claim closing patterns in the Workers' Compensation Insurance and Segregated Portfolio Cell Reinsurance andsegments. The net favorable loss development recognized in the Workers' Compensation Insurance segments.segment is primarily related to the 2012 through 2017 accident years. The net favorable loss development recognized in the Segregated Portfolio Cell Reinsurance segment is primarily related to the 2014 through 2019accident year 2015 and accident years and the2018 through 2020. Consolidated net favorable loss development recognized in 2021 was partially offset by unfavorable reserve development recognized in the Workers' Compensation InsuranceLloyd's Syndicates segment primarilydriven by certain catastrophe related to the 2014 through 2017 accident years.
For additional information regarding ProAssurance's reserve for losses, see Note 1 and Note 8 of the Notes to Consolidated Financial Statements included in ProAssurance's December 31, 2020 report on Form 10-K.losses.
8.6. Commitments and Contingencies
ProAssurance is involved in various legal actions related to insurance policies and claims handling including, but not limited to, claims asserted by policyholders. These types of legal actions arise in the Company's ordinary course of business and, in accordance with GAAP for insurance entities, are considered as a part of the Company's loss reserving process, which is described in detail under the heading "Losses and Loss Adjustment Expenses" in the Accounting Policies section in Note 1 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 20202021 report on Form 10-K. ProAssurance also has other direct actions against the Company unrelated to its claims activity which are evaluated and accounted for as a part of other liabilities. For these corporate legal actions, the Company evaluates each case separately and establishes what it believes is an appropriate reserve based on GAAP guidance related to contingent liabilities. As of March 31, 20212022, there were no material reserves established for corporate legal actions.
As a member of Lloyd's, ProAssurance has obligations to Syndicate 1729 and Syndicate 6131 including a Syndicate Credit Agreement and FAL requirements. The Syndicate Credit Agreement is an unconditional revolving credit agreement to the Premium Trust Fund of Syndicate 1729 for the purpose of providing working capital withcapital. At March 31, 2022, the maximum permitted borrowings ofunder the Syndicate Credit Agreement were approximately £30.0 million (approximately $41.3$39.4 million as ofat March 31, 2021)2022). Effective July 1, 2022, maximum permitted borrowings will be reduced to £15.0 million (approximately $19.7 million at March 31, 2022) from £30.0 million under an amended Syndicate Credit Agreement executed in January 2022. The amended Syndicate Credit Agreement has a maturity date of December 31, 2021June 30, 2023 and contains an annual auto-renewal feature which allows for ProAssurance to elect to non-renew if notice is given at least 30 days prior to the next auto-renewal date, which is one year prior to the maturity date. Under the Syndicate Credit Agreement, advances bear interest at 3.8% annually and may be repaid at any time but are repayable upon demand after December 31, 2021,June 30, 2023, subject to extension through the auto-renewal feature. As of March 31, 2021,2022, there were no outstanding borrowings under the Syndicate Credit Agreement. ProAssurance provides FAL to support underwriting by Syndicate 1729 and Syndicate 6131 andwhich is comprised of investment securities and cash and cash equivalents deposited with Lloyd's with a total fair value of approximately $106.8$37.0 million at March 31, 20212022 (see Note 3).
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2022
ProAssurance has entered into financial instrument transactions that may present off-balance sheet credit risk or market risk. These transactions include a short-term loan commitment and commitments to provide funding to non-public investment entities. Under the short-term loan commitment, ProAssurance has agreed to advance funds on a 30 day basis to a counterparty provided there is no violation of any condition established in the contract. As of March 31, 2021,2022, ProAssurance had total funding commitments related to non-public investment entities as well as the short-term loan commitment of approximately $190.5$234.2 million which included the amount at risk if the full short-term loan is extended and the counterparties default. However, the credit risk associated with the short-term loan commitment is minimal as the counterparties to the contract are highly rated commercial institutions and to-date have been performing in accordance with their contractual obligations. ProAssurance’s expected credit losses associated with this short-term loan commitment were nominal in amount as of March 31, 2021.

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Table of Contents2022.
ProAssurance Corporation and Subsidiaries
Noteshas previously entered into a services agreement with a company to Condensed Consolidated Financial Statements (Unaudited)
March 31,provide data analytics services for certain product lines within the Company's HCPL book of business. In November 2021,
9. Leases
ProAssurance is involved in a numberexecuted an amendment to this services agreement which extended the Company's commitment an additional three years for an annual fee of operating leases primarily for office facilities. Office facility leases have remaining lease terms ranging from one yearapproximately $3.5 million. In addition, the amended services agreement contains an annual one-year auto-extension feature unless either party elects to eleven years; some of which include optionsnon-renew the services agreement by providing notice at least six-months prior to extend the leases for up to fifteen years, and some of which include an option to terminate the lease within one year. ProAssurance subleases certain office facilities to third parties and classifies these leases as operating leases.
The following table provides a summaryend of the componentscontract. ProAssurance incurred operating expenses associated with this services agreement of net lease expense as well as the reporting location in the Condensed Consolidated Statements of Income$0.9 million and Comprehensive Income$0.6 million for the three months ended March 31, 2022 and 2021, respectively. As of March 31, 2022, the remaining commitment under this agreement was estimated to be approximately $9.0 million.
The purchase consideration in the NORCAL acquisition included contingent consideration. NORCAL policyholders who elected to receive NORCAL stock and tender it to ProAssurance are eligible for a share of contingent consideration in an amount of up to approximately $84 million depending upon the after-tax development of NORCAL's ultimate net losses between December 31, 2020 and December 31, 2023. The estimated fair value of this contingent consideration was $24 million as of March 31, 2022, which is unchanged from the acquisition date of May 5, 2021, and 2020.
(In thousands)Location in the Condensed Consolidated Statements of Income and Comprehensive IncomeThree Months Ended March 31
20212020
Operating lease expense (1)
Operating expense$938 $1,625 
Sublease income (2)
Other income(54)(38)
Net lease expense$884 $1,587 
(1) Includes short-term lease costswas derived utilizing a stochastic model. This estimate does not guarantee that contingent consideration will ultimately be paid. Depending on NORCAL's actual ultimate net loss development between December 31, 2020 and variable lease costs, if applicable. ForDecember 31, 2023, the three months ended March 31, 2021actual amount due to eligible policyholders may be greater than or less than the $24 million current fair value estimate. See further discussion around the contingent consideration in Note 2 and 2020, no short-term lease costs were recognized and variable lease costs were nominalfurther discussion on the NORCAL acquisition in amount.
(2) Sublease income excludes rental income from owned properties of $0.6 million during eachNote 2 of the three months ended March 31, 2021 and 2020 which isNotes to Consolidated Financial Statements included in other income. See “Item 2. Properties” in ProAssurance's December 31, 20202021 report on Form 10-K for a listing of currently owned properties.
The following table provides supplemental lease information for operating leases on the Condensed Consolidated Balance Sheets as of March 31, 2021 and December 31, 2020.
($ in thousands)March 31, 2021December 31, 2020
Operating lease ROU assets$18,219 $19,013 
Operating lease liabilities$19,168 $20,116 
Weighted-average remaining lease term8.26 years8.31 years
Weighted-average discount rate2.98 %2.97 %
The following table provides supplemental lease information for the Condensed Consolidated Statements of Cash Flows for the three months ended March 31, 2021 and 2020.
Three Months Ended March 31
(In thousands)20212020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases$1,089 $1,017 
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2021
The following table is a schedule of remaining future minimum lease payments for operating leases that had an initial or remaining non-cancellable lease term in excess of one year as of March 31, 2021.
(In thousands)
2021$3,057 
20223,306 
20232,608 
20242,026 
20251,783 
Thereafter8,875 
Total future minimum lease payments21,655 
Less: Imputed interest2,487 
Total operating lease liabilities$19,168 
10-K.
10.7. Debt
ProAssurance’s outstanding debt consisted of the following:
($ in thousands)($ in thousands)March 31,
2021
December 31,
2020
($ in thousands)March 31,
2022
December 31,
2021
Senior Notes due 2023, unsecured, interest at 5.3% annuallySenior Notes due 2023, unsecured, interest at 5.3% annually$250,000 $250,000 Senior Notes due 2023, unsecured, interest at 5.3% annually$250,000 $250,000 
Contribution Certificates due 2031, interest at 3.0% (effective interest rate at 4.35%) paid annually beginning April 2022Contribution Certificates due 2031, interest at 3.0% (effective interest rate at 4.35%) paid annually beginning April 2022176,351 175,900 
Mortgage Loans, outstanding borrowings are secured by first priority liens on two office buildings, and bear an interest rate of three-month LIBOR plus 1.325% (1.51% and 1.58%, respectively) determined on a quarterly basis35,723 36,113 
Total principalTotal principal285,723 286,113 Total principal426,351 425,900 
Less unamortized debt issuance costsLess unamortized debt issuance costs1,301 1,400 Less unamortized debt issuance costs821 914 
Debt less unamortized debt issuance costsDebt less unamortized debt issuance costs$284,422 $284,713 Debt less unamortized debt issuance costs$425,530 $424,986 
Revolving Credit Agreement
ProAssurance has a Revolving Credit Agreement with 7 participating lenders. The Revolving Credit Agreement, which expires November 2024 that may be used for general corporate purposes, including, but not limited to, short-term working capital, share repurchases as authorized by the Board and support for other activities. ProAssurance's Revolving Credit Agreement permits borrowings up to $250 million, and has available a $50 million accordion feature which, if successfully subscribed, would expand the permitted borrowings to a maximum of $300 million. As of March 31, 20212022 and December 31, 2020,2021, there were 0no outstanding borrowings on the Revolving Credit Agreement.
Covenant Compliance
There are no financial covenants associated with the Senior Notes or the Contribution Certificates due 2023.2023 and 2031, respectively.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2022
The Revolving Credit Agreement contains customary representations, covenants and events constituting default, and remedies for default. The Revolving Credit Agreement also defines financial covenants regarding permitted leverage ratios. ProAssurance is currently in compliance with all covenants of the Revolving Credit Agreement. On April 19, 2021, ProAssurance amended and restated its Revolving Credit Agreement to allow for additional indebtedness of a subsidiary in preparation of the close of the NORCAL acquisition. This amendment to the Revolving Credit Agreement is included as Exhibit 10.1 of this report.
The Mortgage Loans contain customary representations, covenants and events constituting default, and remedies for default. The Mortgage Loans also define a financial covenant regarding a permitted leverage ratio for each of the two ProAssurance subsidiaries that entered into the Mortgage Loans. ProAssurance's subsidiaries are currently in compliance with the financial covenant of the Mortgage Loans.
Additional Information
For additional information regarding ProAssurance's debt, see Note 1113 of the Notes to Consolidated Financial Statements included in ProAssurance's December 31, 20202021 report on Form 10-K.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2021
11.8. Shareholders’ Equity
At March 31, 20212022 and December 31, 2020,2021, ProAssurance had 100 million shares of authorized common stock and 50 million shares of authorized preferred stock. The Board has the authority to determine provisions for the issuance of preferred shares, including the number of shares to be issued, the designations, powers, preferences and rights, and the qualifications, limitations or restrictions of such shares.
ProAssurance declared cash dividends of $0.05 and $0.31 per share during the first quarter of 2021both 2022 and 2020, respectively.2021. Dividends declared during the 20212022 and 20202021 three-month periods totaled $2.7 million and $16.7 million, respectively.in each period. Any decision to pay future cash dividends is subject to the Board’s final determination after a comprehensive review of financial performance, future expectations and other factors deemed relevant by the Board. See Note 1214 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 20202021 report on Form 10-K for additional information.
At March 31, 2021,2022, Board authorizations for the repurchase of common shares or the retirement of outstanding debt of $110 million remained available for use. ProAssurance did 0tnot repurchase any common shares during the three months ended March 31, 20212022 or 2020.2021.
Other Comprehensive Income (Loss) and Accumulated Other Comprehensive Income (Loss)
The following tables provide a detailed breakout of the components of AOCI and the amounts reclassified from AOCI to net income (loss). The tax effects of all amounts in the tables below, except for an immaterial amount of unrealized gains and losses on available-for-sale securities held at the Company's U.K. subsidiary, were computed using the enacted U.S. federal corporate tax rate of 21%. For the three months ended March 31, 2021 and 2020, OCI included a deferred tax benefit of $38.2 million and $8.3 million for the three months ended March 31, 2022 and $11.0 million,2021, respectively.
The changes in the balance of each component of AOCI for the three months ended March 31, 20212022 and 20202021 were as follows:
(In thousands)(In thousands)Unrealized Investment Gains (Losses)Non-credit ImpairmentsUnrecognized Change in Defined Benefit Plan Liabilities*Accumulated Other Comprehensive Income (Loss)(In thousands)Unrealized Investment Gains (Losses)Unrecognized Change in Defined Benefit and Post Retirement LiabilitiesAccumulated Other Comprehensive Income (Loss)
Balance December 31, 2020$75,388 $(57)$(104)$75,227 
Balance, December 31, 2021Balance, December 31, 2021$14,929 $1,355 $16,284 
OCI, before reclassifications, net of taxOCI, before reclassifications, net of tax(30,415)(30,415)OCI, before reclassifications, net of tax(140,808)— (140,808)
Amounts reclassified from AOCI, net of taxAmounts reclassified from AOCI, net of tax(3,347)57 (3,290)Amounts reclassified from AOCI, net of tax(28)(14)(42)
Net OCI, current periodNet OCI, current period(33,762)57 0 (33,705)Net OCI, current period(140,836)(14)(140,850)
Balance March 31, 2021$41,626 $0 $(104)$41,522 
Balance, March 31, 2022Balance, March 31, 2022$(125,907)$1,341 $(124,566)

(In thousands)(In thousands)Unrealized Investment Gains (Losses)Non-credit ImpairmentsUnrecognized Change in Defined Benefit Plan Liabilities*Accumulated Other Comprehensive Income (Loss)(In thousands)Unrealized Investment Gains (Losses)Non-credit Impairments
Unrecognized Change in Defined Benefit Plan Liabilities(1)
Accumulated Other Comprehensive Income (Loss)
Balance December 31, 2019$36,577 $300 $78 $36,955 
Balance, December 31, 2020Balance, December 31, 2020$75,388 $(57)$(104)$75,227 
OCI, before reclassifications, net of taxOCI, before reclassifications, net of tax(42,497)517 (41,980)OCI, before reclassifications, net of tax(30,415)— — (30,415)
Amounts reclassified from AOCI, net of taxAmounts reclassified from AOCI, net of tax115 115 Amounts reclassified from AOCI, net of tax(3,347)57 — (3,290)
Net OCI, current periodNet OCI, current period(42,382)517 (41,865)Net OCI, current period(33,762)57 — (33,705)
Balance March 31, 2020$(5,805)$817 $78 $(4,910)
* Represents the re-estimation of the defined benefit plan liability assumed in the Eastern acquisition. The defined benefit plan is frozen as to the earnings of additional benefits and the benefit plan liability is re-estimated annually.
Balance, March 31, 2021Balance, March 31, 2021$41,626 $— $(104)$41,522 
(1)For three months ended March 31, 2021, amounts represent the re-estimation of the defined benefit plan liability assumed in the Eastern acquisition. The defined benefit plan was frozen as to the earnings of additional benefits and the benefit plan liability was reestimated annually. The Company terminated Eastern's defined benefit plan during the third quarter of 2021.
(1)For three months ended March 31, 2021, amounts represent the re-estimation of the defined benefit plan liability assumed in the Eastern acquisition. The defined benefit plan was frozen as to the earnings of additional benefits and the benefit plan liability was reestimated annually. The Company terminated Eastern's defined benefit plan during the third quarter of 2021.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
12.9. Variable Interest Entities
ProAssurance holds passive interests in a number of entities that are considered to be VIEs under GAAP guidance. ProAssurance's VIE interests principally consist of interests in LPs/LLCs formed for the purpose of achieving diversified equity and debt returns. ProAssurance's VIE interests, carried as a part of investment in unconsolidated subsidiaries, totaled $270.8$291.4 million at March 31, 20212022 and $282.2$303.7 million at December 31, 2020.
2021. ProAssurance does not have power over the activities that most significantly impact the economic performance of these VIEs and thus is not the primary beneficiary. Investments in entities where ProAssurance holds a greater than minor interest but does not hold a controlling interest are accounted for using the equity method. Therefore, ProAssurance has not consolidated these VIEs. ProAssurance’s involvement with each VIEof these VIEs is limited to its direct ownership interest in the VIE. Except for the funding commitments disclosed in Note 8,6, ProAssurance has no arrangements with any of thethese VIEs to provide other financial support to or on behalf of the VIE. At March 31, 2021,2022, ProAssurance’s maximum loss exposure relative to these investments was limited to the carrying value of ProAssurance’s investment in the VIE.
As a result of the Company's acquisition of NORCAL (see Note 2 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 2021 report on Form 10-K), ProAssurance is the primary beneficiary of PPM RRG. While there is no direct ownership of PPM RRG by ProAssurance, it manages the business operations of PPM RRG through its management services agreement and has effective control of the PPM RRG's Board of Directors through an irrevocable voting proxy. The management services agreement allows ProAssurance to provide management and oversight services to the RRG, which includes the ability to make business decisions impacting the operations of PPM RRG. PPM RRG has a $5 million surplus note to NORCAL which is its only source of capital. ProAssurance has consolidated the account balances and transactions of PPM RRG beginning on the NORCAL acquisition date of May 5, 2021. At March 31, 2022, approximately $141 million of ProAssurance's assets and approximately $141 million of its liabilities included on the Condensed Consolidated Balance Sheet were related to PPM RRG.
13.
10. Earnings (Loss) Per Share
Diluted weighted average shares is calculated as basic weighted average shares plus the effect, calculated using the treasury stock method, of assuming that restricted share units and performance share units have vested. The following table provides a reconciliation between the Company's basic weighted average number of common shares outstanding to its diluted weighted average number of common shares outstanding:
(In thousands, except per share data)(In thousands, except per share data)Three Months Ended
March 31
(In thousands, except per share data)Three Months Ended
March 31
20212020(In thousands, except per share data)20222021
Weighted average number of common shares outstanding, basicWeighted average number of common shares outstanding, basic53,918 53,808 54,012 53,918 
Dilutive effect of securities:Dilutive effect of securities:Dilutive effect of securities:
Restricted Share UnitsRestricted Share Units76 74 Restricted Share Units114 76 
Performance Share UnitsPerformance Share Units4 Performance Share Units17 
Weighted average number of common shares outstanding, dilutedWeighted average number of common shares outstanding, diluted53,998 53,885 Weighted average number of common shares outstanding, diluted54,143 53,998 
Effect of dilutive shares on earnings (loss) per shareEffect of dilutive shares on earnings (loss) per share$0 $Effect of dilutive shares on earnings (loss) per share$ $— 
Dilutive common share equivalents are reflected in the earnings (loss) per share calculation while antidilutive common share equivalents are not reflected in the earnings (loss) per share calculation. There were no antidilutive common share equivalents for the three months ended March 31, 2021. For the three months ended March 31, 2020,2022, all incremental common share equivalents were not included in the computation of diluted earnings (loss) per share because to do so would have been antidilutive for the period. There were no antidilutive common share equivalents for the three months ended March 31, 2021.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
14.11. Segment Information
ProAssurance's segments are based on the Company's internal management reporting structure for which financial results are regularly evaluated by the Company's CODM to determine resource allocation and assess operating performance. The Company continually assesses its internal management reporting structure and information evaluated by its CODM to determine whether any changes have occurred that would impact its segment reporting structure.
The Company operates in 5 segments that are organized around the nature of the products and services provided: Specialty P&C, Workers' Compensation Insurance, Segregated Portfolio Cell Reinsurance, Lloyd's Syndicates and Corporate. Additional information regarding ProAssurance's segments is included in Note 18 of the Notes to Consolidated Financial Statements in ProAssurance’s December 31, 2021 report on Form 10-K. A description of each of ProAssurance's 5 operating and reportable segments follows.
Specialty P&C includes professional liability insurance and medical technology liability insurance. Professional liability insurance is primarily comprised of medical professional liability products offered to healthcare providers and institutions. The Company also offers, to a lesser extent, professional liability insurance to attorneys and their firms. Medical technology liability insurance is offered to medical technology and life sciences companies that manufacture or distribute products including entities conducting human clinical trials. In addition, the Company also offers custom alternative risk solutions including loss portfolio transfers, assumed reinsurance and captive cell programs for healthcare professional liability insureds. For the alternative market captive cell programs, the Specialty P&C segment cedes either all or a portion of the premium to certain SPCs in the Company's Segregated Portfolio Cell Reinsurance segment.
Workers' Compensation Insurance includes workers' compensation insurance products which are provided primarily to employers with 1,000 or fewer employees. The segment's products include guaranteed cost policies, policyholder dividend policies, retrospectively-rated policies, deductible policies and alternative market solutions. Alternative market program premiums include program design, fronting, claims administration, risk management, SPC rental, asset management and SPC management services. Alternative market program premiums are 100% ceded to either SPCs in the Company's Segregated Portfolio Cell Reinsurance segment or, to a limited extent, to a captive insurer unaffiliated with ProAssurance.
Segregated Portfolio Cell Reinsurance includes the results (underwriting profit or loss, plus investment results, net of U.S. federal income taxes) of SPCs at Inova Re and Eastern Re, the Company's Cayman Islands SPC operations. Each SPC is owned, fully or in part, by an agency, group or association, and the results of the SPCs are attributable to the participants of that cell. ProAssurance participates to a varying degree in the results of selected SPCs. SPC results attributable to external cell participants are reflected as SPC dividend expense (income) in the Segregated Portfolio Cell Reinsurance segment and in ProAssurance's Condensed Consolidated Statements of Income and Comprehensive Income. In addition, the Segregated Portfolio Cell Reinsurance segment includes the investment results of the SPCs as the investments are solely for the benefit of the cell participants, and investment results attributable to external cell participants are reflected in SPC dividend expense (income). The SPCs assume workers' compensation insurance, healthcare professional liability insurance or a combination of the two from the Company's Workers' Compensation Insurance and Specialty P&C segments.
Lloyd's Syndicates includes the results from ProAssurance's participation in Lloyd's of London Syndicate 1729 and Syndicate 6131. The results of this segment are normally reported on a quarter lag, except when information is available that is material to the current period. Furthermore, investment results associated with the majority of investment assets solely allocated to Lloyd's Syndicate operations and certain U.S. paid administrative expenses are reported concurrently as that information is available on an earlier time frame. Syndicate 1729 underwrites risks over a wide range of property and casualty insurance and reinsurance lines in both the U.S. and international markets while Syndicate 6131 focuses on contingency and specialty property business, also within the U.S. and international markets. To support and grow the Company's core insurance operations, ProAssurance decreased itsProAssurance's participation in the results of Syndicate 1729 for the 2022 underwriting year remains unchanged from the 2021 underwriting year toat 5% from 29%. Effective January 1, 2022, Syndicate 6131 is an SPA that underwritesceased underwriting on a quota share basis with Syndicate 1729. Effective July 1, 2020,1729 as Syndicate 6131 entered into a six-month quota share reinsurance agreement with an unaffiliated insurer. Under this agreement, Syndicate 6131 ceded essentially half of the premium assumed from6131's applicable business is retained within Syndicate 1729 tobeginning with the unaffiliated insurer; the agreement was non-renewed on January 1, 2021 and the Company decreased its participation in the results2022 year of Syndicate 6131 to 50% from 100% for the 2021 underwriting year.account. Due to the quarter lag, the change in the Company's ceased participation in the results of Syndicates 1729 andSyndicate 6131 will not be reflected in itsthe Company's results until the second quarter of 2021.2022.
Corporate includes ProAssurance's investment operations other thanand excludes those reported in the Company's Segregated Portfolio Cell Reinsurance and Lloyd's Syndicates segments,segments. In addition, this segment includes corporate expenses, interest expense andexpense. U.S. income taxes. The segment also includestaxes and non-premium revenues generated outside of the Company's insurance entities and corporate expenses.entities.
The accounting policies of the segments are described in Note 1 of the Notes to Consolidated Financial Statements in ProAssurance’s December 31, 20202021 report on Form 10-K. ProAssurance evaluates the performance of its Specialty P&C and Workers' Compensation Insurance segments based on before tax underwriting profit or loss. ProAssurance evaluates the performance of its Segregated Portfolio Cell Reinsurance segment based on operating profit or loss, which includes investment
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 2021
results of investment assets solely allocated to SPC operations, net of U.S. federal income taxes. Performance of the Lloyd's Syndicates segment is evaluated based on operating profit or loss, which includes investment results of investment assets solely allocated to Lloyd's Syndicate operations, net of U.K. income tax expense. Performance of the Corporate segment is evaluated based on the contribution made to consolidated after-tax results. ProAssurance accounts for inter-segment transactions as if the transactions were to third parties at current market prices. Assets are not allocated to segments because investments, other than the investments discussed above that are solely allocated to the Segregated Portfolio Cell Reinsurance and Lloyd's Syndicates segments, and other assets are not managed at the segment level. The tabular information that follows shows the financial results of the Company's reportable segments reconciled to results reflected in the Condensed Consolidated Statements of Income and Comprehensive Income. Beginning in the second quarter of 2021, transaction-related costs rose to a significant level; therefore, management determined that transaction-related costs will not be included in a segment on a prospective basis beginning in the second quarter of 2021 as ProAssurance does not consider asset impairments, including goodwill and intangible asset impairments,these costs in assessing the financial performance of any of its operating andor reportable segments, and thussegments. As a result, transaction-related costs are included in the reconciliation of segment results to consolidated results.
Financial results by segment were as follows:
Three Months Ended March 31, 2021
(In thousands)Specialty P&CWorkers' Compensation InsuranceSegregated Portfolio Cell ReinsuranceLloyd's SyndicatesCorporateInter-segment EliminationsConsolidated
Net premiums earned$115,613 $40,011 $15,884 $15,850 $0 $0 $187,358 
Net investment income0 0 221 729 14,067 0 15,017 
Equity in earnings (loss) of unconsolidated subsidiaries0 0 0 0 6,788 0 6,788 
Net realized gains (losses)0 0 987 (115)7,977 0 8,849 
Other income (expense)(1)
469 392 1 221 1,894 (972)2,005 
Net losses and loss adjustment expenses(101,186)(26,207)(9,425)(12,967)0 0 (149,785)
Underwriting, policy acquisition and operating expenses(1)
(26,346)(12,286)(5,025)(6,591)(7,175)972 (56,451)
SPC U.S. federal income tax expense(2)
0 0 (356)0 0 0 (356)
SPC dividend (expense) income0 0 (1,742)0 0 0 (1,742)
Interest expense0 0 0 0 (3,212)0 (3,212)
Income tax benefit (expense)0 0 0 0 (736)0 (736)
Segment results$(11,450)$1,910 $545 $(2,873)$19,603 $0 7,735 
Net income (loss)$7,735 
Significant non-cash items:
Depreciation and amortization, net of accretion$2,171 $903 $316 $15 $3,317 $0 $6,722 
for the three months ended March 31, 2022.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
Three Months Ended March 31, 2020
(In thousands)Specialty P&CWorkers' Compensation InsuranceSegregated Portfolio Cell ReinsuranceLloyd's SyndicatesCorporateInter-segment EliminationsConsolidated
Net premiums earned$120,359 $44,515 $16,980 $22,001 $$$203,855 
Net investment income254 1,159 19,417 20,830 
Equity in earnings (loss) of unconsolidated subsidiaries(1,562)(1,562)
Net realized gains (losses)(3,207)81 (25,547)(28,673)
Other income (expense)(1)
1,698 757 136 (232)633 (741)2,251 
Net losses and loss adjustment expenses(110,931)(29,769)(9,352)(14,780)(164,832)
Underwriting, policy acquisition and operating expenses(1)
(29,585)(14,164)(5,079)(9,142)(4,827)741 (62,056)
SPC U.S. federal income tax expense(2)
(222)(222)
SPC dividend (expense) income508 508 
Interest expense(4,129)(4,129)
Income tax benefit (expense)29 12,047 12,076 
Segment results$(18,459)$1,339 $18 $(884)$(3,968)$(21,954)
Net income (loss)$(21,954)
Significant non-cash items:
Depreciation and amortization, net of accretion$1,580 $926 $69 $$2,150 $$4,734 
(1) Certain fees for services provided to the SPCs at Inova Re and Eastern Re are recorded as expenses within the Segregated Portfolio Cell Reinsurance segment and as other income within the Workers' Compensation Insurance segment. These fees are primarily SPC rental fees and are eliminated between segments in consolidation.
(2) Represents the provision for U.S. federal income taxes for SPCs at Inova Re, which have elected to be taxed as a U.S. corporation under Section 953(d) of the Internal Revenue Code. U.S. federal income taxes are included in the total SPC net results and are paid by the individual SPCs.
Financial results by segment were as follows:

Three Months Ended March 31, 2022
(In thousands)Specialty P&CWorkers' Compensation InsuranceSegregated Portfolio Cell ReinsuranceLloyd's SyndicatesCorporateInter-segment EliminationsConsolidated
Net premiums earned$197,967 $40,684 $19,314 $7,746 $ $ $265,711 
Net investment income  112 211 20,120  20,443 
Equity in earnings (loss) of unconsolidated subsidiaries    7,620  7,620 
Net investment gains (losses)  (711)(399)(12,396) (13,506)
Other income (expense)(1)
1,019 682 1 134 2,065 (1,097)2,804 
Net losses and loss adjustment expenses(2)
(165,958)(27,211)(11,491)(4,763)  (209,423)
Underwriting, policy acquisition and operating expenses(1)(2)
(42,878)(13,001)(4,369)(2,709)(8,739)1,097 (70,599)
SPC U.S. federal income tax expense(3)
  (642)   (642)
SPC dividend (expense) income  (2,367)   (2,367)
Interest expense    (4,441) (4,441)
Income tax benefit (expense)    1,770  1,770 
Segment results$(9,850)$1,154 $(153)$220 $5,999 $ (2,630)
Reconciliation of segments to consolidated results:
Transaction-related costs, net(4)
(930)
Net income (loss)$(3,560)
Significant non-cash items:
Depreciation and amortization, net of accretion$2,592 $874 $370 $14 $6,500 $ $10,350 
Three Months Ended March 31, 2021
(In thousands)Specialty P&CWorkers' Compensation InsuranceSegregated Portfolio Cell ReinsuranceLloyd's SyndicatesCorporateInter-segment EliminationsConsolidated
Net premiums earned$115,613 $40,011 $15,884 $15,850 $— $— $187,358 
Net investment income— — 221 729 14,067 — 15,017 
Equity in earnings (loss) of unconsolidated subsidiaries— — — — 6,788 — 6,788 
Net investment gains (losses)— — 987 (115)7,977 — 8,849 
Other income (expense)(1)
469 392 221 1,894 (972)2,005 
Net losses and loss adjustment expenses(101,186)(26,207)(9,425)(12,967)— — (149,785)
Underwriting, policy acquisition and operating expenses(1)
(26,346)(12,286)(5,025)(6,591)(7,175)972 (56,451)
SPC U.S. federal income tax expense(3)
— — (356)— — — (356)
SPC dividend (expense) income— — (1,742)— — — (1,742)
Interest expense— — — — (3,212)— (3,212)
Income tax benefit (expense)— — — — (736)— (736)
Segment results$(11,450)$1,910 $545 $(2,873)$19,603 $— 7,735 
Net income (loss)$7,735 
Significant non-cash items:
Depreciation and amortization, net of accretion$2,171 $903 $316 $15 $3,317 $— $6,722 
(1) Certain fees for services provided to the SPCs at Inova Re and Eastern Re are recorded as expenses within the Segregated Portfolio Cell Reinsurance segment and as other income within the Workers' Compensation Insurance segment. These fees are primarily SPC rental fees and are eliminated between segments in consolidation.
(2) During the first quarter of 2022, ProAssurance revised its estimate of ULAE as a result of substantially integrating NORCAL into the Specialty P&C segment operations. The change in the Company's estimate of ULAE increased underwriting, policy acquisition and operating expenses with an offsetting decrease to net losses and loss adjustment expenses in the Specialty P&C segment; there was no impact on segment results for the three months ended March 31, 2022. See further discussion on this change in estimate in Note 1.
(3) Represents the provision for U.S. federal income taxes for SPCs at Inova Re, which have elected to be taxed as a U.S. corporation under Section 953(d) of the Internal Revenue Code. U.S. federal income taxes are included in the total SPC net results and are paid by the individual SPCs.
(4) Represents the transaction-related costs, after-tax, associated with the acquisition of NORCAL. Pre-tax transaction-related costs of approximately $1.2 million were included as a component of consolidated operating expense and the associated income tax benefit of approximately $0.3 million were included as a component of consolidated income tax benefit (expense) on the Condensed Consolidated Statements of Income and Comprehensive Income for the three months ended March 31, 2022.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022

The following table provides detailed information regarding ProAssurance's gross premiums earned by product as well as a reconciliation to net premiums earned. All gross premiums earned are from external customers except as noted. ProAssurance's insured risks are primarily within the U.S.
Three Months Ended March 31Three Months Ended March 31
(In thousands)(In thousands)20212020(In thousands)20222021
Specialty P&C SegmentSpecialty P&C SegmentSpecialty P&C Segment
Gross premiums earned:Gross premiums earned:Gross premiums earned:
HCPLHCPL$97,045 $103,467 HCPL$175,547 $97,045 
Small Business UnitSmall Business Unit25,925 26,650 Small Business Unit26,538 25,925 
Medical Technology LiabilityMedical Technology Liability8,938 8,529 Medical Technology Liability10,000 8,938 
OtherOther152 377 Other194 152 
Ceded premiums earnedCeded premiums earned(16,447)(18,664)Ceded premiums earned(14,312)(16,447)
Segment net premiums earnedSegment net premiums earned115,613 120,359 Segment net premiums earned197,967 115,613 
Workers' Compensation Insurance SegmentWorkers' Compensation Insurance SegmentWorkers' Compensation Insurance Segment
Gross premiums earned:Gross premiums earned:Gross premiums earned:
Traditional businessTraditional business41,743 47,485 Traditional business43,156 41,743 
Alternative market businessAlternative market business16,889 18,128 Alternative market business17,878 16,889 
Ceded premiums earnedCeded premiums earned(18,621)(21,098)Ceded premiums earned(20,350)(18,621)
Segment net premiums earnedSegment net premiums earned40,011 44,515 Segment net premiums earned40,684 40,011 
Segregated Portfolio Cell Reinsurance SegmentSegregated Portfolio Cell Reinsurance SegmentSegregated Portfolio Cell Reinsurance Segment
Gross premiums earned:Gross premiums earned:Gross premiums earned:
Workers' compensation(1)
Workers' compensation(1)
16,115 17,513 
Workers' compensation(1)
17,178 16,115 
HCPL(2)
HCPL(2)
1,852 1,677 
HCPL(2)
4,486 1,852 
Ceded premiums earnedCeded premiums earned(2,083)(2,210)Ceded premiums earned(2,350)(2,083)
Segment net premiums earnedSegment net premiums earned15,884 16,980 Segment net premiums earned19,314 15,884 
Lloyd's Syndicates SegmentLloyd's Syndicates SegmentLloyd's Syndicates Segment
Gross premiums earned:Gross premiums earned:Gross premiums earned:
Property and casualtyProperty and casualty20,385 28,196 Property and casualty9,232 20,385 
Ceded premiums earnedCeded premiums earned(4,535)(6,195)Ceded premiums earned(1,486)(4,535)
Segment net premiums earnedSegment net premiums earned15,850 22,001 Segment net premiums earned7,746 15,850 
Consolidated net premiums earnedConsolidated net premiums earned$187,358 $203,855 Consolidated net premiums earned$265,711 $187,358 
(1) Premium for all periods is assumed from the Workers' Compensation Insurance segment.
(2) Premium for all periods is assumed from the Specialty P&C segment.
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ProAssurance Corporation and Subsidiaries
Notes to Condensed Consolidated Financial Statements (Unaudited)
March 31, 20212022
15. Subsequent Event12. Benefit Plans
OnProAssurance assumed a defined benefit pension plan on May 5, 2021 ProAssurance completedas a result of its acquisition of NORCAL, by purchasing over 98%which covers substantially all NORCAL employees (except those that were previous employees of Medicus Insurance Company and FD Insurance Company, employees of PPM RRG as well as new hires after December 31, 2013). Benefits are based on years of service and the employee’s average of the converted company stockhighest five years of annual compensation. Annual contributions to the defined benefit pension plan are not less than the minimum funding standards outlined in exchangethe Employee Retirement Income Security Act of 1974, as amended. ProAssurance makes contributions to the defined benefit pension plan with the goal of ensuring that it is adequately funded to meet its future obligations. ProAssurance did not make any contributions to the pension plan during the three months ended March 31, 2022 and does not anticipate making any contributions for base considerationthe remainder of $441 million, which includes cash from ProAssurance of $248 million.2022. The cash consideration from ProAssurancedefined benefit pension plan no longer has future service accruals or compensation increases because this plan was funded by cash on hand as of May 5, 2021. On May 6, 2021, ProAssurance borrowed $15 million under its Revolving Credit Agreement to pay certain transaction-related expenses (see Note 10frozen effective December 31, 2015. See Notes 2 and 19 of the Notes to Condensed Consolidated Financial Statements for further discussion of the terms of the Revolving Credit Agreement). The consideration also includes contribution certificates as well as contingent consideration depending upon the development of NORCAL's ultimate net losses over a three-year period beginningin ProAssurance's December 31, 2020. The contribution certificates will be issued to certain NORCAL policyholders in the conversion of NORCAL Mutual, and those instruments are an obligation of NORCAL Insurance Company, the successor of NORCAL. The base consideration and maximum contingent consideration are subject to final verification as the equity allocation is reviewed and finalized post close.
The determination of the fair value of the contingent consideration, along with the allocation of the final purchase consideration to the assets acquired and liabilities assumed was not complete as of the date of this report. The required disclosures related to this acquisition will be provided in ProAssurance's June 30, 2021 report on Form 10-Q upon completion10-K for more information regarding ProAssurance's acquisition of NORCAL and defined benefit pension plan, respectively.
The components of the valuation ofnet periodic benefit cost (income) for the assets acquired and liabilities assumed.three months ended March 31, 2022 were as follows:
NORCAL is an underwriter of medical professional liability insurance and this transaction will provide strategic and financial benefits including additional scale and geographic diversification in the physician professional liability market and is expected to be accretive to earnings over time.
($ in thousands)Three Months Ended March 31, 2022
Components of net periodic benefit cost (income):
Interest cost$711
Expected return on Plan assets(989)
Total net periodic benefit cost (income)*$(278)
*Net periodic benefit cost (income) is included as a component of operating expense on the Condensed Consolidated Statements of Income and Comprehensive Income for the three months ended March 31, 2022.
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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS.
The following discussion should be read in conjunction with the Condensed Consolidated Financial Statements and Notes to those statements which accompany this report. Throughout the discussion we use certain terms and abbreviations, which can be found in the Glossary of Terms and Acronyms at the beginning of this report. In addition, a glossary of insurance terms and phrases is available on the investor section of our website. Throughout the discussion, references to "ProAssurance," "PRA," "Company," "we," "us" and "our" refer to ProAssurance Corporation and its consolidated subsidiaries. The discussion contains certain forward-looking information that involves significant risks, assumptions and uncertainties. As discussed under the heading "Caution Regarding Forward-Looking Statements," our actual financial condition and results of operations could differ significantly from these forward-looking statements.
ProAssurance Overview
ProAssurance Corporation is a holding company for property and casualty insurance companies. Our wholly owned insurance subsidiaries provide professional liability insurance, liability insurance for medical technology and life sciences risks and workers' compensation insurance. We also provide capital to Syndicate 1729 and Syndicate 6131 at Lloyd's of London.
We operate in five segments which are based on our internal management reporting structure for which financial results are regularly evaluated by our CODM to determine resource allocation and assess operating performance. Descriptions ofperformance: Specialty P&C, Workers' Compensation Insurance, Segregated Portfolio Reinsurance, Lloyd's Syndicates and Corporate. Additional information on ProAssurance's five operating and reportable segments are as follows:
Specialty P&C - This segment includes our professional liability business and medical technology liability business. Our professional liability insurance is primarily comprised of medical professional liability products offered to healthcare providers and institutions. We also offer, to a lesser extent, professional liability insurance to attorneys and their firms. Medical technology liability insurance is offered to medical technology and life sciences companies that manufacture or distribute products including entities conducting human clinical trials. We also offer custom alternative risk solutions including loss portfolio transfers, assumed reinsurance and captive cell programs for healthcare professional liability insureds. For our alternative market captive cell programs, we cede either all or a portion of the premium to certain SPCs in our Segregated Portfolio Cell Reinsurance segment.
Workers' Compensation Insurance - This segment includes our workers' compensation insurance business which is provided primarily to employers with 1,000 or fewer employees. Our workers' compensation products include guaranteed cost policies, policyholder dividend policies, retrospectively-rated policies, deductible policies and alternative market solutions. Alternative market program premiums are 100% ceded to either SPCs in our Segregated Portfolio Cell Reinsurance segment or, to a limited extent, an unaffiliated captive insurer.
Segregated Portfolio Cell Reinsurance - This segment includes the results (underwriting profit or loss, plus investment results, net of U.S. federal income taxes) of SPCs at Inova Re and Eastern Re, our Cayman Islands SPC operations. Each SPC is owned, fully or in part, by an agency, group or association, and the results of the SPCs are attributable to the participants of that cell. We participate to a varying degree in the results of selected SPCs and, for the SPCs in which we participate, our participation interest ranges from a low of 20% to a high of 85%. SPC results attributable to external cell participants are reflected as an SPC dividend expense (income) in our Segregated Portfolio Cell Reinsurance segment. The SPCs assume workers' compensation insurance, healthcare professional liability insurance or a combination of the two from our Workers' Compensation Insurance and Specialty P&C segments.
Lloyd's Syndicates - This segment includes the results from our participation in Lloyd's of London Syndicate 1729 and Syndicate 6131. The results of this segment are normally reported on a quarter lag, except when information is available that is material to the current period. Syndicate 1729 underwrites risks over a wide range of property and casualty insurance and reinsurance lines in both the U.S. and international markets while Syndicate 6131 focuses on contingency and specialty property business, also within the U.S. and international markets. To support and grow our core insurance operations, we decreased our participation in the results of Syndicate 1729 for the 2021 underwriting year to 5% from 29%. Syndicate 6131 is an SPA that underwrites on a quota share basis with Syndicate 1729. Effective July 1, 2020, Syndicate 6131 entered into a six-month quota share reinsurance agreement with an unaffiliated insurer. Under this agreement, Syndicate 6131 ceded essentially half of the premium assumed from Syndicate 1729 to the unaffiliated insurer; the agreement was non-renewed on January 1, 2021 and we decreased our participation in the results of Syndicate 6131 to 50% from 100% for the 2021 underwriting year. Due to the quarter lag, the change in our participation in the results of Syndicates 1729 and 6131 will not be reflected in our results until the second quarter of 2021.
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Corporate - This segment includes our investment operations, other than those reported in our Segregated Portfolio Cell Reinsurance and Lloyd's Syndicates segments, interest expense and U.S. income taxes. This segment also includes non-premium revenues generated outside of our insurance entities and corporate expenses.
Additional information regarding our segments is included in Note 1418 of the Notes to Condensed Consolidated Financial Statements in our December 31, 2021 report on Form 10-K and in the Segment Results sections herein that follow.
Critical Accounting Estimates
Our Condensed Consolidated Financial Statements are prepared in conformity with GAAP. Preparation of these financial statements requires us to make estimates and assumptions that affect the amounts we report on those statements. We evaluate these estimates and assumptions on an ongoing basis based on current and historical developments, market conditions, industry trends and other information that we believe to be reasonable under the circumstances, including the potential impacts of the COVID-19 pandemic (see "Item 1A, Risk Factors" and "Critical Accounting Estimates" in our December 31, 20202021 report on Form 10-K for additional information). We can make no assurance that actual results will conform to our estimates and assumptions; reported results of operations may be materially affected by changes in these estimates and assumptions.
For further information on the significant A detailed discussion of our critical accounting policies we followestimates is included in making estimates that materially affect financial reporting please refer to the Notes to Consolidated Financial Statementsour Critical Accounting Estimates section in Item 7 of our December 31, 20202021 report on Form 10-K.
Management considers the following accounting estimates to be critical because they involve significant judgment by management and those judgments could result in a material effect on our financial statements.statements:
Reserve for Losses and Loss Adjustment Expenses
The largest component of our liabilities is our reserve for losses and loss adjustment expenses ("reserve for losses" or "reserve"), and the largest component of expense for our operations is incurred losses and loss adjustment expenses (also referred to as “losses and loss adjustment expenses,” “incurred losses,” “losses incurred” and “losses”). Incurred losses reported in any period reflect our estimate of losses incurred related to the premiums earned in that period as well as any changes to our previous estimate of the reserve required for prior periods.
As of March 31, 2021, our reserve is comprised almost entirely of long-tail exposures. The estimation of long-tailed losses is inherently difficult and is subject to significant judgment on the part of management. Due to the nature of our claims, our loss costs, even for claims with similar characteristics, can vary significantly depending upon many factors, including but not limited to the specific characteristics of the claim and the manner in which the claim is resolved. Long-tailed insurance is characterized by the extended period of time typically required both to assess the viability of a claim and potential damages, if any, and to reach a resolution of the claim. The claims resolution process may extend to more than five years. The combination of continually changing conditions and the extended time required for claim resolution results in a loss cost estimation process that requires actuarial skill and the application of significant judgment, and such estimates require periodic modification.
Our reserve is established by management after taking into consideration a variety of factors including premium rates, historical paid and incurred loss development trends and our evaluation of the current loss environment including frequency, severity, the expected effect of inflation, general economic and social trends, and the legal and political environment. We also take into consideration the conclusions reached by our internal and consulting actuaries. We update and review the data underlying the estimation of our reserve for losses each reporting period and make adjustments to loss estimation assumptions that we believe best reflect emerging data. Both our internal and consulting actuaries perform an in-depth review of our reserve for losses on at least a semi-annual basis using the loss and exposure data of our insurance subsidiaries.
Our reserving process can be broadly grouped into three areas: the establishment of the reserve for the current accident year (the initial reserve), the re-estimation of the reserve for prior accident years (development of prior accident years) and the establishment of the initial reserve for risks assumed in business combinations, applicable only in periods in which acquisitions occur (the acquired reserve).
Current Accident Year - Initial Reserve
Considerable judgment is required in establishing our initial reserve for any current accident year period, as there is limited data available upon which to base our estimate (see further discussion that follows under heading "Use of Judgment"). Our process for setting an initial reserve considers the unique characteristics of each product, but in general we rely heavily on the loss assumptions that were used to price business, as our pricing reflects our analysis of loss costs that we expect to incur relative to the insurance product being priced.
Specialty P&C Segment. Loss costs within this segment are impacted by many factors including but not limited to the nature of the claim, including whether or not the claim is an individual or a mass tort claim, the personal situation of the claimant or the claimant's family, the outcome of jury trials, the legislative and judicial climate where any potential litigation may occur, general economic and social trends and, for claims involving bodily injury, the trend of healthcare costs. Within our
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Specialty P&C segment, for our professional liability business (80% of our consolidated gross reserve for losses and loss adjustment expenses as of December 31, 2020; predominately comprised of our HCPL products), we set an initial reserve based upon our evaluation of the current loss environment including frequency, severity, economic inflation, social inflation and legal trends.
We observed a reduction in claims frequency in 2020 that has continued into 2021, some of which is likely associated with the COVID-19 pandemic; however, we continue to remain cautious in recognizing these favorable frequency trends in our current accident year reserve due to the long-tailed nature of our HCPL claims as well as the uncertainty surrounding the length and severity of the pandemic. See further discussion in our Segment Results - Specialty Property & Casualty section that follows under the heading "Losses and Loss Adjustment Expenses."
The risks insured in our Medical Technology Liability business (3% of our consolidated gross reserve for losses and loss adjustment expenses as of December 31, 2020) are more varied, and policies are individually priced based on the risk characteristics of the policy and the account. The insured risks range from startup operations to large multinational entities, and the larger entities often have significant deductibles or self-insured retentions. Reserves are established using our most recently developed actuarial estimates of losses expected to be incurred based on factors which include results from prior analysis of similar business, industry indications, observed trends and judgment. Claims in this line of business primarily involve bodily injury to individuals and are affected by factors similar to those of our HCPL line of business. For the Medical Technology Liability business, we also establish an initial reserve using a loss ratio approach, including a provision in consideration of historical loss volatility that this line of business has exhibited.
Workers' Compensation Insurance Segment. Many factors affect the ultimate losses incurred for our workers' compensation coverages (8% of our consolidated gross reserve for losses and loss adjustment expenses as of December 31, 2020) including but not limited to the type and severity of the injury, the age, health and occupation of the injured worker, the estimated length of disability, medical treatment and related costs, and the jurisdiction and workers' compensation laws of the state of the injury occurrence.
We use various actuarial methodologies in developing our workers’ compensation reserve, combined with a review of the payroll exposure base. For the current accident year, given the lack of seasoned information, the different actuarial methodologies produce results with significant variability; therefore, more emphasis is placed on supplementing results from the actuarial methodologies with trends in exposure base, medical expense inflation, general inflation, severity, and claim counts, among other things, to select an expected loss ratio.
As in our Specialty P&C segment, we observed a reduction in claims frequency in 2020 that has continued into 2021 in our Workers' Compensation Insurance segment, some of which is likely associated with the COVID-19 pandemic. While we reduced our current accident year loss ratio in 2020 in our Workers' Compensation Insurance segment in response to these favorable trends as these claims are shorter-tailed in nature as compared to our HCPL claims, we continue to remain cautious in our evaluation of the current accident year reserve due to the uncertainty surrounding the length and severity of the pandemic. Furthermore, the impact of legislative and regulatory bodies in certain states changing or attempting to broaden compensability requirements for COVID-19 claims could, if successful, have an adverse impact on the frequency and severity related to COVID-19 claims. See further discussion in the "Insurance Regulatory Matters" section in Part 1, Item 1 of our December 31, 2020 report on Form 10-K. Furthermore, as it relates to both our Workers' Compensation Insurance and Segregated Portfolio Cell Reinsurance segments, the current economic conditions resulting from the COVID-19 pandemic have introduced significant risk of a prolonged recession, which could have an adverse impact on our return to wellness efforts and the ability of injured workers to return to work, resulting in a potential reduction in favorable claim trends in future periods.
Segregated Portfolio Cell Reinsurance Segment. The factors that affect the ultimate losses incurred for the workers' compensation and HCPL coverages assumed by the SPCs at Inova Re and Eastern Re (4% of our consolidated gross reserve for losses and loss adjustment expenses as of December 31, 2020) are consistent with that of our Workers’ Compensation Insurance and Specialty P&C segments, respectively.
Lloyd's Syndicates Segment. Initial reserves for Syndicate 1729 and Syndicate 6131 are primarily recorded using the loss assumptions by risk category incorporated into each Syndicate's business plan submitted to Lloyd's with consideration given to loss experience incurred to date (5% of our consolidated gross reserve for losses and loss adjustment expenses as of December 31, 2020). The assumptions used in each business plan are consistent with loss results reflected in Lloyd's historical data for similar risks. The loss ratios may also fluctuate due to the mix of earned premium from different open underwriting years which we participate in to varying degrees, as well as the timing of earned premium adjustments. Such adjustments may be the result of premiums for certain policies and assumed reinsurance contracts being reported subsequent to the coverage period and may be subject to adjustment based on loss experience. Premium and exposure for some of Syndicate 1729's insurance policies and reinsurance contracts are initially estimated and subsequently recorded over an extended period of time as reports are received under delegated underwriting authority programs. When reports are received, the premium, exposure and corresponding loss estimates are revised accordingly. Changes in loss estimates due to premium or exposure fluctuations are incurred in the accident year in which the premium is earned.
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For significant property catastrophe exposures, Syndicate 1729 uses third-party catastrophe models to accumulate a listing of potentially affected policies. Each identified policy is given an estimate of loss severity based upon a combination of factors including the probable maximum loss of each policy, market share analytics, underwriting judgment, client/broker estimates and historical loss trends for similar events. These models are inherently uncertain, reliant upon key assumptions and management judgment and are not always a representation of actual events and ensuing potential loss exposure. Determination of actual losses may take an extended period of time until claims are reported and resolved, including coverage litigation.
Development of Prior Accident Years
In addition to setting the initial reserve for the current accident year, each period we reassess the amount of reserve required for prior accident years.
Our reserve re-estimation process is based upon the most recently completed actuarial analysis supplemented by any new analysis, information or trends that have emerged since the date of that study. We also take into account currently available industry trend information. Changes to previously established reserve estimates are recognized in the current period if management’s best estimate of ultimate losses differs from the estimate previously established. While management considers a variety of variables in determining its best estimate, in general, as claims age, our methodologies give more weight to actual loss costs which, for the majority of our reserves, continue to indicate that ultimate loss costs will be lower than our previous estimates. The discussion in our Critical Accounting Estimates section in Item 7 of our December 31, 2020 report on Form 10-K includes additional information regarding the methodologies used to evaluate our reserve.
Any change in our estimate of net ultimate losses for prior accident years is reflected in net income (loss) in the period in which such changes are made. In recent years such changes have reduced our estimate of consolidated net ultimate losses, resulting in a reduction of reported losses for the period and a corresponding increase in pre-tax income.
Due to the size of our consolidated reserve for losses and the large number of claims outstanding at any point in time, even a small percentage adjustment to our total reserve estimate could have a material effect on our results of operations for the period in which the adjustment is made. Please refer to the Executive Summary of Operations and Segment Results sections that follow for a discussion on consolidated and segment prior accident year loss development recognized in the current period.
Use of Judgment
The process of estimating reserves involves a high degree of judgment and is subject to a number of variables. These variables can be affected by both views of internal and external events, such as changes in views of economic inflation, legal trends and legislative changes, as well as differentiating views of individuals involved in the reserve estimation process, among others. We continually refine our estimates in a regular, ongoing process as historical loss experience develops and additional claims are reported and settled. Our objective is to consider all significant facts and circumstances known at the time.
Changes in economic conditions and steps taken by the federal government and the Federal Reserve in response to COVID-19 could lead to inflation trends that are different from those we anticipated when establishing our reserves, which could in turn lead to an increase or decrease in our loss costs and the need to strengthen or reduce reserves. These impacts of inflation on loss costs and reserves could be more pronounced for our HCPL line of business as that business generally requires a longer period of time to settle claims for a given accident year and, accordingly, is relatively more inflation sensitive.
We use various actuarial methods in the process of setting reserves. Each actuarial method generally returns a different value, and for the more recent accident years the variations among the various methodologies can be significant. In order to project ultimate losses, we partition our reserves for analysis such as by line of business, geography, coverage layer or accident year. For each partition of our reserves, we evaluate the results of the various methods, along with the supplementary statistical data regarding such factors as closed with and without indemnity ratios, claim severity trends, the expected duration of such trends, changes in the legal and legislative environment and the current economic environment to develop a point estimate based upon management's judgment and past experience. The series of selected point estimates is then combined to produce an overall point estimate for ultimate losses.
HCPL. Over the past several years the most influential factor affecting the analysis of our HCPL reserves and the related development recognized has been an observed increase in claim severity for the broader medical professional liability industry as well as higher initial loss expectations on incurred claims. The severity trend is an explicit component of our pricing models and directly impacts the reserving process. Our estimate of this trend and our expectations about changes in this trend impact a variety of factors, from the selection of expected loss ratios to the ultimate point estimates established by management.
Because of the implicit and wide-ranging nature of severity trend assumptions on the loss reserving process, it is not practical to specifically isolate the impact of changing severity trends. However, because severity is an explicit component of our HCPL pricing process we can better isolate the impact that changing severity can have on our loss costs and loss ratios in regards to our pricing models for this business component. Our current HCPL pricing models assume severity trends in the
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range of 2% to 5% depending on state, territory and specialty. In some portions of our HCPL business we have observed and reflected higher severity trends in our estimates of losses and loss adjustment expenses.
Due to the long-tailed nature of our claims and the previously discussed historical volatility of loss costs, selection of a severity trend assumption is a subjective process that is inherently likely to prove inaccurate over time. Given the long tail and volatility, we are generally cautious in making changes to the severity assumptions within our pricing models. All open claims and accident years are generally impacted by a change in the severity trend, which compounds the effect of such a change.
Although the future degree and impact of the ultimate severity trend remains uncertain due to the long-tailed nature of our business, we have given consideration to observed loss costs in setting our rates. For our HCPL business, this practice had generally resulted in rate reductions as claim frequency declined and remained at historically low levels. However, from early 2017 to the current period, the average pricing on renewed business has steadily increased reflective of the rising loss cost environment, and we anticipate further renewal pricing increases due to increasing loss severity.
More recently, another factor affecting our analysis of our HCPL reserves and the related development recognized is the reduction in claims frequency in 2020, some of which is likely associated with the COVID-19 pandemic, as previously discussed. In 2020, we established a $10 million reserve related to COVID-19. This reserve represents our best estimate of ultimate COVID-19 related losses based on currently available information and reported incidents. Similar to our views on our current accident year reserve, we remain cautious in recognizing these favorable frequency trends in our prior accident year reserve due to the long-tailed nature of our HCPL claims as well as the uncertainty surrounding the length and severity of the pandemic. Accordingly, no adjustment has been made to this reserve since 2020.
Workers' Compensation. The projection of changes in claim severity trend has not historically been an influential factor affecting our analysis of workers' compensation reserves, as claims are typically resolved more quickly than the industry norm. As previously mentioned, the determination and calculation of loss development factors, in particular, the selection of tail factors which are used to extend the projection of losses beyond historical data, requires considerable judgment.
Investment Valuations
We record the majority of our investments at fair value as shown in the table below. At March 31, 2021, the distribution of our investments based on GAAP fair value hierarchies (levels) was as follows:
 Distribution by GAAP Fair Value Hierarchy
 Level 1Level 2Level 3Not CategorizedTotal
Investments
Investments recorded at:
Fair value10%78%1%7%96%
Other valuations4%
Total Investments100%
Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. All of our fixed maturity and equity investments are carried at fair value. The fair value of our short-term securities approximates the cost of the securities due to their short-term nature.
Because of the number of securities we own and the complexity of developing accurate fair values, we utilize multiple independent pricing services to assist us in establishing the fair value of individual securities. The pricing services provide fair values based on exchange-traded prices, if available. If an exchange-traded price is not available, the pricing services, if possible, provide a fair value that is based on multiple broker/dealer quotes or that has been developed using pricing models. Pricing models vary by asset class and utilize currently available market data for securities comparable to ours to estimate a fair value for our securities. The pricing services scrutinize market data for consistency with other relevant market information before including the data in the pricing models. The pricing services disclose the types of pricing models used and the inputs used for each asset class. Determining fair values using these pricing models requires the use of judgment to identify appropriate comparable securities and to choose a valuation methodology that is appropriate for the asset class and available data.
The pricing services provide a single value per instrument quoted. We review the values provided for reasonableness each quarter by comparing market yields generated by the supplied value versus market yields observed in the marketplace. We also compare yields indicated by the provided values to appropriate benchmark yields and review for values that are unchanged or that reflect an unanticipated variation as compared to prior period values. We utilize a primary pricing service for each security type and compare provided information for consistency with alternate pricing services, known market data and information from our own trades, considering both values and valuation trends. We also review weekly trades versus the prices supplied by the services. If a supplied value appears unreasonable, we discuss the valuation in question with the pricing service and make
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adjustments if deemed necessary. Historically our review has not resulted in any material changes to the values supplied by the pricing services. The pricing services do not provide a fair value unless an exchange-traded price or multiple observable inputs are available. As a result, the pricing services may provide a fair value for a security in some periods but not others, depending upon the level of recent market activity for the security or comparable securities.
Level 1 Investments
Fair values for a majority of our equity securities and portions of our short-term and convertible securities are determined using exchange-traded prices. There is little judgment involved when fair value is determined using an exchange-traded price. In accordance with GAAP, we classify securities valued using an exchange-traded price as Level 1 securities.
Level 2 Investments
Most fixed income securities do not trade daily; thus, exchange-traded prices are generally not available for these securities. However, market information (often referred to as observable inputs or market data, including but not limited to, last reported trade, non-binding broker quotes, bids, benchmark yield curves, issuer spreads, two-sided markets, benchmark securities, offers and recent data regarding assumed prepayment speeds, cash flow and loan performance data) is available for most of our fixed income securities. We determine fair value for a large portion of our fixed income securities using available market information. In accordance with GAAP, we classify securities valued based on multiple market observable inputs as Level 2 securities.
Level 3 Investments
When a pricing service does not provide a value for one of our fixed maturity securities, management estimates fair value using either a single non-binding broker quote or pricing models that utilize market based assumptions which have limited observable inputs. The process involves significant judgment in selecting the appropriate data and modeling techniques to use in the valuation process. In accordance with GAAP, we classify securities valued using limited observable inputs as Level 3 securities.
Fair Values Not Categorized
We hold interests in certain investment funds, primarily LPs/LLCs, which measure fund assets at fair value on a recurring basis and provide us with a NAV for our interest. As a practical expedient, we consider the NAV provided to approximate the fair value of the interest. In accordance with GAAP, we do not categorize these investments within the fair value hierarchy.
Nonrecurring Fair Value Measurements
We measure the fair value of certain assets on a nonrecurring basis when events or changes in circumstances indicate that the carrying amount of the asset may not be recoverable. These assets include investments carried principally at cost, investments in tax credit partnerships, fixed assets, goodwill and other intangible assets. These assets would also include any equity method investments that do not provide a NAV. We did not have any assets or liabilities that were measured at fair value on a nonrecurring basis at March 31, 2021 or December 31, 2020.
Investments - Other Valuation Methodologies
Certain of our investments, in accordance with GAAP for the type of investment, are measured using methodologies other than fair value. At March 31, 2021, these investments represented approximately 4% of total investments, and are detailed in the following table. Additional information about these investments is provided in Notes 2 and 3 of the Notes to Condensed Consolidated Financial Statements.
(In millions)Carrying ValueGAAP Measurement Method
Other investments:
Other, principally FHLB capital stock$2.4 Principally Cost
Investment in unconsolidated subsidiaries:
Investments in tax credit partnerships24.4 Equity
Equity method investments, primarily LPs/LLCs48.1 Equity
72.5 
BOLI66.9 Cash surrender value
Total investments - Other valuation methodologies$141.8
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Impairments
We evaluate our available-for-sale investment securities, which at March 31, 2021 and December 31, 2020 consisted entirely of fixed maturity securities, on at least a quarterly basis for the purpose of determining whether declines in fair value below recorded cost basis represent an impairment loss. We consider a credit-related impairment loss to have occurred:
if there is intent to sell the security;
if it is more likely than not that the security will be required to be sold before full recovery of its amortized cost basis; orReinsurance
if the entire amortized basisValuation of the security is not expected to be recovered.
The assessmentinvestments and impairment of whether the amortized cost basis of a security is expected to be recovered requires management to make assumptions regarding various matters affecting future cash flows. The choice of assumptions is subjective and requires the use of judgment. Actual credit losses experienced in future periods may differ from management’s estimates of those credit losses. Methodologies used to estimate the present value of expected cash flows are:
The estimate of expected cash flows is determined by projecting a recovery value and a recovery time frame and assessing whether further principal and interest will be received. We consider various factors in projecting recovery values and recovery time frames, including the following:
third-party research and credit rating reports;securities
the current credit standing of the issuer, including credit rating downgrades, whether before or after the balance sheet date;Goodwill
the extent to which the decline in fair value is attributable to credit risk specifically associated with the security or its issuer;
internal assessments and the assessments of external portfolio managers regarding specific circumstances surrounding an investment, which indicate the investment is more or less likely to recover its amortized cost than other investments with a similar structure;
for asset-backed securities, the origination date of the underlying loans, the remaining average life, the probability that credit performance of the underlying loans will deteriorate in the future and our assessment of the quality of the collateral underlying the loan;
failure of the issuer of the security to make scheduled interest or principal payments;
any changes to the rating of the security by a rating agency;
recoveries or additional declines in fair value subsequent to the balance sheet date;
adverse legal or regulatory events;
significant deterioration in the market environment that may affect the value of collateral (e.g. decline in real estate prices);
significant deterioration in economic conditions; and
disruption in the business model resulting from changes in technology or new entrants to the industry.
If deemed appropriate and necessary, a discounted cash flow analysis is performed to confirm whether a credit loss exists and, if so, the amount of the credit loss. We use the single best estimate approach for available-for-sale debt securities and consider all reasonably available data points, including industry analyses, credit ratings, expected defaults and the remaining payment terms of the debt security. For fixed rate available-for-sale debt securities, cash flows are discounted at the security's effective interest rate implicit in the security at the date of acquisition. If the available-for-sale debt security’s contractual interest rate varies based on subsequent changes in an independent factor, such as an index or rate, for example, the prime rate, the LIBOR, or the U.S. Treasury bill weekly average, that security’s effective interest rate is calculated based on the factor as it changes over the life of the security. If we intend to sell a debt security or believe we will more likely than not be required to sell a debt security before the amortized cost basis is recovered, any existing allowance will be written off against the security's amortized cost basis, with any remaining difference between the debt security's amortized cost basis and fair value recognized as an impairment loss in earnings.
Exclusive of securities where there is an intent to sell or where it is not more likely than not that the security will be required to be sold before recovery of its amortized cost basis, impairment for debt securities is separated into a credit component and a non-credit component. The credit component of an impairment is the difference between the security’s amortized cost basis and the present value of its expected future cash flows, while the non-credit component is the remaining difference between the security’s fair value and the present value of expected future cash flows. An allowance for expected credit losses will be recorded for the expected credit losses through income and the non-credit component is recognized in OCI. The amount of impairment recognized is limited to the excess of the amortized cost over the fair value of the available-for-sale debt security.
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Deferred Policy Acquisition Costs
Policy acquisition costs (primarily commissions, premium taxes and underwriting salaries) which are directly related to the successful acquisition of new and renewal premiums are capitalized as DPAC and charged to expense, net of ceding commissions earned, as the related premium revenue is recognized. We evaluate the recoverability of our DPAC typically at the segment level each reporting period or in a manner that is consistent with the way we manage our business. Any amounts estimated to be unrecoverable are charged to expense in the current period.
As part of our evaluation of the recoverability of DPAC, we also evaluate our unearned premiums for premium deficiencies. A premium deficiency is recognized if the sum of anticipated losses and loss adjustment expenses, unamortized DPAC and maintenance costs, net of anticipated investment income, exceeds the related unearned premium. If a premium deficiency is identified, the associated DPAC is written off, and a PDR is recorded for the excess deficiency as a component of net losses and loss adjustment expenses in our Condensed Consolidated Statement of Income and Comprehensive Income and as a component of the reserve for losses on our Condensed Consolidated Balance Sheet. During the three months ended March 31, 2021 we did not determine any DPAC to be unrecoverable.
taxes
Estimation of Taxes / Tax Credits
For interim periods, we generally utilize the estimated annual effective tax rate method under which we determine our provision (benefit) for income taxes based on the current estimate of our annual effective tax rate. For the three months ended March 31, 2022, we utilized the discrete effective tax rate method for recording income taxes after the estimated annual effective tax rate method produced an unreliable estimated annual effective tax rate. The discrete method is applied when the application of the estimated annual effective tax rate method is impractical and does not provide a reliable estimate of the annual effective tax rate. We believe the use of the discrete effective tax rate method is more appropriate than the annual effective tax rate method for the three months ended March 31, 2022 as minor changes in our estimated ordinary income would have a significant effect on the estimated annual effective tax rate and would result in sizable variations in the customary relationship between income tax expense (benefit) and pre-tax accounting income (loss). For the three months ended March 31, 2021, we utilized the estimated annual effective tax rate method. Under the estimated annual effective tax rate method, items which are unusual, infrequent, or that cannot be reliably estimated are considered in the effective tax rate in the period in which the item is included in income, and are referred to as discrete items. In calculating our year-to-date income tax expense (benefit), under the estimated annual effective tax rate method, we include the estimated benefit of tax credits for the year-to-date period based on the most recently available information provided by the tax credit partnerships; the actual amounts of credits provided by the tax credit partnerships may prove to be different than our estimates. The effect of such a difference is recognized in the period identified.
Deferred Taxes
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Deferred federal income taxes arise from the recognition of temporary differences between the basis of assets and liabilities determined for financial reporting purposes and the basis determined for income tax purposes. Our temporary differences principally relate to our loss reserves, unearned and advanced premiums, DPAC, tax credit carryforwards, compensation related items, unrealized investment gains (losses) and basis differences on fixed assets, intangible assets and operating leases. Deferred tax assets and liabilities are measured using the enacted tax rates expected to be in effect when such benefits are realized. We review our deferred tax assets quarterly for impairment. If we determine that it is more likely than not that some or all of a deferred tax asset will not be realized, a valuation allowance is recorded to reduce the carrying value of the asset. In assessing the need for a valuation allowance, management is required to make certain judgments and assumptions about our future operations based on historical experience and information as of the measurement period regarding reversal of existing temporary differences, carryback capacity, future taxable income of the appropriate character (including its capital and operating characteristics) and tax planning strategies.
A valuation allowance was established in a prior year against the deferred tax asset related to the NOL carryforwards for the U.K. operations. In addition, a valuation allowance was established in 2020 against a portion of the deferred tax asset related to the U.S. state NOL carryforwards. Management concluded that it was more likely than not that these deferred tax assets will not be realized. We also established a valuation allowance in a prior year against the deferred tax assets of certain SPCs at our wholly owned Cayman Islands reinsurance subsidiary, Inova Re. Due to the limited operations of these SPCs, management concluded that a valuation allowance was required. As of March 31, 2021, management concluded that a valuation allowance was still required against the deferred tax assets related to the NOL carryforwards for the U.K. operations, against the deferred tax assets related to the U.S. state NOL carryforwards and against the deferred tax assets of certain SPCs at Inova Re. See further discussion in Note 5 of the Notes to Consolidated Financial Statements in our December 31, 2020 report on Form 10-K.
U.S. Tax Legislation
Coronavirus Aid, Relief and Economic Security Act
In response to COVID-19, the CARES Act was signed into law on March 27, 2020 and contains several provisions for corporations and eases certain deduction limitations originally imposed by the TCJA. See further discussion in Note 5 of the Notes to Consolidated Financial Statements in our December 31, 2020 report on Form 10-K. We anticipate the temporary changes regarding NOL carryback provisions included in the CARES Act will have a favorable impact on our liquidity (see discussion that follows in the Liquidity and Capital Resources and Financial Condition section under the heading "Taxes").
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American Rescue Plan Act of 2021
In response to economic concerns associated with COVID-19, the American Rescue Plan Act of 2021 was signed into law on March 11, 2021 and includes an expansion of the number of employees covered by the limitation on the deductibility of compensation in excess of $1 million. This provision is effective for tax years beginning after December 31, 2026. We have evaluated this provision as well as the other provisions of the American Rescue Plan Act of 2021 and concluded that they will not have a material impact on our financial position or results of operations as of March 31, 2021. See further discussion in Note 5 of the Notes to Condensed Consolidated Financial Statements.
Unrecognized Tax Benefits
We evaluate tax positions taken on tax returns and recognize positions in our financial statements when it is more likely than not that we will sustain the position upon resolution with a taxing authority. If recognized, the benefit is measured as the largest amount of benefit that has a greater than 50% probability of being realized. We review uncertain tax positions each quarter, considering changes in facts and circumstances, such as changes in tax law, interactions with taxing authorities and developments in case law, and make adjustments as we consider necessary. Adjustments to our unrecognized tax benefits may affect our income tax expense, and settlement of uncertain tax positions may require the use of cash. Other than differences related to timing, no significant adjustments were considered necessary during the three months ended March 31, 2021 or 2020. At March 31, 2021, our liability for unrecognized tax benefits approximated $5.2 million.
Goodwill / Intangibles
Goodwill and intangible assets are tested for impairment annually or more frequently if circumstances indicate an impairment may have occurred. The date of our annual impairment testing is October 1. Impairment of goodwill is tested at the reporting unit level, which is consistent with our reportable segments identified in Note 14 of the Notes to Condensed Consolidated Financial Statements. Of the five reporting units, two have net goodwill - Workers' Compensation Insurance and Segregated Portfolio Cell Reinsurance. For our last annual impairment test at October 1, 2020, we performed qualitative assessments for our Workers' Compensation Insurance and Segregated Portfolio Cell Reinsurance reporting units (see Note 6 of the Notes to Condensed Consolidated Financial Statements). Management concluded that it was not more likely than not that the fair value of each of our two reporting units that have net goodwill was less than the carrying value of each reporting unit as of the testing date; therefore no further impairment testing was required. In addition, there were no triggering events as of March 31, 2021 that would suggest an updated impairment test would be needed for our goodwill and intangible assets. Additional information regarding our goodwill and intangible assets is included Note 1 and Note 6 of the Notes to Consolidated Financial Statements included in our December 31, 2020 report on Form 10-K.
Given the evolving, uncertain nature of the COVID-19 pandemic, the estimates and assumptions used by management in these impairment tests have inherent uncertainties, and different assumptions could lead to materially different results including impairment charges in the future. Management expects to continue to monitor developments and perform updated analyses as necessary.
Accounting Changes
During the first quarter of 2022, we revised our estimate of ULAE as a result of substantially integrating NORCAL into our Specialty P&C segment operations. ULAE are costs that cannot be attributed to processing a specific claim and are allocated to net losses and loss adjustment expenses on the Condensed Consolidated Statement of Income and Comprehensive Income. We have accounted for this change prospectively as a change in accounting estimate. Changes in accounting estimate are reflected prospectively beginning in the period the change in estimate occurs. The change in our estimate of ULAE resulted in an increase to underwriting, policy acquisition and operating expenses with an offsetting decrease to net losses and loss adjustment expenses in our Specialty P&C segment; there was no impact on total expenses or net income (loss) in our Condensed Consolidated Statement of Income and Comprehensive Income for the three months ended March 31, 2022. See further discussion on this change in estimate in the Segment Results - Specialty Property & Casualty section that follows and in Note 1 of the Notes to Condensed Consolidated Financial Statements as a result of this change in the estimate.
We did not have any other change in accounting estimate or policy that had a material effect on our results of operations or financial position during the three months ended March 31, 2021.2022. We are not aware of any accounting changes not yet adopted as of March 31, 20212022 that could have a material impact on our results of operations, financial position or cash flows.
Liquidity and Capital Resources and Financial Condition
Overview
ProAssurance Corporation is a holding company and is a legal entity separate and distinct from its subsidiaries. As a holding company, our principal source of external revenue is our investment revenues. In addition, dividends from our operating subsidiaries represent another source of funds for our obligations, including debt service and shareholder dividends. We also charge our operating subsidiaries within our Specialty P&C (including the acquired operating subsidiaries of
NORCAL effective January 1, 2022) and Workers' Compensation Insurance segments a management fee based on the extent to which services are provided to the subsidiary and the amount of gross premium written by the subsidiary. At March 31, 2021,2022, we held cash and liquid investments of approximately $250$65 million outside our insurance subsidiaries that were available for use without regulatory approval or other restriction. We also have $250 million in permitted borrowings available under our Revolving Credit Agreement as well as the possibility of a $50 million accordion feature, if successfully subscribed. As of April 30, 2021,May 4, 2022, no borrowings were outstanding under our Revolving Credit Agreement.
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To date, during 2021,2022, our operating subsidiaries have paid dividends to us of approximately $15 million, all of which were paid in April 2021. Dividends paid in April 2021 have not been included in our cash and liquid investments held outside of our insurance subsidiaries at March 31, 2021.$1 million. In the aggregate, our insurance subsidiaries are permitted to pay dividends of approximately $92$148 million over the remainder of 20212022 without prior approval of state insurance regulators. However, the payment of any dividend requires prior notice to the insurance regulator in the state of domicile, and the regulator may reduce or prevent the dividend if, in its judgment, payment of the dividend would have an adverse effect on the surplus of the insurance subsidiary. We make the decision to pay dividends from an insurance subsidiary based on the capital needs of that subsidiary and may pay less than the permitted dividend or may also request permission to pay an additional amount (an extraordinary dividend).
Cash Flows
Cash flows between periods compare as follows:
Three Months Ended March 31
(In thousands)20212020Change
Net cash provided (used) by:
Operating activities$28,700 $(12,049)$40,749 
Investing activities(26,261)71,825 (98,086)
Financing activities(3,386)(17,976)14,590 
Increase (decrease) in cash and cash equivalents$(947)$41,800 $(42,747)
Three Months Ended March 31
(In thousands)20202019Change
Net cash provided (used) by:
Operating activities$(12,049)$34,392 $(46,441)
Investing activities71,825 3,868 67,957 
Financing activities(17,976)(46,901)28,925 
Increase (decrease) in cash and cash equivalents$41,800 $(8,641)$50,441 
The principal components of our operating cash flows are the excess of premiums collected and net investment income over losses paid and operating costs, including income taxes. Timing delays exist between the collection of premiums and the payment of losses associated with the premiums. Premiums are generally collected within the twelve-month period after the policy is written, while our claim payments are generally paid over a more extended period of time. Likewise, timing delays exist between the payment of claims and the collection of any associated reinsurance recoveries.
The increase in operating cash flows for the three months ended March 31, 2021 as compared to the three months ended March 31, 2020 of $40.7 million was primarily due to a decrease in paid losses of $54.5 million driven by our Specialty P&C and Segregated Portfolio Cell Reinsurance segments. The decrease in paid losses in our Specialty P&C segment was primarily due to a smaller number of claims resolved with large indemnity payments as compared to the prior year period, some of which is likely associated with the COVID-19 pandemic including the disruption of the court systems. The decrease in paid losses in our Segregated Portfolio Cell Reinsurance segment reflected the effect of the payment of a $10 million claim during the first quarter of 2020 by an SPC at Eastern Re in which we do not participate. This claim payment related to a reserve established by the SPC in 2019 related to an errors and omissions liability policy. Additionally, the increase in operating cash flows reflected a decrease in cash paid for operating expenses of $17.7 million driven by a decrease in various operational expenses in our Specialty P&C, Workers' Compensation Insurance and Corporate segments resulting from improvements over the past year including organizational structure enhancements and improved operating efficiencies. In addition, the decrease in cash paid for operating expenses was due to our decreased participation in the results of Syndicate 1729 for the 2020 underwriting year. Furthermore, the increase in operating cash flows reflected a tax refund of approximately $9.0 million which we received in February 2021 (see additional discussion within this section under the heading "Taxes" that follows). The increase in operating cash flows was partially offset by a decrease in net premium receipts of $33.6 million driven by our Lloyd's Syndicates and Specialty P&C segments. The decrease in premium receipts in our Lloyd's Syndicates segment reflected our decreased participation in the results of Syndicate 1729 for the 2020 underwriting year. The decrease in premium receipts in our Specialty P&C segment was due to our re-underwriting efforts and the dissolution of our arrangement with CAPAssurance. The remaining variance in operating cash flows for the three months ended March 31, 2021 as compared to the three months ended March 31, 2020 was comprised of individually insignificant components.
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The decrease in operating cash flows for the three months ended March 31, 2020 as compared to the three months ended March 31, 2019 of $46.4 million was primarily due to an increase in paid losses of $54.2 million and a decrease in net premium receipts of $9.3 million. The increase in paid losses was driven by our Specialty P&C and Segregated Portfolio Cell Reinsurance segments. The increase in paid losses in our Specialty P&C segment was primarily due to higher average claim payments. The increase in paid losses in our Segregated Portfolio Cell Reinsurance segment reflected the aforementioned payment of a $10 million claim by an SPC at Eastern Re. The decrease in net premium receipts was primarily due to a decline in written premium in our Specialty P&C and Workers' Compensation Insurance segments. The decrease in operating cash flows was somewhat offset by a decrease in 2020 tax payments as compared to 2019 of $6.4 million and a decrease in paid bonuses of $3.0 million. The decrease in tax payments was primarily due to refunds received during the three months ended March 31, 2020. The remaining variance in operating cash flows for the three months ended March 31, 2020 as compared to the three months ended March 31, 2019 was comprised of individually insignificant components.
We manage our investing cash flows to ensure that we will have sufficient liquidity to meet our obligations, taking into consideration the timing of cash flows from our investments, including interest payments, dividends and principal payments, as well as the expected cash flows to be generated by our operations as discussed in this section under the heading "Investing Activities and Related Cash Flows."
Our financing cash flows are primarily comprised of dividend payments and borrowings and repayments under our Revolving Credit Agreement. See further discussion of our financing activities in this section under the heading "Financing Activities and Related Cash Flows."
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Operating Activities and Related Cash Flows
Reinsurance
Within our Specialty P&C segment, we use insurance and reinsurance (collectively, “reinsurance”) to provide capacity to write larger limits of liability, to provide reimbursement for losses incurred under the higher limit coverages we offer and to provide protection against losses in excess of policy limits. Within our Workers' Compensation Insurance segment, we use reinsurance to reduce our net liability on individual risks, to mitigate the effect of significant loss occurrences (including catastrophic events), to stabilize underwriting results and to increase underwriting capacity by decreasing leverage. In both our Specialty P&C and Workers' Compensation Insurance segments, we use reinsurance in risk sharing arrangements to align our objectives with those of our strategic business partners and to provide custom insurance solutions for large customer groups. Within our Lloyd's Syndicates segment, Syndicate 1729 utilizes reinsurance to provide capacity to write larger limits of liability on individual risks, to provide protection against catastrophic loss and to provide protection against losses in excess of policy limits. The discussion in our Liquidity section under the same heading in Item 7 of our December 31, 20202021 report on Form 10-K includes additional information regarding our reinsurance agreements.
Excess of Loss Reinsurance Agreements
We generally reinsure risks under treaties (our excess of loss reinsurance agreements) pursuant to which the reinsurers agree to assume all or a portion of all risks that we insure above our individual risk retention levels, up to the maximum individual limits offered. Generally, these agreements are negotiated and renewed annually. Our HCPL treaty renews annually on October 1 and, for the October 1, 2020 renewal, we increased our retention to $2 million from $1 million and added provisions for reinstatement premiums which resulted in a reduction to the gross rate paid under the renewed treaty. Historically, our Medical Technology Liability treaty renewed annually on January 1; however, the treaty that renewed on January 1, 2020 renewed on a short-term basis and was renewed again for a full year term on October 1, 2020 along with our HCPL treaty. Our Medical Technology Liability treaty which renewed on October 1, 2020 renewed at a lower rate than the previous agreement, with an increase in retention to $2 million from $1 million. Our Workers' Compensation treaty renews annually on May 1. Our traditional workers' compensation treaty renewed May 1, 2020 at a higher rate than the previous agreement, with an increase in the AAD to 3.16% from 2.1% of ceded earned premium, in excess of the $0.5 million retention per loss occurrence; all other material treaty terms were consistent with the expiring agreement. The significant coverages provided by our current excess of loss reinsurance agreements are detailed in the following table.
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Excess of Loss Reinsurance Agreements
pra-20210331_g1.jpgpra-20220331_g1.jpg
Healthcare Professional LiabilityMedical Technology & Life Sciences ProductsWorkers'
Compensation - Traditional
(1) Effective October 1, 2020, one prepaid limit reinstatement of $21M and a second limit reinstatement of up to $21M for the second layer, subject to reinstatement premium, which attaches after the first reinstatement has been completely exhausted. All limit reinstatements thereafter require no additional premium. Effective October 1, 2021, limits can be reinstated a maximum of four times.
(2) Prior to October 1, 2020, retention was $1M.
(3) Historically, retention has ranged from 5%2.5% to 32.5%.
(4) Historically, retention has ranged from $1M to $2M.
(5) Includes an AAD where retention is 3.16%3.5% of subject earned premium in annual losses otherwise recoverable in excess of the $500K retention per loss occurrence.
Large HCPL risks that are above the limits of our basic reinsurance treaties are reinsured on a facultative basis, whereby the reinsurer agrees to insure a particular risk up to a designated limit. We also have in place a number of risk sharing arrangements that apply to the first $2 million of losses for certain large healthcare systems and other insurance entities, as well as with certain insurance agencies that produce business for us.
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Other Reinsurance Arrangements
For the workers' compensation business ceded to Inova Re and Eastern Re, each SPC has in place its own reinsurance arrangements; which are illustrated in the following table.
Segregated Portfolio Cell Reinsurance
pra-20220331_g2.jpg
Per Occurrence CoverageAggregate Coverage
(1) The attachment point is based on a percentage of written premium within individual cells, ranges from 85% to 94%, and varies by cell.
Each SPC has participants
Cash Flows
Cash flows between periods compare as follows:
Three Months Ended March 31
(In thousands)20222021Change
Net cash provided (used) by:
Operating activities$14,265 $28,700 $(14,435)
Investing activities(77,134)(26,261)(50,873)
Financing activities(8,632)(3,386)(5,246)
Increase (decrease) in cash and cash equivalents$(71,501)$(947)$(70,554)
The principal components of our operating cash flows are the excess of premiums collected and net investment income over losses paid and operating costs, including income taxes. Timing delays exist between the collection of premiums and the profit or losspayment of each cell accrues fully to these cell participants. As previously discussed, we participatelosses associated with the premiums. Premiums are generally collected within the twelve-month period after the policy is written, while our claim payments are generally paid over a more extended period of time. Likewise, timing delays exist between the payment of claims and the collection of any associated reinsurance recoveries.
The decrease in certain SPCs to a varying degree. Each SPC maintains a loss fund initially equaloperating cash flows of $14.4 million for the three months ended March 31, 2022 as compared to the difference between premium assumedthree months ended March 31, 2021 was primarily due to:
An increase in paid losses of $67.8 million driven by the cellour Specialty P&C segment primarily due to NORCAL paid losses and the ceding commission.payment of three large claims totaling $16.4 million during the first quarter of 2022.
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An increase in cash paid for operating expenses of $51.7 million driven by our Specialty P&C and Corporate segments. The external participantsincrease in cash paid for operating expenses in our Specialty P&C and Corporate segments was driven by an increase in compensation-related costs primarily attributable to an increase in headcount due to the addition of each cell provide collateral to us, typicallyNORCAL employees. Furthermore, the increase in our Specialty P&C segment reflected an increase in commissions paid driven by additional premiums from our acquisition of NORCAL. Additionally, the increase reflected the termination of deferred compensation arrangements assumed in the formNORCAL acquisition during the first quarter of 2022 totaling approximately $13.2 million. See further discussion of NORCAL's deferred compensation arrangements in Note 2 to the Notes to Condensed Consolidated Financial Statements.
The effect of a lettertax refund of credit, that is initially equalapproximately $9.0 million which we received in February 2021. See additional discussion on this refund in our Liquidity section under the heading "Taxes" in Item 7 of our December 31, 2021 report on Form 10-K.
The decrease in operating cash flows was partially offset by:
An increase in net premium receipts of $95.4 million primarily driven by our Specialty P&C segment, partially offset by a decrease in our Lloyd's Syndicates segment. The increase in our Specialty P&C segment was due to additional premiums from our acquisition of NORCAL and the beneficial impacts of our re-underwriting efforts and focus on rate adequacy. The decrease in premium receipts in our Lloyd's Syndicates segment reflected our decreased participation in the results of Syndicate 1729 and Syndicate 6131 for the 2021 underwriting year.
An increase in cash received from investment income of $18.6 million driven by an increase in distributed earnings and redemptions from our portfolio of investments in LPs/LLCs. The increase in the current period also reflected an increase in our investment balances due to the difference betweenacquisition of NORCAL.
The remaining variance in operating cash flows for the loss fundthree months ended March 31, 2022 as compared to the same period of 2021 was composed of individually insignificant components.
We manage our investing cash flows to ensure that we will have sufficient liquidity to meet our obligations, taking into consideration the SPC (amounttiming of funds available to pay losses after deduction of ceding commission)cash flows from our investments, including interest payments, dividends and principal payments, as well as the aggregate attachment point of the reinsurance. Over time, an SPC's retained profits are considered in the determination of the collateral amount requiredexpected cash flows to be providedgenerated by our operations as discussed in this section under the cell's external participants.heading "Investing Activities and Related Cash Flows."
Our financing cash flows are primarily comprised of dividend payments. See further discussion of our financing activities in this section under the heading "Financing Activities and Related Cash Flows."
Taxes
We are subject to the tax laws and regulations of the U.S., Cayman Islands and U.K. We file a consolidated U.S. federal income tax return that includes the parent company and its U.S. subsidiaries.subsidiaries, except for ProAssurance American Mutual, A Risk Retention Group. Our filing obligations include a requirement to make quarterly payments of estimated taxes to the IRS using the corporate tax rate effective for the tax year. We did not make any quarterly estimated tax payments during the three months ended March 31, 20212022 or 2020.2021.
As a result of the CARES Act that was signed into law on March 27, 2020 as previously discussed, we now have the abilitywere permitted to carryback NOLs generated in tax years 2018, 2019 and 2020 for up to five years. See further discussion in the Critical Accounting Estimate section under the heading "U.S. Tax Legislation" and Note 57 of the Notes to Consolidated Financial Statements included in our December 31, 20202021 report on Form 10-K. We havegenerated an NOL of approximately $45.3$33.3 million from the 2020 tax year that will bewas carried back to the 2015 tax year and is expected to generatethat resulted in a taxclaim for a refund of approximately $15.9 million. Additionally, we had an NOL of approximately $25.6 million from the 2019 tax year which was carried back to the 2014 tax year and generated a tax refund of approximately $9.0$11.7 million, which we receivedanticipate to receive during 2022.
As a result of our acquisition of NORCAL, we recorded $46.8 million of net deferred tax assets reflecting the remeasurement of NORCAL's historical net deferred tax assets at the acquisition date of May 5, 2021. The net deferred tax assets acquired from NORCAL were subject to recalculation following application of all purchase accounting adjustments and our assessment of the realizability of NORCAL's deferred tax assets. As a result of the NORCAL acquisition, we have U.S. federal NOL carryforwards which as of March 31, 2022 were approximately $43.0 million. These NOL carryforwards are subject to limitation by Internal Revenue Code Section 382 and will begin to expire in February 2021.2035. For additional information on the NORCAL acquisition see Note 2 and Note 7 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K.
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Investing Activities and Related Cash Flows
Our investments at March 31, 20212022 and December 31, 20202021 are comprised as follows:
March 31, 2021December 31, 2020 March 31, 2022December 31, 2021
($ in thousands)($ in thousands)Carrying
Value
% of Total InvestmentCarrying
Value
% of Total Investment($ in thousands)Carrying
Value
% of Total InvestmentCarrying
Value
% of Total Investment
Fixed maturities, available-for-saleFixed maturities, available-for-saleFixed maturities, available-for-sale
U.S. Treasury obligationsU.S. Treasury obligations$102,877 3 %$107,059 %U.S. Treasury obligations$225,676 5 %$238,507 %
U.S. Government-sponsored enterprise obligationsU.S. Government-sponsored enterprise obligations11,944 1 %12,261 %U.S. Government-sponsored enterprise obligations16,733 1 %20,234 %
State and municipal bondsState and municipal bonds322,465 9 %332,920 10 %State and municipal bonds492,291 10 %519,196 11 %
Corporate debtCorporate debt1,428,866 42 %1,329,342 39 %Corporate debt1,870,256 40 %1,898,556 39 %
Residential mortgage-backed securitiesResidential mortgage-backed securities271,548 8 %276,541 %Residential mortgage-backed securities417,848 9 %453,941 %
Commercial mortgage-backed securitiesCommercial mortgage-backed securities135,037 4 %126,402 %Commercial mortgage-backed securities236,229 5 %245,624 %
Other asset-backed securitiesOther asset-backed securities290,536 9 %273,006 %Other asset-backed securities441,788 9 %457,664 %
Total fixed maturities, available-for-saleTotal fixed maturities, available-for-sale2,563,273 76 %2,457,531 73 %Total fixed maturities, available-for-sale3,700,821 79 %3,833,722 79 %
Fixed maturities, tradingFixed maturities, trading45,151 1 %48,456 %Fixed maturities, trading49,421 1 %43,670 %
Total fixed maturitiesTotal fixed maturities2,608,424 77 %2,505,987 74 %Total fixed maturities3,750,242 80 %3,877,392 80 %
Equity investments77,537 2 %120,101 %
Equity investments(1)
Equity investments(1)
203,925 4 %214,807 %
Short-term investmentsShort-term investments280,993 8 %337,813 10 %Short-term investments233,345 5 %216,987 %
BOLIBOLI66,932 2 %67,847 %BOLI80,879 2 %81,767 %
Investment in unconsolidated subsidiariesInvestment in unconsolidated subsidiaries299,360 9 %310,529 %Investment in unconsolidated subsidiaries321,402 7 %335,576 %
Other investmentsOther investments71,621 2 %47,068 %Other investments103,876 2 %101,794 %
Total investmentsTotal investments$3,404,867 100 %$3,389,345 100 %Total investments$4,693,669 100 %$4,828,323 100 %
(1) Includes $170.3 million and $187.1 million of investment grade bond funds as of March 31, 2022 December 31, 2021, respectively, which are not subject to significant equity price risk.
(1) Includes $170.3 million and $187.1 million of investment grade bond funds as of March 31, 2022 December 31, 2021, respectively, which are not subject to significant equity price risk.
At March 31, 2021,2022, 99% of our investments in available-for-sale fixed maturity securities were rated and the average rating was A+. The distribution of our investments in available-for-sale fixed maturity securities by rating were as follows:
March 31, 2021December 31, 2020March 31, 2022December 31, 2021
($ in thousands)
($ in thousands)
Carrying
Value
% of Total InvestmentCarrying
Value
% of Total Investment
($ in thousands)
Carrying
Value
% of Total InvestmentCarrying
Value
% of Total Investment
Rating*Rating*Rating*
AAAAAA$721,870 28 %$717,187 29 %AAA$1,055,035 28 %$1,129,136 29 %
AA+AA+100,285 4 %103,996 %AA+117,938 3 %130,077 %
AAAA170,503 7 %168,452 %AA243,342 6 %254,570 %
AA-AA-116,165 4 %122,733 %AA-188,939 5 %194,661 %
A+A+207,918 8 %197,274 %A+223,591 6 %221,473 %
AA360,371 14 %323,044 13 %A506,730 14 %521,598 14 %
A-A-244,943 10 %245,464 10 %A-341,477 9 %364,147 %
BBB+BBB+196,769 8 %189,971 %BBB+285,373 8 %292,984 %
BBBBBB210,681 8 %190,385 %BBB291,795 8 %300,650 %
BBB-BBB-82,604 3 %59,847 %BBB-143,304 4 %127,982 %
Below investment gradeBelow investment grade138,949 5 %133,607 %Below investment grade299,304 8 %296,444 %
Not ratedNot rated12,215 1 %5,571 %Not rated3,993 1 %— — %
TotalTotal$2,563,273 100 %$2,457,531 100 %Total$3,700,821 100 %$3,833,722 100 %
*Average of three NRSRO sources, presented as an S&P equivalent. Source: S&P, Copyright ©2021, S&P Global Market Intelligence
*Average of three NRSRO sources, presented as an S&P equivalent. Source: S&P, Copyright ©2022, S&P Global Market Intelligence*Average of three NRSRO sources, presented as an S&P equivalent. Source: S&P, Copyright ©2022, S&P Global Market Intelligence
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A detailed listing of our investment holdings as of March 31, 20212022 is located under the Financial Information heading on the Investor Relations page of our website which can be reached directly at www.proassurance.com/investmentholdingshttps://investor.proassurance.com/financial-information/quarterly-investment-supplements/default.aspx or through links from the Investor Relations section of our website, investor.proassurance.com.
We manage our investments to ensure that we will have sufficient liquidity to meet our obligations, taking into consideration the timing of cash flows from our investments, including interest payments, dividends and principal payments, as well as the expected cash flows to be generated by our operations. Furthermore, we have managed our investments as part of our capital planning in anticipation of closing our acquisition of NORCAL. In addition to the interest and dividends we will receive from our investments, we anticipate that between $40$70 million and $110$130 million of our portfolio will mature (or be paid down) each quarter over the next twelve months and become available, if needed, to meet our cash flow requirements. The primary outflow of cash at our insurance subsidiaries is related to paid losses and operating costs, including income taxes. The payment of individual claims cannot be predicted with certainty; therefore, we rely upon the history of paid claims in estimating the timing of future claims payments with consideration to current and anticipated industry trends and macroeconomic conditions. To the extent that we may have an unanticipated shortfall in cash, we may either liquidate securities or borrow funds under existing borrowing arrangements through our Revolving Credit Agreement and the FHLB system. Permitted borrowings under our Revolving Credit Agreement are $250 million with the possibility of an additional $50 million accordion feature, if successfully subscribed. Given the duration of our investments, we do not foresee a shortfall that would require us to meet operating cash needs through additional borrowings. Additional information regarding our Revolving Credit Agreement is detailed in Note 107 of the Notes to Condensed Consolidated Financial Statements.
At March 31, 2021,2022, our FAL was comprised of fixed maturity securities with a fair value of $102.8$36.9 million and cash and cash equivalents of $4.0$0.1 million deposited with Lloyd's. See further discussion in Note 3 of the Notes to Condensed Consolidated Financial Statements.
Our investment portfolio continues to be primarily composed of high quality fixed income securities with approximately 94%91% of our fixed maturities being investment grade securities as determined by national rating agencies. The weighted average effective duration of our fixed maturity securities at March 31, 20212022 was 3.393.78 years; the weighted average effective duration of our fixed maturity securities combined with our short-term securities was 3.063.55 years.
The carrying value and unfunded commitments for certain of our investments were as follows:
Carrying ValueMarch 31, 2021Carrying ValueMarch 31, 2022
($ in thousands, except expected funding period)($ in thousands, except expected funding period)March 31, 2021December 31, 2020Unfunded CommitmentExpected funding period in years($ in thousands, except expected funding period)March 31, 2022December 31, 2021Unfunded CommitmentExpected funding period in years
Qualified affordable housing project tax credit partnerships (1)
Qualified affordable housing project tax credit partnerships (1)
$24,351 $27,719 $744 6
Qualified affordable housing project tax credit partnerships (1)
$10,036 $12,424 $581 5
All other investments, primarily investment fund LPs/LLCsAll other investments, primarily investment fund LPs/LLCs275,009 282,810 116,508 3All other investments, primarily investment fund LPs/LLCs311,366 323,152 158,580 5
TotalTotal$299,360 $310,529 $117,252 Total$321,402 $335,576 $159,161 
(1) The carrying value reflects our total commitments (both funded and unfunded) to the partnerships, less any amortization, since our initial investment. We fund these investments based on funding schedules maintained by the partnerships.
(1) The carrying value reflects our total commitments (both funded and unfunded) to the partnerships, less any amortization, since our initial investment. We fund these investments based on funding schedules maintained by the partnerships.
(1) The carrying value reflects our total commitments (both funded and unfunded) to the partnerships, less any amortization, since our initial investment. We fund these investments based on funding schedules maintained by the partnerships.
Investment fund LPs/LLCs are by nature less liquid and may involve more risk than other investments. We manage our risk through diversification of asset class and geographic location. At March 31, 2021,2022, we had investments in 3034 separate investment funds with a total carrying value of $275.0$311.4 million which represented approximately 8%7% of our total investments. Our investment fund LPs/LLCs generate earnings from trading portfolios, secured debt, debt securities, multi-strategy funds and private equity investments, and the performance of these LPs/LLCs is affected by the volatility of equity and credit markets. For our investments in LPs/LLCs, we record our allocable portion of the partnership operating income or loss as the results of the LPs/LLCs become available, typically following the end of a reporting period.
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Acquisitions
On May 5, 2021, we completed the acquisition of NORCAL by purchasing over 98% of the converted company stock in exchange for base consideration of $441 million, which includes cash from ProAssurance of $248 million. The cash consideration from ProAssurance was funded by cash on hand as of May 5, 2021. The final purchase consideration also includes contribution certificates as well as contingent consideration depending upon the development of NORCAL's ultimate net losses over a three-year period beginning December 31, 2020. The base consideration and maximum contingent consideration are subject to final verification as the equity allocation is reviewed and finalized post close. The Agreement and Plan of Acquisition was previously filed as Exhibit 10.19 to our December 31, 2020 report on Form 10-K. Additional information regarding our acquisition of NORCAL is included in Note 15 of the Notes to Condensed Consolidated Financial Statements.
Financing Activities and Related Cash Flows
Treasury Shares
During the three months ended March 31, 2021 and 2020, we did not repurchase any common shares and, as of April 30, 2021, our remaining Board authorization was approximately $110 million.
ProAssurance Shareholder Dividends
Our Board declared quarterly cash dividends of $0.05 and $0.31 per share during the first quarter of 2021 and 2020, respectively. Dividends are paid the month following the quarter in which they are declared. Any decision to pay future cash dividends is subject to the Board’s final determination after a comprehensive review of financial performance, future expectations and other factors deemed relevant by the Board.
Debt
At March 31, 20212022 our debt included $250 million of outstanding unsecured senior notes. The notes bear interest at 5.3% annually and are due in November 2023 although they may be redeemed in whole or part prior to maturity. There are no financial covenants associated with these notes.
NORCAL Insurance Company, successor to NORCAL Mutual Insurance Company, issued Contribution Certificates, which bear interest at 3.0% annually and are due in 2031, to certain NORCAL policyholders in the conversion. The Contribution Certificates have a principal amount of $191 million and were recorded at their fair value of $175 million at the date of the NORCAL acquisition on May 5, 2021. The difference of $16 million between the recorded acquisition date fair value and the principal balance of the Contribution Certificates will be accreted utilizing the effective interest method over the term of the certificates of ten years as an increase to interest expense. Furthermore, interest payments are subject to deferral if we do not receive permission from the California Department of Insurance prior to payment. We received permission from the California Department of Insurance to pay the first annual interest payment which was paid in April 2022. See Note 2 and Note 13 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for additional information on the Contribution Certificates issued in the NORCAL acquisition. There are no financial covenants associated with these certificates.
We have a Revolving Credit Agreement, which expires in November 2024, that may be used for general corporate purposes, including, but not limited to, short-term working capital, share repurchases as authorized by the Board and support for other activities. Our Revolving Credit Agreement permits borrowings of up to $250 million as well as the possibility of a $50 million accordion feature, if successfully subscribed. At March 31, 2021,2022, there were no outstanding borrowings on our Revolving Credit Agreement; we are in compliance with the financial covenants of the Revolving Credit Agreement. On May 6, 2021, we borrowed $15 million under our Revolving Credit Agreement to pay certain transaction-related expenses associated with our acquisition of NORCAL (see Note 15 of the Notes to Condensed Consolidated Financial Statements for additional information).
We have Mortgage Loans with one lender in connection with the recapitalization of two office buildings, which mature in December 2027. The Mortgage Loans accrue interest at three-month LIBOR plus 1.325% with principal and interest payable on a quarterly basis. At March 31, 2021, the outstanding balance of the Mortgage Loans was approximately $36 million; we are in compliance with the financial covenant of the Mortgage Loans.
Additional information regarding our debt is provided in Note 107 of the Notes to Condensed Consolidated Financial Statements.
We utilize an interest rate cap agreement with a notional amount of $35 million to manage our exposure to increases in LIBOR on our Mortgage Loans. Per the interest rate cap agreement, we are entitled to receive cash payments if and when the three-month LIBOR exceeds 2.35%. Additional information on our interest rate cap agreement is provided in Note 11 of the Notes to Consolidated Financial Statements in our December 31, 2020 report on Form 10-K.
TwoThree of our insurance subsidiaries are members of an FHLB. Through membership, those subsidiaries have access to secured cash advances which can be used for liquidity purposes or other operational needs. In order for us to use FHLB proceeds, regulatory approvals may be required depending on the nature of the transaction. To date, those subsidiaries have not materially utilized their membership for borrowing purposes.
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Results of Operations – Three Months Ended March 31, 20212022 Compared to Three Months Ended March 31, 20202021
Selected consolidated financial data for each period is summarized in the table below.
Three Months Ended March 31Three Months Ended March 31
($ in thousands, except per share data)($ in thousands, except per share data)20212020Change($ in thousands, except per share data)20222021Change
Revenues:Revenues:Revenues:
Net premiums writtenNet premiums written$202,270 $232,217 $(29,947)Net premiums written$310,915 $202,270 $108,645 
Net premiums earnedNet premiums earned$187,358 $203,855 $(16,497)Net premiums earned$265,711 $187,358 $78,353 
Net investment resultNet investment result21,805 19,268 2,537 Net investment result28,063 21,805 6,258 
Net realized investment gains (losses)8,849 (28,673)37,522 
Net investment gains (losses)Net investment gains (losses)(13,506)8,849 (22,355)
Other incomeOther income2,005 2,251 (246)Other income2,804 2,005 799 
Total revenuesTotal revenues220,017 196,701 23,316 Total revenues283,072 220,017 63,055 
Expenses:Expenses:Expenses:
Net losses and loss adjustment expensesNet losses and loss adjustment expenses149,785 164,832 (15,047)Net losses and loss adjustment expenses209,423 149,785 59,638 
Underwriting, policy acquisition and operating expensesUnderwriting, policy acquisition and operating expenses56,451 62,056 (5,605)Underwriting, policy acquisition and operating expenses71,776 56,451 15,325 
SPC U.S. federal income tax expenseSPC U.S. federal income tax expense356 222 134 SPC U.S. federal income tax expense642 356 286 
SPC dividend expense (income)SPC dividend expense (income)1,742 (508)2,250 SPC dividend expense (income)2,367 1,742 625 
Interest expenseInterest expense3,212 4,129 (917)Interest expense4,441 3,212 1,229 
Total expensesTotal expenses211,546 230,731 (19,185)Total expenses288,649 211,546 77,103 
Income (loss) before income taxesIncome (loss) before income taxes8,471 (34,030)42,501 Income (loss) before income taxes(5,577)8,471 (14,048)
Income tax expense (benefit)Income tax expense (benefit)736 (12,076)12,812 Income tax expense (benefit)(2,017)736 (2,753)
Net income (loss)Net income (loss)$7,735 $(21,954)$29,689 Net income (loss)$(3,560)$7,735 $(11,295)
Non-GAAP operating income (loss)Non-GAAP operating income (loss)$2,085 $(1,146)$3,231 Non-GAAP operating income (loss)$7,683 $2,085 $5,598 
Earnings (loss) per share:Earnings (loss) per share:Earnings (loss) per share:
BasicBasic$0.14 $(0.41)$0.55 Basic$(0.07)$0.14 $(0.21)
DilutedDiluted$0.14 $(0.41)$0.55 Diluted$(0.07)$0.14 $(0.21)
Non-GAAP operating income (loss) per share:Non-GAAP operating income (loss) per share:Non-GAAP operating income (loss) per share:
BasicBasic$0.04 $(0.02)$0.06 Basic$0.14 $0.04 $0.10 
DilutedDiluted$0.04 $(0.02)$0.06 Diluted$0.14 $0.04 $0.10 
Net loss ratioNet loss ratio79.9 %80.9 %(1.0  pts)Net loss ratio78.8 %79.9 %(1.1  pts)
Underwriting expense ratioUnderwriting expense ratio30.1 %30.4 %(0.3  pts)Underwriting expense ratio27.0 %30.1 %(3.1  pts)
Combined ratioCombined ratio110.0 %111.3 %(1.3  pts)Combined ratio105.8 %110.0 %(4.2  pts)
Operating ratioOperating ratio102.0 %101.1 %0.9  ptsOperating ratio98.1 %102.0 %(3.9  pts)
Effective tax rateEffective tax rate8.7 %35.5 %(26.8  pts)Effective tax rate36.2 %8.7 %27.5  pts
Return on equity*Return on equity*2.3 %(6.0 %)8.3  ptsReturn on equity*(0.8 %)2.3 %(3.1  pts)
*Annualized
*Annualized. See further discussion on this calculation in the Executive Summary of Operations section under the heading "ROE."*Annualized. See further discussion on this calculation in the Executive Summary of Operations section under the heading "ROE."
In all tables that follow, the abbreviation "nm" indicates that the information or the percentage change is not meaningful.In all tables that follow, the abbreviation "nm" indicates that the information or the percentage change is not meaningful.In all tables that follow, the abbreviation "nm" indicates that the information or the percentage change is not meaningful.
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Executive Summary of Operations
The following sections provide an overview of our consolidated and segment results of operations for the three months ended March 31, 20212022 as compared to the three months ended March 31, 2020.2021. Our results for the three months ended March 31, 2022 include NORCAL's results. See the Segment Results sections that follow for additional information regarding each segment's results.
Revenues
The following table shows our consolidated and segment net premiums earned:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Net premiums earnedNet premiums earnedNet premiums earned
Specialty P&CSpecialty P&C$115,613 $120,359 $(4,746)(3.9 %)Specialty P&C$197,967 $115,613 $82,354 71.2 %
Workers' Compensation InsuranceWorkers' Compensation Insurance40,011 44,515 (4,504)(10.1 %)Workers' Compensation Insurance40,684 40,011 673 1.7 %
Segregated Portfolio Cell ReinsuranceSegregated Portfolio Cell Reinsurance15,884 16,980 (1,096)(6.5 %)Segregated Portfolio Cell Reinsurance19,314 15,884 3,430 21.6 %
Lloyd's SyndicatesLloyd's Syndicates15,850 22,001 (6,151)(28.0 %)Lloyd's Syndicates7,746 15,850 (8,104)(51.1 %)
Consolidated totalConsolidated total$187,358 $203,855 $(16,497)(8.1 %)Consolidated total$265,711 $187,358 $78,353 41.8 %
All of our operating segments saw a decrease in consolidated net premiums earned duringFor the three months ended March 31, 20212022, consolidated net premiums earned included additional earned premiums of $80.8 million in our Specialty P&C segment from our acquisition of NORCAL. Excluding NORCAL, consolidated net premiums earned decreased $2.5 million during the 2022 three-month period as compared to the same period of 2020, particularly2021 driven by a decrease in net premiums earned in our Lloyd's Syndicates segment, partially offset by an increase in net premiums earned in our Segregated Portfolio Cell Reinsurance, Specialty P&C and Workers' Compensation Insurance segments. The decrease in our Lloyd's Syndicates segment was due to our decreased participation in the results of Syndicate 1729 and Syndicate 6131 for the 20202021 underwriting yearyear. Net premiums earned in our Segregated Portfolio Cell Reinsurance segment increased during the 2022 three-month period driven by tail coverage premiums primarily related to 29% from 61%. The decreaseone program in netwhich we do not participate, which resulted in $3.0 million of one-time premium written and fully earned. Net premiums earned in our Specialty P&C segment, was primarilyexcluding NORCAL, increased during the 2022 three-month period due to the beneficial impacts of our re-underwriting efforts as we continue to emphasize careful risk selection,and focus on rate adequacy and a willingness to walk away from business that does not fit our goal of achieving long-term underwriting profit, as well as competitive professional liability market conditions.adequacy. For both our Workers' Compensation Insurance and Segregated Portfolio Cell Reinsurance segments, the decrease in net premiums earned reflected the competitive workers' compensation market conditions and, for our Workers' Compensation Insurance segment, a decreasethe increase in auditnet premium andearned during the 2022 three-month period reflected the prior year effect of a reduction in our EBUB estimate.estimate and the impact of audit premium billed to policyholders during the current period.
The following table shows our consolidated net investment result:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Net investment incomeNet investment income$15,017 $20,830 $(5,813)(27.9 %)Net investment income$20,443 $15,017 $5,426 36.1 %
Equity in earnings (loss) of unconsolidated subsidiaries*Equity in earnings (loss) of unconsolidated subsidiaries*6,788 (1,562)8,350 534.6 %Equity in earnings (loss) of unconsolidated subsidiaries*7,620 6,788 832 12.3 %
Net investment resultNet investment result$21,805 $19,268 $2,537 13.2 %Net investment result$28,063 $21,805 $6,258 28.7 %
*Equity in earnings (loss) of unconsolidated subsidiaries includes our share of the operating results of interests we hold in certain LPs/LLCs as well as operating losses associated with our tax credit partnership investments, which are designed to generate returns in the form of tax credits and tax-deductible project operating losses.
The increase in ourOur consolidated net investment result for the three months ended March 31, 20212022 included additional net investment income of approximately $6.5 million from NORCAL. Excluding NORCAL, consolidated net investment income decreased $1.1 million during the 2022 three-month period as compared to the same period of 2020 was2021 driven by higher earnings from a few LPs/LLCs, partially offset by lower yields on our corporate debt securities and, short-term investments given the actions taken by the Federal Reserve to aggressively reduce interest rates in response to COVID-19 and, to a lesser extent, a decreasestate and municipal bonds. The increase in our allocationequity in earnings (loss) of unconsolidated subsidiaries for the three months ended March 31, 2022 as compared to equities. Furthermore, the declinesame period of 2021 was due to lower project operating losses associated with our tax credit partnerships which is an offset to earnings from our LP/LLC portfolio. The increase in net investment income duringour equity in earnings (loss) of unconsolidated subsidiaries for the 2021 three-month period reflected the impactthree months ended March 31, 2022 also included additional earnings from our acquired interests in four LPs from NORCAL of capital planning in anticipation of closing our acquisition of NORCAL.approximately $0.4 million.
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Expenses
The following table shows our consolidated and segment net loss ratios and net loss development:prior accident year reserve development.
Three Months Ended March 31Three Months Ended March 31
($ in millions)($ in millions)20212020Change($ in millions)20222021Change
Current accident year net loss ratioCurrent accident year net loss ratioCurrent accident year net loss ratio
Consolidated ratioConsolidated ratio82.5 %83.8 %(1.3  pts)Consolidated ratio80.8 %82.5 %(1.7  pts)
Specialty P&CSpecialty P&C89.8 %94.2 %(4.4  pts)Specialty P&C85.8 %89.8 %(4.0  pts)
Workers' Compensation InsuranceWorkers' Compensation Insurance71.0 %70.2 %0.8  ptsWorkers' Compensation Insurance71.8 %71.0 %0.8  pts
Segregated Portfolio Cell ReinsuranceSegregated Portfolio Cell Reinsurance68.9 %65.7 %3.2  ptsSegregated Portfolio Cell Reinsurance64.5 %68.9 %(4.4  pts)
Lloyd's SyndicatesLloyd's Syndicates72.1 %68.7 %3.4  ptsLloyd's Syndicates41.8 %72.1 %(30.3  pts)
Calendar year net loss ratioCalendar year net loss ratioCalendar year net loss ratio
Consolidated ratioConsolidated ratio79.9 %80.9 %(1.0  pts)Consolidated ratio78.8 %79.9 %(1.1  pts)
Specialty P&CSpecialty P&C87.5 %92.2 %(4.7  pts)Specialty P&C83.8 %87.5 %(3.7  pts)
Workers' Compensation InsuranceWorkers' Compensation Insurance65.5 %66.9 %(1.4  pts)Workers' Compensation Insurance66.9 %65.5 %1.4  pts
Segregated Portfolio Cell ReinsuranceSegregated Portfolio Cell Reinsurance59.3 %55.1 %4.2  ptsSegregated Portfolio Cell Reinsurance59.5 %59.3 %0.2  pts
Lloyd's SyndicatesLloyd's Syndicates81.8 %67.2 %14.6  ptsLloyd's Syndicates61.5 %81.8 %(20.3  pts)
Favorable (unfavorable) reserve development, prior accident yearsFavorable (unfavorable) reserve development, prior accident yearsFavorable (unfavorable) reserve development, prior accident years
ConsolidatedConsolidated$4.8 $6.0 $(1.2)Consolidated$5.3$4.8$0.5 
Specialty P&CSpecialty P&C$2.7 $2.4 $0.3 Specialty P&C$3.9$2.7$1.2 
Workers' Compensation InsuranceWorkers' Compensation Insurance$2.2 $1.5 $0.7 Workers' Compensation Insurance$2.0$2.2$(0.2)
Segregated Portfolio Cell ReinsuranceSegregated Portfolio Cell Reinsurance$1.4 $1.8 $(0.4)Segregated Portfolio Cell Reinsurance$0.9$1.4$(0.5)
Lloyd's SyndicatesLloyd's Syndicates$(1.5)$0.3 $(1.8)Lloyd's Syndicates$(1.5)$(1.5)$— 
OurThe primary drivers of the change in our consolidated current accident year net loss ratio for the 2021 three-month period decreased by 1.3 percentage pointsthree months ended March 31, 2022 as compared to the same period of 20202021 were as follows:
Increase (Decrease)
 2022 versus 2021
Estimated ratio increase (decrease) attributable to:
NORCAL Operations4.7 pts
NORCAL Acquisition - Purchase Accounting Adjustment(0.9 pts)
Change in Estimate of ULAE(2.7 pts)
All other, net(2.8 pts)
Decrease in the consolidated current accident year net loss ratio(1.7 pts)
Excluding the impact of the items specifically identified in the table above, our consolidated current accident year net loss ratio for the three months ended March 31, 2022 decreased 2.8 percentage points as compared to the prior year period driven by a lowerour Specialty P&C, Lloyd's Syndicates and Segregated Portfolio Cell Reinsurance segments, partially offset by our Workers' Compensation Insurance segment. The improvement in the current accident year net loss ratio in our Specialty P&C segment partially offsetfor the three months ended March 31, 2022 was driven by a higherdecrease to certain loss ratios in our Standard Physician line of business, which we began recognizing in the second half of 2021 and, to a lesser extent, changes in the mix of business. For our Lloyd's Syndicates segment, the lower current accident year net loss ratio reflected the impact of certain property and catastrophe related losses incurred during the prior year period and, to a lesser extent, decreases to certain loss estimates during the first quarter of 2022. The decrease in the current accident year net loss ratio in our Lloyd's Syndicates and Workers' Compensation Insurance segments. The lower current accident year net loss ratio in our Specialty P&C segment during the 2021 three-month period was primarily due to decreases to certain loss ratios during the current period in our Standard Physician and Specialty lines of business as we continue to recognize the beneficial impacts of our re-underwriting efforts and focus on rate adequacy. The higher current accident year net loss ratio in our Lloyd's SyndicatesSegregated Portfolio Cell Reinsurance segment was driven by certain propertyfavorable trends in prior accident year claim results and catastrophe related losses. Fortheir impact on our Workers' Compensation Insurance segment,analysis of the higher current accident year net loss ratio was drivenestimate, partially offset by the continuation of intense price competition and the resulting renewal rate decreases in the workers' compensation business. In our Workers' Compensation Insurance segment, the increase in the current accident year net loss ratio primarily reflects the continuation of intense price competition and the resulting renewal rate decreases, partially offset by the impact of favorable prior year claim trends on the current year estimate. The Workers' Compensation Insurance segment's current accident year net loss ratio for the three months ended March 31, 2022 also reflects an expectation that the labor shortage will continue to have an impact on claim activity during 2022.
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As shown in the previous table, initial loss ratios associated with NORCAL policies were higher than the average for the other books of business in our Specialty P&C segment. The impact of NORCAL operations resulted in a lesser extent,4.7 percentage point increase in our consolidated current accident year net loss ratio for the effectthree months ended March 31, 2022. Also as a result of lowerour acquisition of NORCAL, our consolidated current accident year net premiums earned (see previous discussion underloss ratio for the heading "Revenues").three months ended March 31, 2022 was impacted by amortization of the negative VOBA associated with NORCAL's assumed unearned premium which is recorded as a reduction to current accident year net losses and accounted for a 0.9 percentage point decrease in our current period ratio. The remaining unamortized negative VOBA will be fully amortized in the second quarter of 2022.
During the first quarter of 2022, we decreased our estimate of ULAE in our Specialty P&C segment as a result of substantially integrating NORCAL into our operations, which accounted for a 2.7 percentage point decrease in our current period consolidated current accident year net loss ratio with an offsetting 2.7 percentage point increase in our current period consolidated expense ratio with no impact to our consolidated combined ratio, total expenses or net income. See additional information on this change in ULAE estimate in the Segment Results - Specialty Property and Casualty section that follows.
In both the 2022 and 2021 and 2020 three-month period,periods, our consolidated calendar year net loss ratio was lower than our consolidated current accident year net loss ratio due to the recognition of net favorable prior year reserve development, as shown in the previous table. Consolidated netNet favorable prior accident year reserve development recognized was net of an increase in the 2021 three-month period was lowerour reserve for potential ECO/XPL claims of $4.0 million for three months ended March 31, 2022 as compared to a reduction in this same reserve of $0.2 million during the same period of 2020 due to unfavorable2021. Further, net favorable development recognized during the 2022 three-month period included $2.9 million related to the amortization of the purchase accounting fair value adjustment on NORCAL's assumed net reserve and amortization of the negative VOBA associated with NORCAL's DDR reserve which is recorded as a reduction to prior accident year net losses and loss adjustment expenses. We have not recognized any development related to NORCAL's prior accident year reserves since the date of acquisition on May 5, 2021. See Note 2 of the Notes to Consolidated Financial Statements in our Lloyd's Syndicates segment driven primarily by catastropheDecember 31, 2021 report on Form 10-K for additional information on the NORCAL acquisition and the related losses. Inpurchase accounting adjustments. Excluding the increase in the ECO/XPL reserve and amortization of purchase accounting adjustments, we recognized net favorable prior accident year reserve development of $5.0 million in our Specialty P&C segment we continueduring the three months ended March 31, 2022, principally related to have concerns around elevated loss severity in the broader medical professional liability industry. In both our Specialty P&C and Workers' Compensation Insurance segments, we observed a reduction in claims frequency in 2020 that has continued into 2021, some of which is likely associated with the COVID-19 pandemic including the disruption of the court systems. Inaccident years 2019 through 2021. For our Workers' Compensation Insurance segment, we reduced our current accident year loss ratio in 2020 in response to theseand Segregated Portfolio Cell Reinsurance segments, the net favorable frequency trends as these claims are shorter-tailed in nature as compared to our HCPL claims. Due todevelopment recognized during the long-tailed nature of our HCPL claims, we have not yet recognized thesethree months ended March 31, 2022 reflected overall favorable frequency trends in our HCPL reserves.claim closing patterns.
We continue to remain cautious in our evaluation of our reserves in both our Specialty P&C and Workers' Compensation Insurance segments due to the uncertainty surrounding the length and severity of the pandemic. As it relates to our Workers' Compensation Insurance segment, legislative and regulatory bodies in certain states have changed or are considering changing compensability requirements and presumptions for certain types of workers related to COVID-19 claims. Such changes could have an adverse impact on the frequency and severity related to COVID-19 claims in that segment.
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Our consolidated and segment underwriting expense ratios were as follows:
Three Months Ended March 31Three Months Ended March 31
20212020Change20222021Change
Underwriting Expense RatioUnderwriting Expense RatioUnderwriting Expense Ratio
Consolidated(1)Consolidated(1)30.1 %30.4 %(0.3  pts)Consolidated(1)27.0 %30.1 %(3.1  pts)
Specialty P&CSpecialty P&C22.8 %24.6 %(1.8  pts)Specialty P&C21.7 %22.8 %(1.1  pts)
Workers' Compensation InsuranceWorkers' Compensation Insurance30.7 %31.8 %(1.1  pts)Workers' Compensation Insurance32.0 %30.7 %1.3  pts
Segregated Portfolio Cell ReinsuranceSegregated Portfolio Cell Reinsurance31.6 %29.9 %1.7  ptsSegregated Portfolio Cell Reinsurance22.6 %31.6 %(9.0  pts)
Lloyd's SyndicatesLloyd's Syndicates41.6 %41.6 %—  ptsLloyd's Syndicates35.0 %41.6 %(6.6  pts)
Corporate*3.8 %2.4 %1.4  pts
*There are no net premiums earned associated with the Corporate segment. Ratios shown are the contribution of the Corporate segment to the consolidated ratio (Corporate operating expenses divided by consolidated net premium earned).
Corporate (2)
Corporate (2)
3.3 %3.8 %(0.5  pts)
(1) Consolidated underwriting expenses include transaction-related costs associated with our acquisition of NORCAL. Beginning in the second quarter of 2021, transaction-related costs rose to a significant level; therefore, management determined that transaction-related costs will not be included in a segment on a prospective basis beginning in the second quarter of 2021 as we do not consider these costs in assessing the financial performance of any of our operating or reportable segments. While transaction-related costs are included in the Corporate segment's underwriting expense ratio for the 2021 three-month period, they did not have a significant impact on the ratio. See Note 11 of the Notes to Condensed Consolidated Financial Statements for a reconciliation of our segment results to our consolidated results.
(1) Consolidated underwriting expenses include transaction-related costs associated with our acquisition of NORCAL. Beginning in the second quarter of 2021, transaction-related costs rose to a significant level; therefore, management determined that transaction-related costs will not be included in a segment on a prospective basis beginning in the second quarter of 2021 as we do not consider these costs in assessing the financial performance of any of our operating or reportable segments. While transaction-related costs are included in the Corporate segment's underwriting expense ratio for the 2021 three-month period, they did not have a significant impact on the ratio. See Note 11 of the Notes to Condensed Consolidated Financial Statements for a reconciliation of our segment results to our consolidated results.
(2) There are no net premiums earned associated with the Corporate segment. Ratios shown are the contribution of the Corporate segment to the consolidated ratio (Corporate operating expenses divided by consolidated net premiums earned).
(2) There are no net premiums earned associated with the Corporate segment. Ratios shown are the contribution of the Corporate segment to the consolidated ratio (Corporate operating expenses divided by consolidated net premiums earned).
Despite
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The change in our consolidated underwriting expense ratio for the decrease2022 three-month period as compared to the same period of 2021 was primarily attributable to the following:
Increase (Decrease)
 2022 versus 2021
(In percentage points)Comparative three-month period
Estimated ratio increase (decrease) attributable to:
Increase in Net Premiums Earned and DPAC amortization(1)
(0.6 pts)
Change in Estimate of ULAE2.7 pts
Tail Premium(2)
(1.4 pts)
All other, net(3.8 pts)
Decrease in the underwriting expense ratio(3.1 pts)
(1) Excludes tail premium for the three months ended March 31, 2022 and 2021.
(2) Represents the effect of the premium earned from tail policies for the three months ended March 31, 2022 as compared to the same period on 2021 as there is typically minimal deferred acquisition costs associated with tail premium (see further discussion in the Segment Results - Specialty Property and Casualty and Segregated Portfolio Cell Reinsurance sections that follow).
Excluding the impact of the items specifically identified in earned premium in all of our operating segments, as previously discussed,the table above, our consolidated underwriting expense ratio for the three months ended March 31, 2021 remained relatively unchanged as compared2022 decreased 3.8 percentage points driven by lower operating expenses due to the same period of 2020 driven by decreased operating expenses resultingbenefits from prior organizational restructurings and proactive expense management as well as expense synergies recognized from the operational and structural changes implemented overNORCAL acquisition in our Specialty P&C segment. The decrease in the past year and a half. Furthermore,current period ratio also reflected the change in our allowance for expected credit losses in our Segregated Portfolio Cell Reinsurance segment related to the collection of customer accounts that were previously written off.
As shown in the previous table, the consolidated underwriting expense ratio for the three months ended March 31, 2021 reflected a reduction in employer contributions to the ProAssurance Savings Plan (see Note 17 of the Notes to Consolidated Financial Statementsdecrease in our December 31, 2020 report on Form 10-K). The favorable impactestimate of these reductions was partially offset by an increaseULAE which resulted in professional feesapproximately $7.3 million of expenses remaining in operating expenses instead of being allocated to net losses and loss adjustment expenses. As a result, this change in ULAE estimate had offsetting impacts to our Corporate segment driven by higher transaction-related costs associated with our acquisition of NORCAL (see Note 8 of the Notes to Condensed Consolidated Financial Statements).
For the three months ended March 31, 2021, the underwritingconsolidated loss and expense ratios during the period with no impact to our consolidated combined ratio, total expenses or net income. See additional discussion on this change in our Specialty P&C and Corporate segments also reflectedULAE estimate in the impact of a reduction to the management fee charged to the operating subsidiaries of our Specialty P&C segment by our Corporate segment effective January 1, 2021 (see further discussion in our Segment Results - Specialty Property &and Casualty and Segment Results - Corporate sectionssection that follow). This change had no impact to our consolidated underwriting expense ratio.follows.
Taxes
Our provision for income taxes and effective tax rates for the three months ended March 31, 20212022 and 20202021 were as follows:
($ in thousands)($ in thousands)Three Months Ended March 31($ in thousands)Three Months Ended March 31
20212020Change20222021Change
Income (loss) before income taxesIncome (loss) before income taxes$8,471 $(34,030)$42,501 124.9 %Income (loss) before income taxes$(5,577)$8,471 $(14,048)(165.8 %)
Less: Income tax expense (benefit)Less: Income tax expense (benefit)736 (12,076)12,812 106.1 %Less: Income tax expense (benefit)(2,017)736 (2,753)374.0 %
Net income (loss)Net income (loss)$7,735 $(21,954)$29,689 135.2 %Net income (loss)$(3,560)$7,735 $(11,295)(146.0 %)
Effective tax rateEffective tax rate8.7 %35.5 %(26.8  pts)Effective tax rate36.2%8.7%27.5 pts
We recognized an income tax benefit of $2.0 million and income tax expense of $0.7 million during the three months ended March 31, 2022 and 2021, as compared to an income tax benefit of $12.1 million during the same period of 2020;respectively; however, the comparability of our effective tax rates is impacted by the consolidated pre-tax incomeloss recognized during the 20212022 three-month period as compared to the consolidated pre-tax lossincome recognized in the 20202021 three-month period. Furthermore, the comparability of our effective tax rates is impacted by our use of the discrete effective tax rate method for the three months ended March 31, 2022 versus our use of the estimated annual effective tax rate method for the three months ended March 31, 2021 (see further discussion on these methods in the Critical Accounting Estimates section under the heading "Estimation of Taxes/Tax Credits").
Our effective tax ratesrate for both the 20212022 and 20202021 three-month periods werewas different from the statutory federal income tax rate of 21% primarily due to the benefit recognized from the tax credits transferred to us from our tax credit partnership investments. See further discussion of other notable items impacting our effective tax rate in the Segment Operating Results - Corporate section that follows under the heading "Taxes."
Our projected annual effective tax rate was (38.4 %) as of March 31, 2021 before discrete items were considered and represents an expected tax benefit. Discrete items increased our effective tax rate by 47.1% for the 2021 three-month period mainly due to the treatment of net realized investment gains. This discrete treatment of net realized investment gains of $8.0 million in our Corporate segment for the three months ended March 31, 2021 accounted for an increase of 19.8% in the effective tax rate. Our projected annual effective tax rate as of March 31, 2021 was different from the statutory federal income tax rate of 21% primarily due to the benefit we expect to recognize from the tax credits transferred to us from our tax credit partnership investments. For further discussion in the Segment Results - Corporate section that follows under the heading "Taxes."
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Operating Ratio
Our operating ratio is our combined ratio, less our investment income ratio. This ratio provides the combined effect of underwriting profitability and investment income. Our operating ratio for the three months ended March 31, 20212022 and 20202021 was as follows:
Three Months Ended March 31Three Months Ended March 31
20212020Change20222021Change
Combined ratioCombined ratio110.0 %111.3 %(1.3  pts)Combined ratio105.8 %110.0 %(4.2  pts)
Less: investment income ratioLess: investment income ratio8.0 %10.2 %(2.2  pts)Less: investment income ratio7.7 %8.0 %(0.3  pts)
Operating ratioOperating ratio102.0 %101.1 %0.9  ptsOperating ratio98.1 %102.0 %(3.9  pts)
Combined ratio, excluding transaction-related costs*Combined ratio, excluding transaction-related costs*105.4 %109.6 %(4.2  pts)
*Our consolidated combined ratio for the 2022 and 2021 three-month periods includes $1.2 million and $0.9 million, respectively, of transaction-related costs included in consolidated operating expenses associated with our acquisition of NORCAL. Given these costs do not reflect normal operating expenses, we have excluded their impact from our calculation of the consolidated combined ratio. See previous discussion under the heading "Expenses."*Our consolidated combined ratio for the 2022 and 2021 three-month periods includes $1.2 million and $0.9 million, respectively, of transaction-related costs included in consolidated operating expenses associated with our acquisition of NORCAL. Given these costs do not reflect normal operating expenses, we have excluded their impact from our calculation of the consolidated combined ratio. See previous discussion under the heading "Expenses."
OurThe primary drivers of the change in our operating ratio were as follows:
Increase (Decrease)
 2022 versus 2021
(In percentage points)Comparative
three-month
periods
Estimated ratio increase (decrease) attributable to:
NORCAL Acquisition - Purchase Accounting Adjustments(2.1 pts)
NORCAL Investment Results(2.4 pts)
Investment Results (1)
2.7 pts
All other, net(2.1 pts)
Decrease in the operating ratio(3.9 pts)
(1) Excludes net investment income contributed by NORCAL for the 2022 three-month period.
Excluding the impact of the items specifically identified in the table above, our operating ratio for the three months ended March 31, 20212022 three-month period improved by 2.1 percentage points as compared to the same period of 2020 increased approximately 0.9 percentage points driven by a lower investment income2021 primarily due to an improvement in our expense ratio largely offset by a lower combinedand net loss ratio in our Specialty P&C segment. The lower investment income ratio was primarily due to lower yields on our corporate debt securities and short-term investments given the actions takenLloyd's Syndicates segments, partially offset by the Federal Reserve in response to COVID-19 and, to a lesser extent, a decrease in our allocation to equities. The lower combinedhigher net loss ratio in our Specialty P&C segment was driven by improvement in the current accident year net loss ratio primarily due to our re-underwriting efforts and focus on rate adequacy.Workers' Compensation Insurance. See previous discussion in this section under the heading "Expenses" and further discussion in our Segment Operating Results - Specialty Property & Casualty sectionsections that follows under the heading "Losses and Loss Adjustment Expenses."follow.
ROE
ROE is calculated as annualized net income (loss) for the period divided by the average of beginning and ending shareholders’ equity. This ratio measures our overall after-tax profitability and shows how efficiently capital is being used. Beginning in the second quarter of 2021, transaction-related costs rose to a significant level; therefore, management determined prospectively that transaction-related costs associated with our acquisition of NORCAL will not be annualized in our quarterly calculation of ROE as these costs are considered non-recurring in nature. ROE for the three months ended March 31, 2022 and 2021 and 2020 waswere as follows:
Three Months Ended March 31
20212020Change
ROE2.3 %(6.0 %)8.3  pts
Three Months Ended March 31
20222021Change
ROE(0.8 %)2.3 %(3.1  pts)
The increase in ourOur ROE for the current year period was impacted by purchase accounting adjustments associated with our acquisition of NORCAL which increased our ROE by 1.7 percentage points. See Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for additional information on the NORCAL acquisition and the related purchase accounting adjustments. Excluding the purchase accounting adjustments, ROE for the 2022 three-month period as compared to the same period of 2020 wasdecreased 4.8 percentage points driven by unrealized holding losses resulting from changes in the change in fair value of our equity portfolio and convertible securities, higher earnings from a few LPS/LLCs and improved underwriting results (see previous discussion in this section underinvestments which decreased our ROE by 4.3 percentage points during the heading "Investments").current period.
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Book Value per Share
Book value per share is calculated as total shareholders’ equity at the balance sheet date divided by the total number of common shares outstanding. This ratio measures the net worth of the Company to shareholders on a per share basis. Our book value per share at March 31, 20212022 as compared to December 31, 20202021 is shown in the following table.
Book Value Per Share
Book Value Per Share at December 31, 20202021$25.0426.46 
Increase (decrease) to book value per share during the three months ended March 31, 20212022 attributable to:
Dividends declared(0.05)
Net income (loss)0.14(0.07)
OCI(1)
(0.63)(2.61)
Other(2)
(0.01)
Book Value Per Share at March 31, 20212022$24.4923.72 
(1)Primarily the impact of unrealized investment gains (losses)holding losses on our available-for-sale fixed maturity investments. See Note 118 of the Notes to Condensed Consolidated Financial Statements for additional information.
(2)Includes the impact of share-based compensation.
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Non-GAAP Financial Measures
Non-GAAP operating income (loss) is a financial measure that is widely used to evaluate performance within the insurance sector. In calculating Non-GAAP operating income (loss), we have excluded the effects of the items listed in the following table that do not reflect normal results. We believe Non-GAAP operating income (loss) presents a useful view of the performance of our insurance operations, however it should be considered in conjunction with net income (loss) computed in accordance with GAAP.
The following table is a reconciliation of net income (loss) to Non-GAAP operating income (loss):
Three Months Ended
March 31
Three Months Ended
March 31
(In thousands, except per share data)(In thousands, except per share data)20212020(In thousands, except per share data)20222021
Net income (loss)Net income (loss)$7,735 $(21,954)Net income (loss)$(3,560)$7,735 
Items excluded in the calculation of Non-GAAP operating income (loss):Items excluded in the calculation of Non-GAAP operating income (loss):Items excluded in the calculation of Non-GAAP operating income (loss):
Net realized investment (gains) losses(8,849)28,673 
Net realized gains (losses) attributable to SPCs which no profit/loss is retained (1)
789 (2,498)
Net investment (gains) lossesNet investment (gains) losses13,506 (8,849)
Net investment gains (losses) attributable to SPCs which no profit/loss is retained (1)
Net investment gains (losses) attributable to SPCs which no profit/loss is retained (1)
(602)789 
Transaction-related costs (2)
Transaction-related costs (2)
925 — 
Transaction-related costs (2)
1,177 925 
Guaranty fund assessments (recoupments)Guaranty fund assessments (recoupments)4 (2)Guaranty fund assessments (recoupments)13 
Pre-tax effect of exclusionsPre-tax effect of exclusions(7,131)26,173 Pre-tax effect of exclusions14,094 (7,131)
Tax effect, at 21% (3)
Tax effect, at 21% (3)
1,481 (5,365)
Tax effect, at 21% (3)
(2,851)1,481 
After-tax effect of exclusionsAfter-tax effect of exclusions(5,650)20,808 After-tax effect of exclusions11,243 (5,650)
Non-GAAP operating income (loss)Non-GAAP operating income (loss)$2,085 $(1,146)Non-GAAP operating income (loss)$7,683 $2,085 
Per diluted common share:Per diluted common share:Per diluted common share:
Net income (loss)Net income (loss)$0.14 $(0.41)Net income (loss)$(0.07)$0.14 
Effect of exclusionsEffect of exclusions(0.10)0.39 Effect of exclusions0.21 (0.10)
Non-GAAP operating income (loss) per diluted common shareNon-GAAP operating income (loss) per diluted common share$0.04 $(0.02)Non-GAAP operating income (loss) per diluted common share$0.14 $0.04 
(1) Net realized investment gains (losses) on investments related to SPCs are recognized in our Segregated Portfolio Cell Reinsurance segment. SPC results, including any realized gain or loss, that are attributable to external cell participants are reflected in the SPC dividend expense (income). To be consistent with our exclusion of net realized investment gains (losses) recognized in earnings, we are excluding the portion of net realized investment gains (losses) that is included in the SPC dividend expense (income) which is attributable to the external cell participants.
(2) Transaction-related costs associated with our acquisition of NORCAL. Given the significance of these transaction-related costs to the current period, we are excluding these costs as they do not reflect normal operating results and are unique and non-recurring in nature.
(3) The 21% rate is the annual expected statutory tax rate associated with the taxable or tax deductible items listed above. Our effective tax rate for the respective periods was applied to these items in calculating net income (loss), excluding net realized investment gains (losses) and related adjustments. Net realized investment gains (losses) in our Corporate segment are discrete items and are tax affected at the annual expected statutory tax rate (21%) in the period they are included in our consolidated tax provision and net income (loss). See previous discussion in this section under the heading "Taxes." The taxes associated with the net realized investment gains (losses) related to SPCs in our Segregated Portfolio Cell Reinsurance segment are paid by the individual SPCs and are not included in our consolidated tax provision or net income (loss); therefore, both the net realized investment gains (losses) from our Segregated Portfolio Cell Reinsurance segment and the adjustment to exclude the portion of net realized investment gains (losses) included in the SPC dividend expense (income) in the table above are not tax effected.
(1) Net investment gains (losses) on investments related to SPCs are recognized in our Segregated Portfolio Cell Reinsurance segment. SPC results, including any net investment gain or loss, that are attributable to external cell participants are reflected in the SPC dividend expense (income). To be consistent with our exclusion of net investment gains (losses) recognized in earnings, we are excluding the portion of net investment gains (losses) that is included in the SPC dividend expense (income) which is attributable to the external cell participants.
(1) Net investment gains (losses) on investments related to SPCs are recognized in our Segregated Portfolio Cell Reinsurance segment. SPC results, including any net investment gain or loss, that are attributable to external cell participants are reflected in the SPC dividend expense (income). To be consistent with our exclusion of net investment gains (losses) recognized in earnings, we are excluding the portion of net investment gains (losses) that is included in the SPC dividend expense (income) which is attributable to the external cell participants.
(2) Transaction-related costs associated with our acquisition of NORCAL. We are excluding these costs as they do not reflect normal operating results and are unique and non-recurring in nature.
(2) Transaction-related costs associated with our acquisition of NORCAL. We are excluding these costs as they do not reflect normal operating results and are unique and non-recurring in nature.
(3) The 21% rate is the annual expected statutory tax rate associated with the taxable or tax deductible items listed above. We utilized the discrete effective tax rate method for the three months ended March 31, 2022 while we utilized the estimated annual effective tax rate method for the three months ended March 31, 2021. For the 2022 period, our statutory tax rate was applied to these items in calculating net income (loss). For the 2021 period, our effective tax rate was applied to these items in calculating net income (loss), excluding net investment gains (losses) and related adjustments. See further discussion on these methods in the Critical Accounting Estimates section under the heading "Estimation of Taxes/Tax Credits". Under both methods, net investment gains (losses) in our Corporate segment are treated as discrete items and are tax effected at the annual expected statutory tax rate (21%) in the period they are included in our consolidated tax provision and net income (loss). The taxes associated with the net investment gains (losses) related to SPCs in our Segregated Portfolio Cell Reinsurance segment are paid by the individual SPCs and are not included in our consolidated tax provision or net income (loss); therefore, both the net investment gains (losses) from our Segregated Portfolio Cell Reinsurance segment and the adjustment to exclude the portion of net investment gains (losses) included in the SPC dividend expense (income) in the table above are not tax effected.
(3) The 21% rate is the annual expected statutory tax rate associated with the taxable or tax deductible items listed above. We utilized the discrete effective tax rate method for the three months ended March 31, 2022 while we utilized the estimated annual effective tax rate method for the three months ended March 31, 2021. For the 2022 period, our statutory tax rate was applied to these items in calculating net income (loss). For the 2021 period, our effective tax rate was applied to these items in calculating net income (loss), excluding net investment gains (losses) and related adjustments. See further discussion on these methods in the Critical Accounting Estimates section under the heading "Estimation of Taxes/Tax Credits". Under both methods, net investment gains (losses) in our Corporate segment are treated as discrete items and are tax effected at the annual expected statutory tax rate (21%) in the period they are included in our consolidated tax provision and net income (loss). The taxes associated with the net investment gains (losses) related to SPCs in our Segregated Portfolio Cell Reinsurance segment are paid by the individual SPCs and are not included in our consolidated tax provision or net income (loss); therefore, both the net investment gains (losses) from our Segregated Portfolio Cell Reinsurance segment and the adjustment to exclude the portion of net investment gains (losses) included in the SPC dividend expense (income) in the table above are not tax effected.

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Segment Results - Specialty Property & Casualty
Our Specialty P&C segment focuses on professional liability insurance and medical technology liability insurance as discussed in Note 1418 of the Notes to Condensed Consolidated Financial Statements.Statements in our December 31, 2021 report on Form 10-K. On May 5, 2021, we completed our acquisition of NORCAL, an underwriter of healthcare professional liability insurance (Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K provides additional information regarding this acquisition). Segment results reflected pre-tax underwriting profit or loss from these insurance lines.lines, and for the three months ended March 31, 2022, included the pre-tax underwriting results of NORCAL as well as certain purchase accounting adjustments. Segment results for the three months ended March 31, 2022 exclude transaction-related costs as we do not consider these costs in assessing the financial performance of the segment. Segment results included the following:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Net premiums writtenNet premiums written$121,313 $131,255 $(9,942)(7.6 %)Net premiums written$234,838$121,313$113,525 93.6 %
Net premiums earnedNet premiums earned$115,613 $120,359 $(4,746)(3.9 %)Net premiums earned$197,967$115,613$82,354 71.2 %
Other incomeOther income469 1,698 (1,229)(72.4 %)Other income1,019469550 117.3 %
Net losses and loss adjustment expensesNet losses and loss adjustment expenses(101,186)(110,931)9,745 (8.8 %)Net losses and loss adjustment expenses(165,958)(101,186)(64,772)64.0 %
Underwriting, policy acquisition and operating expensesUnderwriting, policy acquisition and operating expenses(26,346)(29,585)3,239 (10.9 %)Underwriting, policy acquisition and operating expenses(42,878)(26,346)(16,532)62.7 %
Segment resultsSegment results$(11,450)$(18,459)$7,009 38.0 %Segment results$(9,850)$(11,450)$1,600 14.0 %
Net loss ratioNet loss ratio87.5 %92.2 %(4.7 pts)Net loss ratio83.8%87.5%(3.7 pts)
Underwriting expense ratioUnderwriting expense ratio22.8 %24.6 %(1.8 pts)Underwriting expense ratio21.7%22.8%(1.1 pts)
Premiums Written
Changes in our premium volume within our Specialty P&C segment are generally driven by fourthree primary factors: (1) the amount of new business written, (2) our retention of existing business and (3) the premium charged for business that is renewed, which is affected by rates charged and by the amount and type of coverage an insured chooses to purchase and (4) the timing of premium written through multi-period policies.purchase. In addition, premium volume may periodically be affected by shifts in the timing of renewals between periods. For the three months ended March 31, 2022, our premium volume was primarily affected by our acquisition of NORCAL.
The professional liability market, which accounts for a majority of the revenues in this segment, remains challenging as physicians continue joining hospitals or larger group practices and, therefore, are thus no longer purchasing individual or group policies in the standard market. In addition, some competitors have chosen to compete primarily on price; both factors may impact our ability to write new business and retain existing business. Furthermore, the insurance and reinsurance markets have historically been cyclical, characterized by extended periods of intense price competition and other periods of reduced competition. The professional liability areamarket has been particularly affected by these cycles. Underwriting cycles are generally driven by an excess of capacity available and actively pursuing business that is deemed profitable. Changes in the frequency and severity of losses may affect the cycles of the insurance and reinsurance markets significantly. During “soft markets” where price competition is high and underwriting profits are poor, growth and retention of business become challenging which may result in reduced premium volumes.
Gross, ceded and net premiums written were as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Gross premiums writtenGross premiums written$138,289 $155,381 $(17,092)(11.0 %)Gross premiums written$257,672 $138,289 $119,383 86.3 %
Less: Ceded premiums writtenLess: Ceded premiums written16,976 24,126 (7,150)(29.6 %)Less: Ceded premiums written22,834 16,976 5,858 34.5 %
Net premiums writtenNet premiums written$121,313 $131,255 $(9,942)(7.6 %)Net premiums written$234,838 $121,313 $113,525 93.6 %
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Gross Premiums Written
During the second quarter of 2020, we reorganized our presentation of gross premiums written by component and related metrics below to better align with the current internal management reporting structure within the segment. All prior period information has been recast to conform to the current period presentation.
Gross premiums written by component were as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Professional LiabilityProfessional LiabilityProfessional Liability
HCPLHCPLHCPL
Standard Physician(1)
Standard Physician(1)
Standard Physician(1)
$52,653 $52,617 $36 0.1 %
Twelve month term$52,617 $56,918 $(4,301)(7.6 %)
Twenty-four month term 7,366 (7,366)nm
NORCAL Standard Physician(2)
NORCAL Standard Physician(2)
106,476 — 106,476 nm
Total Standard PhysicianTotal Standard Physician52,617 64,284 (11,667)(18.1 %)Total Standard Physician159,129 52,617 106,512 202.4 %
SpecialtySpecialtySpecialty
Custom Physician(2)(10)
15,837 30,399 (14,562)(47.9 %)
Hospitals and Facilities(3)(10)
16,341 16,357 (16)(0.1 %)
Senior Care(4)(10)
5,041 3,885 1,156 29.8 %
Reinsurance (assumed)(5)
10,437 4,789 5,648 117.9 %
Custom Physician(3)
Custom Physician(3)
7,407 15,837 (8,430)(53.2 %)
NORCAL Custom Physician(4)
NORCAL Custom Physician(4)
11,638 — 11,638 nm
Hospitals and Facilities(5)
Hospitals and Facilities(5)
14,197 16,341 (2,144)(13.1 %)
NORCAL Hospitals and Facilities(6)
NORCAL Hospitals and Facilities(6)
3,067 — 3,067 nm
Senior Care(7)(12)
Senior Care(7)(12)
4,493 5,041 (548)(10.9 %)
Reinsurance assumed(8)
Reinsurance assumed(8)
9,761 10,437 (676)(6.5 %)
Total SpecialtyTotal Specialty47,656 55,430 (7,774)(14.0 %)Total Specialty50,563 47,656 2,907 6.1 %
Total HCPLTotal HCPL100,273 119,714 (19,441)(16.2 %)Total HCPL209,692 100,273 109,419 109.1 %
Small Business Unit(6)
22,766 22,901 (135)(0.6 %)
Tail Coverages(7)(10)
8,138 6,189 1,949 31.5 %
Small Business Unit(9)
Small Business Unit(9)
22,519 22,766 (247)(1.1 %)
Tail Coverages(10)(12)
Tail Coverages(10)(12)
9,838 8,138 1,700 20.9 %
NORCAL Tail Coverages(10)
NORCAL Tail Coverages(10)
7,733 — 7,733 nm
Total Professional LiabilityTotal Professional Liability131,177 148,804 (17,627)(11.8 %)Total Professional Liability249,782 131,177 118,605 90.4 %
Medical Technology Liability(8)
6,984 6,219 765 12.3 %
Other(9)
128 358 (230)(64.2 %)
Medical Technology Liability(11)
Medical Technology Liability(11)
7,700 6,984 716 10.3 %
OtherOther190 128 62 48.4 %
TotalTotal$138,289 $155,381 $(17,092)(11.0 %)Total$257,672 $138,289 $119,383 86.3 %
(1) Standard Physician premium was our greatest source of premium revenues in both 2021 and 2020 and is predominately comprised of twelve month term policies. The decrease in twelve month term policiesremained relatively unchanged during the 20212022 three-month period was driven byas compared to the same period of 2021 as retention losses partiallywere offset by an increase in renewal pricing, the conversion of twenty-four month term policies an increase in renewal pricing and, to a lesser extent, new business written. Renewal pricing increases in 2021during the 2022 three-month period reflect the rising loss cost environment and new business written reflects general market conditions. Retention losses in 2021during the 2022 three-month period were largely attributable to our targeted state strategy to reassess our underwriting appetite in certain unprofitable states. We will continue to perform a detailed evaluation of venues, specialties and other areas to improve our underwriting results. We also continue to focus on underwriting discipline as we emphasize careful risk selection, rate adequacy, improved contract terms and a willingness to walk away from business that does not fit our goal of achieving a long-term underwriting profit. While retention in the current period has recovered somewhat from the impact of our re-underwriting efforts over the past year and a half, it remains lower than our historical average for this line of business as we continue to reevaluate certain states and set our rates to reflect our observations of higher severity trends. Retention losses during the 20212022 three-month period also reflected the loss of two large policies totaling $1.4a $2.0 million policy that chose to utilize self-insurance as well as the loss of a $1.0 million policy due to price competition. Standard Physician premium in the 2020 three-month period also included twenty-four month term premiums that were offered to physician insureds in one selected jurisdiction. We ceased offering twenty-four month term policies beginning in the second quarter of 2020, and the majority of the policies that were up for renewal in the current period2021 were renewed to twelve month term policies; however, a portion of the premium from the 2020 three-month period reflectedrelated to policies that will beare subject to renewal and conversion in 2022.
(2) NORCAL Standard Physician premium represents premium contributed by NORCAL and is comprised of three and twelve month term policies. NORCAL Standard Physician premium during the 2022 three-month period was impacted by retention losses, including the loss of one large policy, partially offset by an increase in renewal pricing and, to a lesser extent, new business written.
(3) Custom Physician premium includes large complex physician groups, multi-state physician groups and non-standard physicians and is written primarily on an excess and surplus lines basis. The decrease in Custom Physician premium during the 20212022 three-month period as compared to the same period of 20202021 was driven by retention losses, partially offset by an increase in renewal pricing and, to a lesser extent, new business written. Retention losses for the mutual decision2022 three-month period were driven by the loss of two large policies totaling approximately $9.0 million due to dissolve our arrangement with CAPAssurance as a result of our acquisition of NORCAL,price competition, which resulted in the loss of a large program and two large policies in California totaling $10.2 million. The decrease in our Specialty retention rate of 18.9 percentage points. Renewal pricing increases for the 2022 three-month period reflect the rising loss cost environment and new business written reflects general market conditions.
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(4) NORCAL Custom Physician premium represents premium contributed by NORCAL and includes large complex physician groups, multi-state physician groups and non-standard physicians and is written primarily on an excess and surplus lines basis. NORCAL Custom Physician premium during the 20212022 three-month period also reflectedwas impacted by retention losses, partially offset by an increase in renewal pricing and, to a lesser extent, new business written.
(5) Hospitals and Facilities premium (which includes hospitals, surgery centers and miscellaneous medical facilities) decreased during the 2022 three-month period as compared to the same period of 2021 driven by retention losses and, to a lesser extent, the timing of the renewal of a $1.6 million policy between periods; this policy will renew in the second quarter of 2022 as compared to the first quarter of 2021. Retention losses in the 2022 three-month period were largely attributable to the loss of a $1.4 million policy due to the insured entering into a captive arrangement and our non-renewal of a $1.2 million policy due to our focus on underwriting discipline as we continue to emphasize careful risk selection, rate adequacy, improved contract terms and a willingness to walk away from business that does not fit our goal
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of achieving a long-term underwriting profit, which resulted in the non-renewal of two large policies totaling $7.3 million.discipline. The decrease in Custom PhysicianHospitals and Facilities premium for the 2022 three-month period was partially offset by new business written, primarily miscellaneous medical facilities, and, to a lesser extent, an increase in renewal pricing. Renewal pricing increases for the 2021 three-month period reflect the rising loss cost environment and new business written reflects general market conditions. The lower retention for the 2021 three-month period also reflects the aforementioned dissolution of our arrangement with CAPAssurance, which resulted in a decrease to our Specialty retention rate of 22.6 percentage points. We anticipate retention rates to begin to normalize going forward as we substantially completed our re-underwriting efforts as of the end of 2020, except for a large program that was renewed on a two-year term in 2019 that was carefully evaluated and subsequently non-renewed in the current quarter, as previously discussed.
(3) Hospitals and Facilities premium (which includes hospitals, surgery centers and miscellaneous medical facilities) was relatively unchanged during the 2021 three-month period as compared to the same period of 2020 as retention losses were almost entirely offset by new business written, an increase in renewal pricing and, to a lesser extent, net timing differences of $0.5 million. Renewal pricing increases for the 20212022 three-month period reflect rate increases and contract modifications that we believe are appropriate given the current loss environment and new business written reflects general market conditions. Retention losses in
(6) NORCAL Hospitals and Facilities premium represents premium contributed by NORCAL and includes hospitals, surgery centers and miscellaneous medical facilities. NORCAL Hospitals and Facilities premium during the 20212022 three-month period were drivenwas impacted by our decision notretention losses, partially offset by new business written and, to renew certain products. As we substantially completed our re-underwriting efforts on certain books of business as of the end of the third quarter of 2020, retention rates have started to normalize.a lesser extent, an increase in renewal pricing.
(4)(7) Senior Care premium includes facilities specializing in long term residential care primarily for the elderly ranging from independent living through skilled nursing. Our Senior Care premium increaseddecreased for the 20212022 three-month period as compared to the same period of 20202021 driven by renewal pricing increases and, to a lesser extent, new business written,retention losses, partially offset by retention losses.new business written. The increase in renewal pricing in 2021lower premium retention was primarily due to a large account renewing with a meaningful reduction in exposure. Renewal pricing for the result of an increase in the rate charged for certain renewed policies in select states. Retention losses in the 20212022 three-month period were driven by our decision notremained relatively unchanged as compared to renew certain classesthe same period of Senior Care business based on our expectations of poor loss performance. As we completed our re-underwriting efforts on certain books of business during the third quarter of 2020, retention rates have started to normalize.2021.
(5)(8) We offer custom alternative risk solutions including assumed reinsurance. The increasedecrease in premium during the 20212022 three-month period primarily reflected the impact of an assumed reinsurance arrangement with a regional hospital group entered into during the current period,first quarter of 2021 which resulted in $4.5 million of premium written, comprised of $2.3 million of retroactive premium written and fully earned and $2.2 million of prospective premium written. Seewritten (see Note 45 of the Notes to Condensed Consolidated Financial Statements for further informationin our December 31, 2021 report on this transaction. Our custom alternative risk solutions also includeForm 10-K). The decrease in premium during the 2022 three-month period was largely offset by an increase in premiums assumed on a quota share basis through a strategic partnership in place since 2016 with an international medical professional liability insurer. ForIn 2021, we increased our participation in the original program and entered into another program with this insurer in a new international territory. Thus, weWe anticipate the volume of premium assumed through this partnership will continue to grow going forward.
(6)(9) Our Small Business Unit is primarily comprised of premium associated with podiatrists, legal professionals, dentists and chiropractors. Our Small Business Unit premium wasremained relatively unchanged forduring the 20212022 three-month period as compared to the same period of 20202021 as retention losses were largelyalmost entirely offset by new business written and, to a lesser extent, an increase in renewal pricing. The increase in renewal pricing in 2021during the 2022 three-month period was primarily the result of an increase in the rate charged for certain renewed policies in select states.
(7)(10) We offer extended reporting endorsement or "tail" coverage to insureds who discontinue their claims-made coverage with us, and we also periodically offer tail coverage through stand-alone policies. Tail coverage premiums are generally 100% earned in the period written because the policies insure only incidents that occurred in prior periods and are not cancellable. The amount of tail coverage premium written can vary significantly from period to period. The increase during the 2021 three-month period as compared to the same period of 2020 was primarily due to two large tail policies written and fully earned in the current period totaling $2.1 million.
(8)(11) Our Medical Technology Liability business is marketed throughout the U.S.; coverage is typically offered on a primary basis, within specified limits, to manufacturers and distributors of medical technology and life sciences products including entities conducting human clinical trials. In addition to the previously listed factors that affect our premium volume, our Medical Technology Liability premium is also impacted by the sales volume of insureds. Our Medical Technology Liability premium increased during the 20212022 three-month period as compared to the same period of 20202021 due to new business written including the addition of a few large policies totaling $1.1 million, partially offset by retention losses and, to a lesser extent, renewal pricing decreases. Retention losses in the 2021 three-month period are primarily attributable to an increase in competition on terms and pricing.renewal pricing, partially offset by retention losses. Renewal pricing decreasesincreases during the 20212022 three-month period are primarily due to changes in the sales volume of certain insureds, including changes in exposureexposure. Retention losses during the 2022 three-month period are primarily attributable to an increase in competition on several renewing policies.terms and pricing, as well as merger activity within the industry.
(9) This component of gross premiums written includes all other product lines within our Specialty P&C segment.
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(10)(12) Certain components of our gross premiums written include alternative market premiums. We currently cede either all or a portion of the alternative market premium, net of reinsurance, to three SPCs of our wholly owned Cayman Islands reinsurance subsidiaries, Inova Re and Eastern Re, which are reported in our Segregated Portfolio Cell Reinsurance segment (see further discussion in the Ceded Premiums Written section that follows). The portion not ceded to the SPCs is retained within our Specialty P&C segment.
Three Months Ended March 31Three Months Ended March 31
($ in millions)($ in millions)20212020Change($ in millions)20222021Change
Custom Physician$ $0.1 $(0.1)nm
Hospitals and Facilities 0.1 (0.1)nm
Senior CareSenior Care4.2 3.6 0.6 16.7 %Senior Care$3.9 $4.2 $(0.3)(7.1 %)
Tail CoveragesTail Coverages0.3 — 0.3 nmTail Coverages3.0 0.3 2.7 900.0 %
TotalTotal$4.5 $3.8 $0.7 18.4 %Total$6.9 $4.5 $2.4 53.3 %
Alternative market gross premiums written increased during the 20212022 three-month period as compared to the same period of 20202021 driven by renewal pricing increases, primarily due to an increase in the rate charged fortail coverage premium, primarily related to one program and, to a lesser extent, the addition of a tail policy.program.
We are committed to a rate structure that will allow us to fulfill our obligations to our insureds while generating competitive long-term returns for our shareholders. Our pricing continues to be based on expected losses as indicated by our historical loss data and available industry loss data. In recent years, this practice has resulted in gradual rate increases and we anticipate further rate increases due to indications of increasing projected loss severity. Additionally, the pricing of our business includes the effects of filed rates, surcharges and discounts. Renewal pricing also reflects changes in our exposure base, deductibles, self-insurance retention limits and other policy terms and conditions. See further explanation of changes in renewal pricing above under the heading "Gross Premiums Written".
The change in renewal pricing for our Specialty P&C segment, including by major component, was as follows:
Three Months Ended
March 31
20212022
Specialty P&C segment69 %
HCPL
Standard Physician(1)
610 %
Specialty(1)
86 %
Total HCPL69 %
Small Business Unit(1)
45 %
Medical Technology Liability(1)
(210 %)
(1) See Gross Premiums Written section for further explanation of changes in renewal pricing.
New business written by major component on a direct basis was as follows:
Three Months Ended
March 31
Three Months Ended
March 31
(In millions)(In millions)20212020(In millions)20222021
HCPLHCPLHCPL
Standard Physician(1)Standard Physician(1)$0.6 $0.6 Standard Physician(1)$1.8 $0.6 
Specialty(1)Specialty(1)8.7 1.9 Specialty(1)3.7 8.7 
Total HCPLTotal HCPL9.3 2.5 Total HCPL5.5 9.3 
Small Business UnitSmall Business Unit1.0 1.2 Small Business Unit1.0 1.0 
Medical Technology LiabilityMedical Technology Liability1.8 0.7 Medical Technology Liability1.7 1.8 
TotalTotal$12.1 $4.4 Total$8.2 $12.1 
(1) Includes premium contributed by NORCAL during the 2022 three-month period.
(1) Includes premium contributed by NORCAL during the 2022 three-month period.
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For our Specialty P&C segment, we calculate retention as annualized renewed premium divided by all annualized premium subject to renewal. Retention is affected by a number of factors. We may lose insureds to competitors or to alternative insurance mechanisms such as risk retention groups, captive arrangements or self-insurance entities (often when physicians join hospitals or large group practices) or due to pricing or other issues. We may choose not to renew an insured as a result of our underwriting evaluation. Insureds may also terminate coverage because they have left the practice of medicine for various reasons, principally for retirement, death or disability, but also for personal reasons.
Retention for our Specialty P&C segment, including by major component, was as follows:
Three Months Ended
March 31
Three Months Ended
March 31
2021202020222021
Specialty P&C segmentSpecialty P&C segment77 %81 %Specialty P&C segment83 %77 %
HCPLHCPLHCPL
Standard Physician(1)Standard Physician(1)86 %80 %Standard Physician(1)88 %86 %
Specialty(1)
Specialty(1)
56 %82 %
Specialty(1)
61 %56 %
Total HCPLTotal HCPL73 %81 %Total HCPL82 %73 %
Small Business UnitSmall Business Unit91 %85 %Small Business Unit91 %91 %
Medical Technology Liability(2)Medical Technology Liability(2)87 %78 %Medical Technology Liability(2)84 %87 %
(1) See Gross Premiums Written section for further explanation of retention decline in 2021.
(1) Includes premium contributed by NORCAL during the 2022 three-month period. We continue the process of evaluating the NORCAL book of business and implementing ProAssurance's underwriting strategies, which will likely impact retention in future quarters.
(1) Includes premium contributed by NORCAL during the 2022 three-month period. We continue the process of evaluating the NORCAL book of business and implementing ProAssurance's underwriting strategies, which will likely impact retention in future quarters.
(2) See Gross Premiums Written section for further explanation of retention decline in 2022.
(2) See Gross Premiums Written section for further explanation of retention decline in 2022.
Ceded Premiums Written
Ceded premiums represent the amounts owed to our reinsurers for their assumption of a portion of our losses. For ourOur HCPL and Medical Technology Liability excess of loss reinsurance arrangements renew annually on October 1. For those excess of loss reinsurance arrangements in effect prior to October 1, 2020,2021, we generally retained the first $1$2 million in risk insured by us and ceded coverages in excess of this amount. Effective October 1, 2020,2021, our HCPL treaty renewed at a lower gross rate and we generally retain the first $2 million in risk insured by us and cede coverages in excess of this amount. For our HCPL coverages, we also retain from 0% to 14.5%5% of the next $24 million of risk for our HCPL coverages in excess of $2 million. Our HCPL excess of loss reinsurance arrangement that renewed on October 1, 2021 also incorporated NORCAL policies. Prior to October 1, 2021, NORCAL policies were reinsured under separate reinsurance agreements, primarily excess of loss, which have historically renewed annually on January 1. For the NORCAL excess of loss reinsurance arrangement that renewed on January 1, 2021, retention was generally the first $2 million in risk and coverages in excess of this amount were ceded up to $24 million. For our Medical Technology Liability treaty which also renewed effective October 1, 2020,2021, we also retain 2.5% of the next $8 million of risk for coverages in excess of $2 million. TheseThere were no significant changes in terms for boththe cost or structure of our HCPL and Medical Technology Liability treaties resulted in a reduction totreaty upon the gross rate paid for the treaty year effective October 1, 2020. We pay our reinsurers a ceding premium in exchange for their accepting the risk, and in2021 renewal.
In certain of our excess of loss arrangements, the ultimate amount of whichceded premium is determined by the loss experience of the business ceded, subject to certain minimum and maximum amounts.
Given the length of time that it takes to resolve our claims, many years may elapse before all losses recoverable under a reinsurance arrangement are known. As a part of the process of estimating our loss reserve we also make estimates regarding the amounts recoverable under our reinsurance arrangements. As a result, we may have an adjustment to our estimate of expected losses and associated recoveries for prior year ceded losses under certain loss sensitive reinsurance agreements. Any changes to estimates of premiums ceded related to prior accident years are fully earned in the period the changes in estimates occur.
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Ceded premiums written were as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Excess of loss reinsurance arrangements (1)
Excess of loss reinsurance arrangements (1)
$7,678 $8,617 $(939)(10.9 %)
Excess of loss reinsurance arrangements (1)
$9,496 $7,678 $1,818 23.7 %
Other shared risk arrangements (2)
Other shared risk arrangements (2)
3,963 10,864 (6,901)(63.5 %)
Other shared risk arrangements (2)
4,336 3,963 373 9.4 %
Premium ceded to SPCs (3)
Premium ceded to SPCs (3)
4,469 3,784 685 18.1 %
Premium ceded to SPCs (3)
6,881 4,469 2,412 54.0 %
Other ceded premiums written866 861 0.6 %
Other ceded premiums written(4)
Other ceded premiums written(4)
2,121 866 1,255 144.9 %
Total ceded premiums writtenTotal ceded premiums written$16,976 $24,126 $(7,150)(29.6 %)Total ceded premiums written$22,834 $16,976 $5,858 34.5 %
(1) We generally reinsure risks under our excess of loss reinsurance arrangements pursuant to which the reinsurers agree to assume all or a portion of all risks that we insure above our individual risk retention levels, up to the maximum individual limits offered. Premium due to reinsurers also fluctuates with the volume of written premium subject to cession under the arrangement. In certain of our excess of loss reinsurance arrangements, the premium due to the reinsurer is determined by the loss experience of that business reinsured, subject to certain minimum and maximum amounts. The decreaseincrease in ceded premiums written under our excess of loss reinsurance arrangements during the 20212022 three-month period as compared to
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the same period of 20202021 was driven by additional ceded premiums of $4.4 million as a result of incorporating NORCAL policies into our existing HCPL excess of loss reinsurance arrangements with the October 1, 2021 renewal, as previously discussed. Excluding NORCAL, ceded premiums written under our excess of loss reinsurance arrangements decreased by approximately $2.4 million primarily reflecteddue to a decrease in the overall volume of gross premiums written subject to cession and, to a lesser extent, the reduced rate on the treaty year effective October 1, 2020.2021.
(2) We have entered into various shared risk arrangements, including quota share, fronting, and captive arrangements, with certain large healthcare systems and other insurance entities. While we cede a large portion of the premium written under these arrangements, they provide us an opportunity to grow net premium through strategic partnerships. These arrangements primarily include our Ascension Health program and, prior to the fourth quarter of 2020, our CAPAssurance program. Our CAPAssurance program was mutually dissolved on October 1, 2020 as a result of our acquisition of NORCAL and their concentration in the state of California. In addition, we entered into a new shared risk arrangement with a regional hospital group during the current period. The decrease in cededCeded premiums written under our shared risk arrangements during the 20212022 three-month period remained relatively unchanged as compared to the same period of 2020 was primarily due to the aforementioned dissolution of our arrangement with CAPAssurance, our non-renewal of two large policies in certain of our other shared risk arrangements effective May 1, 2020 and, to a lesser extent, a decrease in premium ceded to our Ascension Health program, somewhat offset by the premium ceded under our new shared risk arrangement, as previously discussed.2021.
(3) As previously discussed, as a part of our alternative market solutions, all or a portion of certain healthcare premium written is ceded to SPCs in our Segregated Portfolio Cell Reinsurance segment under either excess of loss or quota share reinsurance agreements, depending on the structure of the individual program. See the Segment Results - Segregated Portfolio Cell Reinsurance section for further discussion on the cession to the SPCs from our Specialty P&C segment. The increase in premiums ceded to SPCs during the 20212022 three-month period as compared to the same period of 20202021 was driven by renewal pricing increasesthe impact of tail coverages, primarily related to one program (see discussion in footnote 1012 under the heading "Gross Premiums Written").
(4) The increase in other ceded premiums written during the 2022 three-month period as compared to the same period of 2021 was primarily driven by the incorporation of NORCAL's cyber liability coverages into our existing HCPL cyber liability arrangement with the October 1, 2021 renewal.
Ceded Premiums Ratio
The ceded premiums ratio was as follows:
Three Months Ended March 31
 20212020Change
Ceded premiums ratio12.3%15.5%(3.2 pts)
Three Months Ended March 31
 20222021Change
Ceded premiums ratio8.9%12.3%(3.4 pts)
The above table reflects ceded premiums written as a percent of gross premiums written. The decrease in theour ceded premiums ratio duringfor the 20212022 three-month period as compared to the same period of 2021 was primarily duedriven by the reduced rate on our excess of loss reinsurance arrangements for the treaty year effective October 1, 2021 as well as the impact of the addition of the NORCAL gross written premium base for the 2022 three-month period. The decrease in our ceded premiums ratio for the 2022 three-month period as compared to a decreasethe same period of 2021 was partially offset by an increase in premiums ceded under our shared risk arrangements and, to a lesser extent, the effect of the aforementioned assumed reinsurance program entered into during the current period with a regional hospital group (increase in gross premiums written with no premium ceded).SPCs. See further discussion on the assumed reinsurance program in footnote 5 under the heading "Gross Premiums Written" and additional discussion on our shared risk arrangementsNORCAL ceded premiums and premiums ceded to SPCs above under the heading "Ceded Premiums Written."
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Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that we cede to our reinsurers for their assumption of a portion of our losses. Because premiums are generally earned pro rata over the entire policy period, fluctuations in premiums earned tend to lag those of premiums written. Generally,The majority of our policies carry a term of one year; however, some of our Medical Technology Liability policies have a multi-year term and some of our NORCAL Standard Physician policies have a three-month term. In addition, prior to the third quarter of 2020, we wrote certain Standard Physician policies with a twenty-four month term, and a few of our Medical Technology Liability policies have a multi-year term. Tail coverage premiums are generally 100% earned in the period written because the policies insure only incidents that occurred in prior periods and are not cancellable. Retroactive coverage premiums are 100% earned at the inception of the contract, as all of the associated underlying loss events occurred in the past. Additionally, any ceded premium changes due to changes to estimates of premiums owed under reinsurance agreements for prior accident years are fully earned in the period of change.
Net premiums earned were as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Gross premiums earnedGross premiums earned$132,060 $139,023 $(6,963)(5.0 %)Gross premiums earned$212,279 $132,060 $80,219 60.7 %
Less: Ceded premiums earnedLess: Ceded premiums earned16,447 18,664 (2,217)(11.9 %)Less: Ceded premiums earned14,312 16,447 (2,135)(13.0 %)
Net premiums earnedNet premiums earned$115,613 $120,359 $(4,746)(3.9 %)Net premiums earned$197,967 $115,613 $82,354 71.2 %
Gross premiums earned during the 20212022 three-month period included $2.3additional earned premiums of approximately $79.7 million from our acquisition of retroactive premium written and fully earnedNORCAL. Excluding premiums associated with an assumed reinsurance program (see previous discussion in footnote 5 under the heading "Gross Premiums Written"). After removing the impact of the retroactive premium,NORCAL acquisition, gross premiums earned decreased $9.3 millionremained relatively unchanged during the 20212022 three-month period as compared to the same period of 2020 driven by the pro rata effect of a decrease in the volume of written premium2021.
Ceded premiums earned decreased during the preceding twelve months, predominantly in our Specialty line of business, due to our re-
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underwriting efforts and, to a lesser extent, the dissolution of our arrangement with CAPAssurance, partially offset by two large tail policies written and fully earned in the current period.
The decrease in ceded premiums earned during the 20212022 three-month period as compared to the same period of 2020 was2021 driven by the pro rata effect of a decrease in premium ceded under our shared risk and excess of loss arrangements during the preceding twelve months.
Losses and Loss Adjustment Expenses
The determination of calendar year losses involves the actuarial evaluation of incurred losses for the current accident year and the actuarial re-evaluation of incurred losses for prior accident years, including an evaluation of the reserve amounts required for ECO/XPL losses. As part of the review of our prior accident year reserves, we also make estimates of expected losses and associated recoveries for prior year ceded losses under certain loss sensitive reinsurance agreements. This analysis may result in reductionschanges to estimates of premiums owed under reinsurance agreements for prior accident years which impactsimpact net premiums earned (the denominator of the net loss ratio) in the period the adjustment is made; nomade. No such adjustments were made during the three months ended March 31, 20212022 or 2020.2021. See previous discussion under the heading "Ceded Premiums Written" for additional information.
Accident year refers to the accounting period in which the insured event becomes a liability of the insurer. For claims-made policies, which represent the majority of the premiums written in our Specialty P&C segment, the insured event generally becomes a liability when the event is first reported to us. For occurrence policies, the insured event becomes a liability when the event takes place. For retroactive coverages, the insured event becomes a liability at inception of the underlying contract. We believe that measuring losses on an accident year basis is the best measure of the underlying profitability of the premiums earned in that period, since it associates policy premiums earned with the estimate of the losses incurred related to those policy premiums.
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The following table summarizes calendar year net loss ratios for our Specialty P&C segment by separating losses between the current accident year and all prior accident years.
The In addition, net loss ratios for our Specialty P&C segment were as follows:the three months ended March 31, 2022 in the following table include the impact of NORCAL.
Net Loss Ratios (1)
Net Loss Ratios (1)
Three Months Ended March 31Three Months Ended March 31
20212020Change20222021Change
Calendar year net loss ratioCalendar year net loss ratio87.5 %92.2 %(4.7  pts)Calendar year net loss ratio83.8 %87.5 %(3.7  pts)
Less impact of prior accident years on the net loss ratioLess impact of prior accident years on the net loss ratio(2.3 %)(2.0 %)(0.3  pts)Less impact of prior accident years on the net loss ratio(2.0 %)(2.3 %)0.3  pts
Current accident year net loss ratio(2)
Current accident year net loss ratio(2)
89.8 %94.2 %(4.4  pts)
Current accident year net loss ratio (2)
85.8 %89.8 %(4.0  pts)
(1)Net losses, as specified, divided by net premiums earned.
(2)ForOur current accident year net loss ratio (as shown in the table above) decreased 4.0 percentage points during the three months ended March 31, 2021,2022 as compared to the same period of 2021. The change in our current accident year net loss ratio in each period was primarily attributable to the following:
(In percentage points)Increase (Decrease)
2022 versus 2021
Comparative
three-month
period
Estimated ratio increase (decrease) attributable to:
NORCAL Operations4.0 pts
NORCAL Acquisition - Purchase Accounting Adjustment(1.2 pts)
Change in Estimate of ULAE(3.7 pts)
All other, net(3.1 pts)
Decrease in current accident year net loss ratio(4.0 pts)
Excluding the impact of the items specifically identified in the table above, our current accident year net loss ratio for the three months ended March 31, 2022 improved 4.43.1 percentage points as compared to the sameprior year period of 2020 driven by decreasesa decrease to certain loss ratios during the current period in our Standard Physician and Specialty linesline of business, aswhich we began recognizing in the second half of 2021 and, to a lesser extent, changes in the mix of business. We continue to recognize the beneficial impactsobserve a reduction in claims frequency that started to emerge in 2020, some of which is due to our re-underwriting efforts and focussome of which, we believe, is associated with the COVID-19 pandemic including the disruption of the court systems. Given the consistent and prolonged nature of this favorable claims frequency trend, we reduced certain loss ratios in our Standard Physician line of business during the third and fourth quarters of 2021. We continue to remain cautious in recognizing the full impact of these favorable trends in our current accident year reserve due to the long-tailed nature of our HCPL claims as well as the uncertainty surrounding the length and severity of the pandemic.
Initial loss ratios associated with NORCAL policies were higher than the average for our other books of business in this segment. The impact of NORCAL operations resulted in a 4.0 percentage point increase in our current accident year net loss ratio for the three months ended March 31, 2022. We continue the process of evaluating the NORCAL book of business and implementing ProAssurance's underwriting strategies. Also as a result of our acquisition of NORCAL, our current accident year net loss ratio for the three months ended March 31, 2022 was impacted by amortization of the negative VOBA associated with NORCAL's assumed unearned premium which is recorded as a reduction to current accident year net losses and accounted for a 1.2 percentage point decrease in our current period ratio. The remaining unamortized negative VOBA will be fully amortized in the second quarter of 2022 (see Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on rate adequacy.Form 10-K for additional information on the remaining expected amortization of the NORCAL acquisition purchase accounting adjustments).
During the first quarter of 2022, we decreased our estimate of ULAE as a result of substantially integrating NORCAL into our Specialty P&C segment operations, which accounted for a 3.7 percentage point decrease in our current period accident year loss ratio with an offsetting 3.7 percentage point increase in our current period expense ratio with no impact to our combined ratio or segment results (see discussion on our expense ratio in the following section under the heading "Underwriting, Policy Acquisition and Operating Expenses"). This change in estimated ULAE had no impact on our combined ratio or segment results.
We re-evaluate our previously established reserve each quarter based upon the most recently completed actuarial analysis supplemented by any new analysis, information or trends that have emerged since the date of that study. We also take into account currently available industry trend information. We observed a reduction in claims frequency in 2020 that has continued into 2021, some
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Table of which is likely associated with the ContentsCOVID-19 pandemic including the disruption of the court systems; however, we continue to remain cautious in recognizing these favorable frequency trends in our current accident year reserve due to the possibility of delays in reporting and uncertainty surrounding the length and severity of the pandemic.
We recognized net favorable prior accident year reserve development of $2.7$3.9 million and $2.4 million forduring the three months ended March 31, 2022 as compared to $2.7 million during the same period of 2021. Net favorable development recognized during the three months ended March 31, 2022 was net of an increase in our reserve for potential ECO/XPL claims of $4.0 million as compared to a reduction in this same reserve of $0.2 million during the same period of 2021. Furthermore, net favorable development recognized during the three months ended March 31, 2022 included $2.9 million related to the amortization of the purchase accounting fair value adjustment on NORCAL's assumed net reserve and amortization of the negative VOBA associated with NORCAL's DDR reserve which is recorded as a reduction to prior accident year net losses and loss adjustment expenses. See Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for additional information on the remaining expected amortization of the NORCAL acquisition purchase accounting adjustments. We have not recognized any development related to NORCAL's prior accident year reserves since the date of acquisition on May 5, 2021. Excluding the increase in the ECO/XPL reserve and 2020, respectively.amortization of purchase accounting adjustments, we recognized net favorable prior accident year reserve development of $5.0 million during the three months ended March 31, 2022, principally related to accident years 2019 through 2021. Development recognized during the three months ended March 31, 2021 principally related to accident years 2017 and 2018. Prior accident year reserve development recognized for the three months ended March 31, 2020 was due to a reduction in our reserve for potential ECO/XPL claims; prior accident year development recognized in the current period included a reduction to this same reserve of $0.2 million.
A detailed discussion of factors influencing our recognition of loss development is included in our Critical Accounting Estimates section under the heading "Reserve for Losses and Loss Adjustment Expenses" and in our December 31, 20202021 report on Form 10-K under the same heading.10-K. Assumptions used in establishing our reserve are regularly reviewed and updated by management as new data becomes available. Any adjustments necessary are reflected in the then current operations. Due to the
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size of our reserve, even a small percentage adjustment to the assumptions can have a material effect on our results of operations for the period in which the change is made, as was the case in both 20212022 and 2020.2021.
Underwriting, Policy Acquisition and Operating Expenses
Our Specialty P&C segment underwriting, policy acquisition and operating expenses, including NORCAL expenses for the 2022 three-month period, were comprised as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
DPAC amortizationDPAC amortization$12,396 $13,916 $(1,520)(10.9 %)DPAC amortization$21,740 $12,396 $9,344 75.4 %
Management feesManagement fees1,001 1,832 (831)(45.4 %)Management fees1,402 1,001 401 40.1 %
Other underwriting and operating expensesOther underwriting and operating expenses12,949 13,837 (888)(6.4 %)Other underwriting and operating expenses19,736 12,949 6,787 52.4 %
TotalTotal$26,346 $29,585 $(3,239)(10.9 %)Total$42,878 $26,346 $16,532 62.7 %
DPAC amortizationdecreased for the three months ended March2022 three-month period included approximately $8.1 million of DPAC amortization associated with NORCAL policies written subsequent to our acquisition; however, this level of DPAC amortization is approximately $1.0 million lower than would be considered normal for the quarter due to the application of GAAP purchase accounting rules whereby the capitalized policy acquisition costs for policies written prior to the acquisition date were written off through purchase accounting on May 5, 2021 rather than being expensed pro rata over the remaining term of the associated policies (see Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for more information). The remaining increase in DPAC amortization for the 2022 three-month period as compared to the same period of 2020 driven by a decrease2021 reflected an increase in earned premium. In addition,brokerage expenses due to our increased participation with an international medical professional liability insurer in our Specialty line of business (see discussion under the decrease in DPAC amortization during the 2021 three-month period reflected a decrease in compensation-related expenses driven by a reduction in headcount as a result of the 2020 organizational restructuring. Partially offsetting the decrease in DPAC amortization for the 2021 three-month period was a decrease in ceding commission income, which is an offset to expense, from certain of our shared risk arrangements.heading "Gross Premiums Written").
Management fees are charged pursuant to a management agreement by the Corporate segment to the operating subsidiaries within our Specialty P&C segment for services provided based on the extent to which services are provided to the subsidiary and the amount of premium written by the subsidiary. Fluctuations in the amount of premium written by each subsidiary can result in corresponding variations in the management fee charged to each subsidiary during a particular period. Due to continued organizational structure enhancements in our Specialty P&C segment during 2020,2021 as well as operational alignments as a result of the integration of NORCAL, the extent to which services are provided by the Corporate segment to the operating subsidiaries within the segment decreased further effective January 1, 2021.2022. Accordingly, we reduced the fee charged to the segment's operating subsidiaries duringin 2022. Also effective January 1, 2022, the 2021 three-monthmanagement agreement included operating subsidiaries of NORCAL contributing to $0.6 million of additional management fees in the current period.
Other underwriting and operating expensesdecreased increased during the 20212022 three-month period as comparedprimarily due to the same periodaddition of 2020 drivenexpenses contributed by decreased operatingNORCAL as well as a decrease in our estimate of ULAE which resulted in approximately $7.3 million of expenses resulting from the operational and structural changes implemented over the past year and a half. The decreaseremaining in operating expenses instead of being allocated to net losses and loss adjustment expenses. As a result, this change in ULAE estimate had offsetting impacts to our loss and expense ratios during the 2021 three-month period also reflected the effect of $1.4 million of one-time expenses incurred during the prior year period primarily relatedwith no impact to the restructuring of our HCPL field office organization and, to a lesser extent, a decreasecombined ratio or segment results. See additional discussion on this change in employer contributions to the ProAssurance Savings PlanULAE estimate in the current period (see Note 17previous section under the heading "Losses and Loss Adjustment Expenses." Excluding expenses contributed by NORCAL and the impact of the Notes to Consolidated Financial Statements change
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in our December 31, 2020 report on Form 10-K). The remaining variance inULAE, other underwriting and operating expenses fordecreased due to benefits from prior organizational restructurings and proactive expense management, somewhat offset by one-time expenses of $1.6 million incurred during the 2021 three-monthcurrent period as compared to the same period of 2020 wasmainly comprised of individually insignificant components.one-time bonuses, employee severance charges and lease exit costs.
Underwriting Expense Ratio (the Expense Ratio)
Our expense ratio for the Specialty P&C segment was as follows:
 Three Months Ended March 31
 20212020Change
Underwriting expense ratio22.8 %24.6 %(1.8  pts)
 Three Months Ended March 31
 20222021Change
Underwriting expense ratio21.7 %22.8 %(1.1  pts)
The underwriting expense ratiochange in the current period also included the effect of one-time retroactive premium earned associated with a new assumed reinsurance program (net premiums earned with no associated operating expenses). Excluding the impact of the retroactive premium, theour expense ratio for the 20212022 three-month period was 23.2% which reflects the impact of a reductionas compared to the management fee charged bysame period of 2021 was primarily attributable to the Corporate segment, as previously discussed, as well as a decreasefollowing:
Increase (Decrease)
 2022 versus 2021
(In percentage points)Comparative three-month period
Estimated ratio increase (decrease) attributable to:
Increase in Net Premiums Earned and DPAC amortization(1)
0.3 pts
Change in Estimate of ULAE3.7 pts
Tail Premium(2)
(1.2 pts)
All other, net(3.9 pts)
Decrease in the underwriting expense ratio(1.1 pts)
(1) Excludes tail premium for the three months ended March 31, 2022 and 2021.
(2) Represents the effect of the premium earned from tail policies for the three months ended March 31, 2022 as compared to the same period of 2021 as there is typically minimal expense associated with tail premium (see discussion under the heading "Gross Premiums Written").
Excluding the items specifically identified in various operational expenses resulting from improvements over the past year including organizational structure enhancements and improved operating efficiencies. The underwritingtable above, our expense ratio for the three months ended March 31, 2020 also reflected2022 three-month period decreased by 3.9 percentage points primarily due to lower operating expenses due to the effectbenefits from prior organizational restructurings and proactive expense management as well as expense synergies recognized from the NORCAL acquisition. However, as previously discussed, DPAC amortization associated with NORCAL recorded during the 2022 three-month period was lower than would be considered normal for the quarter due to the application of one-time expenses related toGAAP purchase accounting rules. Normalizing this amortization would have increased our HCPL field office reorganization which increased the expense ratio for the 2022 three-month period by 1.2an estimated 0.5 percentage points in the prior year period.points.
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Segment Results - Workers' Compensation Insurance
Our Workers' Compensation Insurance segment includes workers' compensation products provided to employers generally with 1,000 or fewer employees, as discussed in Note 1418 of the Notes to Condensed Consolidated Financial Statements.Statements in our December 31, 2021 report on Form 10-K. Workers' compensation products offered include guaranteed cost policies, policyholder dividend policies, retrospectively-rated policies, deductible policies and alternative market programs. Alternative market programs include program design, fronting, claims administration, risk management, SPC rental, asset management and SPC management services. Alternative market program premiums are 100% ceded to either the SPCs within our Segregated Portfolio Cell Reinsurance segment or, to a limited extent, an unaffiliated captive insurer for one program. Our Workers' Compensation Insurance segment results reflectedreflect pre-tax underwriting profit or loss from these workers' compensation products, exclusive of investment results, which are included in our Corporate segment. Segment results included the following:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Net premiums writtenNet premiums written$46,884 $50,312 $(3,428)(6.8 %)Net premiums written$45,266 $46,884 $(1,618)(3.5 %)
Net premiums earnedNet premiums earned$40,011 $44,515 $(4,504)(10.1 %)Net premiums earned$40,684 $40,011 $673 1.7 %
Other incomeOther income392 757 (365)(48.2 %)Other income682 392 290 74.0 %
Net losses and loss adjustment expensesNet losses and loss adjustment expenses(26,207)(29,769)3,562 (12.0 %)Net losses and loss adjustment expenses(27,211)(26,207)(1,004)3.8 %
Underwriting, policy acquisition and operating expensesUnderwriting, policy acquisition and operating expenses(12,286)(14,164)1,878 (13.3 %)Underwriting, policy acquisition and operating expenses(13,001)(12,286)(715)5.8 %
Segment resultsSegment results$1,910 $1,339 $571 42.6 %Segment results$1,154 $1,910 $(756)(39.6 %)
Net loss ratioNet loss ratio65.5%66.9%(1.4 pts)Net loss ratio66.9%65.5%1.4 pts
Underwriting expense ratioUnderwriting expense ratio30.7%31.8%(1.1 pts)Underwriting expense ratio32.0%30.7%1.3 pts

Premiums Written
Our workers’ compensation premium volume is driven by five primary factors: (1) the amount of new business written, (2) retention of our existing book of business, (3) premium rates charged on our renewal book of business, (4) changes in payroll exposure and (5) audit premium.
Gross, ceded and net premiums written were as follows:
Three Months Ended March 31
($ in thousands)20212020Change
Gross premiums written$72,328 $79,243 $(6,915)(8.7 %)
Less: Ceded premiums written25,444 28,931 (3,487)(12.1 %)
Net premiums written$46,884 $50,312 $(3,428)(6.8 %)
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Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums written$72,118 $72,328 $(210)(0.3 %)
Less: Ceded premiums written26,852 25,444 1,408 5.5 %
Net premiums written$45,266 $46,884 $(1,618)(3.5 %)
Gross Premiums Written
Gross premiums written by product were as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Traditional business:Traditional business:Traditional business:
Guaranteed costGuaranteed cost$38,196 $42,062 $(3,866)(9.2 %)Guaranteed cost$35,503 $38,196 $(2,693)(7.1 %)
Policyholder dividendPolicyholder dividend7,520 8,031 (511)(6.4 %)Policyholder dividend7,862 7,520 342 4.5 %
DeductibleDeductible2,052 1,926 126 6.5 %Deductible2,120 2,052 68 3.3 %
Retrospective(1)
Retrospective(1)
455 344 111 32.3 %
Retrospective(1)
646 455 191 42.0 %
OtherOther1,600 1,781 (181)(10.2 %)Other1,615 1,600 15 0.9 %
Alternative market business(2)
Alternative market business(2)
23,715 25,959 (2,244)(8.6 %)
Alternative market business(2)
24,372 23,715 657 2.8 %
Change in EBUB estimateChange in EBUB estimate(1,210)(860)(350)40.7 %Change in EBUB estimate (1,210)1,210 nm
TotalTotal$72,328 $79,243 $(6,915)(8.7 %)Total$72,118 $72,328 $(210)(0.3 %)
(1) The change in retrospectively-relatedretrospectively-rated policies included adjustmentsan adjustment that decreased premium by $0.1 million and $0.2 million for each of the three months ended March 31, 20212022 and 2020, respectively.2021.
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(2) A majority of alternative market premiums are ceded to SPCs in our Segregated Portfolio Cell Reinsurance segment. See further discussion on alternative market gross premiums written in our Segment Operating Results - Segregated Portfolio Cell Reinsurance section under the heading "Gross Premiums Written" that follows.
Gross premiums written decreasedremained relatively unchanged during the three months ended March 31, 20212022 as compared to the same period of 2020, which primarily reflected a decrease2021 as decreases in new business, renewal retention and renewal rate changes were largely offset by an increase in audit premium aand the prior year impact of the reduction of our EBUB estimate and the continuation of competitive market conditions.estimate. Policy audits processed during the first quarter of 20212022 three-month period resulted in audit premium returnedbilled to policyholders totaling $0.8$1.7 million as compared to audit premium billedreturned to policyholders of $0.9$0.8 million for the same period of 2020. In addition,in 2021. We did not adjust our EBUB estimate for the 2022 three-month period; however, we reduced our EBUB estimate by $1.2 million and $0.9 million during the three months ended March 31, 2021 and 2020, respectively. The decrease in audit premium processed as well as the reduction of our EBUB estimate primarily reflected the impact of COVID-19 on both actual and expected final payroll audits for policies written prior to the onset of the pandemic in 2020. The competitive market conditions resulted in renewal rate decreases of 3% for the three months ended March 31, 2021same period in 2021. Renewal rate retention was 88% for the 2022 three-month period as compared to 90% for the same period of 2021. Renewal rate decreased 4% during the 2022 three-month period as compared to 3% during the same period of 2020. Additionally, new2021. New business written decreased $2.4$2.1 million forduring the three months ended March 31, 20212022 three-month period as compared to the same period of 2020. The renewal rate decreases2021, reflecting the competitive workers' compensation market conditions and reductiona decrease in new business were partially offset by an improvementsubmissions in renewal retention, which was 90% for the three months ended March 31, 2021 as compared to 83% for the same period in 2020. The 2020 renewal retention was impacted by the reduction in premium funding for a large alternative market program. 2022 three-month period.
We retained 100% of the nine workers’ compensation alternative market programs that were up for renewal during the first quarter of 2021.three months ended March 31, 2022.
New business, audit premium, renewal retention and renewal price changes for both theour traditional business and the alternative market business are shown in the table below:
Three Months Ended March 31
20212020
($ in millions)Traditional BusinessAlternative Market BusinessSegment
Results
Traditional BusinessAlternative Market BusinessSegment
Results
New business$5.9 $0.8 $6.7 $8.0 $1.1 $9.1 
Audit premium (including EBUB)$(2.2)$0.2 $(2.0)$0.3 $(0.3)$— 
Retention rate (1)
89 %92 %90 %85 %78 %83 %
Change in renewal pricing (2)
(2 %)(5 %)(3 %)(4 %)(6 %)(4 %)
(1) We calculate our workers' compensation retention rate as annualized expiring renewed premium divided by all annualized expiring premium subject to renewal. Our retention rate can be impacted by various factors, including price or other competitive issues, insureds being acquired, or a decision not to renew based on our underwriting evaluation.
(2) The pricing of our business includes an assessment of the underlying policy exposure and market conditions. We continue to base our pricing on expected losses, as indicated by our historical loss data.
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Three Months Ended March 31
20222021
($ in millions)Traditional BusinessAlternative Market BusinessSegment
Results
Traditional BusinessAlternative Market BusinessSegment
Results
New business$3.5 $1.1 $4.6 $5.9 $0.8 $6.7 
Audit premium (excluding EBUB)$0.1 $1.6 $1.7 $(1.0)$0.2 $(0.8)
Retention rate (1)
85 %92 %88 %89 %92 %90 %
Change in renewal pricing (2)
(4 %)(3 %)(4 %)(2 %)(5 %)(3 %)
(1) We calculate our workers' compensation retention rate as annualized expiring renewed premium divided by all annualized expiring premium subject to renewal. Our retention rate can be impacted by various factors, including price or other competitive issues, insureds being acquired, or a decision not to renew based on our underwriting evaluation.
(2) The pricing of our business includes an assessment of the underlying policy exposure and market conditions. We continue to base our pricing on expected losses, as indicated by our historical loss data.
Ceded Premiums Written
Ceded premiums written were as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Premiums ceded to SPCsPremiums ceded to SPCs$20,682 $23,356 $(2,674)(11.4 %)Premiums ceded to SPCs$21,488 $20,682 $806 3.9 %
Premiums ceded to external reinsurersPremiums ceded to external reinsurers2,974 3,245 (271)(8.4 %)Premiums ceded to external reinsurers3,155 2,974 181 6.1 %
Premiums ceded to unaffiliated captive insurerPremiums ceded to unaffiliated captive insurer3,033 2,603 430 16.5 %Premiums ceded to unaffiliated captive insurer2,884 3,033 (149)(4.9 %)
Change in return premium estimate under external reinsuranceChange in return premium estimate under external reinsurance(474)31 (505)(1,629.0 %)Change in return premium estimate under external reinsurance29 (474)503 106.1 %
Estimated revenue share(771)(304)(467)153.6 %
Estimated revenue share under external reinsuranceEstimated revenue share under external reinsurance(704)(771)67 (8.7 %)
Total ceded premiums writtenTotal ceded premiums written$25,444 $28,931 $(3,487)(12.1 %)Total ceded premiums written$26,852 $25,444 $1,408 5.5 %
Premiums ceded to SPCs representsrepresent alternative market business that is ceded under 100% quota share reinsurance agreements to the SPCs in our Segregated Portfolio Cell Reinsurance segment. Premiums ceded to thean unaffiliated captive insurer reflect therepresent alternative market business for one program that is ceded under a 100% quota share reinsurance agreement for one program. The decreaseagreement. Alternative market premiums written increased for the three months ended March 31, 2021 primarily reflects2022 three-month period, which resulted in higher premiums ceded to SPCs. See further discussion on alternative market gross premiums written in our Segment Operating Results - Segregated Portfolio Cell Reinsurance section under the competitive workers' compensation market conditions.heading "Gross Premiums Written" that follows.
Under our external reinsurance agreementtreaty for traditional business, we retain the first $0.5 million in risk insured by us and cede losses in excess of this amount on each loss occurrence, under our primary external reinsurance treaty, subject to an AAD, equal to 3.16%3.5% of ceded earned premium. Per our reinsurance agreements, we cede premiums related topremium for the treaty year effective May 1, 2021. Premiums ceded under our traditional businessreinsurance treaty are based on anpremium earned premium basis.
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during the treaty period. The decreaseincrease in premiums ceded to external reinsurers during the 20212022 three-month period primarily reflected the decrease in traditional earned premium, partially offset by an increase in reinsurance rates.rates effective May 1, 2021.
Changes in the return premium estimate reflected adjustments to our estimate of expected future recovery of ceded premium based on the underlying loss experience of our reinsurance contractstreaties that include a provision for return premium. We increasedAs shown in the table above, we decreased our estimate of return premium by a nominal amount during the 2022 three-month period as compared to an increase of $0.5 million during the three months ended March 31, 2021, as compared to a nominal decrease in our estimate for the same respective period in 2020. The change2021. Changes in the estimated return premium for the three months ended March 31, 2021 primarily reflected favorable prior yearreflect adjustments to loss developmentestimates on previously reported reinsured claims.
Our reinsurance program includesWe are party to a revenue sharesharing agreement with our reinsurance broker under which we shareparticipate in the broker's revenue above an agreed upon minimum retention. We increased our estimate of the revenue share withearned under our reinsurance broker relatedtreaties based on the volume of premium ceded. We estimate the amount of revenue we expect to receive under this agreement as premiums are recognized and ceded to the current contract year during the three months ended March 31, 2021, reflecting an increase in the ceded premium under the reinsurance treaties.reinsurers.
Ceded Premiums Ratio
Ceded premiums ratio was as follows:
Three Months Ended March 31Three Months Ended March 31
20212020Change20222021Change
Ceded premiums ratio, as reportedCeded premiums ratio, as reported31.8 %32.2 %(0.4  pts)Ceded premiums ratio, as reported33.3 %31.8 %1.5  pts
Less the effect of:Less the effect of:Less the effect of:
Premiums ceded to SPCs (100%)Premiums ceded to SPCs (100%)25.9 %24.7 %1.2  ptsPremiums ceded to SPCs (100%)26.1 %25.9 %0.2  pts
Premiums ceded to unaffiliated captive insurers (100%)Premiums ceded to unaffiliated captive insurers (100%)1.7 %1.2 %0.5  ptsPremiums ceded to unaffiliated captive insurers (100%)1.5 %1.7 %(0.2  pts)
Change in EBUBChange in EBUB0.1 %0.1 %—  ptsChange in EBUB %0.1 %(0.1  pts)
Change in return premium estimate under external reinsuranceChange in return premium estimate under external reinsurance(1.1 %)0.1 %(1.2  pts)Change in return premium estimate under external reinsurance0.1 %(1.1 %)1.2  pts
Estimated revenue shareEstimated revenue share(1.8 %)(0.6 %)(1.2  pts)Estimated revenue share(1.6 %)(1.8 %)0.2  pts
Assumed premiums earned (not ceded to external reinsurers)Assumed premiums earned (not ceded to external reinsurers)(0.3 %)(0.2 %)(0.1  pts)Assumed premiums earned (not ceded to external reinsurers)(0.3 %)(0.3 %)—  pts
Ceded premiums ratio (related to external reinsurance), less the effects of aboveCeded premiums ratio (related to external reinsurance), less the effects of above7.3 %6.9 %0.4  ptsCeded premiums ratio (related to external reinsurance), less the effects of above7.5 %7.3 %0.2  pts
The above table reflects traditional ceded premiums earned as a percent of traditional gross premiums earned. As discussed above, we cede premiums related toceded under our traditional business to external reinsurersreinsurance treaty are based on anpremiums earned premium basis.during the treaty period. The increase in the ceded premiums ratio for the three months ended March 31, 20212022 as compared to the same period in 20202021 primarily reflects thereflected an increase in reinsurance rates for the contract period beginning May 1, 2020.
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rates.
Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that we cede to SPCs in our Segregated Portfolio Cell Reinsurance segment, external reinsurers (including changes related to the return premium and revenue share estimates) and the unaffiliated captive insurer. Because premiums are generally earned pro rata over the entire policy period, fluctuations in premiums earned tend to lag those of premiums written. Our workers’ compensation policies are twelve month term policies, and premiums are earned on a pro rata basis over the policy period. Net premiums earned also include premium adjustments related to the audit of our insureds' payrolls, changes in our EBUB estimate and premium adjustments related to retrospectively-rated policies. Payroll audits are conducted subsequent to the end of the policy period and any related premium adjustments processed are recorded as fully earned in the current period. In addition, we record an estimate for EBUB and evaluate the estimate on a quarterly basis.
Net premiums earned were as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Gross premiums earnedGross premiums earned$58,632 $65,613 $(6,981)(10.6 %)Gross premiums earned$61,034 $58,632 $2,402 4.1 %
Less: Ceded premiums earnedLess: Ceded premiums earned18,621 21,098 (2,477)(11.7 %)Less: Ceded premiums earned20,350 18,621 1,729 9.3 %
Net premiums earnedNet premiums earned$40,011 $44,515 $(4,504)(10.1 %)Net premiums earned$40,684 $40,011 $673 1.7 %
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The decreaseincrease in net premiums earned during the three months ended March 31, 20212022 as compared to the same period of 2020in 2021 primarily reflected the impact of the adjustment to EBUB in the prior year period. Excluding the adjustment to EBUB during the 2021 three-month period, net premiums earned decreased during the three months ended March 31, 2022 as compared to the same period in 2021 primarily due to the pro rata effect of a reduction in net premiums written during the preceding twelve months, amonths. The decrease in audit premium and, to a lesser extent, the reduction in our EBUB estimate, partially offset by an increase in broker revenue sharing and, to a lesser extent, return premium estimates under our reinsurance contracts. We reduced our EBUB estimate by $1.2 million and $0.9 millionnet premiums earned during the three months ended March 31, 2021 and 2020, respectively. The reduction2022 was partially offset by an increase in our EBUB estimate during the current period primarily reflected the impact of COVID-19 on both actual and expected final payroll audits for policies written prioraudit premium billed to the onset of the pandemic in 2020. Please see "Item 1A, Risk Factors" in our December 31, 2020 report on Form 10-K for additional information on the economic impact of COVID-19.policyholders.

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Losses and Loss Adjustment Expenses
We estimate our current accident year loss and loss adjustment expenses by developing actual reported losses using historical loss development factors, adjusted to reflect current and expected trends based on an expected loss ratio. Incurred lossesvarious internal analyses and loss adjustment expenses for the current accident year are determined by applying the expected loss ratio to net premiums earned for the respective period.supplemental information. The following table summarizes calendar year net loss ratios by separating losses between the current accident year and all prior accident years. Calendar year and current accident year net loss ratios by component were as follows:
Three Months Ended March 31Three Months Ended March 31
20212020Change20222021Change
Calendar year net loss ratioCalendar year net loss ratio65.5 %66.9 %(1.4  pts)Calendar year net loss ratio66.9 %65.5 %1.4  pts
Less impact of prior accident years on the net loss ratioLess impact of prior accident years on the net loss ratio(5.5 %)(3.3 %)(2.2  pts)Less impact of prior accident years on the net loss ratio(4.9 %)(5.5 %)0.6  pts
Current accident year net loss ratioCurrent accident year net loss ratio71.0 %70.2 %0.8  ptsCurrent accident year net loss ratio71.8 %71.0 %0.8  pts
The increase in the current accident year net loss ratio forduring the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected the continuation of intense price competition and the resulting renewal rate decreases, as well aspartially offset by the effectimpact of lower net premiums earned driven by a reduction in audit premium and our EBUB estimate, as previously discussed.favorable prior year claim trends on the current year estimate. The increase in the current accident year net loss ratio was partially offset by favorable claim trends in prior accident year claim results and theirfor the three months ended March 31, 2022 also reflects an expectation that the labor shortage will continue to have an impact on our analysis of the current accident year loss estimate. As a result of the COVID-19 pandemic, legislative and regulatory bodies in certain states have changed or are considering changes to compensability requirements and presumptions for certain types of workers related to COVID-19 claims. Such changes could have an adverse impact on the frequency and severity related to COVID-19 claims.claim activity during 2022.
Calendar year incurred losses (excluding IBNR) ceded toin excess of our external reinsurers decreased $0.5 million for the three months ended March 31, 2021 as compared to the same period of 2020. There were no current accident year ceded incurred losses (excluding IBNR) during the three months ended March 31, 2021 or 2020, reflecting lower claim severity and the impactper occurrence reinsurance retention, before consideration of the AAD (see previous discussion under the heading "Ceded Premiums Written"). The decrease in ceded incurred losses, increased $1.7 million for
the three months ended March 31, 2021 reflects favorable development on prior2022 as compared to the same period of 2021; however, of the $1.7 million, we retained losses in excess of our per occurrence retention totaling $1.0 million which reflected losses within the AAD. There were no current accident year reinsured claims.reported losses ceded to reinsurers during the three months ended March 31, 2022 or 2021.
We recognized net favorable prior year development related to our previously established reserve of $2.2 million and $1.5$2.0 million for the three months ended March 31, 2021 and 2020, respectively.2022 as compared to $2.2 million for the same period of 2021. The net favorable prior year reserve development for the three months ended March 31, 20212022 and 20202021 reflected overall favorable trends in claim closing patterns. Net favorable development for the 2022 three months ended was primarily related to accident years 2019 and prior. Net favorable development for the 2021 three-month period was primarily related to theaccident years 2017 accident year and prior. Net favorable development for the 2020 three-month period was related to the 2015 and 2016 accident years.
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Underwriting, Policy Acquisition and Operating Expenses
Underwriting, policy acquisition and operating expenses includesinclude the amortization of commissions, premium taxes and underwriting salaries, which are capitalized and deferred over the related workers’ compensation policy period, net of ceding commissions earned. The capitalization of underwriting salaries can vary as they are subject to the success rate of our contract acquisition efforts. These expenses also include a management fee charged by our Corporate segment, which represents intercompany charges pursuant to a management agreement, and the amortization of intangible assets, primarily related to the acquisition of Eastern by ProAssurance. The management fee is based on the extent to which services are provided to the subsidiary and the amount of premium written by the subsidiary.
Our Workers' Compensation Insurance segment underwriting, policy acquisition and operating expenses were comprised as follows:
Three Months Ended March 31
($ in thousands)20212020Change
DPAC amortization$6,741 $7,850 $(1,109)(14.1 %)
Management fees542 601 (59)(9.8 %)
Other underwriting and operating expenses8,521 10,032 (1,511)(15.1 %)
SPC ceding commission offset(3,518)(4,319)801 (18.5 %)
Total$12,286 $14,164 $(1,878)(13.3 %)
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Three Months Ended March 31
($ in thousands)20222021Change
DPAC amortization$7,061 $6,741 $320 4.7 %
Management fees541 542 (1)(0.2 %)
Other underwriting and operating expenses8,868 8,252 616 7.5 %
Policyholder dividend expense209 269 (60)(22.3 %)
SPC ceding commission offset(3,678)(3,518)(160)4.5 %
Total$13,001 $12,286 $715 5.8 %
The decreaseincrease in DPAC amortization for the three months ended March 31, 20212022 as compared to the same period in 20202021 primarily reflectsreflected the decreaseincrease in netgross premiums earned.
The decreaseincrease in other underwriting and operating expenses for the three months ended March 31, 20212022 as compared to the same period of 20202021 primarily reflected a decreasean increase in compensation-related costs and, to a lesser extent, a decrease in travel-related costs related to compensation, business-related travel, lease exit costs and an increase in the COVID-19 pandemic. The decrease in compensation-relatedallowance for credit losses. Marketing costs during the 2021 three-month period was driven by a reduction in headcountincluded advertising and website-related activities that were planned for 2022. Business-related travel has increased as a result of the 2020 organizational restructuring and, to a lesser extent, a decrease in employer contributionseasing of pandemic-related restrictions. During the first quarter of 2022, we recognized one-time lease exit costs of $0.2 million due to the ProAssurance Savings Plan (see Note 17early termination of an office lease; however, as a result, we anticipate annual expense savings of approximately $0.1 million. The increase in the Notes to Consolidated Financial Statementsallowance for credit losses primarily reflects an increase in our December 31, 2020 report on Form 10-K).accounts greater than 90 days old, which we believe is a timing issue that will reverse in future periods.
As previously discussed, alternative market premiums written throughby our Workers' Compensation Insurance segment's alternative market business unitsegment are 100% ceded, less a ceding commission, to either the SPCs in our Segregated Portfolio Cell Reinsurance segment or, to a limited extent, an unaffiliated captive insurer. The ceding commission charged to the SPCs consists of an amount for fronting fees, cell rental fees, commissions, premium taxes and risk management fees. The fronting fees, commissions, premium taxes and risk management fees are recorded as an offset to underwriting, policy acquisition and operating expenses. Cell rental fees are recorded as a component of other income and claims administration fees are recorded as ceded ULAE. The decreaseincrease in SPC ceding commissions earned for the three months ended March 31, 20212022 as compared to the same respective period of 2020,2021, primarily reflectsreflected the decreaseincrease in alternative market ceded earned premium.
Underwriting Expense Ratio (the Expense Ratio)
The underwriting expense ratio included the impact of the following:
Three Months Ended March 31Three Months Ended March 31
20212020Change20222021Change
Underwriting expense ratio, as reportedUnderwriting expense ratio, as reported30.7 %31.8 %(1.1  pts)Underwriting expense ratio, as reported32.0 %30.7 %1.3  pts
Less estimated ratio increase (decrease) attributable to:Less estimated ratio increase (decrease) attributable to:Less estimated ratio increase (decrease) attributable to:
Impact of ceding commissions received from SPCsImpact of ceding commissions received from SPCs2.9 %2.3 %0.6  ptsImpact of ceding commissions received from SPCs3.5 %2.9 %0.6  pts
Retrospective premium adjustment %0.1 %(0.1  pts)
Impact of audit premiumImpact of audit premium1.0 %(0.2 %)1.2  ptsImpact of audit premium(0.1 %)1.0 %(1.1  pts)
Change in return premium estimate under external reinsuranceChange in return premium estimate under external reinsurance(0.2 %)— %(0.2  pts)Change in return premium estimate under external reinsurance %(0.2 %)0.2  pts
Estimated revenue shareEstimated revenue share(0.4 %)(0.1 %)(0.3  pts)Estimated revenue share(0.3 %)(0.4 %)0.1  pts
Underwriting expense ratio, less listed effectsUnderwriting expense ratio, less listed effects27.4 %29.7 %(2.3  pts)Underwriting expense ratio, less listed effects28.9 %27.4 %1.5  pts
Excluding the items noted in the table above, the expense ratio decreasedincreased for the three months ended March 31, 2021,2022, primarily reflecting the decreaseincrease in compensation-related costsother underwriting and to a lesser extent, travel-related costs, partially offset by the decrease in net premiums earned.operating expenses, as previously discussed.
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Premiums Written
Changes in our premium volume within our Specialty P&C segment are generally driven by three primary factors: (1) the amount of new business written, (2) our retention of existing business and (3) the premium charged for business that is renewed, which is affected by rates charged and by the amount and type of coverage an insured chooses to purchase. In addition, premium volume may periodically be affected by shifts in the timing of renewals between periods. For the three months ended March 31, 2022, our premium volume was primarily affected by our acquisition of NORCAL.
The professional liability market, which accounts for a majority of the revenues in this segment, remains challenging as physicians continue joining hospitals or larger group practices and, therefore, are no longer purchasing individual or group policies in the standard market. In addition, some competitors have chosen to compete primarily on price; both factors may impact our ability to write new business and retain existing business. Furthermore, the insurance and reinsurance markets have historically been cyclical, characterized by extended periods of intense price competition and other periods of reduced competition. The professional liability market has been particularly affected by these cycles. Underwriting cycles are generally driven by an excess of capacity available and actively pursuing business that is deemed profitable. Changes in the frequency and severity of losses may affect the cycles of the insurance and reinsurance markets significantly. During “soft markets” where price competition is high and underwriting profits are poor, growth and retention of business become challenging which may result in reduced premium volumes.
Gross, ceded and net premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums written$257,672 $138,289 $119,383 86.3 %
Less: Ceded premiums written22,834 16,976 5,858 34.5 %
Net premiums written$234,838 $121,313 $113,525 93.6 %
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Gross Premiums Written
Gross premiums written by component were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Professional Liability
HCPL
Standard Physician(1)
$52,653 $52,617 $36 0.1 %
NORCAL Standard Physician(2)
106,476 — 106,476 nm
Total Standard Physician159,129 52,617 106,512 202.4 %
Specialty
Custom Physician(3)
7,407 15,837 (8,430)(53.2 %)
NORCAL Custom Physician(4)
11,638 — 11,638 nm
Hospitals and Facilities(5)
14,197 16,341 (2,144)(13.1 %)
NORCAL Hospitals and Facilities(6)
3,067 — 3,067 nm
Senior Care(7)(12)
4,493 5,041 (548)(10.9 %)
Reinsurance assumed(8)
9,761 10,437 (676)(6.5 %)
Total Specialty50,563 47,656 2,907 6.1 %
Total HCPL209,692 100,273 109,419 109.1 %
Small Business Unit(9)
22,519 22,766 (247)(1.1 %)
Tail Coverages(10)(12)
9,838 8,138 1,700 20.9 %
NORCAL Tail Coverages(10)
7,733 — 7,733 nm
Total Professional Liability249,782 131,177 118,605 90.4 %
Medical Technology Liability(11)
7,700 6,984 716 10.3 %
Other190 128 62 48.4 %
Total$257,672 $138,289 $119,383 86.3 %
(1) Standard Physician premium remained relatively unchanged during the 2022 three-month period as compared to the same period of 2021 as retention losses were offset by an increase in renewal pricing, the conversion of twenty-four month term policies and, to a lesser extent, new business written. Renewal pricing increases during the 2022 three-month period reflect the rising loss cost environment and new business written reflects general market conditions. Retention losses during the 2022 three-month period were largely attributable to our targeted state strategy to reassess our underwriting appetite in certain unprofitable states. We will continue to perform a detailed evaluation of venues, specialties and other areas to improve our underwriting results. We also continue to focus on underwriting discipline as we emphasize careful risk selection, rate adequacy, improved contract terms and a willingness to walk away from business that does not fit our goal of achieving a long-term underwriting profit. Retention losses during the 2022 three-month period also reflected the loss of a $2.0 million policy that chose to utilize self-insurance as well as the loss of a $1.0 million policy due to price competition. We ceased offering twenty-four month term policies beginning in the second quarter of 2020, and the majority of the policies that were up for renewal in 2021 were renewed to twelve month term policies; however, a portion of the premium from 2020 related to policies that are subject to renewal and conversion in 2022.
(2) NORCAL Standard Physician premium represents premium contributed by NORCAL and is comprised of three and twelve month term policies. NORCAL Standard Physician premium during the 2022 three-month period was impacted by retention losses, including the loss of one large policy, partially offset by an increase in renewal pricing and, to a lesser extent, new business written.
(3) Custom Physician premium includes large complex physician groups, multi-state physician groups and non-standard physicians and is written primarily on an excess and surplus lines basis. The decrease in Custom Physician premium during the 2022 three-month period as compared to the same period of 2021 was driven by retention losses, partially offset by an increase in renewal pricing and, to a lesser extent, new business written. Retention losses for the 2022 three-month period were driven by the loss of two large policies totaling approximately $9.0 million due to price competition, which resulted in a decrease in our Specialty retention rate of 18.9 percentage points. Renewal pricing increases for the 2022 three-month period reflect the rising loss cost environment and new business written reflects general market conditions.
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(4) NORCAL Custom Physician premium represents premium contributed by NORCAL and includes large complex physician groups, multi-state physician groups and non-standard physicians and is written primarily on an excess and surplus lines basis. NORCAL Custom Physician premium during the 2022 three-month period was impacted by retention losses, partially offset by an increase in renewal pricing and, to a lesser extent, new business written.
(5) Hospitals and Facilities premium (which includes hospitals, surgery centers and miscellaneous medical facilities) decreased during the 2022 three-month period as compared to the same period of 2021 driven by retention losses and, to a lesser extent, the timing of the renewal of a $1.6 million policy between periods; this policy will renew in the second quarter of 2022 as compared to the first quarter of 2021. Retention losses in the 2022 three-month period were largely attributable to the loss of a $1.4 million policy due to the insured entering into a captive arrangement and our non-renewal of a $1.2 million policy due to our focus on underwriting discipline. The decrease in Hospitals and Facilities premium for the 2022 three-month period was partially offset by new business written, primarily miscellaneous medical facilities, and, to a lesser extent, an increase in renewal pricing. Renewal pricing increases for the 2022 three-month period reflect rate increases and contract modifications that we believe are appropriate given the current loss environment and new business written reflects general market conditions.
(6) NORCAL Hospitals and Facilities premium represents premium contributed by NORCAL and includes hospitals, surgery centers and miscellaneous medical facilities. NORCAL Hospitals and Facilities premium during the 2022 three-month period was impacted by retention losses, partially offset by new business written and, to a lesser extent, an increase in renewal pricing.
(7) Senior Care premium includes facilities specializing in long term residential care primarily for the elderly ranging from independent living through skilled nursing. Our Senior Care premium decreased for the 2022 three-month period as compared to the same period of 2021 driven by retention losses, partially offset by new business written. The lower premium retention was primarily due to a large account renewing with a meaningful reduction in exposure. Renewal pricing for the 2022 three-month period remained relatively unchanged as compared to the same period of 2021.
(8) We offer custom alternative risk solutions including assumed reinsurance. The decrease in premium during the 2022 three-month period primarily reflected the impact of an assumed reinsurance arrangement with a regional hospital group entered into during the first quarter of 2021 which resulted in $4.5 million of premium written, comprised of $2.3 million of retroactive premium written and fully earned and $2.2 million of prospective premium written (see Note 5 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K). The decrease in premium during the 2022 three-month period was largely offset by an increase in premiums assumed on a quota share basis through a strategic partnership in place since 2016 with an international medical professional liability insurer. In 2021, we increased our participation in the original program and entered into another program with this insurer in a new international territory. We anticipate the volume of premium assumed through this partnership will continue to grow going forward.
(9) Our Small Business Unit is primarily comprised of premium associated with podiatrists, legal professionals, dentists and chiropractors. Our Small Business Unit premium remained relatively unchanged during the 2022 three-month period as compared to the same period of 2021 as retention losses were almost entirely offset by new business written and, to a lesser extent, an increase in renewal pricing. The increase in renewal pricing during the 2022 three-month period was primarily the result of an increase in the rate charged for certain renewed policies in select states.
(10) We offer extended reporting endorsement or "tail" coverage to insureds who discontinue their claims-made coverage with us, and we also periodically offer tail coverage through stand-alone policies. Tail coverage premiums are generally 100% earned in the period written because the policies insure only incidents that occurred in prior periods and are not cancellable. The amount of tail coverage premium written can vary significantly from period to period.
(11) Our Medical Technology Liability business is marketed throughout the U.S.; coverage is typically offered on a primary basis, within specified limits, to manufacturers and distributors of medical technology and life sciences products including entities conducting human clinical trials. In addition to the previously listed factors that affect our premium volume, our Medical Technology Liability premium is also impacted by the sales volume of insureds. Our Medical Technology Liability premium increased during the 2022 three-month period as compared to the same period of 2021 due to new business written and, to a lesser extent, an increase in renewal pricing, partially offset by retention losses. Renewal pricing increases during the 2022 three-month period are primarily due to changes in the sales volume of certain insureds, including changes in exposure. Retention losses during the 2022 three-month period are primarily attributable to an increase in competition on terms and pricing, as well as merger activity within the industry.

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(12) Certain components of our gross premiums written include alternative market premiums. We currently cede either all or a portion of the alternative market premium, net of reinsurance, to three SPCs of our wholly owned Cayman Islands reinsurance subsidiaries, Inova Re and Eastern Re, which are reported in our Segregated Portfolio Cell Reinsurance segment (see further discussion in the Ceded Premiums Written section that follows). The portion not ceded to the SPCs is retained within our Specialty P&C segment.
Three Months Ended March 31
($ in millions)20222021Change
Senior Care$3.9 $4.2 $(0.3)(7.1 %)
Tail Coverages3.0 0.3 2.7 900.0 %
Total$6.9 $4.5 $2.4 53.3 %
Alternative market gross premiums written increased during the 2022 three-month period as compared to the same period of 2021 driven by an increase in tail coverage premium, primarily related to one program.
We are committed to a rate structure that will allow us to fulfill our obligations to our insureds while generating competitive long-term returns for our shareholders. Our pricing continues to be based on expected losses as indicated by our historical loss data and available industry loss data. In recent years, this practice has resulted in gradual rate increases and we anticipate further rate increases due to indications of increasing projected loss severity. Additionally, the pricing of our business includes the effects of filed rates, surcharges and discounts. Renewal pricing also reflects changes in our exposure base, deductibles, self-insurance retention limits and other policy terms and conditions. See further explanation of changes in renewal pricing above under the heading "Gross Premiums Written".
The change in renewal pricing for our Specialty P&C segment, including by major component, was as follows:
Three Months Ended
March 31
2022
Specialty P&C segment9%
HCPL
Standard Physician10%
Specialty6%
Total HCPL9%
Small Business Unit5%
Medical Technology Liability10%
New business written by major component on a direct basis was as follows:
Three Months Ended
March 31
(In millions)20222021
HCPL
Standard Physician(1)
$1.8 $0.6 
Specialty(1)
3.7 8.7 
Total HCPL5.5 9.3 
Small Business Unit1.0 1.0 
Medical Technology Liability1.7 1.8 
Total$8.2 $12.1 
(1) Includes premium contributed by NORCAL during the 2022 three-month period.
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For our Specialty P&C segment, we calculate retention as annualized renewed premium divided by all annualized premium subject to renewal. Retention is affected by a number of factors. We may lose insureds to competitors or to alternative insurance mechanisms such as risk retention groups, captive arrangements or self-insurance entities (often when physicians join hospitals or large group practices) or due to pricing or other issues. We may choose not to renew an insured as a result of our underwriting evaluation. Insureds may also terminate coverage because they have left the practice of medicine for various reasons, principally for retirement, death or disability, but also for personal reasons.
Retention for our Specialty P&C segment, including by major component, was as follows:
Three Months Ended
March 31
20222021
Specialty P&C segment83 %77 %
HCPL
Standard Physician(1)
88 %86 %
Specialty(1)
61 %56 %
Total HCPL82 %73 %
Small Business Unit91 %91 %
Medical Technology Liability(2)
84 %87 %
(1) Includes premium contributed by NORCAL during the 2022 three-month period. We continue the process of evaluating the NORCAL book of business and implementing ProAssurance's underwriting strategies, which will likely impact retention in future quarters.
(2) See Gross Premiums Written section for further explanation of retention decline in 2022.
Ceded Premiums Written
Ceded premiums represent the amounts owed to our reinsurers for their assumption of a portion of our losses. Our HCPL and Medical Technology Liability excess of loss reinsurance arrangements renew annually on October 1. For those excess of loss reinsurance arrangements in effect prior to October 1, 2021, we generally retained the first $2 million in risk insured by us and ceded coverages in excess of this amount. Effective October 1, 2021, our HCPL treaty renewed at a lower gross rate and we generally retain from 0% to 5% of the next $24 million of risk for our HCPL coverages in excess of $2 million. Our HCPL excess of loss reinsurance arrangement that renewed on October 1, 2021 also incorporated NORCAL policies. Prior to October 1, 2021, NORCAL policies were reinsured under separate reinsurance agreements, primarily excess of loss, which have historically renewed annually on January 1. For the NORCAL excess of loss reinsurance arrangement that renewed on January 1, 2021, retention was generally the first $2 million in risk and coverages in excess of this amount were ceded up to $24 million. For our Medical Technology Liability treaty which also renewed effective October 1, 2021, we also retain 2.5% of the next $8 million of risk for coverages in excess of $2 million. There were no significant changes in the cost or structure of our Medical Technology Liability treaty upon the October 2021 renewal.
In certain of our excess of loss arrangements, the ultimate amount of ceded premium is determined by the loss experience of the business ceded, subject to certain minimum and maximum amounts. Given the length of time that it takes to resolve our claims, many years may elapse before all losses recoverable under a reinsurance arrangement are known. As a part of the process of estimating our loss reserve we also make estimates regarding the amounts recoverable under our reinsurance arrangements. As a result, we may have an adjustment to our estimate of expected losses and associated recoveries for prior year ceded losses under certain loss sensitive reinsurance agreements. Any changes to estimates of premiums ceded related to prior accident years are fully earned in the period the changes in estimates occur.
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Ceded premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Excess of loss reinsurance arrangements (1)
$9,496 $7,678 $1,818 23.7 %
Other shared risk arrangements (2)
4,336 3,963 373 9.4 %
Premium ceded to SPCs (3)
6,881 4,469 2,412 54.0 %
Other ceded premiums written(4)
2,121 866 1,255 144.9 %
Total ceded premiums written$22,834 $16,976 $5,858 34.5 %
(1) We generally reinsure risks under our excess of loss reinsurance arrangements pursuant to which the reinsurers agree to assume all or a portion of all risks that we insure above our individual risk retention levels, up to the maximum individual limits offered. Premium due to reinsurers also fluctuates with the volume of written premium subject to cession under the arrangement. In certain of our excess of loss reinsurance arrangements, the premium due to the reinsurer is determined by the loss experience of that business reinsured, subject to certain minimum and maximum amounts. The increase in ceded premiums written under our excess of loss reinsurance arrangements during the 2022 three-month period as compared to the same period of 2021 was driven by additional ceded premiums of $4.4 million as a result of incorporating NORCAL policies into our existing HCPL excess of loss reinsurance arrangements with the October 1, 2021 renewal, as previously discussed. Excluding NORCAL, ceded premiums written under our excess of loss reinsurance arrangements decreased by approximately $2.4 million primarily due to a decrease in the overall volume of gross premiums written subject to cession and, to a lesser extent, the reduced rate on the treaty year effective October 1, 2021.
(2) We have entered into various shared risk arrangements, including quota share, fronting, and captive arrangements, with certain large healthcare systems and other insurance entities. While we cede a large portion of the premium written under these arrangements, they provide us an opportunity to grow net premium through strategic partnerships. These arrangements primarily include our Ascension Health program. Ceded premiums written under our shared risk arrangements during the 2022 three-month period remained relatively unchanged as compared to the same period of 2021.
(3) As previously discussed, as a part of our alternative market solutions, all or a portion of certain healthcare premium written is ceded to SPCs in our Segregated Portfolio Cell Reinsurance segment under either excess of loss or quota share reinsurance agreements, depending on the structure of the individual program. See the Segment Results - Segregated Portfolio Cell Reinsurance section for further discussion on the cession to the SPCs from our Specialty P&C segment. The increase in premiums ceded to SPCs during the 2022 three-month period as compared to the same period of 2021 was driven by the impact of tail coverages, primarily related to one program (see discussion in footnote 12 under the heading "Gross Premiums Written").
(4) The increase in other ceded premiums written during the 2022 three-month period as compared to the same period of 2021 was primarily driven by the incorporation of NORCAL's cyber liability coverages into our existing HCPL cyber liability arrangement with the October 1, 2021 renewal.
Ceded Premiums Ratio
The ceded premiums ratio was as follows:
Three Months Ended March 31
 20222021Change
Ceded premiums ratio8.9%12.3%(3.4 pts)
The above table reflects ceded premiums written as a percent of gross premiums written. The decrease in our ceded premiums ratio for the 2022 three-month period as compared to the same period of 2021 was driven by the reduced rate on our excess of loss reinsurance arrangements for the treaty year effective October 1, 2021 as well as the impact of the addition of the NORCAL gross written premium base for the 2022 three-month period. The decrease in our ceded premiums ratio for the 2022 three-month period as compared to the same period of 2021 was partially offset by an increase in premiums ceded to SPCs. See additional discussion on NORCAL ceded premiums and premiums ceded to SPCs above under the heading "Ceded Premiums Written."
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Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that we cede to our reinsurers for their assumption of a portion of our losses. Because premiums are generally earned pro rata over the entire policy period, fluctuations in premiums earned tend to lag those of premiums written. The majority of our policies carry a term of one year; however, some of our Medical Technology Liability policies have a multi-year term and some of our NORCAL Standard Physician policies have a three-month term. In addition, prior to the third quarter of 2020, we wrote certain Standard Physician policies with a twenty-four month term. Tail coverage premiums are generally 100% earned in the period written because the policies insure only incidents that occurred in prior periods and are not cancellable. Retroactive coverage premiums are 100% earned at the inception of the contract, as all of the associated underlying loss events occurred in the past. Additionally, any ceded premium changes due to changes to estimates of premiums owed under reinsurance agreements for prior accident years are fully earned in the period of change.
Net premiums earned were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums earned$212,279 $132,060 $80,219 60.7 %
Less: Ceded premiums earned14,312 16,447 (2,135)(13.0 %)
Net premiums earned$197,967 $115,613 $82,354 71.2 %
Gross premiums earned during the 2022 three-month period included additional earned premiums of approximately $79.7 million from our acquisition of NORCAL. Excluding premiums associated with the NORCAL acquisition, gross premiums earned remained relatively unchanged during the 2022 three-month period as compared to the same period of 2021.
Ceded premiums earned decreased during the 2022 three-month period as compared to the same period of 2021 driven by the pro rata effect of a decrease in premium ceded under our shared risk and excess of loss arrangements during the preceding twelve months.
Losses and Loss Adjustment Expenses
The determination of calendar year losses involves the actuarial evaluation of incurred losses for the current accident year and the actuarial re-evaluation of incurred losses for prior accident years, including an evaluation of the reserve amounts required for ECO/XPL losses. As part of the review of our prior accident year reserves, we also make estimates of expected losses and associated recoveries for prior year ceded losses under certain loss sensitive reinsurance agreements. This analysis may result in changes to estimates of premiums owed under reinsurance agreements for prior accident years which impact net premiums earned (the denominator of the net loss ratio) in the period the adjustment is made. No such adjustments were made during the three months ended March 31, 2022 or 2021. See previous discussion under the heading "Ceded Premiums Written" for additional information.
Accident year refers to the accounting period in which the insured event becomes a liability of the insurer. For claims-made policies, which represent the majority of the premiums written in our Specialty P&C segment, the insured event generally becomes a liability when the event is first reported to us. For occurrence policies, the insured event becomes a liability when the event takes place. For retroactive coverages, the insured event becomes a liability at inception of the underlying contract. We believe that measuring losses on an accident year basis is the best measure of the underlying profitability of the premiums earned in that period, since it associates policy premiums earned with the estimate of the losses incurred related to those policy premiums.
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The following table summarizes calendar year net loss ratios for our Specialty P&C segment by separating losses between the current accident year and all prior accident years. In addition, net loss ratios for the three months ended March 31, 2022 in the following table include the impact of NORCAL.
Net Loss Ratios (1)
Three Months Ended March 31
20222021Change
Calendar year net loss ratio83.8 %87.5 %(3.7  pts)
Less impact of prior accident years on the net loss ratio(2.0 %)(2.3 %)0.3  pts
Current accident year net loss ratio (2)
85.8 %89.8 %(4.0  pts)
(1)Net losses, as specified, divided by net premiums earned.
(2)Our current accident year net loss ratio (as shown in the table above) decreased 4.0 percentage points during the three months ended March 31, 2022 as compared to the same period of 2021. The change in our current accident year net loss ratio in each period was primarily attributable to the following:
(In percentage points)Increase (Decrease)
2022 versus 2021
Comparative
three-month
period
Estimated ratio increase (decrease) attributable to:
NORCAL Operations4.0 pts
NORCAL Acquisition - Purchase Accounting Adjustment(1.2 pts)
Change in Estimate of ULAE(3.7 pts)
All other, net(3.1 pts)
Decrease in current accident year net loss ratio(4.0 pts)
Excluding the impact of the items specifically identified in the table above, our current accident year net loss ratio for the three months ended March 31, 2022 improved 3.1 percentage points as compared to the prior year period driven by a decrease to certain loss ratios in our Standard Physician line of business, which we began recognizing in the second half of 2021 and, to a lesser extent, changes in the mix of business. We continue to observe a reduction in claims frequency that started to emerge in 2020, some of which is due to our re-underwriting efforts and some of which, we believe, is associated with the COVID-19 pandemic including the disruption of the court systems. Given the consistent and prolonged nature of this favorable claims frequency trend, we reduced certain loss ratios in our Standard Physician line of business during the third and fourth quarters of 2021. We continue to remain cautious in recognizing the full impact of these favorable trends in our current accident year reserve due to the long-tailed nature of our HCPL claims as well as the uncertainty surrounding the length and severity of the pandemic.
Initial loss ratios associated with NORCAL policies were higher than the average for our other books of business in this segment. The impact of NORCAL operations resulted in a 4.0 percentage point increase in our current accident year net loss ratio for the three months ended March 31, 2022. We continue the process of evaluating the NORCAL book of business and implementing ProAssurance's underwriting strategies. Also as a result of our acquisition of NORCAL, our current accident year net loss ratio for the three months ended March 31, 2022 was impacted by amortization of the negative VOBA associated with NORCAL's assumed unearned premium which is recorded as a reduction to current accident year net losses and accounted for a 1.2 percentage point decrease in our current period ratio. The remaining unamortized negative VOBA will be fully amortized in the second quarter of 2022 (see Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for additional information on the remaining expected amortization of the NORCAL acquisition purchase accounting adjustments).
During the first quarter of 2022, we decreased our estimate of ULAE as a result of substantially integrating NORCAL into our Specialty P&C segment operations, which accounted for a 3.7 percentage point decrease in our current period accident year loss ratio with an offsetting 3.7 percentage point increase in our current period expense ratio with no impact to our combined ratio or segment results (see discussion on our expense ratio in the following section under the heading "Underwriting, Policy Acquisition and Operating Expenses"). This change in estimated ULAE had no impact on our combined ratio or segment results.
We re-evaluate our previously established reserve each quarter based upon the most recently completed actuarial analysis supplemented by any new analysis, information or trends that have emerged since the date of that study. We also take into account currently available industry trend information.
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We recognized net favorable prior accident year reserve development of $3.9 million during the three months ended March 31, 2022 as compared to $2.7 million during the same period of 2021. Net favorable development recognized during the three months ended March 31, 2022 was net of an increase in our reserve for potential ECO/XPL claims of $4.0 million as compared to a reduction in this same reserve of $0.2 million during the same period of 2021. Furthermore, net favorable development recognized during the three months ended March 31, 2022 included $2.9 million related to the amortization of the purchase accounting fair value adjustment on NORCAL's assumed net reserve and amortization of the negative VOBA associated with NORCAL's DDR reserve which is recorded as a reduction to prior accident year net losses and loss adjustment expenses. See Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for additional information on the remaining expected amortization of the NORCAL acquisition purchase accounting adjustments. We have not recognized any development related to NORCAL's prior accident year reserves since the date of acquisition on May 5, 2021. Excluding the increase in the ECO/XPL reserve and amortization of purchase accounting adjustments, we recognized net favorable prior accident year reserve development of $5.0 million during the three months ended March 31, 2022, principally related to accident years 2019 through 2021. Development recognized during the three months ended March 31, 2021 principally related to accident years 2017 and 2018.
A detailed discussion of factors influencing our recognition of loss development is included in our Critical Accounting Estimates section under the heading "Reserve for Losses and Loss Adjustment Expenses" in our December 31, 2021 report on Form 10-K. Assumptions used in establishing our reserve are regularly reviewed and updated by management as new data becomes available. Any adjustments necessary are reflected in the then current operations. Due to the size of our reserve, even a small percentage adjustment to the assumptions can have a material effect on our results of operations for the period in which the change is made, as was the case in both 2022 and 2021.
Underwriting, Policy Acquisition and Operating Expenses
Our Specialty P&C segment underwriting, policy acquisition and operating expenses, including NORCAL expenses for the 2022 three-month period, were comprised as follows:
Three Months Ended March 31
($ in thousands)20222021Change
DPAC amortization$21,740 $12,396 $9,344 75.4 %
Management fees1,402 1,001 401 40.1 %
Other underwriting and operating expenses19,736 12,949 6,787 52.4 %
Total$42,878 $26,346 $16,532 62.7 %
DPAC amortization for the 2022 three-month period included approximately $8.1 million of DPAC amortization associated with NORCAL policies written subsequent to our acquisition; however, this level of DPAC amortization is approximately $1.0 million lower than would be considered normal for the quarter due to the application of GAAP purchase accounting rules whereby the capitalized policy acquisition costs for policies written prior to the acquisition date were written off through purchase accounting on May 5, 2021 rather than being expensed pro rata over the remaining term of the associated policies (see Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for more information). The remaining increase in DPAC amortization for the 2022 three-month period as compared to the same period of 2021 reflected an increase in brokerage expenses due to our increased participation with an international medical professional liability insurer in our Specialty line of business (see discussion under the heading "Gross Premiums Written").
Management fees are charged pursuant to a management agreement by the Corporate segment to the operating subsidiaries within our Specialty P&C segment for services provided based on the extent to which services are provided to the subsidiary and the amount of premium written by the subsidiary. Fluctuations in the amount of premium written by each subsidiary can result in corresponding variations in the management fee charged to each subsidiary during a particular period. Due to continued organizational structure enhancements in our Specialty P&C segment during 2021 as well as operational alignments as a result of the integration of NORCAL, the extent to which services are provided by the Corporate segment to the operating subsidiaries within the segment decreased further effective January 1, 2022. Accordingly, we reduced the fee charged to the operating subsidiaries in 2022. Also effective January 1, 2022, the management agreement included operating subsidiaries of NORCAL contributing to $0.6 million of additional management fees in the current period.
Other underwriting and operating expenses increased during the 2022 three-month period primarily due to the addition of expenses contributed by NORCAL as well as a decrease in our estimate of ULAE which resulted in approximately $7.3 million of expenses remaining in operating expenses instead of being allocated to net losses and loss adjustment expenses. As a result, this change in ULAE estimate had offsetting impacts to our loss and expense ratios during the period with no impact to our combined ratio or segment results. See additional discussion on this change in ULAE estimate in the previous section under the heading "Losses and Loss Adjustment Expenses." Excluding expenses contributed by NORCAL and the impact of the change
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in ULAE, other underwriting and operating expenses decreased due to benefits from prior organizational restructurings and proactive expense management, somewhat offset by one-time expenses of $1.6 million incurred during the current period mainly comprised of one-time bonuses, employee severance charges and lease exit costs.
Underwriting Expense Ratio (the Expense Ratio)
Our expense ratio for the Specialty P&C segment was as follows:
 Three Months Ended March 31
 20222021Change
Underwriting expense ratio21.7 %22.8 %(1.1  pts)
The change in our expense ratio for the 2022 three-month period as compared to the same period of 2021 was primarily attributable to the following:
Increase (Decrease)
 2022 versus 2021
(In percentage points)Comparative three-month period
Estimated ratio increase (decrease) attributable to:
Increase in Net Premiums Earned and DPAC amortization(1)
0.3 pts
Change in Estimate of ULAE3.7 pts
Tail Premium(2)
(1.2 pts)
All other, net(3.9 pts)
Decrease in the underwriting expense ratio(1.1 pts)
(1) Excludes tail premium for the three months ended March 31, 2022 and 2021.
(2) Represents the effect of the premium earned from tail policies for the three months ended March 31, 2022 as compared to the same period of 2021 as there is typically minimal expense associated with tail premium (see discussion under the heading "Gross Premiums Written").
Excluding the items specifically identified in the table above, our expense ratio for the 2022 three-month period decreased by 3.9 percentage points primarily due to lower operating expenses due to the benefits from prior organizational restructurings and proactive expense management as well as expense synergies recognized from the NORCAL acquisition. However, as previously discussed, DPAC amortization associated with NORCAL recorded during the 2022 three-month period was lower than would be considered normal for the quarter due to the application of GAAP purchase accounting rules. Normalizing this amortization would have increased our expense ratio for the 2022 three-month period by an estimated 0.5 percentage points.
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Segment Results - Workers' Compensation Insurance
Our Workers' Compensation Insurance segment includes workers' compensation products provided to employers generally with 1,000 or fewer employees, as discussed in Note 18 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K. Workers' compensation products offered include guaranteed cost policies, policyholder dividend policies, retrospectively-rated policies, deductible policies and alternative market programs. Alternative market programs include program design, fronting, claims administration, risk management, SPC rental, asset management and SPC management services. Alternative market program premiums are 100% ceded to either the SPCs within our Segregated Portfolio Cell Reinsurance segment includes theor, to a limited extent, an unaffiliated captive insurer for one program. Our Workers' Compensation Insurance segment results (underwritingreflect pre-tax underwriting profit or loss plusfrom these workers' compensation products, exclusive of investment results, which are included in our Corporate segment. Segment results included the following:
Three Months Ended March 31
($ in thousands)20222021Change
Net premiums written$45,266 $46,884 $(1,618)(3.5 %)
Net premiums earned$40,684 $40,011 $673 1.7 %
Other income682 392 290 74.0 %
Net losses and loss adjustment expenses(27,211)(26,207)(1,004)3.8 %
Underwriting, policy acquisition and operating expenses(13,001)(12,286)(715)5.8 %
Segment results$1,154 $1,910 $(756)(39.6 %)
Net loss ratio66.9%65.5%1.4 pts
Underwriting expense ratio32.0%30.7%1.3 pts

Premiums Written
Our workers’ compensation premium volume is driven by five primary factors: (1) the amount of new business written, (2) retention of our existing book of business, (3) premium rates charged on our renewal book of business, (4) changes in payroll exposure and (5) audit premium.
Gross, ceded and net of U.S. federal income taxes) of SPCs at Inova Re and Eastern Re, our Cayman Islands SPC operations,premiums written were as discussedfollows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums written$72,118 $72,328 $(210)(0.3 %)
Less: Ceded premiums written26,852 25,444 1,408 5.5 %
Net premiums written$45,266 $46,884 $(1,618)(3.5 %)
Gross Premiums Written
Gross premiums written by product were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Traditional business:
Guaranteed cost$35,503 $38,196 $(2,693)(7.1 %)
Policyholder dividend7,862 7,520 342 4.5 %
Deductible2,120 2,052 68 3.3 %
Retrospective(1)
646 455 191 42.0 %
Other1,615 1,600 15 0.9 %
Alternative market business(2)
24,372 23,715 657 2.8 %
Change in EBUB estimate (1,210)1,210 nm
Total$72,118 $72,328 $(210)(0.3 %)
(1) The change in Note 14retrospectively-rated policies included an adjustment that decreased premium by $0.1 million for each of the Notesthree months ended March 31, 2022 and 2021.
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(2) A majority of alternative market premiums are ceded to Condensed Consolidated Financial Statements. SPCs are segregated pools of assets and liabilities that provide an insurance facility for a defined set of risks. Assets of each SPC are solely for the benefit of that individual cell and each SPC is solely responsible for the liabilities of that individual cell. Assets of one SPC are statutorily protected from the creditors of the others. Each SPC is owned, fully or in part, by an agency, group or association and the results of the SPCs are attributable to the participants of that cell. We participate to a varying degree in the results of selected SPCs and, for the SPCs in which we participate, our participation interest ranges from a low of 20% to a high of 85%. SPC results attributable to external cell participants are reported as an SPC dividend (expense) income in our Segregated Portfolio Cell Reinsurance segment. In addition,See further discussion on alternative market gross premiums written in our Segment Operating Results - Segregated Portfolio Cell Reinsurance section under the heading "Gross Premiums Written" that follows.
Gross premiums written remained relatively unchanged during the three months ended March 31, 2022 as compared to the same period of 2021 as decreases in new business, renewal retention and renewal rate changes were largely offset by an increase in audit premium and the prior year impact of the reduction of our EBUB estimate. Policy audits processed during the 2022 three-month period resulted in audit premium billed to policyholders totaling $1.7 million as compared to audit premium returned to policyholders of $0.8 million for the same period in 2021. We did not adjust our EBUB estimate for the 2022 three-month period; however, we reduced our EBUB estimate by $1.2 million for the same period in 2021. Renewal rate retention was 88% for the 2022 three-month period as compared to 90% for the same period of 2021. Renewal rate decreased 4% during the 2022 three-month period as compared to 3% during the same period of 2021. New business written decreased $2.1 million during the 2022 three-month period as compared to the same period of 2021, reflecting the competitive workers' compensation market conditions and a decrease in new business submissions in the 2022 three-month period.
We retained 100% of the nine workers’ compensation alternative market programs that were up for renewal during the three months ended March 31, 2022.
New business, audit premium, renewal retention and renewal price changes for our traditional business and the alternative market business are shown in the table below:
Three Months Ended March 31
20222021
($ in millions)Traditional BusinessAlternative Market BusinessSegment
Results
Traditional BusinessAlternative Market BusinessSegment
Results
New business$3.5 $1.1 $4.6 $5.9 $0.8 $6.7 
Audit premium (excluding EBUB)$0.1 $1.6 $1.7 $(1.0)$0.2 $(0.8)
Retention rate (1)
85 %92 %88 %89 %92 %90 %
Change in renewal pricing (2)
(4 %)(3 %)(4 %)(2 %)(5 %)(3 %)
(1) We calculate our workers' compensation retention rate as annualized expiring renewed premium divided by all annualized expiring premium subject to renewal. Our retention rate can be impacted by various factors, including price or other competitive issues, insureds being acquired, or a decision not to renew based on our underwriting evaluation.
(2) The pricing of our business includes an assessment of the underlying policy exposure and market conditions. We continue to base our pricing on expected losses, as indicated by our historical loss data.
Ceded Premiums Written
Ceded premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Premiums ceded to SPCs$21,488 $20,682 $806 3.9 %
Premiums ceded to external reinsurers3,155 2,974 181 6.1 %
Premiums ceded to unaffiliated captive insurer2,884 3,033 (149)(4.9 %)
Change in return premium estimate under external reinsurance29 (474)503 106.1 %
Estimated revenue share under external reinsurance(704)(771)67 (8.7 %)
Total ceded premiums written$26,852 $25,444 $1,408 5.5 %
Premiums ceded to SPCs represent alternative market business that is ceded under 100% quota share reinsurance agreements to the SPCs in our Segregated Portfolio Cell Reinsurance segment. Premiums ceded to an unaffiliated captive insurer represent alternative market business for one program that is ceded under a 100% quota share reinsurance agreement. Alternative market premiums written increased for the 2022 three-month period, which resulted in higher premiums ceded to SPCs. See further discussion on alternative market gross premiums written in our Segment Operating Results - Segregated Portfolio Cell Reinsurance section under the heading "Gross Premiums Written" that follows.
Under our external reinsurance treaty for traditional business, we retain the first $0.5 million in risk insured by us and cede losses in excess of this amount on each loss occurrence, subject to an AAD, equal to 3.5% of ceded earned premium for the treaty year effective May 1, 2021. Premiums ceded under our traditional reinsurance treaty are based on premium earned
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during the treaty period. The increase in premiums ceded to external reinsurers during the 2022 three-month period primarily reflected the increase in reinsurance rates effective May 1, 2021.
Changes in the return premium estimate reflected adjustments to our estimate of expected future recovery of ceded premium based on the underlying loss experience of our reinsurance treaties that include a provision for return premium. As shown in the table above, we decreased our estimate of return premium by a nominal amount during the 2022 three-month period as compared to an increase of $0.5 million during the same respective period in 2021. Changes in the estimated return premium primarily reflect adjustments to loss estimates on previously reported reinsured claims.
We are party to a revenue sharing agreement with our reinsurance broker under which we participate in the broker's revenue earned under our reinsurance treaties based on the volume of premium ceded. We estimate the amount of revenue we expect to receive under this agreement as premiums are recognized and ceded to the reinsurers.
Ceded Premiums Ratio
Ceded premiums ratio was as follows:
Three Months Ended March 31
20222021Change
Ceded premiums ratio, as reported33.3 %31.8 %1.5  pts
Less the effect of:
Premiums ceded to SPCs (100%)26.1 %25.9 %0.2  pts
Premiums ceded to unaffiliated captive insurers (100%)1.5 %1.7 %(0.2  pts)
Change in EBUB %0.1 %(0.1  pts)
Change in return premium estimate under external reinsurance0.1 %(1.1 %)1.2  pts
Estimated revenue share(1.6 %)(1.8 %)0.2  pts
Assumed premiums earned (not ceded to external reinsurers)(0.3 %)(0.3 %)—  pts
Ceded premiums ratio (related to external reinsurance), less the effects of above7.5 %7.3 %0.2  pts
The above table reflects traditional ceded premiums earned as a percent of traditional gross premiums earned. As discussed above, premiums ceded under our traditional reinsurance treaty are based on premiums earned during the treaty period. The increase in the ceded premiums ratio for the three months ended March 31, 2022 as compared to the same period in 2021 primarily reflected an increase in reinsurance rates.
Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that we cede to SPCs in our Segregated Portfolio Cell Reinsurance segment, includesexternal reinsurers (including changes related to the investment resultsreturn premium and revenue share estimates) and the unaffiliated captive insurer. Because premiums are generally earned pro rata over the entire policy period, fluctuations in premiums earned tend to lag those of premiums written. Our workers’ compensation policies are twelve month term policies, and premiums are earned on a pro rata basis over the policy period. Net premiums earned also include premium adjustments related to the audit of our insureds' payrolls, changes in our EBUB estimate and premium adjustments related to retrospectively-rated policies. Payroll audits are conducted subsequent to the end of the SPCspolicy period and any related premium adjustments processed are recorded as fully earned in the investments are solelycurrent period. In addition, we record an estimate for EBUB and evaluate the estimate on a quarterly basis.
Net premiums earned were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums earned$61,034 $58,632 $2,402 4.1 %
Less: Ceded premiums earned20,350 18,621 1,729 9.3 %
Net premiums earned$40,684 $40,011 $673 1.7 %
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The increase in net premiums earned during the three months ended March 31, 2022 as compared to the same period in 2021 primarily reflected the impact of the adjustment to EBUB in the prior year period. Excluding the adjustment to EBUB during the 2021 three-month period, net premiums earned decreased during the three months ended March 31, 2022 as compared to the same period in 2021 primarily due to the pro rata effect of a reduction in net premiums written during the preceding twelve months. The decrease in net premiums earned during the three months ended March 31, 2022 was partially offset by an increase in audit premium billed to policyholders.
Losses and Loss Adjustment Expenses
We estimate our current accident year loss and loss adjustment expenses by developing actual reported losses using historical loss development factors, adjusted to reflect current and expected trends based on various internal analyses and supplemental information. The following table summarizes calendar year net loss ratios by separating losses between the current accident year and all prior accident years. Calendar year and current accident year net loss ratios by component were as follows:
Three Months Ended March 31
20222021Change
Calendar year net loss ratio66.9 %65.5 %1.4  pts
Less impact of prior accident years on the net loss ratio(4.9 %)(5.5 %)0.6  pts
Current accident year net loss ratio71.8 %71.0 %0.8  pts
The increase in the current accident year net loss ratio during the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected the continuation of intense price competition and the resulting renewal rate decreases, partially offset by the impact of favorable prior year claim trends on the current year estimate. The current accident year net loss ratio for the benefitthree months ended March 31, 2022 also reflects an expectation that the labor shortage will continue to have an impact on claim activity during 2022.
Calendar year incurred losses (excluding IBNR) in excess of our per occurrence reinsurance retention, before consideration of the cell participantsAAD (see previous discussion under the heading "Ceded Premiums Written"), increased $1.7 million for the three months ended March 31, 2022 as compared to the same period of 2021; however, of the $1.7 million, we retained losses in excess of our per occurrence retention totaling $1.0 million which reflected losses within the AAD. There were no current accident year reported losses ceded to reinsurers during the three months ended March 31, 2022 or 2021.
We recognized net favorable prior year development related to our previously established reserve of $2.0 million for the three months ended March 31, 2022 as compared to $2.2 million for the same period of 2021. The net favorable prior year reserve development for the three months ended March 31, 2022 and investment results attributable2021 reflected overall favorable trends in claim closing patterns. Net favorable development for the 2022 three months ended was primarily related to external cell participantsaccident years 2019 and prior. Net favorable development for the 2021 three-month period was primarily related to accident years 2017 and prior.
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Underwriting, Policy Acquisition and Operating Expenses
Underwriting, policy acquisition and operating expenses include the amortization of commissions, premium taxes and underwriting salaries, which are capitalized and deferred over the related workers’ compensation policy period, net of ceding commissions earned. The capitalization of underwriting salaries can vary as they are subject to the success rate of our contract acquisition efforts. These expenses also include a management fee charged by our Corporate segment, which represents intercompany charges pursuant to a management agreement, and the amortization of intangible assets, primarily related to the acquisition of Eastern by ProAssurance. The management fee is based on the extent to which services are provided to the subsidiary and the amount of premium written by the subsidiary.
Our Workers' Compensation Insurance segment underwriting, policy acquisition and operating expenses were comprised as follows:
Three Months Ended March 31
($ in thousands)20222021Change
DPAC amortization$7,061 $6,741 $320 4.7 %
Management fees541 542 (1)(0.2 %)
Other underwriting and operating expenses8,868 8,252 616 7.5 %
Policyholder dividend expense209 269 (60)(22.3 %)
SPC ceding commission offset(3,678)(3,518)(160)4.5 %
Total$13,001 $12,286 $715 5.8 %
The increase in DPAC amortization for the three months ended March 31, 2022 as compared to the same period in 2021 primarily reflected the increase in gross premiums earned.
The increase in other underwriting and operating expenses for the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected an increase in costs related to compensation, business-related travel, lease exit costs and an increase in the SPC dividend (expense) income. As of March 31, 2021, thereallowance for credit losses. Marketing costs included advertising and website-related activities that were 27 (3 inactive) SPCs. The SPCs assume workers' compensation insurance, healthcare professional liability insurance orplanned for 2022. Business-related travel has increased as a combinationresult of the two fromeasing of pandemic-related restrictions. During the first quarter of 2022, we recognized one-time lease exit costs of $0.2 million due to the early termination of an office lease; however, as a result, we anticipate annual expense savings of approximately $0.1 million. The increase in the allowance for credit losses primarily reflects an increase in accounts greater than 90 days old, which we believe is a timing issue that will reverse in future periods.
As previously discussed, alternative market premiums written by our Workers' Compensation Insurance and Specialty P&C segments. As of March 31, 2021, there were two SPCs that assumed both workers' compensation insurance and healthcare professional liability insurance and one SPC that assumed only healthcare professional liability insurance.
Segment results reflects our share of the underwriting and investment results ofsegment are 100% ceded, less a ceding commission, to either the SPCs in which we participate,our Segregated Portfolio Cell Reinsurance segment or, to a limited extent, an unaffiliated captive insurer. The ceding commission charged to the SPCs consists of an amount for fronting fees, cell rental fees, commissions, premium taxes and risk management fees. The fronting fees, commissions, premium taxes and risk management fees are recorded as an offset to underwriting, policy acquisition and operating expenses. Cell rental fees are recorded as a component of other income and claims administration fees are recorded as ceded ULAE. The increase in SPC ceding commissions earned for the three months ended March 31, 2022 as compared to the same period of 2021, primarily reflected the increase in alternative market ceded earned premium.
Underwriting Expense Ratio (the Expense Ratio)
The underwriting expense ratio included the impact of the following:
Three Months Ended March 31
($ in thousands)20212020Change
Net premiums written$22,188 $23,990 $(1,802)(7.5 %)
Net premiums earned$15,884 $16,980 $(1,096)(6.5 %)
Net investment income221 254 (33)(13.0 %)
Net realized gains (losses)987 (3,207)4,194 130.8 %
Other income1 136 (135)(99.3 %)
Net losses and loss adjustment expenses(9,425)(9,352)(73)0.8 %
Underwriting, policy acquisition and operating expenses(5,025)(5,079)54 (1.1 %)
SPC U.S. federal income tax expense (1)
(356)(222)(134)60.4 %
SPC net results2,287 (490)2,777 566.7 %
SPC dividend (expense) income (2)
(1,742)508 (2,250)442.9 %
Segment results (3)
$545 $18 $527 2,927.8 %
Net loss ratio59.3 %55.1 %4.2 pts
Underwriting expense ratio31.6 %29.9 %1.7 pts
(1) Represents the provision for U.S. federal income taxes for SPCs at Inova Re, which have elected to be taxed as a U.S. corporation under Section 953(d) of the Internal Revenue Code. U.S. federal income taxes are included in the total SPC net results and are paid by the individual SPCs.
(2) Represents the net (profit) loss attributable to external cell participants.
(3) Represents our share of the net profit (loss) of the SPCs in which we participate.
Three Months Ended March 31
20222021Change
Underwriting expense ratio, as reported32.0 %30.7 %1.3  pts
Less estimated ratio increase (decrease) attributable to:
Impact of ceding commissions received from SPCs3.5 %2.9 %0.6  pts
Impact of audit premium(0.1 %)1.0 %(1.1  pts)
Change in return premium estimate under external reinsurance %(0.2 %)0.2  pts
Estimated revenue share(0.3 %)(0.4 %)0.1  pts
Underwriting expense ratio, less listed effects28.9 %27.4 %1.5  pts


Excluding the items noted in the table above, the expense ratio increased for the three months ended March 31, 2022, primarily reflecting the increase in other underwriting and operating expenses, as previously discussed.
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Premiums Written
PremiumsChanges in our Segregated Portfolio Cell Reinsurancepremium volume within our Specialty P&C segment are assumed from either our Workers' Compensation Insurance or Specialty P&C segments. Premium volume isgenerally driven by fivethree primary factors: (1) the amount of new business written, (2) our retention of existing business and (3) the premium charged for business that is renewed, which is affected by rates charged and by the amount and type of coverage an insured chooses to purchase. In addition, premium volume may periodically be affected by shifts in the timing of renewals between periods. For the three months ended March 31, 2022, our premium volume was primarily affected by our acquisition of NORCAL.
The professional liability market, which accounts for a majority of the revenues in this segment, remains challenging as physicians continue joining hospitals or larger group practices and, therefore, are no longer purchasing individual or group policies in the standard market. In addition, some competitors have chosen to compete primarily on price; both factors may impact our ability to write new business and retain existing bookbusiness. Furthermore, the insurance and reinsurance markets have historically been cyclical, characterized by extended periods of intense price competition and other periods of reduced competition. The professional liability market has been particularly affected by these cycles. Underwriting cycles are generally driven by an excess of capacity available and actively pursuing business that is deemed profitable. Changes in the frequency and severity of losses may affect the cycles of the insurance and reinsurance markets significantly. During “soft markets” where price competition is high and underwriting profits are poor, growth and retention of business (3)become challenging which may result in reduced premium rates charged on the renewal book of business and, for workers' compensation business, (4) changes in payroll exposure and (5) audit premium.volumes.
Gross, ceded and net premiums written were as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Gross premiums writtenGross premiums written$25,151 $27,140 $(1,989)(7.3 %)Gross premiums written$257,672 $138,289 $119,383 86.3 %
Less: Ceded premiums writtenLess: Ceded premiums written2,963 3,150 (187)(5.9 %)Less: Ceded premiums written22,834 16,976 5,858 34.5 %
Net premiums writtenNet premiums written$22,188 $23,990 $(1,802)(7.5 %)Net premiums written$234,838 $121,313 $113,525 93.6 %
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Gross Premiums Written
Gross premiums written reflected reinsurance premiums assumed by component were as follows:
Three Months Ended March 31
($ in thousands)20212020Change
Workers' compensation$20,682 $23,356 $(2,674)(11.4 %)
Healthcare professional liability4,469 3,784 685 18.1 %
Gross Premiums Written$25,151 $27,140 $(1,989)(7.3 %)
Three Months Ended March 31
($ in thousands)20222021Change
Professional Liability
HCPL
Standard Physician(1)
$52,653 $52,617 $36 0.1 %
NORCAL Standard Physician(2)
106,476 — 106,476 nm
Total Standard Physician159,129 52,617 106,512 202.4 %
Specialty
Custom Physician(3)
7,407 15,837 (8,430)(53.2 %)
NORCAL Custom Physician(4)
11,638 — 11,638 nm
Hospitals and Facilities(5)
14,197 16,341 (2,144)(13.1 %)
NORCAL Hospitals and Facilities(6)
3,067 — 3,067 nm
Senior Care(7)(12)
4,493 5,041 (548)(10.9 %)
Reinsurance assumed(8)
9,761 10,437 (676)(6.5 %)
Total Specialty50,563 47,656 2,907 6.1 %
Total HCPL209,692 100,273 109,419 109.1 %
Small Business Unit(9)
22,519 22,766 (247)(1.1 %)
Tail Coverages(10)(12)
9,838 8,138 1,700 20.9 %
NORCAL Tail Coverages(10)
7,733 — 7,733 nm
Total Professional Liability249,782 131,177 118,605 90.4 %
Medical Technology Liability(11)
7,700 6,984 716 10.3 %
Other190 128 62 48.4 %
Total$257,672 $138,289 $119,383 86.3 %
Gross premiums written for the three months ended March 31, 2021 and 2020 were primarily comprised of workers' compensation coverages assumed from our Workers' Compensation Insurance segment. The decrease in workers' compensation gross premiums written(1) Standard Physician premium remained relatively unchanged during the three months ended March 31, 20212022 three-month period as compared to the same period of 2021 as retention losses were offset by an increase in 2020 primarilyrenewal pricing, the conversion of twenty-four month term policies and, to a lesser extent, new business written. Renewal pricing increases during the 2022 three-month period reflect the rising loss cost environment and new business written reflects general market conditions. Retention losses during the 2022 three-month period were largely attributable to our targeted state strategy to reassess our underwriting appetite in certain unprofitable states. We will continue to perform a detailed evaluation of venues, specialties and other areas to improve our underwriting results. We also continue to focus on underwriting discipline as we emphasize careful risk selection, rate adequacy, improved contract terms and a willingness to walk away from business that does not fit our goal of achieving a long-term underwriting profit. Retention losses during the 2022 three-month period also reflected the competitive workers’ compensation market conditionsloss of a $2.0 million policy that chose to utilize self-insurance as well as the loss of a $1.0 million policy due to price competition. We ceased offering twenty-four month term policies beginning in the second quarter of 2020, and the resultingmajority of the policies that were up for renewal rate decreasesin 2021 were renewed to twelve month term policies; however, a portion of 5%,the premium from 2020 related to policies that are subject to renewal and conversion in 2022.
(2) NORCAL Standard Physician premium represents premium contributed by NORCAL and is comprised of three and twelve month term policies. NORCAL Standard Physician premium during the 2022 three-month period was impacted by retention losses, including the loss of one large policy, partially offset by an improvement in the renewal retention rate. The renewal retention rate for the three months ended March 31, 2020 included the impact of a reduction in premium funding for a large workers' compensation alternative market program. We do not participate in this program; therefore, the reduction in premium funding had no effect on the segment results for the three months ended March 31, 2020. The increase in healthcare professional liability gross premiumsrenewal pricing and, to a lesser extent, new business written.
(3) Custom Physician premium includes large complex physician groups, multi-state physician groups and non-standard physicians and is written primarily on an excess and surplus lines basis. The decrease in Custom Physician premium during the three months ended March 31, 20212022 three-month period as compared to the same period in 2020of 2021 was driven by retention losses, partially offset by an increase in renewal pricing increases, primarilyand, to a lesser extent, new business written. Retention losses for the 2022 three-month period were driven by the loss of two large policies totaling approximately $9.0 million due to increasesprice competition, which resulted in exposure for one program. We retained 100%a decrease in our Specialty retention rate of the eight workers' compensation programs and one healthcare professional liability program up for renewal during the three months ended March 31, 2021.
New business, audit premium, retention and renewal price changes18.9 percentage points. Renewal pricing increases for the assumed workers' compensation premium is shown in2022 three-month period reflect the table below:
Three Months Ended March 31
($ in millions)20212020
New business$0.8 $1.1 
Audit premium (including EBUB)$0.2 $(0.3)
Retention rate (1)
92 %78 %
Change in renewal pricing (2)
(5 %)(6 %)
(1) We calculate our workers' compensation retention rate as annualized expiring renewed premium divided by all annualized expiring premium subject to renewal. Our retention rate can be impacted by various factors, including price or other competitive issues, insureds being acquired, or a decision not to renew based on our underwriting evaluation.
(2) The pricing of our business includes an assessment of the underlying policy exposure and market conditions. We continue to base our pricing on expected losses, as indicated by our historical loss data.
rising loss cost environment and new business written reflects general market conditions.
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(4) NORCAL Custom Physician premium represents premium contributed by NORCAL and includes large complex physician groups, multi-state physician groups and non-standard physicians and is written primarily on an excess and surplus lines basis. NORCAL Custom Physician premium during the 2022 three-month period was impacted by retention losses, partially offset by an increase in renewal pricing and, to a lesser extent, new business written.
(5) Hospitals and Facilities premium (which includes hospitals, surgery centers and miscellaneous medical facilities) decreased during the 2022 three-month period as compared to the same period of 2021 driven by retention losses and, to a lesser extent, the timing of the renewal of a $1.6 million policy between periods; this policy will renew in the second quarter of 2022 as compared to the first quarter of 2021. Retention losses in the 2022 three-month period were largely attributable to the loss of a $1.4 million policy due to the insured entering into a captive arrangement and our non-renewal of a $1.2 million policy due to our focus on underwriting discipline. The decrease in Hospitals and Facilities premium for the 2022 three-month period was partially offset by new business written, primarily miscellaneous medical facilities, and, to a lesser extent, an increase in renewal pricing. Renewal pricing increases for the 2022 three-month period reflect rate increases and contract modifications that we believe are appropriate given the current loss environment and new business written reflects general market conditions.
(6) NORCAL Hospitals and Facilities premium represents premium contributed by NORCAL and includes hospitals, surgery centers and miscellaneous medical facilities. NORCAL Hospitals and Facilities premium during the 2022 three-month period was impacted by retention losses, partially offset by new business written and, to a lesser extent, an increase in renewal pricing.
(7) Senior Care premium includes facilities specializing in long term residential care primarily for the elderly ranging from independent living through skilled nursing. Our Senior Care premium decreased for the 2022 three-month period as compared to the same period of 2021 driven by retention losses, partially offset by new business written. The lower premium retention was primarily due to a large account renewing with a meaningful reduction in exposure. Renewal pricing for the 2022 three-month period remained relatively unchanged as compared to the same period of 2021.
(8) We offer custom alternative risk solutions including assumed reinsurance. The decrease in premium during the 2022 three-month period primarily reflected the impact of an assumed reinsurance arrangement with a regional hospital group entered into during the first quarter of 2021 which resulted in $4.5 million of premium written, comprised of $2.3 million of retroactive premium written and fully earned and $2.2 million of prospective premium written (see Note 5 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K). The decrease in premium during the 2022 three-month period was largely offset by an increase in premiums assumed on a quota share basis through a strategic partnership in place since 2016 with an international medical professional liability insurer. In 2021, we increased our participation in the original program and entered into another program with this insurer in a new international territory. We anticipate the volume of premium assumed through this partnership will continue to grow going forward.
(9) Our Small Business Unit is primarily comprised of premium associated with podiatrists, legal professionals, dentists and chiropractors. Our Small Business Unit premium remained relatively unchanged during the 2022 three-month period as compared to the same period of 2021 as retention losses were almost entirely offset by new business written and, to a lesser extent, an increase in renewal pricing. The increase in renewal pricing during the 2022 three-month period was primarily the result of an increase in the rate charged for certain renewed policies in select states.
(10) We offer extended reporting endorsement or "tail" coverage to insureds who discontinue their claims-made coverage with us, and we also periodically offer tail coverage through stand-alone policies. Tail coverage premiums are generally 100% earned in the period written because the policies insure only incidents that occurred in prior periods and are not cancellable. The amount of tail coverage premium written can vary significantly from period to period.
(11) Our Medical Technology Liability business is marketed throughout the U.S.; coverage is typically offered on a primary basis, within specified limits, to manufacturers and distributors of medical technology and life sciences products including entities conducting human clinical trials. In addition to the previously listed factors that affect our premium volume, our Medical Technology Liability premium is also impacted by the sales volume of insureds. Our Medical Technology Liability premium increased during the 2022 three-month period as compared to the same period of 2021 due to new business written and, to a lesser extent, an increase in renewal pricing, partially offset by retention losses. Renewal pricing increases during the 2022 three-month period are primarily due to changes in the sales volume of certain insureds, including changes in exposure. Retention losses during the 2022 three-month period are primarily attributable to an increase in competition on terms and pricing, as well as merger activity within the industry.

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(12) Certain components of our gross premiums written include alternative market premiums. We currently cede either all or a portion of the alternative market premium, net of reinsurance, to three SPCs of our wholly owned Cayman Islands reinsurance subsidiaries, Inova Re and Eastern Re, which are reported in our Segregated Portfolio Cell Reinsurance segment (see further discussion in the Ceded Premiums Written section that follows). The portion not ceded to the SPCs is retained within our Specialty P&C segment.
Three Months Ended March 31
($ in millions)20222021Change
Senior Care$3.9 $4.2 $(0.3)(7.1 %)
Tail Coverages3.0 0.3 2.7 900.0 %
Total$6.9 $4.5 $2.4 53.3 %
Alternative market gross premiums written increased during the 2022 three-month period as compared to the same period of 2021 driven by an increase in tail coverage premium, primarily related to one program.
We are committed to a rate structure that will allow us to fulfill our obligations to our insureds while generating competitive long-term returns for our shareholders. Our pricing continues to be based on expected losses as indicated by our historical loss data and available industry loss data. In recent years, this practice has resulted in gradual rate increases and we anticipate further rate increases due to indications of increasing projected loss severity. Additionally, the pricing of our business includes the effects of filed rates, surcharges and discounts. Renewal pricing also reflects changes in our exposure base, deductibles, self-insurance retention limits and other policy terms and conditions. See further explanation of changes in renewal pricing above under the heading "Gross Premiums Written".
The change in renewal pricing for our Specialty P&C segment, including by major component, was as follows:
Three Months Ended
March 31
2022
Specialty P&C segment9%
HCPL
Standard Physician10%
Specialty6%
Total HCPL9%
Small Business Unit5%
Medical Technology Liability10%
New business written by major component on a direct basis was as follows:
Three Months Ended
March 31
(In millions)20222021
HCPL
Standard Physician(1)
$1.8 $0.6 
Specialty(1)
3.7 8.7 
Total HCPL5.5 9.3 
Small Business Unit1.0 1.0 
Medical Technology Liability1.7 1.8 
Total$8.2 $12.1 
(1) Includes premium contributed by NORCAL during the 2022 three-month period.
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For our Specialty P&C segment, we calculate retention as annualized renewed premium divided by all annualized premium subject to renewal. Retention is affected by a number of factors. We may lose insureds to competitors or to alternative insurance mechanisms such as risk retention groups, captive arrangements or self-insurance entities (often when physicians join hospitals or large group practices) or due to pricing or other issues. We may choose not to renew an insured as a result of our underwriting evaluation. Insureds may also terminate coverage because they have left the practice of medicine for various reasons, principally for retirement, death or disability, but also for personal reasons.
Retention for our Specialty P&C segment, including by major component, was as follows:
Three Months Ended
March 31
20222021
Specialty P&C segment83 %77 %
HCPL
Standard Physician(1)
88 %86 %
Specialty(1)
61 %56 %
Total HCPL82 %73 %
Small Business Unit91 %91 %
Medical Technology Liability(2)
84 %87 %
(1) Includes premium contributed by NORCAL during the 2022 three-month period. We continue the process of evaluating the NORCAL book of business and implementing ProAssurance's underwriting strategies, which will likely impact retention in future quarters.
(2) See Gross Premiums Written section for further explanation of retention decline in 2022.
Ceded Premiums Written
Ceded premiums represent the amounts owed to our reinsurers for their assumption of a portion of our losses. Our HCPL and Medical Technology Liability excess of loss reinsurance arrangements renew annually on October 1. For those excess of loss reinsurance arrangements in effect prior to October 1, 2021, we generally retained the first $2 million in risk insured by us and ceded coverages in excess of this amount. Effective October 1, 2021, our HCPL treaty renewed at a lower gross rate and we generally retain from 0% to 5% of the next $24 million of risk for our HCPL coverages in excess of $2 million. Our HCPL excess of loss reinsurance arrangement that renewed on October 1, 2021 also incorporated NORCAL policies. Prior to October 1, 2021, NORCAL policies were reinsured under separate reinsurance agreements, primarily excess of loss, which have historically renewed annually on January 1. For the NORCAL excess of loss reinsurance arrangement that renewed on January 1, 2021, retention was generally the first $2 million in risk and coverages in excess of this amount were ceded up to $24 million. For our Medical Technology Liability treaty which also renewed effective October 1, 2021, we also retain 2.5% of the next $8 million of risk for coverages in excess of $2 million. There were no significant changes in the cost or structure of our Medical Technology Liability treaty upon the October 2021 renewal.
In certain of our excess of loss arrangements, the ultimate amount of ceded premium is determined by the loss experience of the business ceded, subject to certain minimum and maximum amounts. Given the length of time that it takes to resolve our claims, many years may elapse before all losses recoverable under a reinsurance arrangement are known. As a part of the process of estimating our loss reserve we also make estimates regarding the amounts recoverable under our reinsurance arrangements. As a result, we may have an adjustment to our estimate of expected losses and associated recoveries for prior year ceded losses under certain loss sensitive reinsurance agreements. Any changes to estimates of premiums ceded related to prior accident years are fully earned in the period the changes in estimates occur.
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Ceded premiums written were as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Ceded premiums written$2,963 $3,150 $(187)(5.9 %)
Excess of loss reinsurance arrangements (1)
Excess of loss reinsurance arrangements (1)
$9,496 $7,678 $1,818 23.7 %
Other shared risk arrangements (2)
Other shared risk arrangements (2)
4,336 3,963 373 9.4 %
Premium ceded to SPCs (3)
Premium ceded to SPCs (3)
6,881 4,469 2,412 54.0 %
Other ceded premiums written(4)
Other ceded premiums written(4)
2,121 866 1,255 144.9 %
Total ceded premiums writtenTotal ceded premiums written$22,834 $16,976 $5,858 34.5 %
For(1) We generally reinsure risks under our excess of loss reinsurance arrangements pursuant to which the workers' compensation business, each SPC has in place its own external reinsurance arrangements. The healthcare professional liability business is assumed netreinsurers agree to assume all or a portion of reinsurance fromall risks that we insure above our Specialty P&C segment; therefore, there are no ceded premiums relatedindividual risk retention levels, up to the healthcare professional liability business reflected inmaximum individual limits offered. Premium due to reinsurers also fluctuates with the table above. The risk retention for each loss occurrence for the workers' compensation business ranges from $0.3 million to $0.4 million based on the program, with limits up to $119.7 million. In addition, each program has aggregate reinsurance coverage between $1.1 million and $2.1 million on a program year basis. Per the SPC external reinsurance agreements, premiums are ceded on avolume of written premium basis.subject to cession under the arrangement. In certain of our excess of loss reinsurance arrangements, the premium due to the reinsurer is determined by the loss experience of that business reinsured, subject to certain minimum and maximum amounts. The decreaseincrease in ceded premiums written under our excess of loss reinsurance arrangements during the three months ended March 31, 20212022 three-month period as compared to the same period of 2020,2021 was driven by additional ceded premiums of $4.4 million as a result of incorporating NORCAL policies into our existing HCPL excess of loss reinsurance arrangements with the October 1, 2021 renewal, as previously discussed. Excluding NORCAL, ceded premiums written under our excess of loss reinsurance arrangements decreased by approximately $2.4 million primarily due to a decrease in workers' compensationthe overall volume of gross premiums written subject to cession and, was partially offset byto a lesser extent, the reduced rate on the treaty year effective October 1, 2021.
(2) We have entered into various shared risk arrangements, including quota share, fronting, and captive arrangements, with certain large healthcare systems and other insurance entities. While we cede a large portion of the premium written under these arrangements, they provide us an opportunity to grow net premium through strategic partnerships. These arrangements primarily include our Ascension Health program. Ceded premiums written under our shared risk arrangements during the 2022 three-month period remained relatively unchanged as compared to the same period of 2021.
(3) As previously discussed, as a part of our alternative market solutions, all or a portion of certain healthcare premium written is ceded to SPCs in our Segregated Portfolio Cell Reinsurance segment under either excess of loss or quota share reinsurance agreements, depending on the structure of the individual program. See the Segment Results - Segregated Portfolio Cell Reinsurance section for further discussion on the cession to the SPCs from our Specialty P&C segment. The increase in reinsurance rates for programspremiums ceded to SPCs during the 2022 three-month period as compared to the same period of 2021 was driven by the impact of tail coverages, primarily related to one program (see discussion in footnote 12 under the heading "Gross Premiums Written").
(4) The increase in other ceded premiums written during the 2022 three-month period as compared to the same period of 2021 was primarily driven by the incorporation of NORCAL's cyber liability coverages into our existing HCPL cyber liability arrangement with renewal dates on or after Maythe October 1, 2020. External reinsurance rates vary based on the alternative market program.2021 renewal.
Ceded Premiums Ratio
The ceded premiums ratio was as follows:
Three Months Ended March 31
 20222021Change
Ceded premiums ratio8.9%12.3%(3.4 pts)
The above table reflects ceded premiums written as a percent of gross premiums written. The decrease in our ceded premiums ratio for the 2022 three-month period as compared to the same period of 2021 was driven by the reduced rate on our excess of loss reinsurance arrangements for the treaty year effective October 1, 2021 as well as the impact of the addition of the NORCAL gross written premium base for the 2022 three-month period. The decrease in our ceded premiums ratio for the 2022 three-month period as compared to the same period of 2021 was partially offset by an increase in premiums ceded to SPCs. See additional discussion on NORCAL ceded premiums and premiums ceded to SPCs above under the heading "Ceded Premiums Written."
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Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that we cede to our reinsurers for their assumption of a portion of our losses. Because premiums are generally earned pro rata over the entire policy period, fluctuations in premiums earned tend to lag those of premiums written. The majority of our policies carry a term of one year; however, some of our Medical Technology Liability policies have a multi-year term and some of our NORCAL Standard Physician policies have a three-month term. In addition, prior to the third quarter of 2020, we wrote certain Standard Physician policies with a twenty-four month term. Tail coverage premiums are generally 100% earned in the period written because the policies insure only incidents that occurred in prior periods and are not cancellable. Retroactive coverage premiums are 100% earned at the inception of the contract, as all of the associated underlying loss events occurred in the past. Additionally, any ceded premium changes due to changes to estimates of premiums owed under reinsurance agreements for prior accident years are fully earned in the period of change.
Net premiums earned were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums earned$212,279 $132,060 $80,219 60.7 %
Less: Ceded premiums earned14,312 16,447 (2,135)(13.0 %)
Net premiums earned$197,967 $115,613 $82,354 71.2 %
Gross premiums earned during the 2022 three-month period included additional earned premiums of approximately $79.7 million from our acquisition of NORCAL. Excluding premiums associated with the NORCAL acquisition, gross premiums earned remained relatively unchanged during the 2022 three-month period as compared to the same period of 2021.
Ceded premiums earned decreased during the 2022 three-month period as compared to the same period of 2021 driven by the pro rata effect of a decrease in premium ceded under our shared risk and excess of loss arrangements during the preceding twelve months.
Losses and Loss Adjustment Expenses
The determination of calendar year losses involves the actuarial evaluation of incurred losses for the current accident year and the actuarial re-evaluation of incurred losses for prior accident years, including an evaluation of the reserve amounts required for ECO/XPL losses. As part of the review of our prior accident year reserves, we also make estimates of expected losses and associated recoveries for prior year ceded losses under certain loss sensitive reinsurance agreements. This analysis may result in changes to estimates of premiums owed under reinsurance agreements for prior accident years which impact net premiums earned (the denominator of the net loss ratio) in the period the adjustment is made. No such adjustments were made during the three months ended March 31, 2022 or 2021. See previous discussion under the heading "Ceded Premiums Written" for additional information.
Accident year refers to the accounting period in which the insured event becomes a liability of the insurer. For claims-made policies, which represent the majority of the premiums written in our Specialty P&C segment, the insured event generally becomes a liability when the event is first reported to us. For occurrence policies, the insured event becomes a liability when the event takes place. For retroactive coverages, the insured event becomes a liability at inception of the underlying contract. We believe that measuring losses on an accident year basis is the best measure of the underlying profitability of the premiums earned in that period, since it associates policy premiums earned with the estimate of the losses incurred related to those policy premiums.
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The following table summarizes calendar year net loss ratios for our Specialty P&C segment by separating losses between the current accident year and all prior accident years. In addition, net loss ratios for the three months ended March 31, 2022 in the following table include the impact of NORCAL.
Net Loss Ratios (1)
Three Months Ended March 31
20222021Change
Calendar year net loss ratio83.8 %87.5 %(3.7  pts)
Less impact of prior accident years on the net loss ratio(2.0 %)(2.3 %)0.3  pts
Current accident year net loss ratio (2)
85.8 %89.8 %(4.0  pts)
(1)Net losses, as specified, divided by net premiums earned.
(2)Our current accident year net loss ratio (as shown in the table above) decreased 4.0 percentage points during the three months ended March 31, 2022 as compared to the same period of 2021. The change in our current accident year net loss ratio in each period was primarily attributable to the following:
(In percentage points)Increase (Decrease)
2022 versus 2021
Comparative
three-month
period
Estimated ratio increase (decrease) attributable to:
NORCAL Operations4.0 pts
NORCAL Acquisition - Purchase Accounting Adjustment(1.2 pts)
Change in Estimate of ULAE(3.7 pts)
All other, net(3.1 pts)
Decrease in current accident year net loss ratio(4.0 pts)
Excluding the impact of the items specifically identified in the table above, our current accident year net loss ratio for the three months ended March 31, 2022 improved 3.1 percentage points as compared to the prior year period driven by a decrease to certain loss ratios in our Standard Physician line of business, which we began recognizing in the second half of 2021 and, to a lesser extent, changes in the mix of business. We continue to observe a reduction in claims frequency that started to emerge in 2020, some of which is due to our re-underwriting efforts and some of which, we believe, is associated with the COVID-19 pandemic including the disruption of the court systems. Given the consistent and prolonged nature of this favorable claims frequency trend, we reduced certain loss ratios in our Standard Physician line of business during the third and fourth quarters of 2021. We continue to remain cautious in recognizing the full impact of these favorable trends in our current accident year reserve due to the long-tailed nature of our HCPL claims as well as the uncertainty surrounding the length and severity of the pandemic.
Initial loss ratios associated with NORCAL policies were higher than the average for our other books of business in this segment. The impact of NORCAL operations resulted in a 4.0 percentage point increase in our current accident year net loss ratio for the three months ended March 31, 2022. We continue the process of evaluating the NORCAL book of business and implementing ProAssurance's underwriting strategies. Also as a result of our acquisition of NORCAL, our current accident year net loss ratio for the three months ended March 31, 2022 was impacted by amortization of the negative VOBA associated with NORCAL's assumed unearned premium which is recorded as a reduction to current accident year net losses and accounted for a 1.2 percentage point decrease in our current period ratio. The remaining unamortized negative VOBA will be fully amortized in the second quarter of 2022 (see Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for additional information on the remaining expected amortization of the NORCAL acquisition purchase accounting adjustments).
During the first quarter of 2022, we decreased our estimate of ULAE as a result of substantially integrating NORCAL into our Specialty P&C segment operations, which accounted for a 3.7 percentage point decrease in our current period accident year loss ratio with an offsetting 3.7 percentage point increase in our current period expense ratio with no impact to our combined ratio or segment results (see discussion on our expense ratio in the following section under the heading "Underwriting, Policy Acquisition and Operating Expenses"). This change in estimated ULAE had no impact on our combined ratio or segment results.
We re-evaluate our previously established reserve each quarter based upon the most recently completed actuarial analysis supplemented by any new analysis, information or trends that have emerged since the date of that study. We also take into account currently available industry trend information.
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We recognized net favorable prior accident year reserve development of $3.9 million during the three months ended March 31, 2022 as compared to $2.7 million during the same period of 2021. Net favorable development recognized during the three months ended March 31, 2022 was net of an increase in our reserve for potential ECO/XPL claims of $4.0 million as compared to a reduction in this same reserve of $0.2 million during the same period of 2021. Furthermore, net favorable development recognized during the three months ended March 31, 2022 included $2.9 million related to the amortization of the purchase accounting fair value adjustment on NORCAL's assumed net reserve and amortization of the negative VOBA associated with NORCAL's DDR reserve which is recorded as a reduction to prior accident year net losses and loss adjustment expenses. See Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for additional information on the remaining expected amortization of the NORCAL acquisition purchase accounting adjustments. We have not recognized any development related to NORCAL's prior accident year reserves since the date of acquisition on May 5, 2021. Excluding the increase in the ECO/XPL reserve and amortization of purchase accounting adjustments, we recognized net favorable prior accident year reserve development of $5.0 million during the three months ended March 31, 2022, principally related to accident years 2019 through 2021. Development recognized during the three months ended March 31, 2021 principally related to accident years 2017 and 2018.
A detailed discussion of factors influencing our recognition of loss development is included in our Critical Accounting Estimates section under the heading "Reserve for Losses and Loss Adjustment Expenses" in our December 31, 2021 report on Form 10-K. Assumptions used in establishing our reserve are regularly reviewed and updated by management as new data becomes available. Any adjustments necessary are reflected in the then current operations. Due to the size of our reserve, even a small percentage adjustment to the assumptions can have a material effect on our results of operations for the period in which the change is made, as was the case in both 2022 and 2021.
Underwriting, Policy Acquisition and Operating Expenses
Our Specialty P&C segment underwriting, policy acquisition and operating expenses, including NORCAL expenses for the 2022 three-month period, were comprised as follows:
Three Months Ended March 31
($ in thousands)20222021Change
DPAC amortization$21,740 $12,396 $9,344 75.4 %
Management fees1,402 1,001 401 40.1 %
Other underwriting and operating expenses19,736 12,949 6,787 52.4 %
Total$42,878 $26,346 $16,532 62.7 %
DPAC amortization for the 2022 three-month period included approximately $8.1 million of DPAC amortization associated with NORCAL policies written subsequent to our acquisition; however, this level of DPAC amortization is approximately $1.0 million lower than would be considered normal for the quarter due to the application of GAAP purchase accounting rules whereby the capitalized policy acquisition costs for policies written prior to the acquisition date were written off through purchase accounting on May 5, 2021 rather than being expensed pro rata over the remaining term of the associated policies (see Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for more information). The remaining increase in DPAC amortization for the 2022 three-month period as compared to the same period of 2021 reflected an increase in brokerage expenses due to our increased participation with an international medical professional liability insurer in our Specialty line of business (see discussion under the heading "Gross Premiums Written").
Management fees are charged pursuant to a management agreement by the Corporate segment to the operating subsidiaries within our Specialty P&C segment for services provided based on the extent to which services are provided to the subsidiary and the amount of premium written by the subsidiary. Fluctuations in the amount of premium written by each subsidiary can result in corresponding variations in the management fee charged to each subsidiary during a particular period. Due to continued organizational structure enhancements in our Specialty P&C segment during 2021 as well as operational alignments as a result of the integration of NORCAL, the extent to which services are provided by the Corporate segment to the operating subsidiaries within the segment decreased further effective January 1, 2022. Accordingly, we reduced the fee charged to the operating subsidiaries in 2022. Also effective January 1, 2022, the management agreement included operating subsidiaries of NORCAL contributing to $0.6 million of additional management fees in the current period.
Other underwriting and operating expenses increased during the 2022 three-month period primarily due to the addition of expenses contributed by NORCAL as well as a decrease in our estimate of ULAE which resulted in approximately $7.3 million of expenses remaining in operating expenses instead of being allocated to net losses and loss adjustment expenses. As a result, this change in ULAE estimate had offsetting impacts to our loss and expense ratios during the period with no impact to our combined ratio or segment results. See additional discussion on this change in ULAE estimate in the previous section under the heading "Losses and Loss Adjustment Expenses." Excluding expenses contributed by NORCAL and the impact of the change
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in ULAE, other underwriting and operating expenses decreased due to benefits from prior organizational restructurings and proactive expense management, somewhat offset by one-time expenses of $1.6 million incurred during the current period mainly comprised of one-time bonuses, employee severance charges and lease exit costs.
Underwriting Expense Ratio (the Expense Ratio)
Our expense ratio for the Specialty P&C segment was as follows:
 Three Months Ended March 31
 20222021Change
Underwriting expense ratio21.7 %22.8 %(1.1  pts)
The change in our expense ratio for the 2022 three-month period as compared to the same period of 2021 was primarily attributable to the following:
Increase (Decrease)
 2022 versus 2021
(In percentage points)Comparative three-month period
Estimated ratio increase (decrease) attributable to:
Increase in Net Premiums Earned and DPAC amortization(1)
0.3 pts
Change in Estimate of ULAE3.7 pts
Tail Premium(2)
(1.2 pts)
All other, net(3.9 pts)
Decrease in the underwriting expense ratio(1.1 pts)
(1) Excludes tail premium for the three months ended March 31, 2022 and 2021.
(2) Represents the effect of the premium earned from tail policies for the three months ended March 31, 2022 as compared to the same period of 2021 as there is typically minimal expense associated with tail premium (see discussion under the heading "Gross Premiums Written").
Excluding the items specifically identified in the table above, our expense ratio for the 2022 three-month period decreased by 3.9 percentage points primarily due to lower operating expenses due to the benefits from prior organizational restructurings and proactive expense management as well as expense synergies recognized from the NORCAL acquisition. However, as previously discussed, DPAC amortization associated with NORCAL recorded during the 2022 three-month period was lower than would be considered normal for the quarter due to the application of GAAP purchase accounting rules. Normalizing this amortization would have increased our expense ratio for the 2022 three-month period by an estimated 0.5 percentage points.
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Segment Results - Workers' Compensation Insurance
Our Workers' Compensation Insurance segment includes workers' compensation products provided to employers generally with 1,000 or fewer employees, as discussed in Note 18 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K. Workers' compensation products offered include guaranteed cost policies, policyholder dividend policies, retrospectively-rated policies, deductible policies and alternative market programs. Alternative market programs include program design, fronting, claims administration, risk management, SPC rental, asset management and SPC management services. Alternative market program premiums are 100% ceded to either the SPCs within our Segregated Portfolio Cell Reinsurance segment or, to a limited extent, an unaffiliated captive insurer for one program. Our Workers' Compensation Insurance segment results reflect pre-tax underwriting profit or loss from these workers' compensation products, exclusive of investment results, which are included in our Corporate segment. Segment results included the following:
Three Months Ended March 31
($ in thousands)20222021Change
Net premiums written$45,266 $46,884 $(1,618)(3.5 %)
Net premiums earned$40,684 $40,011 $673 1.7 %
Other income682 392 290 74.0 %
Net losses and loss adjustment expenses(27,211)(26,207)(1,004)3.8 %
Underwriting, policy acquisition and operating expenses(13,001)(12,286)(715)5.8 %
Segment results$1,154 $1,910 $(756)(39.6 %)
Net loss ratio66.9%65.5%1.4 pts
Underwriting expense ratio32.0%30.7%1.3 pts

Premiums Written
Our workers’ compensation premium volume is driven by five primary factors: (1) the amount of new business written, (2) retention of our existing book of business, (3) premium rates charged on our renewal book of business, (4) changes in payroll exposure and (5) audit premium.
Gross, ceded and net premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums written$72,118 $72,328 $(210)(0.3 %)
Less: Ceded premiums written26,852 25,444 1,408 5.5 %
Net premiums written$45,266 $46,884 $(1,618)(3.5 %)
Gross Premiums Written
Gross premiums written by product were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Traditional business:
Guaranteed cost$35,503 $38,196 $(2,693)(7.1 %)
Policyholder dividend7,862 7,520 342 4.5 %
Deductible2,120 2,052 68 3.3 %
Retrospective(1)
646 455 191 42.0 %
Other1,615 1,600 15 0.9 %
Alternative market business(2)
24,372 23,715 657 2.8 %
Change in EBUB estimate (1,210)1,210 nm
Total$72,118 $72,328 $(210)(0.3 %)
(1) The change in retrospectively-rated policies included an adjustment that decreased premium by $0.1 million for each of the three months ended March 31, 2022 and 2021.
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(2) A majority of alternative market premiums are ceded to SPCs in our Segregated Portfolio Cell Reinsurance segment. See further discussion on alternative market gross premiums written in our Segment Operating Results - Segregated Portfolio Cell Reinsurance section under the heading "Gross Premiums Written" that follows.
Gross premiums written remained relatively unchanged during the three months ended March 31, 2022 as compared to the same period of 2021 as decreases in new business, renewal retention and renewal rate changes were largely offset by an increase in audit premium and the prior year impact of the reduction of our EBUB estimate. Policy audits processed during the 2022 three-month period resulted in audit premium billed to policyholders totaling $1.7 million as compared to audit premium returned to policyholders of $0.8 million for the same period in 2021. We did not adjust our EBUB estimate for the 2022 three-month period; however, we reduced our EBUB estimate by $1.2 million for the same period in 2021. Renewal rate retention was 88% for the 2022 three-month period as compared to 90% for the same period of 2021. Renewal rate decreased 4% during the 2022 three-month period as compared to 3% during the same period of 2021. New business written decreased $2.1 million during the 2022 three-month period as compared to the same period of 2021, reflecting the competitive workers' compensation market conditions and a decrease in new business submissions in the 2022 three-month period.
We retained 100% of the nine workers’ compensation alternative market programs that were up for renewal during the three months ended March 31, 2022.
New business, audit premium, renewal retention and renewal price changes for our traditional business and the alternative market business are shown in the table below:
Three Months Ended March 31
20222021
($ in millions)Traditional BusinessAlternative Market BusinessSegment
Results
Traditional BusinessAlternative Market BusinessSegment
Results
New business$3.5 $1.1 $4.6 $5.9 $0.8 $6.7 
Audit premium (excluding EBUB)$0.1 $1.6 $1.7 $(1.0)$0.2 $(0.8)
Retention rate (1)
85 %92 %88 %89 %92 %90 %
Change in renewal pricing (2)
(4 %)(3 %)(4 %)(2 %)(5 %)(3 %)
(1) We calculate our workers' compensation retention rate as annualized expiring renewed premium divided by all annualized expiring premium subject to renewal. Our retention rate can be impacted by various factors, including price or other competitive issues, insureds being acquired, or a decision not to renew based on our underwriting evaluation.
(2) The pricing of our business includes an assessment of the underlying policy exposure and market conditions. We continue to base our pricing on expected losses, as indicated by our historical loss data.
Ceded Premiums Written
Ceded premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Premiums ceded to SPCs$21,488 $20,682 $806 3.9 %
Premiums ceded to external reinsurers3,155 2,974 181 6.1 %
Premiums ceded to unaffiliated captive insurer2,884 3,033 (149)(4.9 %)
Change in return premium estimate under external reinsurance29 (474)503 106.1 %
Estimated revenue share under external reinsurance(704)(771)67 (8.7 %)
Total ceded premiums written$26,852 $25,444 $1,408 5.5 %
Premiums ceded to SPCs represent alternative market business that is ceded under 100% quota share reinsurance agreements to the SPCs in our Segregated Portfolio Cell Reinsurance segment. Premiums ceded to an unaffiliated captive insurer represent alternative market business for one program that is ceded under a 100% quota share reinsurance agreement. Alternative market premiums written increased for the 2022 three-month period, which resulted in higher premiums ceded to SPCs. See further discussion on alternative market gross premiums written in our Segment Operating Results - Segregated Portfolio Cell Reinsurance section under the heading "Gross Premiums Written" that follows.
Under our external reinsurance treaty for traditional business, we retain the first $0.5 million in risk insured by us and cede losses in excess of this amount on each loss occurrence, subject to an AAD, equal to 3.5% of ceded earned premium for the treaty year effective May 1, 2021. Premiums ceded under our traditional reinsurance treaty are based on premium earned
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during the treaty period. The increase in premiums ceded to external reinsurers during the 2022 three-month period primarily reflected the increase in reinsurance rates effective May 1, 2021.
Changes in the return premium estimate reflected adjustments to our estimate of expected future recovery of ceded premium based on the underlying loss experience of our reinsurance treaties that include a provision for return premium. As shown in the table above, we decreased our estimate of return premium by a nominal amount during the 2022 three-month period as compared to an increase of $0.5 million during the same respective period in 2021. Changes in the estimated return premium primarily reflect adjustments to loss estimates on previously reported reinsured claims.
We are party to a revenue sharing agreement with our reinsurance broker under which we participate in the broker's revenue earned under our reinsurance treaties based on the volume of premium ceded. We estimate the amount of revenue we expect to receive under this agreement as premiums are recognized and ceded to the reinsurers.
Ceded Premiums Ratio
Ceded premiums ratio was as follows:
Three Months Ended March 31
20212020Change
Ceded premiums ratio14.3%13.5%0.8 pts
Three Months Ended March 31
20222021Change
Ceded premiums ratio, as reported33.3 %31.8 %1.5  pts
Less the effect of:
Premiums ceded to SPCs (100%)26.1 %25.9 %0.2  pts
Premiums ceded to unaffiliated captive insurers (100%)1.5 %1.7 %(0.2  pts)
Change in EBUB %0.1 %(0.1  pts)
Change in return premium estimate under external reinsurance0.1 %(1.1 %)1.2  pts
Estimated revenue share(1.6 %)(1.8 %)0.2  pts
Assumed premiums earned (not ceded to external reinsurers)(0.3 %)(0.3 %)—  pts
Ceded premiums ratio (related to external reinsurance), less the effects of above7.5 %7.3 %0.2  pts
The above table reflects traditional ceded premiums earned as a percent of traditional gross premiums earned. As discussed above, premiums ceded under our traditional reinsurance treaty are based on premiums earned during the treaty period. The increase in the ceded premiums ratio for the three months ended March 31, 2022 as compared to the same period in 2021 primarily reflected an increase in reinsurance rates.
Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that we cede to SPCs in our Segregated Portfolio Cell Reinsurance segment, external reinsurers (including changes related to the return premium and revenue share estimates) and the unaffiliated captive insurer. Because premiums are generally earned pro rata over the entire policy period, fluctuations in premiums earned tend to lag those of premiums written. Our workers’ compensation policies are twelve month term policies, and premiums are earned on a pro rata basis over the policy period. Net premiums earned also include premium adjustments related to the audit of our insureds' payrolls, changes in our EBUB estimate and premium adjustments related to retrospectively-rated policies. Payroll audits are conducted subsequent to the end of the policy period and any related premium adjustments processed are recorded as fully earned in the current period. In addition, we record an estimate for EBUB and evaluate the estimate on a quarterly basis.
Net premiums earned were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums earned$61,034 $58,632 $2,402 4.1 %
Less: Ceded premiums earned20,350 18,621 1,729 9.3 %
Net premiums earned$40,684 $40,011 $673 1.7 %
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The increase in net premiums earned during the three months ended March 31, 2022 as compared to the same period in 2021 primarily reflected the impact of the adjustment to EBUB in the prior year period. Excluding the adjustment to EBUB during the 2021 three-month period, net premiums earned decreased during the three months ended March 31, 2022 as compared to the same period in 2021 primarily due to the pro rata effect of a reduction in net premiums written during the preceding twelve months. The decrease in net premiums earned during the three months ended March 31, 2022 was partially offset by an increase in audit premium billed to policyholders.
Losses and Loss Adjustment Expenses
We estimate our current accident year loss and loss adjustment expenses by developing actual reported losses using historical loss development factors, adjusted to reflect current and expected trends based on various internal analyses and supplemental information. The following table summarizes calendar year net loss ratios by separating losses between the current accident year and all prior accident years. Calendar year and current accident year net loss ratios by component were as follows:
Three Months Ended March 31
20222021Change
Calendar year net loss ratio66.9 %65.5 %1.4  pts
Less impact of prior accident years on the net loss ratio(4.9 %)(5.5 %)0.6  pts
Current accident year net loss ratio71.8 %71.0 %0.8  pts
The increase in the current accident year net loss ratio during the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected the continuation of intense price competition and the resulting renewal rate decreases, partially offset by the impact of favorable prior year claim trends on the current year estimate. The current accident year net loss ratio for the three months ended March 31, 2022 also reflects an expectation that the labor shortage will continue to have an impact on claim activity during 2022.
Calendar year incurred losses (excluding IBNR) in excess of our per occurrence reinsurance retention, before consideration of the AAD (see previous discussion under the heading "Ceded Premiums Written"), increased $1.7 million for the three months ended March 31, 2022 as compared to the same period of 2021; however, of the $1.7 million, we retained losses in excess of our per occurrence retention totaling $1.0 million which reflected losses within the AAD. There were no current accident year reported losses ceded to reinsurers during the three months ended March 31, 2022 or 2021.
We recognized net favorable prior year development related to our previously established reserve of $2.0 million for the three months ended March 31, 2022 as compared to $2.2 million for the same period of 2021. The net favorable prior year reserve development for the three months ended March 31, 2022 and 2021 reflected overall favorable trends in claim closing patterns. Net favorable development for the 2022 three months ended was primarily related to accident years 2019 and prior. Net favorable development for the 2021 three-month period was primarily related to accident years 2017 and prior.
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Underwriting, Policy Acquisition and Operating Expenses
Underwriting, policy acquisition and operating expenses include the amortization of commissions, premium taxes and underwriting salaries, which are capitalized and deferred over the related workers’ compensation policy period, net of ceding commissions earned. The capitalization of underwriting salaries can vary as they are subject to the success rate of our contract acquisition efforts. These expenses also include a management fee charged by our Corporate segment, which represents intercompany charges pursuant to a management agreement, and the amortization of intangible assets, primarily related to the acquisition of Eastern by ProAssurance. The management fee is based on the extent to which services are provided to the subsidiary and the amount of premium written by the subsidiary.
Our Workers' Compensation Insurance segment underwriting, policy acquisition and operating expenses were comprised as follows:
Three Months Ended March 31
($ in thousands)20222021Change
DPAC amortization$7,061 $6,741 $320 4.7 %
Management fees541 542 (1)(0.2 %)
Other underwriting and operating expenses8,868 8,252 616 7.5 %
Policyholder dividend expense209 269 (60)(22.3 %)
SPC ceding commission offset(3,678)(3,518)(160)4.5 %
Total$13,001 $12,286 $715 5.8 %
The increase in DPAC amortization for the three months ended March 31, 2022 as compared to the same period in 2021 primarily reflected the increase in gross premiums earned.
The increase in other underwriting and operating expenses for the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected an increase in costs related to compensation, business-related travel, lease exit costs and an increase in the allowance for credit losses. Marketing costs included advertising and website-related activities that were planned for 2022. Business-related travel has increased as a result of the easing of pandemic-related restrictions. During the first quarter of 2022, we recognized one-time lease exit costs of $0.2 million due to the early termination of an office lease; however, as a result, we anticipate annual expense savings of approximately $0.1 million. The increase in the allowance for credit losses primarily reflects an increase in accounts greater than 90 days old, which we believe is a timing issue that will reverse in future periods.
As previously discussed, alternative market premiums written by our Workers' Compensation Insurance segment are 100% ceded, less a ceding commission, to either the SPCs in our Segregated Portfolio Cell Reinsurance segment or, to a limited extent, an unaffiliated captive insurer. The ceding commission charged to the SPCs consists of an amount for fronting fees, cell rental fees, commissions, premium taxes and risk management fees. The fronting fees, commissions, premium taxes and risk management fees are recorded as an offset to underwriting, policy acquisition and operating expenses. Cell rental fees are recorded as a component of other income and claims administration fees are recorded as ceded ULAE. The increase in SPC ceding commissions earned for the three months ended March 31, 2022 as compared to the same period of 2021, primarily reflected the increase in alternative market ceded earned premium.
Underwriting Expense Ratio (the Expense Ratio)
The underwriting expense ratio included the impact of the following:
Three Months Ended March 31
20222021Change
Underwriting expense ratio, as reported32.0 %30.7 %1.3  pts
Less estimated ratio increase (decrease) attributable to:
Impact of ceding commissions received from SPCs3.5 %2.9 %0.6  pts
Impact of audit premium(0.1 %)1.0 %(1.1  pts)
Change in return premium estimate under external reinsurance %(0.2 %)0.2  pts
Estimated revenue share(0.3 %)(0.4 %)0.1  pts
Underwriting expense ratio, less listed effects28.9 %27.4 %1.5  pts
Excluding the items noted in the table above, the expense ratio increased for the three months ended March 31, 2022, primarily reflecting the increase in other underwriting and operating expenses, as previously discussed.
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Segment Results - Segregated Portfolio Cell Reinsurance
The Segregated Portfolio Cell Reinsurance segment includes the results (underwriting profit or loss, plus investment results, net of U.S. federal income taxes) of SPCs at Inova Re and Eastern Re, our Cayman Islands SPC operations, as discussed in Note 18 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K. SPCs are segregated pools of assets and liabilities that provide an insurance facility for a defined set of risks. Assets of each SPC are solely for the benefit of that individual cell and each SPC is solely responsible for the liabilities of that individual cell. Assets of one SPC are statutorily protected from the creditors of the others. Each SPC is owned, fully or in part, by an individual company, agency, group or association and the results of the SPCs are attributable to the participants of that cell. We participate to a varying degree in the results of selected SPCs and, for the SPCs in which we participate, our participation interest ranges from a low of 20% to a high of 85%. SPC results attributable to external cell participants are reported as an SPC dividend (expense) income in our Segregated Portfolio Cell Reinsurance segment. In addition, our Segregated Portfolio Cell Reinsurance segment includes the investment results of the SPCs as the investments are solely for the benefit of the cell participants and investment results attributable to external cell participants are reflected in the SPC dividend (expense) income. As of March 31, 2022, there were 27 (4 inactive) SPCs. The SPCs assume workers' compensation insurance, healthcare professional liability insurance or a combination of the two from our Workers' Compensation Insurance and Specialty P&C segments. As of March 31, 2022, there were two SPCs that assumed both workers' compensation insurance and healthcare professional liability insurance and one SPC that assumed only healthcare professional liability insurance.
Segment results reflects our share of the underwriting and investment results of the SPCs in which we participate, and included the following:
Three Months Ended March 31
($ in thousands)20222021Change
Net premiums written$25,217 $22,188 $3,029 13.7 %
Net premiums earned$19,314 $15,884 $3,430 21.6 %
Net investment income112 221 (109)(49.3 %)
Net investment gains (losses)(711)987 (1,698)(172.0 %)
Other income1 — — %
Net losses and loss adjustment expenses(11,491)(9,425)(2,066)21.9 %
Underwriting, policy acquisition and operating expenses(4,369)(5,025)656 (13.1 %)
SPC U.S. federal income tax expense (1)
(642)(356)(286)80.3 %
SPC net results2,214 2,287 (73)(3.2 %)
SPC dividend (expense) income (2)
(2,367)(1,742)(625)35.9 %
Segment results (3)
$(153)$545 $(698)(128.1 %)
Net loss ratio59.5%59.3%0.2 pts
Underwriting expense ratio22.6%31.6%(9.0 pts)
(1) Represents the provision for U.S. federal income taxes for SPCs at Inova Re, which have elected to be taxed as a U.S. corporation under Section 953(d) of the Internal Revenue Code. U.S. federal income taxes are included in the total SPC net results and are paid by the individual SPCs.
(2) Represents the net (profit) loss attributable to external cell participants.
(3) Represents our share of the net profit (loss) of the SPCs in which we participate.


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Premiums Written
Premiums in our Segregated Portfolio Cell Reinsurance segment are assumed from either our Workers' Compensation Insurance or Specialty P&C segments. Premium volume is driven by five primary factors: (1) the amount of new business written, (2) retention of the existing book of business, (3) premium rates charged on the renewal book of business and, for workers' compensation business, (4) changes in payroll exposure and (5) audit premium.
Gross, ceded and net premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums written$28,369 $25,151 $3,218 12.8 %
Less: Ceded premiums written3,152 2,963 189 6.4 %
Net premiums written$25,217 $22,188 $3,029 13.7 %
Gross Premiums Written
Gross premiums written reflected reinsurance premiums assumed by component as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Workers' compensation$21,488 $20,682 $806 3.9 %
Healthcare professional liability6,881 4,469 2,412 54.0 %
Gross Premiums Written$28,369 $25,151 $3,218 12.8 %
Gross premiums written for the three months ended March 31, 2022 and 2021 were primarily comprised of workers' compensation coverages assumed from our Workers' Compensation Insurance segment. Workers' compensation gross premiums written increased during the three months ended March 31, 2022 as compared to the same period of 2021 driven by an increase in audit premium billed to policyholders and new business written, partially offset by renewal rate decreases of 3%. Healthcare professional liability gross premiums written increased during the three months ended March 31, 2022 as compared to the same period of 2021 driven by the effect of tail coverage premium primarily related to one program in which we do not participate, which resulted in $3.0 million of one-time premium written and fully earned. We retained 100% of the eight workers' compensation programs and one healthcare professional liability program up for renewal during the three months ended March 31, 2022.
New business, audit premium, retention and renewal price changes for the assumed workers' compensation premium is shown in the table below:
Three Months Ended March 31
($ in millions)20222021
New business$1.1 $0.8 
Audit premium$1.6 $0.2 
Retention rate (1)
92 %92 %
Change in renewal pricing (2)
(3 %)(5 %)
(1) We calculate our workers' compensation retention rate as annualized expiring renewed premium divided by all annualized expiring premium subject to renewal. Our retention rate can be impacted by various factors, including price or other competitive issues, insureds being acquired, or a decision not to renew based on our underwriting evaluation.
(2) The pricing of our business includes an assessment of the underlying policy exposure and market conditions. We continue to base our pricing on expected losses, as indicated by our historical loss data.
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Ceded Premiums Written
Ceded premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Ceded premiums written$3,152 $2,963 $189 6.4 %
For the workers' compensation business, each SPC has in place its own external reinsurance coverage. The healthcare professional liability business is assumed net of reinsurance from our Specialty P&C segment; therefore, there are no ceded premiums related to the healthcare professional liability business reflected in the table above. The risk retention for each loss occurrence for the workers' compensation business ranges from $0.3 million to $0.4 million based on the program, with limits up to $119.7 million. In addition, each program has aggregate reinsurance coverage between $1.1 million and $2.1 million on a program year basis. Premiums ceded under our SPC reinsurance treaty are based on premiums written during the treaty period. The change in ceded premiums written during the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected the change in workers' compensation gross premiums written and the impact of rate increases under the external reinsurance treaty. External reinsurance rates vary based on the alternative market program.
Ceded Premiums Ratio
Ceded premiums ratio was as follows:
Three Months Ended March 31
20222021Change
Ceded premiums ratio14.7%14.3%0.4 pts
The above table reflects ceded premiums as a percent of gross premiums written for the workers' compensation business only; healthcare professional liability business is assumed net of reinsurance, as discussed above. The ceded premiums ratio reflects the weighted average reinsurance rates of all SPC programs. The increase in the ceded premiums ratio for the three months ended March 31, 20212022 primarily reflectsreflected an increase in reinsurance rates for programs renewing on or after May 1, 2020.rates.
Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that the SPCs cede to external reinsurers. Because premiums are generally earned pro rata over the entire policy period, fluctuations in premiums earned tend to lag those of premiums written. Policies ceded to the SPCs are twelve month term policies and premiums are earned on a pro rata basis over the policy period. Net premiums earned also include premium adjustments related to the audit of workers' compensation insureds' payrolls. Payroll audits are conducted subsequent to the end of the policy period and any related adjustments are recorded as fully earned in the current period.
Gross, ceded and net premiums earned were as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Gross premiums earnedGross premiums earned$17,967 $19,190 $(1,223)(6.4 %)Gross premiums earned$21,664 $17,967 $3,697 20.6 %
Less: Ceded premiums earnedLess: Ceded premiums earned2,083 2,210 (127)(5.7 %)Less: Ceded premiums earned2,350 2,083 267 12.8 %
Net premiums earnedNet premiums earned$15,884 $16,980 $(1,096)(6.5 %)Net premiums earned$19,314 $15,884 $3,430 21.6 %
The decreaseincrease in net premiums earned during the three months ended March 31, 20212022 primarily reflected the aforementioned effect of $3.0 million of tail premium fully written and earned during the current period and the increase in audit premium billed to policyholders, partially offset by the pro rata effect of a reduction in net premiums written during the preceding twelve months.
Net Investment Income and Net Realized Investment Gains (Losses)
Net investment income for the three months ended March 31, 2021 and 2020 was primarily attributable to interest earned on available-for-sale fixed maturity investments, which primarily includes investment-grade corporate debt securities. We recognized $1.0 million of net realized investment gains during the three months ended March 31, 2021, which primarily reflected an increase in the fair value on our equity portfolio. We recognized $3.2 million of net realized investment losses during the three months ended March 31, 2020 driven by changes in the fair value of our equity portfolio attributable to the disruptions in global financial markets related to COVID-19.
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Losses and Loss Adjustment Expenses
The following table summarizes the calendar year net loss ratios by separating losses between the current accident year and all prior accident years. The current accident year net loss ratio reflected the aggregate loss ratio for all programs. Loss reserves are estimated for each program on a quarterly basis. Due to the size of some of the programs, quarterly loss results can create volatility in the current accident year net loss ratio from period to period.
Calendar year and current accident year net loss ratios for the three months ended March 31, 2022 and 2021 and 2020 waswere as follows:
Three Months Ended March 31Three Months Ended March 31
20212020Change20222021Change
Calendar year net loss ratioCalendar year net loss ratio59.3 %55.1 %4.2  ptsCalendar year net loss ratio59.5 %59.3 %0.2  pts
Less impact of prior accident years on the net loss ratioLess impact of prior accident years on the net loss ratio(9.6 %)(10.6 %)1.0  ptsLess impact of prior accident years on the net loss ratio(5.0 %)(9.6 %)4.6  pts
Current accident year net loss ratioCurrent accident year net loss ratio68.9 %65.7 %3.2  ptsCurrent accident year net loss ratio64.5 %68.9 %(4.4  pts)
The increasecurrent accident year net loss ratio decreased 4.4 percentage points for the three months ended March 31, 2022 as compared to the same period of 2021. The decrease in the current accident year net loss ratio for the 2021 three-month periodthree months ended March 31, 2022 primarily reflected favorable trends in prior accident year claim results and their impact on our analysis of 3.2 percentage points as compared to the same period of 2020 primarily reflectedcurrent accident year loss estimate, partially offset by the continuation of intense price competition and the resulting renewal rate decreases in the workers' compensation business. As a result of the COVID-19 pandemic, legislative and regulatory bodies in certain states have changed or are considering changes to compensability requirements and presumptions for certain types of workers related to COVID-19 claims. Such changes could have an adverse impact on the frequency and severity related to COVID-19 claims.
Calendar year incurred losses (excluding IBNR) ceded to our external reinsurers increased $3.1decreased $2.8 million for the 2021three months ended March 31, 2022 as compared to the same period of 2021. Current accident year ceded incurred losses (excluding IBNR) increased $0.1 million for the 2022 three-month period as compared to the same period of 2020, primarily reflecting the impact of three large claims reported in the first quarter of 2021 that occurred in late 2020. Current accident year ceded incurred losses (excluding IBNR) decreased $0.4 million for the 2021 three-month period, as compared to the same period of 2020.2021.
We recognized net favorable prior year reserve development of $1.4 million and $1.8$0.9 million for the three months ended March 31, 20212022 as compared to $1.4 million for the same period of 2021. The net favorable prior year reserve development for the three months ended March 31, 2022 related entirely to workers’ compensation business, which reflected overall favorable trends in claim closing patterns primarily in accident years 2019 and 2020, respectively.2020. The net favorable prior year reserve development for the three months ended March 31, 2021 also related entirely to the workers’ compensation business which primarily reflected overall favorable claim trends in claim closing patterns primarily in theaccident years 2018 and 2019 accident years. The net favorable prior year development for the three months ended March 31, 2020 included $0.8 million and $1.0 million related to the workers' compensation and healthcare professional liability business, respectively. The workers' compensation favorable development was primarily related to the 2018 accident year, while the healthcare professional liability favorable development was primarily related to the 2016 through 2018 accident years.2019.
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Underwriting, Policy Acquisition and Operating Expenses
Our Segregated Portfolio Cell Reinsurance segment underwriting, policy acquisition and operating expenses were comprised as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
DPAC amortizationDPAC amortization$4,636 $5,135 $(499)(9.7 %)DPAC amortization$5,294 $4,636 $658 14.2 %
Policyholder dividend expensePolicyholder dividend expense66 173 (107)(61.8 %)
Other underwriting and operating expensesOther underwriting and operating expenses389 (56)445 794.6 %Other underwriting and operating expenses(991)216 (1,207)(558.8 %)
TotalTotal$5,025 $5,079 $(54)(1.1 %)Total$4,369 $5,025 $(656)(13.1 %)
DPAC amortization primarily represents ceding commissions, which vary by program and are paid to our Workers' Compensation Insurance and Specialty P&C segments for premiums assumed. Ceding commissions include an amount for fronting fees, commissions, premium taxes and risk management fees, which are reported as an offset to underwriting, policy acquisition and operating expenses within our Workers' Compensation Insurance and Specialty P&C segments. In addition, ceding commissions paid to our Workers' Compensation Insurance segment include cell rental fees which are recorded as other income and claims administration fees which are recorded as ceded ULAE within our Workers' Compensation Insurance segment.
Other underwriting and operating expenses primarily include bank fees, professional fees and bad debt expense.changes in the allowance for expected credit losses. The increasedecrease in other underwriting and operating expenses for the three months ended March 31, 20212022 as compared to the same period in 2020of 2021 primarily reflected the effect of recoveries of premiums receivables during the first quarter of 2020 that were previously written off, which resultedchange in a reduction to our allowance for expected credit losses and,related to a lesser extent, an increasethe collection of customer accounts that were previously written off.
The decrease in policyholder dividend expense for the three months ended March 31, 2022 as compared to the same period of 2021, related primarily to one SPC program.
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program, in which we do not participate.
Underwriting Expense Ratio (the Expense Ratio)
The underwriting expense ratio included the impact of the following:
Three Months Ended March 31Three Months Ended March 31
20212020Change20222021Change
Underwriting expense ratio, as reportedUnderwriting expense ratio, as reported31.6%29.9%1.7 ptsUnderwriting expense ratio, as reported22.6%31.6%(9.0 pts)
Less: impact of audit premium on expense ratioLess: impact of audit premium on expense ratio(0.3%)0.6%(0.9 pts)Less: impact of audit premium on expense ratio(2.0%)(0.3%)(1.7 pts)
Underwriting expense ratio, excluding the effect of audit premiumUnderwriting expense ratio, excluding the effect of audit premium31.9%29.3%2.6 ptsUnderwriting expense ratio, excluding the effect of audit premium24.6%31.9%(7.3 pts)
Excluding the effect of audit premium, the increaseunderwriting expense ratio decreased for the 2022 three-month period. The decrease in the underwriting expense ratio duringfor the 20212022 three-month period primarily reflected the effect ofchange in the aforementioned premiums receivable recoveries during the first quarter of 2020allowance for expected credit losses and the increase in policyholder dividend expense, partially offset by a decrease in the weighted average ceding commission percentage of all SPC programs.
SPC U.S. Federal Income Tax Expense
The SPCs at Inova Re have made a 953(d) election under the U.S. Internal Revenue Code and are subject to U.S. federal income tax. U.S. federal income taxes incurred totaled $0.4 million and $0.2 million for the three months ended March 31, 2021 and 2020, respectively. U.S. federal income taxes are included in the total SPC net results and are paid by the individual SPCs.as discussed above.
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Segment Results - Lloyd's SyndicatesCeded Premiums Written
Our Lloyd's Syndicates segment includesCeded premiums represent the results from our participation in certain Syndicates at Lloyd's of London. In additionamounts owed to our participation in Syndicate results, we have investments in and other obligations to our Lloyd's Syndicates consistingreinsurers for their assumption of a Syndicate Credit Agreementportion of our losses. Our HCPL and FAL requirements.Medical Technology Liability excess of loss reinsurance arrangements renew annually on October 1. For those excess of loss reinsurance arrangements in effect prior to October 1, 2021, we generally retained the first $2 million in risk insured by us and ceded coverages in excess of this amount. Effective October 1, 2021, our HCPL treaty renewed at a lower gross rate and we generally retain from 0% to 5% of the next $24 million of risk for our HCPL coverages in excess of $2 million. Our HCPL excess of loss reinsurance arrangement that renewed on October 1, 2021 also incorporated NORCAL policies. Prior to October 1, 2021, NORCAL policies were reinsured under separate reinsurance agreements, primarily excess of loss, which have historically renewed annually on January 1. For the 2021 underwriting year, our FAL was comprisedNORCAL excess of investment securities and cash and cash equivalents deposited with Lloyd's which at March 31, 2021 had a fair value of approximately $106.8 million, as discussed in Note 3 of the Notes to Condensed Consolidated Financial Statements.
We normally report results from our involvement in Lloyd's Syndicates on a quarter lag, except when information is availableloss reinsurance arrangement that is material to the current period. Furthermore, the investment results associated with our FAL investments and certain U.S. paid administrative expenses are reported concurrently as that information is available on an earlier time frame.
Lloyd's Syndicate 1729. We provide capital to Syndicate 1729, which covers a range of property and casualty insurance and reinsurance lines in both the U.S. and international markets. The remaining capital for Syndicate 1729 is provided by unrelated third parties, including private names and other corporate members. To support and grow our core insurance operations, we decreased our participation in the results of Syndicate 1729 for the 2021 underwriting year to 5% from 29% which, due to the quarter lag, will not be reflected in our results until the second quarter of 2021. Syndicate 1729's maximum underwriting capacity for the 2021 underwriting year is £185 million (approximately $255 million based on March 31, 2021 exchange rates), of which £9 million (approximately $13 million based on March 31, 2021 exchange rates) is our allocated underwriting capacity.
Lloyd's Syndicate 6131. We provide capital to an SPA, Syndicate 6131, which focuses on contingency and specialty property business, primarily for risks in both U.S. and international markets. As an SPA, Syndicate 6131 underwrites on a quota share basis with Syndicate 1729. Effective July 1, 2020, Syndicate 6131 entered into a six-month quota share reinsurance agreement with an unaffiliated insurer. Under this agreement, Syndicate 6131 ceded essentially half of the premium assumed from Syndicate 1729 to the unaffiliated insurer; the agreement was non-renewedrenewed on January 1, 2021, retention was generally the first $2 million in risk and coverages in excess of this amount were ceded up to $24 million. For our Medical Technology Liability treaty which also renewed effective October 1, 2021, we decreased our participationalso retain 2.5% of the next $8 million of risk for coverages in excess of $2 million. There were no significant changes in the resultscost or structure of Syndicate 6131 to 50% from 100% forour Medical Technology Liability treaty upon the October 2021 underwriting year. Due to the quarter lag, this reduced participation will not be reflected in our results until the second quarter of 2021. Syndicate 6131's maximum underwriting capacity for the 2021 underwriting year is £20 million (approximately $28 million based on March 31, 2021 exchange rates), of which £10 million (approximately $14 million based on March 31, 2021 exchange rates) is our allocated underwriting capacity.renewal.
In addition to the resultscertain of our participation in Lloyd's Syndicates, as discussed above, our Lloyd's Syndicates segment also includes 100% of the results of our wholly owned subsidiaries that support our operations at Lloyd's. For the three months ended March 31, 2021 and 2020, the results of our Lloyd's Syndicates segment were as follows:
Three Months Ended March 31
($ in thousands)20212020Change
Net premiums written$11,885 $26,660 $(14,775)(55.4 %)
Net premiums earned$15,850 $22,001 $(6,151)(28.0 %)
Net investment income729 1,159 (430)(37.1 %)
Net realized gains (losses)(115)81 (196)(242.0 %)
Other income (loss)221 (232)453 195.3 %
Net losses and loss adjustment expenses(12,967)(14,780)1,813 (12.3 %)
Underwriting, policy acquisition and operating expenses(6,591)(9,142)2,551 (27.9 %)
Income tax benefit (expense) 29 (29)nm
Segment results$(2,873)$(884)$(1,989)(225.0 %)
Net loss ratio81.8 %67.2 %14.6  pts
Underwriting expense ratio41.6 %41.6 %—  pts
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Premiums Written
Changes in our premium volume within our Lloyd's Syndicates segment are driven by five primary factors: (1) changes in our participation in the Syndicates, (2) the amount of new business and the channels in which the business is written, (3) our retention of existing business, (4) the premium charged for business that is renewed, which is affected by rates charged and by the amount and type of coverage an insured chooses to purchase, and (5) the timing of premium written through multi-period policies.
Gross, ceded and net premiums written were as follows:
Three Months Ended March 31
($ in thousands)20212020Change
Gross premiums written$14,102 $27,861 $(13,759)(49.4 %)
Less: Ceded premiums written2,217 1,201 1,016 84.6 %
Net premiums written$11,885 $26,660 $(14,775)(55.4 %)
Gross Premiums Written
Gross premiums written during the three months ended March 31, 2021 consisted of property insurance coverages (35% of total gross premiums written), specialty property coverages (30%), casualty coverages (25%), contingency coverages (8%) and property reinsurance coverages (2%). The decrease in gross premiums written during the 2021 three-month period as compared to the same period of 2020 was primarily driven by our decreased participation in the results of Syndicate 1729, partially offset by new business written, primarily on specialty property coverages. In addition, the decrease in gross premiums written for the 2021 three-month period also reflected the effect of a certain type of coverage reaching capacity limits as set forth by Syndicate 1729's business plan and, to a lesser extent, the effect of estimated reinstatement premiums of $0.6 million as compared to $1.8 million in the prior year period. The reinstatement premiums represent amounts payable to Syndicate 1729 under certain excess of loss arrangements, the ultimate amount of ceded premium is determined by the loss experience of the business ceded, subject to certain minimum and maximum amounts. Given the length of time that it takes to resolve our claims, many years may elapse before all losses recoverable under a reinsurance treaties, primarilyarrangement are known. As a part of the process of estimating our loss reserve we also make estimates regarding the amounts recoverable under our reinsurance arrangements. As a result, we may have an adjustment to our estimate of expected losses and associated with property and catastropherecoveries for prior year ceded losses under certain loss sensitive reinsurance agreements. Any changes to estimates of premiums ceded related losses, whichto prior accident years are fully earned in the period the changes in estimates occur.
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Ceded premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Excess of loss reinsurance arrangements (1)
$9,496 $7,678 $1,818 23.7 %
Other shared risk arrangements (2)
4,336 3,963 373 9.4 %
Premium ceded to SPCs (3)
6,881 4,469 2,412 54.0 %
Other ceded premiums written(4)
2,121 866 1,255 144.9 %
Total ceded premiums written$22,834 $16,976 $5,858 34.5 %
(1) We generally reinsure risks under our excess of loss reinsurance arrangements pursuant to which the reinsurers agree to assume all or a portion of all risks that we insure above our individual risk retention levels, up to the maximum individual limits offered. Premium due to reinsurers also fluctuates with the volume of written premium subject to cession under the arrangement. In certain of our excess of loss reinsurance arrangements, the premium due to the reinsurer is determined by the loss experience of that business reinsured, subject to certain minimum and maximum amounts. The increase in ceded premiums written under our excess of loss reinsurance arrangements during the 2022 three-month period as compared to the same period of 2021 was driven by additional ceded premiums of $4.4 million as a result of incorporating NORCAL policies into our existing HCPL excess of loss reinsurance arrangements with the October 1, 2021 renewal, as previously discussed. Excluding NORCAL, ceded premiums written under our excess of loss reinsurance arrangements decreased by approximately $2.4 million primarily due to a decrease in the overall volume of gross premiums written subject to cession and, to a lesser extent, the reduced rate on the treaty year effective October 1, 2021.
(2) We have entered into various shared risk arrangements, including quota share, fronting, and captive arrangements, with certain large healthcare systems and other insurance entities. While we cede a large portion of the premium written under these arrangements, they provide us an opportunity to grow net premium through strategic partnerships. These arrangements primarily include our Ascension Health program. Ceded premiums written under our shared risk arrangements during the 2022 three-month period remained relatively unchanged as compared to the same period of 2021.
(3) As previously discussed, as a part of our alternative market solutions, all or a portion of certain healthcare premium written is ceded to SPCs in our Segregated Portfolio Cell Reinsurance segment under either excess of loss or quota share reinsurance agreements, depending on the structure of the individual program. See the Segment Results - Segregated Portfolio Cell Reinsurance section for further discussion on the cession to the SPCs from our Specialty P&C segment. The increase in premiums ceded to SPCs during the 2022 three-month period as compared to the same period of 2021 was driven by the impact of tail coverages, primarily related to one program (see discussion in footnote 12 under the heading "Gross Premiums Written").
(4) The increase in other ceded premiums written during the 2022 three-month period as compared to the same period of 2021 was primarily driven by the incorporation of NORCAL's cyber liability coverages into our existing HCPL cyber liability arrangement with the October 1, 2021 renewal.
Ceded Premiums Ratio
The ceded premiums ratio was as follows:
Three Months Ended March 31
 20222021Change
Ceded premiums ratio8.9%12.3%(3.4 pts)
The above table reflects ceded premiums written as a percent of gross premiums written. The decrease in our ceded premiums ratio for the 2022 three-month period as compared to the same period of 2021 was driven by the reduced rate on our excess of loss reinsurance arrangements for the treaty year effective October 1, 2021 as well as the impact of the addition of the NORCAL gross written premium base for the 2022 three-month period. The decrease in our ceded premiums ratio for the 2022 three-month period as compared to the same period of 2021 was partially offset by an increase in premiums ceded to SPCs. See additional discussion on NORCAL ceded premiums and premiums ceded to SPCs above under the heading "Ceded Premiums Written."
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Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that we cede to our reinsurers for their assumption of a portion of our losses. Because premiums are generally earned pro rata over the entire policy period, fluctuations in premiums earned tend to lag those of premiums written. The majority of our policies carry a term of one year; however, some of our Medical Technology Liability policies have a multi-year term and some of our NORCAL Standard Physician policies have a three-month term. In addition, prior to the third quarter of 2020, we wrote certain Standard Physician policies with a twenty-four month term. Tail coverage premiums are generally 100% earned in the period written because the policies insure only incidents that occurred in prior periods and are not cancellable. Retroactive coverage premiums are 100% earned at the inception of the contract, as all of the associated underlying loss events occurred in the past. Additionally, any ceded premium changes due to changes to estimates of premiums owed under reinsurance agreements for prior accident years are fully earned in the period of change.
Net premiums earned were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums earned$212,279 $132,060 $80,219 60.7 %
Less: Ceded premiums earned14,312 16,447 (2,135)(13.0 %)
Net premiums earned$197,967 $115,613 $82,354 71.2 %
Gross premiums earned during the 2022 three-month period included additional earned premiums of approximately $79.7 million from our acquisition of NORCAL. Excluding premiums associated with the NORCAL acquisition, gross premiums earned remained relatively unchanged during the 2022 three-month period as compared to the same period of 2021.
Ceded premiums earned decreased during the 2022 three-month period as compared to the same period of 2021 driven by the pro rata effect of a decrease in premium ceded under our shared risk and excess of loss arrangements during the preceding twelve months.
Losses and Loss Adjustment Expenses
The determination of calendar year losses involves the actuarial evaluation of incurred losses for the current accident year and the actuarial re-evaluation of incurred losses for prior accident years, including an evaluation of the reserve amounts required for ECO/XPL losses. As part of the review of our prior accident year reserves, we also make estimates of expected losses and associated recoveries for prior year ceded losses under certain loss sensitive reinsurance agreements. This analysis may result in changes to estimates of premiums owed under reinsurance agreements for prior accident years which impact net premiums earned (the denominator of the net loss ratio) in the period the adjustment is made. No such adjustments were made during the three months ended March 31, 2022 or 2021. See previous discussion under the heading "Ceded Premiums Written" for additional information.
Accident year refers to the accounting period in which the insured event becomes a liability of the insurer. For claims-made policies, which represent the majority of the premiums written in our Specialty P&C segment, the insured event generally becomes a liability when the event is first reported to us. For occurrence policies, the insured event becomes a liability when the event takes place. For retroactive coverages, the insured event becomes a liability at inception of the underlying contract. We believe that measuring losses on an accident year basis is the best measure of the underlying profitability of the premiums earned in that period, since it associates policy premiums earned with the estimate of the losses incurred related to those policy premiums.
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The following table summarizes calendar year net loss ratios for our Specialty P&C segment by separating losses between the current accident year and all prior accident years. In addition, net loss ratios for the three months ended March 31, 2022 in the following table include the impact of NORCAL.
Net Loss Ratios (1)
Three Months Ended March 31
20222021Change
Calendar year net loss ratio83.8 %87.5 %(3.7  pts)
Less impact of prior accident years on the net loss ratio(2.0 %)(2.3 %)0.3  pts
Current accident year net loss ratio (2)
85.8 %89.8 %(4.0  pts)
(1)Net losses, as specified, divided by net premiums earned.
(2)Our current accident year net loss ratio (as shown in the table above) decreased 4.0 percentage points during the three months ended March 31, 2022 as compared to the same period of 2021. The change in our current accident year net loss ratio in each period was primarily attributable to the following:
(In percentage points)Increase (Decrease)
2022 versus 2021
Comparative
three-month
period
Estimated ratio increase (decrease) attributable to:
NORCAL Operations4.0 pts
NORCAL Acquisition - Purchase Accounting Adjustment(1.2 pts)
Change in Estimate of ULAE(3.7 pts)
All other, net(3.1 pts)
Decrease in current accident year net loss ratio(4.0 pts)
Excluding the impact of the items specifically identified in the table above, our current accident year net loss ratio for the three months ended March 31, 2022 improved 3.1 percentage points as compared to the prior year period driven by a decrease to certain loss ratios in our Standard Physician line of business, which we began recognizing in the second half of 2021 and, to a lesser extent, changes in the mix of business. We continue to observe a reduction in claims frequency that started to emerge in 2020, some of which is due to our re-underwriting efforts and some of which, we believe, is associated with the COVID-19 pandemic including the disruption of the court systems. Given the consistent and prolonged nature of this favorable claims frequency trend, we reduced certain loss ratios in our Standard Physician line of business during the third and fourth quarters of 2021. We continue to remain cautious in recognizing the full impact of these favorable trends in our current accident year reserve due to the long-tailed nature of our HCPL claims as well as the uncertainty surrounding the length and severity of the pandemic.
Initial loss ratios associated with NORCAL policies were higher than the average for our other books of business in this segment. The impact of NORCAL operations resulted in a 4.0 percentage point increase in our current accident year net loss ratio for the three months ended March 31, 2022. We continue the process of evaluating the NORCAL book of business and implementing ProAssurance's underwriting strategies. Also as a result of our acquisition of NORCAL, our current accident year net loss ratio for the three months ended March 31, 2022 was impacted by amortization of the negative VOBA associated with NORCAL's assumed unearned premium which is recorded as a reduction to current accident year net losses and accounted for a 1.2 percentage point decrease in our current period ratio. The remaining unamortized negative VOBA will be fully amortized in the second quarter of 2022 (see Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for additional information on the remaining expected amortization of the NORCAL acquisition purchase accounting adjustments).
During the first quarter of 2022, we decreased our estimate of ULAE as a result of substantially integrating NORCAL into our Specialty P&C segment operations, which accounted for a 3.7 percentage point decrease in our current period accident year loss ratio with an offsetting 3.7 percentage point increase in our current period expense ratio with no impact to our combined ratio or segment results (see discussion on our expense ratio in the following section under the heading "Underwriting, Policy Acquisition and Operating Expenses"). This change in estimated ULAE had no impact on our combined ratio or segment results.
We re-evaluate our previously established reserve each quarter based upon the most recently completed actuarial analysis supplemented by any new analysis, information or trends that have emerged since the date of that study. We also take into account currently available industry trend information.
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We recognized net favorable prior accident year reserve development of $3.9 million during the three months ended March 31, 2022 as compared to $2.7 million during the same period of 2021. Net favorable development recognized during the three months ended March 31, 2022 was net of an increase in our reserve for potential ECO/XPL claims of $4.0 million as compared to a reduction in this same reserve of $0.2 million during the same period of 2021. Furthermore, net favorable development recognized during the three months ended March 31, 2022 included $2.9 million related to the amortization of the purchase accounting fair value adjustment on NORCAL's assumed net reserve and amortization of the negative VOBA associated with NORCAL's DDR reserve which is recorded as a reduction to prior accident year net losses and loss adjustment expenses. See Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for additional information on the remaining expected amortization of the NORCAL acquisition purchase accounting adjustments. We have not recognized any development related to NORCAL's prior accident year reserves since the date of acquisition on May 5, 2021. Excluding the increase in the ECO/XPL reserve and amortization of purchase accounting adjustments, we recognized net favorable prior accident year reserve development of $5.0 million during the three months ended March 31, 2022, principally related to accident years 2019 through 2021. Development recognized during the three months ended March 31, 2021 principally related to accident years 2017 and 2018.
A detailed discussion of factors influencing our recognition of loss development is included in our Critical Accounting Estimates section under the heading "Reserve for Losses and Loss Adjustment Expenses" in our December 31, 2021 report on Form 10-K. Assumptions used in establishing our reserve are regularly reviewed and updated by management as new data becomes available. Any adjustments necessary are reflected in the then current operations. Due to the size of our reserve, even a small percentage adjustment to the assumptions can have a material effect on our results of operations for the period in which the change is made, as was the case in both 2022 and 2021.
Underwriting, Policy Acquisition and Operating Expenses
Our Specialty P&C segment underwriting, policy acquisition and operating expenses, including NORCAL expenses for the 2022 three-month period, were comprised as follows:
Three Months Ended March 31
($ in thousands)20222021Change
DPAC amortization$21,740 $12,396 $9,344 75.4 %
Management fees1,402 1,001 401 40.1 %
Other underwriting and operating expenses19,736 12,949 6,787 52.4 %
Total$42,878 $26,346 $16,532 62.7 %
DPAC amortization for the 2022 three-month period included approximately $8.1 million of DPAC amortization associated with NORCAL policies written subsequent to our acquisition; however, this level of DPAC amortization is approximately $1.0 million lower than would be considered normal for the quarter due to the application of GAAP purchase accounting rules whereby the capitalized policy acquisition costs for policies written prior to the acquisition date were written off through purchase accounting on May 5, 2021 rather than being expensed pro rata over the remaining term of the associated policies (see Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for more information). The remaining increase in DPAC amortization for the 2022 three-month period as compared to the same period of 2021 reflected an increase in brokerage expenses due to our increased participation with an international medical professional liability insurer in our Specialty line of business (see discussion under the heading "Gross Premiums Written").
Management fees are charged pursuant to a management agreement by the Corporate segment to the operating subsidiaries within our Specialty P&C segment for services provided based on the extent to which services are provided to the subsidiary and the amount of premium written by the subsidiary. Fluctuations in the amount of premium written by each subsidiary can result in corresponding variations in the management fee charged to each subsidiary during a particular period. Due to continued organizational structure enhancements in our Specialty P&C segment during 2021 as well as operational alignments as a result of the integration of NORCAL, the extent to which services are provided by the Corporate segment to the operating subsidiaries within the segment decreased further effective January 1, 2022. Accordingly, we reduced the fee charged to the operating subsidiaries in 2022. Also effective January 1, 2022, the management agreement included operating subsidiaries of NORCAL contributing to $0.6 million of additional management fees in the current period.
Other underwriting and operating expenses increased during the 2022 three-month period primarily due to the addition of expenses contributed by NORCAL as well as a decrease in our estimate of ULAE which resulted in approximately $7.3 million of expenses remaining in operating expenses instead of being allocated to net losses and loss adjustment expenses. As a result, this change in ULAE estimate had offsetting impacts to our loss and expense ratios during the period with no impact to our combined ratio or segment results. See additional discussion on this change in ULAE estimate in the previous section under the heading "Losses and Loss Adjustment Expenses." Excluding expenses contributed by NORCAL and the impact of the change
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in ULAE, other underwriting and operating expenses decreased due to benefits from prior organizational restructurings and proactive expense management, somewhat offset by one-time expenses of $1.6 million incurred during the current period mainly comprised of one-time bonuses, employee severance charges and lease exit costs.
Underwriting Expense Ratio (the Expense Ratio)
Our expense ratio for the Specialty P&C segment was as follows:
 Three Months Ended March 31
 20222021Change
Underwriting expense ratio21.7 %22.8 %(1.1  pts)
The change in our expense ratio for the 2022 three-month period as compared to the same period of 2021 was primarily attributable to the following:
Increase (Decrease)
 2022 versus 2021
(In percentage points)Comparative three-month period
Estimated ratio increase (decrease) attributable to:
Increase in Net Premiums Earned and DPAC amortization(1)
0.3 pts
Change in Estimate of ULAE3.7 pts
Tail Premium(2)
(1.2 pts)
All other, net(3.9 pts)
Decrease in the underwriting expense ratio(1.1 pts)
(1) Excludes tail premium for the three months ended March 31, 2022 and 2021.
(2) Represents the effect of the premium earned from tail policies for the three months ended March 31, 2022 as compared to the same period of 2021 as there is typically minimal expense associated with tail premium (see discussion under the heading "Gross Premiums Written").
Excluding the items specifically identified in the table above, our expense ratio for the 2022 three-month period decreased by 3.9 percentage points primarily due to lower operating expenses due to the benefits from prior organizational restructurings and proactive expense management as well as expense synergies recognized from the NORCAL acquisition. However, as previously discussed, DPAC amortization associated with NORCAL recorded during the 2022 three-month period was lower than would be considered normal for the quarter due to the application of GAAP purchase accounting rules. Normalizing this amortization would have increased our expense ratio for the 2022 three-month period by an estimated 0.5 percentage points.
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Segment Results - Workers' Compensation Insurance
Our Workers' Compensation Insurance segment includes workers' compensation products provided to employers generally with 1,000 or fewer employees, as discussed in Note 18 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K. Workers' compensation products offered include guaranteed cost policies, policyholder dividend policies, retrospectively-rated policies, deductible policies and alternative market programs. Alternative market programs include program design, fronting, claims administration, risk management, SPC rental, asset management and SPC management services. Alternative market program premiums are 100% ceded to either the SPCs within our Segregated Portfolio Cell Reinsurance segment or, to a limited extent, an unaffiliated captive insurer for one program. Our Workers' Compensation Insurance segment results reflect pre-tax underwriting profit or loss from these workers' compensation products, exclusive of investment results, which are included in our Corporate segment. Segment results included the following:
Three Months Ended March 31
($ in thousands)20222021Change
Net premiums written$45,266 $46,884 $(1,618)(3.5 %)
Net premiums earned$40,684 $40,011 $673 1.7 %
Other income682 392 290 74.0 %
Net losses and loss adjustment expenses(27,211)(26,207)(1,004)3.8 %
Underwriting, policy acquisition and operating expenses(13,001)(12,286)(715)5.8 %
Segment results$1,154 $1,910 $(756)(39.6 %)
Net loss ratio66.9%65.5%1.4 pts
Underwriting expense ratio32.0%30.7%1.3 pts

Premiums Written
Our workers’ compensation premium volume is driven by five primary factors: (1) the amount of new business written, (2) retention of our existing book of business, (3) premium rates charged on our renewal book of business, (4) changes in payroll exposure and (5) audit premium.
Gross, ceded and net premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums written$72,118 $72,328 $(210)(0.3 %)
Less: Ceded premiums written26,852 25,444 1,408 5.5 %
Net premiums written$45,266 $46,884 $(1,618)(3.5 %)
Gross Premiums Written
Gross premiums written by product were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Traditional business:
Guaranteed cost$35,503 $38,196 $(2,693)(7.1 %)
Policyholder dividend7,862 7,520 342 4.5 %
Deductible2,120 2,052 68 3.3 %
Retrospective(1)
646 455 191 42.0 %
Other1,615 1,600 15 0.9 %
Alternative market business(2)
24,372 23,715 657 2.8 %
Change in EBUB estimate (1,210)1,210 nm
Total$72,118 $72,328 $(210)(0.3 %)
(1) The change in retrospectively-rated policies included an adjustment that decreased premium by $0.1 million for each of the three months ended March 31, 2022 and 2021.
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(2) A majority of alternative market premiums are ceded to SPCs in our Segregated Portfolio Cell Reinsurance segment. See further discussion on alternative market gross premiums written in our Segment Operating Results - Segregated Portfolio Cell Reinsurance section under the heading "Gross Premiums Written" that follows.
Gross premiums written remained relatively unchanged during the three months ended March 31, 2022 as compared to the same period of 2021 as decreases in new business, renewal retention and renewal rate changes were largely offset by an increase in audit premium and the prior year impact of the reduction of our EBUB estimate. Policy audits processed during the 2022 three-month period resulted in audit premium billed to policyholders totaling $1.7 million as compared to audit premium returned to policyholders of $0.8 million for the same period in 2021. We did not adjust our EBUB estimate for the 2022 three-month period; however, we reduced our EBUB estimate by $1.2 million for the same period in 2021. Renewal rate retention was 88% for the 2022 three-month period as compared to 90% for the same period of 2021. Renewal rate decreased 4% during the 2022 three-month period as compared to 3% during the same period of 2021. New business written decreased $2.1 million during the 2022 three-month period as compared to the same period of 2021, reflecting the competitive workers' compensation market conditions and a decrease in new business submissions in the 2022 three-month period.
We retained 100% of the nine workers’ compensation alternative market programs that were up for renewal during the three months ended March 31, 2022.
New business, audit premium, renewal retention and renewal price changes for our traditional business and the alternative market business are shown in the table below:
Three Months Ended March 31
20222021
($ in millions)Traditional BusinessAlternative Market BusinessSegment
Results
Traditional BusinessAlternative Market BusinessSegment
Results
New business$3.5 $1.1 $4.6 $5.9 $0.8 $6.7 
Audit premium (excluding EBUB)$0.1 $1.6 $1.7 $(1.0)$0.2 $(0.8)
Retention rate (1)
85 %92 %88 %89 %92 %90 %
Change in renewal pricing (2)
(4 %)(3 %)(4 %)(2 %)(5 %)(3 %)
(1) We calculate our workers' compensation retention rate as annualized expiring renewed premium divided by all annualized expiring premium subject to renewal. Our retention rate can be impacted by various factors, including price or other competitive issues, insureds being acquired, or a decision not to renew based on our underwriting evaluation.
(2) The pricing of our business includes an assessment of the underlying policy exposure and market conditions. We continue to base our pricing on expected losses, as indicated by our historical loss data.
Ceded Premiums Written
Ceded premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Premiums ceded to SPCs$21,488 $20,682 $806 3.9 %
Premiums ceded to external reinsurers3,155 2,974 181 6.1 %
Premiums ceded to unaffiliated captive insurer2,884 3,033 (149)(4.9 %)
Change in return premium estimate under external reinsurance29 (474)503 106.1 %
Estimated revenue share under external reinsurance(704)(771)67 (8.7 %)
Total ceded premiums written$26,852 $25,444 $1,408 5.5 %
Premiums ceded to SPCs represent alternative market business that is ceded under 100% quota share reinsurance agreements to the SPCs in our Segregated Portfolio Cell Reinsurance segment. Premiums ceded to an unaffiliated captive insurer represent alternative market business for one program that is ceded under a 100% quota share reinsurance agreement. Alternative market premiums written increased for the 2022 three-month period, which resulted in higher premiums ceded to SPCs. See further discussion on alternative market gross premiums written in our Segment Operating Results - Segregated Portfolio Cell Reinsurance section under the heading "Gross Premiums Written" that follows.
Under our external reinsurance treaty for traditional business, we retain the first $0.5 million in risk insured by us and cede losses in excess of this amount on each loss occurrence, subject to an AAD, equal to 3.5% of ceded earned premium for the treaty year effective May 1, 2021. Premiums ceded under our traditional reinsurance treaty are based on premium earned
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during the treaty period. The increase in premiums ceded to external reinsurers during the 2022 three-month period primarily reflected the increase in reinsurance rates effective May 1, 2021.
Changes in the return premium estimate reflected adjustments to our estimate of expected future recovery of ceded premium based on the underlying loss experience of our reinsurance treaties that include a provision for return premium. As shown in the table above, we decreased our estimate of return premium by a nominal amount during the 2022 three-month period as compared to an increase of $0.5 million during the same respective period in 2021. Changes in the estimated return premium primarily reflect adjustments to loss estimates on previously reported reinsured claims.
We are party to a revenue sharing agreement with our reinsurance broker under which we participate in the broker's revenue earned under our reinsurance treaties based on the volume of premium ceded. We estimate the amount of revenue we expect to receive under this agreement as premiums are recognized and ceded to the reinsurers.
Ceded Premiums Ratio
Ceded premiums ratio was as follows:
Three Months Ended March 31
20222021Change
Ceded premiums ratio, as reported33.3 %31.8 %1.5  pts
Less the effect of:
Premiums ceded to SPCs (100%)26.1 %25.9 %0.2  pts
Premiums ceded to unaffiliated captive insurers (100%)1.5 %1.7 %(0.2  pts)
Change in EBUB %0.1 %(0.1  pts)
Change in return premium estimate under external reinsurance0.1 %(1.1 %)1.2  pts
Estimated revenue share(1.6 %)(1.8 %)0.2  pts
Assumed premiums earned (not ceded to external reinsurers)(0.3 %)(0.3 %)—  pts
Ceded premiums ratio (related to external reinsurance), less the effects of above7.5 %7.3 %0.2  pts
The above table reflects traditional ceded premiums earned as a percent of traditional gross premiums earned. As discussed above, premiums ceded under our traditional reinsurance treaty are based on premiums earned during the treaty period. The increase in the ceded premiums ratio for the three months ended March 31, 2022 as compared to the same period in 2021 primarily reflected an increase in reinsurance rates.
Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that we cede to SPCs in our Segregated Portfolio Cell Reinsurance segment, external reinsurers (including changes related to the return premium and revenue share estimates) and the unaffiliated captive insurer. Because premiums are generally earned pro rata over the entire policy period, fluctuations in premiums earned tend to lag those of premiums written. Our workers’ compensation policies are twelve month term policies, and premiums are earned on a pro rata basis over the policy period. Net premiums earned also include premium adjustments related to the audit of our insureds' payrolls, changes in our EBUB estimate and premium adjustments related to retrospectively-rated policies. Payroll audits are conducted subsequent to the end of the policy period and any related premium adjustments processed are recorded as fully earned in the current period. In addition, we record an estimate for EBUB and evaluate the estimate on a quarterly basis.
Net premiums earned were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums earned$61,034 $58,632 $2,402 4.1 %
Less: Ceded premiums earned20,350 18,621 1,729 9.3 %
Net premiums earned$40,684 $40,011 $673 1.7 %
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The increase in net premiums earned during the three months ended March 31, 2022 as compared to the same period in 2021 primarily reflected the impact of the adjustment to EBUB in the prior year period. Excluding the adjustment to EBUB during the 2021 three-month period, net premiums earned decreased during the three months ended March 31, 2022 as compared to the same period in 2021 primarily due to the pro rata effect of a reduction in net premiums written during the preceding twelve months. The decrease in net premiums earned during the three months ended March 31, 2022 was partially offset by an increase in audit premium billed to policyholders.
Losses and Loss Adjustment Expenses
We estimate our current accident year loss and loss adjustment expenses by developing actual reported losses using historical loss development factors, adjusted to reflect current and expected trends based on various internal analyses and supplemental information. The following table summarizes calendar year net loss ratios by separating losses between the current accident year and all prior accident years. Calendar year and current accident year net loss ratios by component were as follows:
Three Months Ended March 31
20222021Change
Calendar year net loss ratio66.9 %65.5 %1.4  pts
Less impact of prior accident years on the net loss ratio(4.9 %)(5.5 %)0.6  pts
Current accident year net loss ratio71.8 %71.0 %0.8  pts
The increase in the current accident year net loss ratio during the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected the continuation of intense price competition and the resulting renewal rate decreases, partially offset by the impact of favorable prior year claim trends on the current year estimate. The current accident year net loss ratio for the three months ended March 31, 2022 also reflects an expectation that the labor shortage will continue to have an impact on claim activity during 2022.
Calendar year incurred losses (excluding IBNR) in excess of our per occurrence reinsurance retention, before consideration of the AAD (see previous discussion under the heading "Ceded Premiums Written"), increased $1.7 million for the three months ended March 31, 2022 as compared to the same period of 2021; however, of the $1.7 million, we retained losses in excess of our per occurrence retention totaling $1.0 million which reflected losses within the AAD. There were no current accident year reported losses ceded to reinsurers during the three months ended March 31, 2022 or 2021.
We recognized net favorable prior year development related to our previously established reserve of $2.0 million for the three months ended March 31, 2022 as compared to $2.2 million for the same period of 2021. The net favorable prior year reserve development for the three months ended March 31, 2022 and 2021 reflected overall favorable trends in claim closing patterns. Net favorable development for the 2022 three months ended was primarily related to accident years 2019 and prior. Net favorable development for the 2021 three-month period was primarily related to accident years 2017 and prior.
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Underwriting, Policy Acquisition and Operating Expenses
Underwriting, policy acquisition and operating expenses include the amortization of commissions, premium taxes and underwriting salaries, which are capitalized and deferred over the related workers’ compensation policy period, net of ceding commissions earned. The capitalization of underwriting salaries can vary as they are subject to the success rate of our contract acquisition efforts. These expenses also include a management fee charged by our Corporate segment, which represents intercompany charges pursuant to a management agreement, and the amortization of intangible assets, primarily related to the acquisition of Eastern by ProAssurance. The management fee is based on the extent to which services are provided to the subsidiary and the amount of premium written by the subsidiary.
Our Workers' Compensation Insurance segment underwriting, policy acquisition and operating expenses were comprised as follows:
Three Months Ended March 31
($ in thousands)20222021Change
DPAC amortization$7,061 $6,741 $320 4.7 %
Management fees541 542 (1)(0.2 %)
Other underwriting and operating expenses8,868 8,252 616 7.5 %
Policyholder dividend expense209 269 (60)(22.3 %)
SPC ceding commission offset(3,678)(3,518)(160)4.5 %
Total$13,001 $12,286 $715 5.8 %
The increase in DPAC amortization for the three months ended March 31, 2022 as compared to the same period in 2021 primarily reflected the increase in gross premiums earned.
The increase in other underwriting and operating expenses for the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected an increase in costs related to compensation, business-related travel, lease exit costs and an increase in the allowance for credit losses. Marketing costs included advertising and website-related activities that were planned for 2022. Business-related travel has increased as a result of the easing of pandemic-related restrictions. During the first quarter of 2022, we recognized one-time lease exit costs of $0.2 million due to the early termination of an office lease; however, as a result, we anticipate annual expense savings of approximately $0.1 million. The increase in the allowance for credit losses primarily reflects an increase in accounts greater than 90 days old, which we believe is a timing issue that will reverse in future periods.
As previously discussed, alternative market premiums written by our Workers' Compensation Insurance segment are 100% ceded, less a ceding commission, to either the SPCs in our Segregated Portfolio Cell Reinsurance segment or, to a limited extent, an unaffiliated captive insurer. The ceding commission charged to the SPCs consists of an amount for fronting fees, cell rental fees, commissions, premium taxes and risk management fees. The fronting fees, commissions, premium taxes and risk management fees are recorded as an offset to underwriting, policy acquisition and operating expenses. Cell rental fees are recorded as a component of other income and claims administration fees are recorded as ceded ULAE. The increase in SPC ceding commissions earned for the three months ended March 31, 2022 as compared to the same period of 2021, primarily reflected the increase in alternative market ceded earned premium.
Underwriting Expense Ratio (the Expense Ratio)
The underwriting expense ratio included the impact of the following:
Three Months Ended March 31
20222021Change
Underwriting expense ratio, as reported32.0 %30.7 %1.3  pts
Less estimated ratio increase (decrease) attributable to:
Impact of ceding commissions received from SPCs3.5 %2.9 %0.6  pts
Impact of audit premium(0.1 %)1.0 %(1.1  pts)
Change in return premium estimate under external reinsurance %(0.2 %)0.2  pts
Estimated revenue share(0.3 %)(0.4 %)0.1  pts
Underwriting expense ratio, less listed effects28.9 %27.4 %1.5  pts
Excluding the items noted in the table above, the expense ratio increased for the three months ended March 31, 2022, primarily reflecting the increase in other underwriting and operating expenses, as previously discussed.
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Segment Results - Segregated Portfolio Cell Reinsurance
The Segregated Portfolio Cell Reinsurance segment includes the results (underwriting profit or loss, plus investment results, net of U.S. federal income taxes) of SPCs at Inova Re and Eastern Re, our Cayman Islands SPC operations, as discussed in Note 18 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K. SPCs are segregated pools of assets and liabilities that provide an insurance facility for a defined set of risks. Assets of each SPC are solely for the benefit of that individual cell and each SPC is solely responsible for the liabilities of that individual cell. Assets of one SPC are statutorily protected from the creditors of the others. Each SPC is owned, fully or in part, by an individual company, agency, group or association and the results of the SPCs are attributable to the participants of that cell. We participate to a varying degree in the results of selected SPCs and, for the SPCs in which we participate, our participation interest ranges from a low of 20% to a high of 85%. SPC results attributable to external cell participants are reported as an SPC dividend (expense) income in our Segregated Portfolio Cell Reinsurance segment. In addition, our Segregated Portfolio Cell Reinsurance segment includes the investment results of the SPCs as the investments are solely for the benefit of the cell participants and investment results attributable to external cell participants are reflected in the SPC dividend (expense) income. As of March 31, 2022, there were 27 (4 inactive) SPCs. The SPCs assume workers' compensation insurance, healthcare professional liability insurance or a combination of the two from our Workers' Compensation Insurance and Specialty P&C segments. As of March 31, 2022, there were two SPCs that assumed both workers' compensation insurance and healthcare professional liability insurance and one SPC that assumed only healthcare professional liability insurance.
Segment results reflects our share of the underwriting and investment results of the SPCs in which we participate, and included the following:
Three Months Ended March 31
($ in thousands)20222021Change
Net premiums written$25,217 $22,188 $3,029 13.7 %
Net premiums earned$19,314 $15,884 $3,430 21.6 %
Net investment income112 221 (109)(49.3 %)
Net investment gains (losses)(711)987 (1,698)(172.0 %)
Other income1 — — %
Net losses and loss adjustment expenses(11,491)(9,425)(2,066)21.9 %
Underwriting, policy acquisition and operating expenses(4,369)(5,025)656 (13.1 %)
SPC U.S. federal income tax expense (1)
(642)(356)(286)80.3 %
SPC net results2,214 2,287 (73)(3.2 %)
SPC dividend (expense) income (2)
(2,367)(1,742)(625)35.9 %
Segment results (3)
$(153)$545 $(698)(128.1 %)
Net loss ratio59.5%59.3%0.2 pts
Underwriting expense ratio22.6%31.6%(9.0 pts)
(1) Represents the provision for U.S. federal income taxes for SPCs at Inova Re, which have elected to be taxed as a U.S. corporation under Section 953(d) of the Internal Revenue Code. U.S. federal income taxes are included in the total SPC net results and are paid by the individual SPCs.
(2) Represents the net (profit) loss attributable to external cell participants.
(3) Represents our share of the net profit (loss) of the SPCs in which we participate.


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Premiums Written
Premiums in our Segregated Portfolio Cell Reinsurance segment are assumed from either our Workers' Compensation Insurance or Specialty P&C segments. Premium volume is driven by five primary factors: (1) the amount of new business written, (2) retention of the existing book of business, (3) premium rates charged on the renewal book of business and, for workers' compensation business, (4) changes in payroll exposure and (5) audit premium.
Gross, ceded and net premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums written$28,369 $25,151 $3,218 12.8 %
Less: Ceded premiums written3,152 2,963 189 6.4 %
Net premiums written$25,217 $22,188 $3,029 13.7 %
Gross Premiums Written
Gross premiums written reflected reinsurance premiums assumed by component as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Workers' compensation$21,488 $20,682 $806 3.9 %
Healthcare professional liability6,881 4,469 2,412 54.0 %
Gross Premiums Written$28,369 $25,151 $3,218 12.8 %
Gross premiums written for the three months ended March 31, 2022 and 2021 were primarily comprised of workers' compensation coverages assumed from our Workers' Compensation Insurance segment. Workers' compensation gross premiums written increased during the three months ended March 31, 2022 as compared to the same period of 2021 driven by an increase in audit premium billed to policyholders and new business written, partially offset by renewal rate decreases of 3%. Healthcare professional liability gross premiums written increased during the three months ended March 31, 2022 as compared to the same period of 2021 driven by the effect of tail coverage premium primarily related to one program in which we do not participate, which resulted in $3.0 million of one-time premium written and fully earned. We retained 100% of the eight workers' compensation programs and one healthcare professional liability program up for renewal during the three months ended March 31, 2022.
New business, audit premium, retention and renewal price changes for the assumed workers' compensation premium is shown in the table below:
Three Months Ended March 31
($ in millions)20222021
New business$1.1 $0.8 
Audit premium$1.6 $0.2 
Retention rate (1)
92 %92 %
Change in renewal pricing (2)
(3 %)(5 %)
(1) We calculate our workers' compensation retention rate as annualized expiring renewed premium divided by all annualized expiring premium subject to renewal. Our retention rate can be impacted by various factors, including price or other competitive issues, insureds being acquired, or a decision not to renew based on our underwriting evaluation.
(2) The pricing of our business includes an assessment of the underlying policy exposure and market conditions. We continue to base our pricing on expected losses, as indicated by our historical loss data.
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Ceded Premiums Written
Ceded premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Ceded premiums written$3,152 $2,963 $189 6.4 %
For the workers' compensation business, each SPC has in place its own external reinsurance coverage. The healthcare professional liability business is assumed net of reinsurance from our Specialty P&C segment; therefore, there are no ceded premiums related to the healthcare professional liability business reflected in the table above. The risk retention for each loss occurrence for the workers' compensation business ranges from $0.3 million to $0.4 million based on the program, with limits up to $119.7 million. In addition, each program has aggregate reinsurance coverage between $1.1 million and $2.1 million on a program year basis. Premiums ceded under our SPC reinsurance treaty are based on premiums written during the treaty period. The change in ceded premiums written during the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected the change in workers' compensation gross premiums written and the impact of rate increases under the external reinsurance treaty. External reinsurance rates vary based on the alternative market program.
Ceded Premiums Ratio
Ceded premiums ratio was as follows:
Three Months Ended March 31
20222021Change
Ceded premiums ratio14.7%14.3%0.4 pts
The above table reflects ceded premiums as a percent of gross premiums written for the workers' compensation business only; healthcare professional liability business is assumed net of reinsurance, as discussed above. The ceded premiums ratio reflects the weighted average reinsurance rates of all SPC programs. The increase in the ceded premiums ratio for the three months ended March 31, 2022 primarily reflected an increase in reinsurance rates.
Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that the SPCs cede to external reinsurers. Because premiums are generally earned pro rata over the entire policy period, fluctuations in premiums earned tend to lag those of premiums written. Policies ceded to the SPCs are twelve month term policies and premiums are earned on a pro rata basis over the policy period. Net premiums earned also include premium adjustments related to the audit of workers' compensation insureds' payrolls. Payroll audits are conducted subsequent to the end of the policy period and any related adjustments are recorded as fully earned in the current period.
Gross, ceded and net premiums earned were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums earned$21,664 $17,967 $3,697 20.6 %
Less: Ceded premiums earned2,350 2,083 267 12.8 %
Net premiums earned$19,314 $15,884 $3,430 21.6 %
The increase in net premiums earned during the three months ended March 31, 2022 primarily reflected the aforementioned effect of $3.0 million of tail premium fully written and earned during the current period and the increase in audit premium billed to policyholders, partially offset by the pro rata effect of a reduction in net premiums written during the preceding twelve months.
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Losses and Loss Adjustment Expenses
The following table summarizes the calendar year net loss ratios by separating losses between the current accident year and all prior accident years. The current accident year net loss ratio reflected the aggregate loss ratio for all programs. Loss reserves are estimated for each program on a quarterly basis. Due to the size of some of the programs, quarterly loss results can create volatility in the current accident year net loss ratio from period to period.
Calendar year and current accident year net loss ratios for the three months ended March 31, 2022 and 2021 were as follows:
Three Months Ended March 31
20222021Change
Calendar year net loss ratio59.5 %59.3 %0.2  pts
Less impact of prior accident years on the net loss ratio(5.0 %)(9.6 %)4.6  pts
Current accident year net loss ratio64.5 %68.9 %(4.4  pts)
The current accident year net loss ratio decreased 4.4 percentage points for the three months ended March 31, 2022 as compared to the same period of 2021. The decrease in the current accident year net loss ratio for the three months ended March 31, 2022 primarily reflected favorable trends in prior accident year claim results and their impact on our analysis of the current accident year loss estimate, partially offset by the continuation of intense price competition and the resulting renewal rate decreases in the workers' compensation business.
Calendar year incurred losses (excluding IBNR) ceded to our external reinsurers decreased $2.8 million for the three months ended March 31, 2022 as compared to the same period of 2021. Current accident year ceded incurred losses (excluding IBNR) increased $0.1 million for the 2022 three-month period as compared to the same period of 2021.
We recognized net favorable prior year reserve development of $0.9 million for the three months ended March 31, 2022 as compared to $1.4 million for the same period of 2021. The net favorable prior year reserve development for the three months ended March 31, 2022 related entirely to workers’ compensation business, which reflected overall favorable trends in claim closing patterns primarily in accident years 2019 and 2020. The net favorable prior year reserve development for the three months ended March 31, 2021 also related entirely to the workers’ compensation business which primarily reflected overall favorable claim trends in claim closing patterns in accident years 2018 and 2019.
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Underwriting, Policy Acquisition and Operating Expenses
Our Segregated Portfolio Cell Reinsurance segment underwriting, policy acquisition and operating expenses were comprised as follows:
Three Months Ended March 31
($ in thousands)20222021Change
DPAC amortization$5,294 $4,636 $658 14.2 %
Policyholder dividend expense66 173 (107)(61.8 %)
Other underwriting and operating expenses(991)216 (1,207)(558.8 %)
Total$4,369 $5,025 $(656)(13.1 %)
DPAC amortization primarily represents ceding commissions, which vary by program and are paid to our Workers' Compensation Insurance and Specialty P&C segments for premiums assumed. Ceding commissions include an amount for fronting fees, commissions, premium taxes and risk management fees, which are reported as an offset to underwriting, policy acquisition and operating expenses within our Workers' Compensation Insurance and Specialty P&C segments. In addition, ceding commissions paid to our Workers' Compensation Insurance segment include cell rental fees which are recorded as other income and claims administration fees which are recorded as ceded ULAE within our Workers' Compensation Insurance segment.
Other underwriting and operating expenses primarily include bank fees, professional fees and changes in the allowance for expected credit losses. The decrease in other underwriting and operating expenses for the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected the change in our allowance for expected credit losses related to the collection of customer accounts that were previously written off.
The decrease in policyholder dividend expense for the three months ended March 31, 2022 as compared to the same period of 2021, related primarily to one SPC program, in which we do not participate.
Underwriting Expense Ratio (the Expense Ratio)
The underwriting expense ratio included the impact of the following:
Three Months Ended March 31
20222021Change
Underwriting expense ratio, as reported22.6%31.6%(9.0 pts)
Less: impact of audit premium on expense ratio(2.0%)(0.3%)(1.7 pts)
Underwriting expense ratio, excluding the effect of audit premium24.6%31.9%(7.3 pts)
Excluding the effect of audit premium, the underwriting expense ratio decreased for the 2022 three-month period. The decrease in the underwriting expense ratio for the 2022 three-month period primarily reflected the change in the allowance for expected credit losses and policyholder dividend expense, as discussed above.
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Ceded Premiums Written
Syndicate 1729 utilizesCeded premiums represent the amounts owed to our reinsurers for their assumption of a portion of our losses. Our HCPL and Medical Technology Liability excess of loss reinsurance arrangements renew annually on October 1. For those excess of loss reinsurance arrangements in effect prior to provideOctober 1, 2021, we generally retained the capacity to write larger limits of liability on individual risks, to provide protection against catastrophic lossfirst $2 million in risk insured by us and to provide protection against lossesceded coverages in excess of policy limits. As previously discussed, for the second half of 2020 Syndicate 6131 utilized external quota share reinsurancethis amount. Effective October 1, 2021, our HCPL treaty renewed at a lower gross rate and we generally retain from 0% to manage the net loss exposure on the specialty property and contingency coverages it assumed from Syndicate 1729 by ceding essentially half5% of the premium assumednext $24 million of risk for our HCPL coverages in excess of $2 million. Our HCPL excess of loss reinsurance arrangement that renewed on October 1, 2021 also incorporated NORCAL policies. Prior to an unaffiliated insurer; this agreement was non-renewedOctober 1, 2021, NORCAL policies were reinsured under separate reinsurance agreements, primarily excess of loss, which have historically renewed annually on January 1. For the NORCAL excess of loss reinsurance arrangement that renewed on January 1, 2021. Due to2021, retention was generally the quarter lag, the effectfirst $2 million in risk and coverages in excess of this amount were ceded up to $24 million. For our Medical Technology Liability treaty which also renewed effective October 1, 2021, we also retain 2.5% of the next $8 million of risk for coverages in excess of $2 million. There were no significant changes in the cost or structure of our Medical Technology Liability treaty upon the October 2021 renewal.
In certain of our excess of loss arrangements, the ultimate amount of ceded premium is determined by the loss experience of the business ceded, subject to certain minimum and maximum amounts. Given the length of time that it takes to resolve our claims, many years may elapse before all losses recoverable under a reinsurance arrangement was not reflectedare known. As a part of the process of estimating our loss reserve we also make estimates regarding the amounts recoverable under our reinsurance arrangements. As a result, we may have an adjustment to our estimate of expected losses and associated recoveries for prior year ceded losses under certain loss sensitive reinsurance agreements. Any changes to estimates of premiums ceded related to prior accident years are fully earned in our results until the fourth quarterperiod the changes in estimates occur.
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Ceded premiums written increased forwere as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Excess of loss reinsurance arrangements (1)
$9,496 $7,678 $1,818 23.7 %
Other shared risk arrangements (2)
4,336 3,963 373 9.4 %
Premium ceded to SPCs (3)
6,881 4,469 2,412 54.0 %
Other ceded premiums written(4)
2,121 866 1,255 144.9 %
Total ceded premiums written$22,834 $16,976 $5,858 34.5 %
(1) We generally reinsure risks under our excess of loss reinsurance arrangements pursuant to which the three months ended March 31, 2021reinsurers agree to assume all or a portion of all risks that we insure above our individual risk retention levels, up to the maximum individual limits offered. Premium due to reinsurers also fluctuates with the volume of written premium subject to cession under the arrangement. In certain of our excess of loss reinsurance arrangements, the premium due to the reinsurer is determined by the loss experience of that business reinsured, subject to certain minimum and maximum amounts. The increase in ceded premiums written under our excess of loss reinsurance arrangements during the 2022 three-month period as compared to the same period of 20202021 was driven by additional ceded premiums of $4.4 million as a result of incorporating NORCAL policies into our existing HCPL excess of loss reinsurance arrangements with the October 1, 2021 renewal, as previously discussed. Excluding NORCAL, ceded premiums written under our excess of loss reinsurance arrangements decreased by approximately $2.4 million primarily due to a decrease in the overall volume of gross premiums written subject to cession and, to a lesser extent, the reduced rate on the treaty year effective October 1, 2021.
(2) We have entered into various shared risk arrangements, including quota share, fronting, and captive arrangements, with certain large healthcare systems and other insurance entities. While we cede a large portion of the premium written under these arrangements, they provide us an opportunity to grow net premium through strategic partnerships. These arrangements primarily include our Ascension Health program. Ceded premiums written under our shared risk arrangements during the 2022 three-month period remained relatively unchanged as compared to the same period of 2021.
(3) As previously discussed, as a part of our alternative market solutions, all or a portion of certain healthcare premium written is ceded to SPCs in our Segregated Portfolio Cell Reinsurance segment under either excess of loss or quota share reinsurance agreements, depending on the structure of the individual program. See the Segment Results - Segregated Portfolio Cell Reinsurance section for further discussion on the cession to the SPCs from our Specialty P&C segment. The increase in premiums ceded to SPCs during the 2022 three-month period as compared to the same period of 2021 was driven by the impact of tail coverages, primarily related to one program (see discussion in footnote 12 under the heading "Gross Premiums Written").
(4) The increase in other ceded premiums written during the 2022 three-month period as compared to the same period of 2021 was primarily driven by the incorporation of NORCAL's cyber liability coverages into our existing HCPL cyber liability arrangement with the October 1, 2021 renewal.
Ceded Premiums Ratio
The ceded under Syndicate 6131's six-month quota share agreement,premiums ratio was as follows:
Three Months Ended March 31
 20222021Change
Ceded premiums ratio8.9%12.3%(3.4 pts)
The above table reflects ceded premiums written as a percent of gross premiums written. The decrease in our ceded premiums ratio for the 2022 three-month period as compared to the same period of 2021 was driven by the reduced rate on our excess of loss reinsurance arrangements for the treaty year effective October 1, 2021 as well as the impact of the addition of the NORCAL gross written premium base for the 2022 three-month period. The decrease in our ceded premiums ratio for the 2022 three-month period as compared to the same period of 2021 was partially offset by our decreased participationan increase in premiums ceded to SPCs. See additional discussion on NORCAL ceded premiums and premiums ceded to SPCs above under the results of Syndicate 1729.heading "Ceded Premiums Written."
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Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that the Syndicateswe cede to our reinsurers for their assumption of a portion of our losses. Premiums written through open-market channelsBecause premiums are generally earned pro rata over the entire policy period, which is predominately twelve months, whereas premiums written through delegated underwriting authority arrangements are earned over twenty-four months. Therefore, net premiums earned is affected by shifts in the mix of policies written between the open-market and delegated underwriting authority arrangements. Additionally, net premiums earned consists of a mix of policies earned from different open underwriting years. As previously discussed, we participate to a varying degree in each open underwriting year which may cause fluctuations in premiums earned. Furthermore, fluctuations in premiums earned tend to lag those of premiums written. The majority of our policies carry a term of one year; however, some of our Medical Technology Liability policies have a multi-year term and some of our NORCAL Standard Physician policies have a three-month term. In addition, prior to the third quarter of 2020, we wrote certain Standard Physician policies with a twenty-four month term. Tail coverage premiums are generally 100% earned in the period written because the policies insure only incidents that occurred in prior periods and are not cancellable. Retroactive coverage premiums are 100% earned at the inception of the contract, as all of the associated underlying loss events occurred in the past. Additionally, any ceded premium changes due to changes to estimates of premiums owed under reinsurance agreements for prior accident years are fully earned in the period of change.
Net premiums earned were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums earned$212,279 $132,060 $80,219 60.7 %
Less: Ceded premiums earned14,312 16,447 (2,135)(13.0 %)
Net premiums earned$197,967 $115,613 $82,354 71.2 %
Gross premiums earned during the 2022 three-month period included additional earned premiums of approximately $79.7 million from our acquisition of NORCAL. Excluding premiums associated with the NORCAL acquisition, gross premiums earned remained relatively unchanged during the 2022 three-month period as compared to the same period of 2021.
Ceded premiums earned decreased during the 2022 three-month period as compared to the same period of 2021 driven by the pro rata effect of a decrease in premium ceded under our shared risk and excess of loss arrangements during the preceding twelve months.
Losses and Loss Adjustment Expenses
The determination of calendar year losses involves the actuarial evaluation of incurred losses for the current accident year and the actuarial re-evaluation of incurred losses for prior accident years, including an evaluation of the reserve amounts required for ECO/XPL losses. As part of the review of our prior accident year reserves, we also make estimates of expected losses and associated recoveries for prior year ceded losses under certain loss sensitive reinsurance agreements. This analysis may result in changes to estimates of premiums owed under reinsurance agreements for prior accident years which impact net premiums earned (the denominator of the net loss ratio) in the period the adjustment is made. No such adjustments were made during the three months ended March 31, 2022 or 2021. See previous discussion under the heading "Ceded Premiums Written" for additional information.
Accident year refers to the accounting period in which the insured event becomes a liability of the insurer. For claims-made policies, which represent the majority of the premiums written in our Specialty P&C segment, the insured event generally becomes a liability when the event is first reported to us. For occurrence policies, the insured event becomes a liability when the event takes place. For retroactive coverages, the insured event becomes a liability at inception of the underlying contract. We believe that measuring losses on an accident year basis is the best measure of the underlying profitability of the premiums earned in that period, since it associates policy premiums earned with the estimate of the losses incurred related to those policy premiums.
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The following table summarizes calendar year net loss ratios for our Specialty P&C segment by separating losses between the current accident year and all prior accident years. In addition, net loss ratios for the three months ended March 31, 2022 in the following table include the impact of NORCAL.
Net Loss Ratios (1)
Three Months Ended March 31
20222021Change
Calendar year net loss ratio83.8 %87.5 %(3.7  pts)
Less impact of prior accident years on the net loss ratio(2.0 %)(2.3 %)0.3  pts
Current accident year net loss ratio (2)
85.8 %89.8 %(4.0  pts)
(1)Net losses, as specified, divided by net premiums earned.
(2)Our current accident year net loss ratio (as shown in the table above) decreased 4.0 percentage points during the three months ended March 31, 2022 as compared to the same period of 2021. The change in our current accident year net loss ratio in each period was primarily attributable to the following:
(In percentage points)Increase (Decrease)
2022 versus 2021
Comparative
three-month
period
Estimated ratio increase (decrease) attributable to:
NORCAL Operations4.0 pts
NORCAL Acquisition - Purchase Accounting Adjustment(1.2 pts)
Change in Estimate of ULAE(3.7 pts)
All other, net(3.1 pts)
Decrease in current accident year net loss ratio(4.0 pts)
Excluding the impact of the items specifically identified in the table above, our current accident year net loss ratio for the three months ended March 31, 2022 improved 3.1 percentage points as compared to the prior year period driven by a decrease to certain loss ratios in our Standard Physician line of business, which we began recognizing in the second half of 2021 and, to a lesser extent, changes in the mix of business. We continue to observe a reduction in claims frequency that started to emerge in 2020, some of which is due to our re-underwriting efforts and some of which, we believe, is associated with the COVID-19 pandemic including the disruption of the court systems. Given the consistent and prolonged nature of this favorable claims frequency trend, we reduced certain loss ratios in our Standard Physician line of business during the third and fourth quarters of 2021. We continue to remain cautious in recognizing the full impact of these favorable trends in our current accident year reserve due to the long-tailed nature of our HCPL claims as well as the uncertainty surrounding the length and severity of the pandemic.
Initial loss ratios associated with NORCAL policies were higher than the average for our other books of business in this segment. The impact of NORCAL operations resulted in a 4.0 percentage point increase in our current accident year net loss ratio for the three months ended March 31, 2022. We continue the process of evaluating the NORCAL book of business and implementing ProAssurance's underwriting strategies. Also as a result of our acquisition of NORCAL, our current accident year net loss ratio for the three months ended March 31, 2022 was impacted by amortization of the negative VOBA associated with NORCAL's assumed unearned premium which is recorded as a reduction to current accident year net losses and accounted for a 1.2 percentage point decrease in our current period ratio. The remaining unamortized negative VOBA will be fully amortized in the second quarter of 2022 (see Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for additional information on the remaining expected amortization of the NORCAL acquisition purchase accounting adjustments).
During the first quarter of 2022, we decreased our estimate of ULAE as a result of substantially integrating NORCAL into our Specialty P&C segment operations, which accounted for a 3.7 percentage point decrease in our current period accident year loss ratio with an offsetting 3.7 percentage point increase in our current period expense ratio with no impact to our combined ratio or segment results (see discussion on our expense ratio in the following section under the heading "Underwriting, Policy Acquisition and Operating Expenses"). This change in estimated ULAE had no impact on our combined ratio or segment results.
We re-evaluate our previously established reserve each quarter based upon the most recently completed actuarial analysis supplemented by any new analysis, information or trends that have emerged since the date of that study. We also take into account currently available industry trend information.
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We recognized net favorable prior accident year reserve development of $3.9 million during the three months ended March 31, 2022 as compared to $2.7 million during the same period of 2021. Net favorable development recognized during the three months ended March 31, 2022 was net of an increase in our reserve for potential ECO/XPL claims of $4.0 million as compared to a reduction in this same reserve of $0.2 million during the same period of 2021. Furthermore, net favorable development recognized during the three months ended March 31, 2022 included $2.9 million related to the amortization of the purchase accounting fair value adjustment on NORCAL's assumed net reserve and amortization of the negative VOBA associated with NORCAL's DDR reserve which is recorded as a reduction to prior accident year net losses and loss adjustment expenses. See Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for additional information on the remaining expected amortization of the NORCAL acquisition purchase accounting adjustments. We have not recognized any development related to NORCAL's prior accident year reserves since the date of acquisition on May 5, 2021. Excluding the increase in the ECO/XPL reserve and amortization of purchase accounting adjustments, we recognized net favorable prior accident year reserve development of $5.0 million during the three months ended March 31, 2022, principally related to accident years 2019 through 2021. Development recognized during the three months ended March 31, 2021 principally related to accident years 2017 and 2018.
A detailed discussion of factors influencing our recognition of loss development is included in our Critical Accounting Estimates section under the heading "Reserve for Losses and Loss Adjustment Expenses" in our December 31, 2021 report on Form 10-K. Assumptions used in establishing our reserve are regularly reviewed and updated by management as new data becomes available. Any adjustments necessary are reflected in the then current operations. Due to the size of our reserve, even a small percentage adjustment to the assumptions can have a material effect on our results of operations for the period in which the change is made, as was the case in both 2022 and 2021.
Underwriting, Policy Acquisition and Operating Expenses
Our Specialty P&C segment underwriting, policy acquisition and operating expenses, including NORCAL expenses for the 2022 three-month period, were comprised as follows:
Three Months Ended March 31
($ in thousands)20222021Change
DPAC amortization$21,740 $12,396 $9,344 75.4 %
Management fees1,402 1,001 401 40.1 %
Other underwriting and operating expenses19,736 12,949 6,787 52.4 %
Total$42,878 $26,346 $16,532 62.7 %
DPAC amortization for the 2022 three-month period included approximately $8.1 million of DPAC amortization associated with NORCAL policies written subsequent to our acquisition; however, this level of DPAC amortization is approximately $1.0 million lower than would be considered normal for the quarter due to the application of GAAP purchase accounting rules whereby the capitalized policy acquisition costs for policies written prior to the acquisition date were written off through purchase accounting on May 5, 2021 rather than being expensed pro rata over the remaining term of the associated policies (see Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for more information). The remaining increase in DPAC amortization for the 2022 three-month period as compared to the same period of 2021 reflected an increase in brokerage expenses due to our increased participation with an international medical professional liability insurer in our Specialty line of business (see discussion under the heading "Gross Premiums Written").
Management fees are charged pursuant to a management agreement by the Corporate segment to the operating subsidiaries within our Specialty P&C segment for services provided based on the extent to which services are provided to the subsidiary and the amount of premium written by the subsidiary. Fluctuations in the amount of premium written by each subsidiary can result in corresponding variations in the management fee charged to each subsidiary during a particular period. Due to continued organizational structure enhancements in our Specialty P&C segment during 2021 as well as operational alignments as a result of the integration of NORCAL, the extent to which services are provided by the Corporate segment to the operating subsidiaries within the segment decreased further effective January 1, 2022. Accordingly, we reduced the fee charged to the operating subsidiaries in 2022. Also effective January 1, 2022, the management agreement included operating subsidiaries of NORCAL contributing to $0.6 million of additional management fees in the current period.
Other underwriting and operating expenses increased during the 2022 three-month period primarily due to the addition of expenses contributed by NORCAL as well as a decrease in our estimate of ULAE which resulted in approximately $7.3 million of expenses remaining in operating expenses instead of being allocated to net losses and loss adjustment expenses. As a result, this change in ULAE estimate had offsetting impacts to our loss and expense ratios during the period with no impact to our combined ratio or segment results. See additional discussion on this change in ULAE estimate in the previous section under the heading "Losses and Loss Adjustment Expenses." Excluding expenses contributed by NORCAL and the impact of the change
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in ULAE, other underwriting and operating expenses decreased due to benefits from prior organizational restructurings and proactive expense management, somewhat offset by one-time expenses of $1.6 million incurred during the current period mainly comprised of one-time bonuses, employee severance charges and lease exit costs.
Underwriting Expense Ratio (the Expense Ratio)
Our expense ratio for the Specialty P&C segment was as follows:
 Three Months Ended March 31
 20222021Change
Underwriting expense ratio21.7 %22.8 %(1.1  pts)
The change in our expense ratio for the 2022 three-month period as compared to the same period of 2021 was primarily attributable to the following:
Increase (Decrease)
 2022 versus 2021
(In percentage points)Comparative three-month period
Estimated ratio increase (decrease) attributable to:
Increase in Net Premiums Earned and DPAC amortization(1)
0.3 pts
Change in Estimate of ULAE3.7 pts
Tail Premium(2)
(1.2 pts)
All other, net(3.9 pts)
Decrease in the underwriting expense ratio(1.1 pts)
(1) Excludes tail premium for the three months ended March 31, 2022 and 2021.
(2) Represents the effect of the premium earned from tail policies for the three months ended March 31, 2022 as compared to the same period of 2021 as there is typically minimal expense associated with tail premium (see discussion under the heading "Gross Premiums Written").
Excluding the items specifically identified in the table above, our expense ratio for the 2022 three-month period decreased by 3.9 percentage points primarily due to lower operating expenses due to the benefits from prior organizational restructurings and proactive expense management as well as expense synergies recognized from the NORCAL acquisition. However, as previously discussed, DPAC amortization associated with NORCAL recorded during the 2022 three-month period was lower than would be considered normal for the quarter due to the application of GAAP purchase accounting rules. Normalizing this amortization would have increased our expense ratio for the 2022 three-month period by an estimated 0.5 percentage points.
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Segment Results - Workers' Compensation Insurance
Our Workers' Compensation Insurance segment includes workers' compensation products provided to employers generally with 1,000 or fewer employees, as discussed in Note 18 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K. Workers' compensation products offered include guaranteed cost policies, policyholder dividend policies, retrospectively-rated policies, deductible policies and assumedalternative market programs. Alternative market programs include program design, fronting, claims administration, risk management, SPC rental, asset management and SPC management services. Alternative market program premiums are 100% ceded to either the SPCs within our Segregated Portfolio Cell Reinsurance segment or, to a limited extent, an unaffiliated captive insurer for one program. Our Workers' Compensation Insurance segment results reflect pre-tax underwriting profit or loss from these workers' compensation products, exclusive of investment results, which are included in our Corporate segment. Segment results included the following:
Three Months Ended March 31
($ in thousands)20222021Change
Net premiums written$45,266 $46,884 $(1,618)(3.5 %)
Net premiums earned$40,684 $40,011 $673 1.7 %
Other income682 392 290 74.0 %
Net losses and loss adjustment expenses(27,211)(26,207)(1,004)3.8 %
Underwriting, policy acquisition and operating expenses(13,001)(12,286)(715)5.8 %
Segment results$1,154 $1,910 $(756)(39.6 %)
Net loss ratio66.9%65.5%1.4 pts
Underwriting expense ratio32.0%30.7%1.3 pts

Premiums Written
Our workers’ compensation premium volume is driven by five primary factors: (1) the amount of new business written, (2) retention of our existing book of business, (3) premium rates charged on our renewal book of business, (4) changes in payroll exposure and (5) audit premium.
Gross, ceded and net premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums written$72,118 $72,328 $(210)(0.3 %)
Less: Ceded premiums written26,852 25,444 1,408 5.5 %
Net premiums written$45,266 $46,884 $(1,618)(3.5 %)
Gross Premiums Written
Gross premiums written by product were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Traditional business:
Guaranteed cost$35,503 $38,196 $(2,693)(7.1 %)
Policyholder dividend7,862 7,520 342 4.5 %
Deductible2,120 2,052 68 3.3 %
Retrospective(1)
646 455 191 42.0 %
Other1,615 1,600 15 0.9 %
Alternative market business(2)
24,372 23,715 657 2.8 %
Change in EBUB estimate (1,210)1,210 nm
Total$72,118 $72,328 $(210)(0.3 %)
(1) The change in retrospectively-rated policies included an adjustment that decreased premium by $0.1 million for each of the three months ended March 31, 2022 and 2021.
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(2) A majority of alternative market premiums are ceded to SPCs in our Segregated Portfolio Cell Reinsurance segment. See further discussion on alternative market gross premiums written in our Segment Operating Results - Segregated Portfolio Cell Reinsurance section under the heading "Gross Premiums Written" that follows.
Gross premiums written remained relatively unchanged during the three months ended March 31, 2022 as compared to the same period of 2021 as decreases in new business, renewal retention and renewal rate changes were largely offset by an increase in audit premium and the prior year impact of the reduction of our EBUB estimate. Policy audits processed during the 2022 three-month period resulted in audit premium billed to policyholders totaling $1.7 million as compared to audit premium returned to policyholders of $0.8 million for the same period in 2021. We did not adjust our EBUB estimate for the 2022 three-month period; however, we reduced our EBUB estimate by $1.2 million for the same period in 2021. Renewal rate retention was 88% for the 2022 three-month period as compared to 90% for the same period of 2021. Renewal rate decreased 4% during the 2022 three-month period as compared to 3% during the same period of 2021. New business written decreased $2.1 million during the 2022 three-month period as compared to the same period of 2021, reflecting the competitive workers' compensation market conditions and a decrease in new business submissions in the 2022 three-month period.
We retained 100% of the nine workers’ compensation alternative market programs that were up for renewal during the three months ended March 31, 2022.
New business, audit premium, renewal retention and renewal price changes for our traditional business and the alternative market business are shown in the table below:
Three Months Ended March 31
20222021
($ in millions)Traditional BusinessAlternative Market BusinessSegment
Results
Traditional BusinessAlternative Market BusinessSegment
Results
New business$3.5 $1.1 $4.6 $5.9 $0.8 $6.7 
Audit premium (excluding EBUB)$0.1 $1.6 $1.7 $(1.0)$0.2 $(0.8)
Retention rate (1)
85 %92 %88 %89 %92 %90 %
Change in renewal pricing (2)
(4 %)(3 %)(4 %)(2 %)(5 %)(3 %)
(1) We calculate our workers' compensation retention rate as annualized expiring renewed premium divided by all annualized expiring premium subject to renewal. Our retention rate can be impacted by various factors, including price or other competitive issues, insureds being acquired, or a decision not to renew based on our underwriting evaluation.
(2) The pricing of our business includes an assessment of the underlying policy exposure and market conditions. We continue to base our pricing on expected losses, as indicated by our historical loss data.
Ceded Premiums Written
Ceded premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Premiums ceded to SPCs$21,488 $20,682 $806 3.9 %
Premiums ceded to external reinsurers3,155 2,974 181 6.1 %
Premiums ceded to unaffiliated captive insurer2,884 3,033 (149)(4.9 %)
Change in return premium estimate under external reinsurance29 (474)503 106.1 %
Estimated revenue share under external reinsurance(704)(771)67 (8.7 %)
Total ceded premiums written$26,852 $25,444 $1,408 5.5 %
Premiums ceded to SPCs represent alternative market business that is ceded under 100% quota share reinsurance contractsagreements to the SPCs in our Segregated Portfolio Cell Reinsurance segment. Premiums ceded to an unaffiliated captive insurer represent alternative market business for one program that is ceded under a 100% quota share reinsurance agreement. Alternative market premiums written increased for the 2022 three-month period, which resulted in higher premiums ceded to SPCs. See further discussion on alternative market gross premiums written in our Segment Operating Results - Segregated Portfolio Cell Reinsurance section under the heading "Gross Premiums Written" that follows.
Under our external reinsurance treaty for traditional business, we retain the first $0.5 million in risk insured by us and cede losses in excess of this amount on each loss occurrence, subject to an AAD, equal to 3.5% of ceded earned premium for the treaty year effective May 1, 2021. Premiums ceded under our traditional reinsurance treaty are based on premium earned
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during the treaty period. The increase in premiums ceded to external reinsurers during the 2022 three-month period primarily reflected the increase in reinsurance rates effective May 1, 2021.
Changes in the return premium estimate reflected adjustments to our estimate of expected future recovery of ceded premium based on the underlying loss experience of our reinsurance treaties that include a provision for return premium. As shown in the table above, we decreased our estimate of return premium by a nominal amount during the 2022 three-month period as compared to an increase of $0.5 million during the same respective period in 2021. Changes in the estimated return premium primarily reflect adjustments to loss estimates on previously reported reinsured claims.
We are party to a revenue sharing agreement with our reinsurance broker under which we participate in the broker's revenue earned under our reinsurance treaties based on the volume of premium ceded. We estimate the amount of revenue we expect to receive under this agreement as premiums are recognized and ceded to the reinsurers.
Ceded Premiums Ratio
Ceded premiums ratio was as follows:
Three Months Ended March 31
20222021Change
Ceded premiums ratio, as reported33.3 %31.8 %1.5  pts
Less the effect of:
Premiums ceded to SPCs (100%)26.1 %25.9 %0.2  pts
Premiums ceded to unaffiliated captive insurers (100%)1.5 %1.7 %(0.2  pts)
Change in EBUB %0.1 %(0.1  pts)
Change in return premium estimate under external reinsurance0.1 %(1.1 %)1.2  pts
Estimated revenue share(1.6 %)(1.8 %)0.2  pts
Assumed premiums earned (not ceded to external reinsurers)(0.3 %)(0.3 %)—  pts
Ceded premiums ratio (related to external reinsurance), less the effects of above7.5 %7.3 %0.2  pts
The above table reflects traditional ceded premiums earned as a percent of traditional gross premiums earned. As discussed above, premiums ceded under our traditional reinsurance treaty are based on premiums earned during the treaty period. The increase in the ceded premiums ratio for the three months ended March 31, 2022 as compared to the same period in 2021 primarily reflected an increase in reinsurance rates.
Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that we cede to SPCs in our Segregated Portfolio Cell Reinsurance segment, external reinsurers (including changes related to the return premium and revenue share estimates) and the unaffiliated captive insurer. Because premiums are generally earned pro rata over the entire policy period, fluctuations in premiums earned tend to lag those of premiums written. Our workers’ compensation policies are twelve month term policies, and premiums are earned on a pro rata basis over the policy period. Net premiums earned also include premium adjustments related to the audit of our insureds' payrolls, changes in our EBUB estimate and premium adjustments related to retrospectively-rated policies. Payroll audits are conducted subsequent to the coverageend of the policy period and/and any related premium adjustments processed are recorded as fully earned in the current period. In addition, we record an estimate for EBUB and evaluate the estimate on a quarterly basis.
Net premiums earned were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums earned$61,034 $58,632 $2,402 4.1 %
Less: Ceded premiums earned20,350 18,621 1,729 9.3 %
Net premiums earned$40,684 $40,011 $673 1.7 %
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The increase in net premiums earned during the three months ended March 31, 2022 as compared to the same period in 2021 primarily reflected the impact of the adjustment to EBUB in the prior year period. Excluding the adjustment to EBUB during the 2021 three-month period, net premiums earned decreased during the three months ended March 31, 2022 as compared to the same period in 2021 primarily due to the pro rata effect of a reduction in net premiums written during the preceding twelve months. The decrease in net premiums earned during the three months ended March 31, 2022 was partially offset by an increase in audit premium billed to policyholders.
Losses and Loss Adjustment Expenses
We estimate our current accident year loss and loss adjustment expenses by developing actual reported losses using historical loss development factors, adjusted to reflect current and expected trends based on various internal analyses and supplemental information. The following table summarizes calendar year net loss ratios by separating losses between the current accident year and all prior accident years. Calendar year and current accident year net loss ratios by component were as follows:
Three Months Ended March 31
20222021Change
Calendar year net loss ratio66.9 %65.5 %1.4  pts
Less impact of prior accident years on the net loss ratio(4.9 %)(5.5 %)0.6  pts
Current accident year net loss ratio71.8 %71.0 %0.8  pts
The increase in the current accident year net loss ratio during the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected the continuation of intense price competition and the resulting renewal rate decreases, partially offset by the impact of favorable prior year claim trends on the current year estimate. The current accident year net loss ratio for the three months ended March 31, 2022 also reflects an expectation that the labor shortage will continue to have an impact on claim activity during 2022.
Calendar year incurred losses (excluding IBNR) in excess of our per occurrence reinsurance retention, before consideration of the AAD (see previous discussion under the heading "Ceded Premiums Written"), increased $1.7 million for the three months ended March 31, 2022 as compared to the same period of 2021; however, of the $1.7 million, we retained losses in excess of our per occurrence retention totaling $1.0 million which reflected losses within the AAD. There were no current accident year reported losses ceded to reinsurers during the three months ended March 31, 2022 or may be2021.
We recognized net favorable prior year development related to our previously established reserve of $2.0 million for the three months ended March 31, 2022 as compared to $2.2 million for the same period of 2021. The net favorable prior year reserve development for the three months ended March 31, 2022 and 2021 reflected overall favorable trends in claim closing patterns. Net favorable development for the 2022 three months ended was primarily related to accident years 2019 and prior. Net favorable development for the 2021 three-month period was primarily related to accident years 2017 and prior.
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Underwriting, Policy Acquisition and Operating Expenses
Underwriting, policy acquisition and operating expenses include the amortization of commissions, premium taxes and underwriting salaries, which are capitalized and deferred over the related workers’ compensation policy period, net of ceding commissions earned. The capitalization of underwriting salaries can vary as they are subject to adjustmentthe success rate of our contract acquisition efforts. These expenses also include a management fee charged by our Corporate segment, which represents intercompany charges pursuant to a management agreement, and the amortization of intangible assets, primarily related to the acquisition of Eastern by ProAssurance. The management fee is based on the extent to which services are provided to the subsidiary and the amount of premium written by the subsidiary.
Our Workers' Compensation Insurance segment underwriting, policy acquisition and operating expenses were comprised as follows:
Three Months Ended March 31
($ in thousands)20222021Change
DPAC amortization$7,061 $6,741 $320 4.7 %
Management fees541 542 (1)(0.2 %)
Other underwriting and operating expenses8,868 8,252 616 7.5 %
Policyholder dividend expense209 269 (60)(22.3 %)
SPC ceding commission offset(3,678)(3,518)(160)4.5 %
Total$13,001 $12,286 $715 5.8 %
The increase in DPAC amortization for the three months ended March 31, 2022 as compared to the same period in 2021 primarily reflected the increase in gross premiums earned.
The increase in other underwriting and operating expenses for the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected an increase in costs related to compensation, business-related travel, lease exit costs and an increase in the allowance for credit losses. Marketing costs included advertising and website-related activities that were planned for 2022. Business-related travel has increased as a result of the easing of pandemic-related restrictions. During the first quarter of 2022, we recognized one-time lease exit costs of $0.2 million due to the early termination of an office lease; however, as a result, we anticipate annual expense savings of approximately $0.1 million. The increase in the allowance for credit losses primarily reflects an increase in accounts greater than 90 days old, which we believe is a timing issue that will reverse in future periods.
As previously discussed, alternative market premiums written by our Workers' Compensation Insurance segment are 100% ceded, less a ceding commission, to either the SPCs in our Segregated Portfolio Cell Reinsurance segment or, to a limited extent, an unaffiliated captive insurer. The ceding commission charged to the SPCs consists of an amount for fronting fees, cell rental fees, commissions, premium taxes and risk management fees. The fronting fees, commissions, premium taxes and risk management fees are recorded as an offset to underwriting, policy acquisition and operating expenses. Cell rental fees are recorded as a component of other income and claims administration fees are recorded as ceded ULAE. The increase in SPC ceding commissions earned for the three months ended March 31, 2022 as compared to the same period of 2021, primarily reflected the increase in alternative market ceded earned premium.
Underwriting Expense Ratio (the Expense Ratio)
The underwriting expense ratio included the impact of the following:
Three Months Ended March 31
20222021Change
Underwriting expense ratio, as reported32.0 %30.7 %1.3  pts
Less estimated ratio increase (decrease) attributable to:
Impact of ceding commissions received from SPCs3.5 %2.9 %0.6  pts
Impact of audit premium(0.1 %)1.0 %(1.1  pts)
Change in return premium estimate under external reinsurance %(0.2 %)0.2  pts
Estimated revenue share(0.3 %)(0.4 %)0.1  pts
Underwriting expense ratio, less listed effects28.9 %27.4 %1.5  pts
Excluding the items noted in the table above, the expense ratio increased for the three months ended March 31, 2022, primarily reflecting the increase in other underwriting and operating expenses, as previously discussed.
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Segment Results - Segregated Portfolio Cell Reinsurance
The Segregated Portfolio Cell Reinsurance segment includes the results (underwriting profit or loss, experience. Theseplus investment results, net of U.S. federal income taxes) of SPCs at Inova Re and Eastern Re, our Cayman Islands SPC operations, as discussed in Note 18 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K. SPCs are segregated pools of assets and liabilities that provide an insurance facility for a defined set of risks. Assets of each SPC are solely for the benefit of that individual cell and each SPC is solely responsible for the liabilities of that individual cell. Assets of one SPC are statutorily protected from the creditors of the others. Each SPC is owned, fully or in part, by an individual company, agency, group or association and the results of the SPCs are attributable to the participants of that cell. We participate to a varying degree in the results of selected SPCs and, for the SPCs in which we participate, our participation interest ranges from a low of 20% to a high of 85%. SPC results attributable to external cell participants are reported as an SPC dividend (expense) income in our Segregated Portfolio Cell Reinsurance segment. In addition, our Segregated Portfolio Cell Reinsurance segment includes the investment results of the SPCs as the investments are solely for the benefit of the cell participants and investment results attributable to external cell participants are reflected in the SPC dividend (expense) income. As of March 31, 2022, there were 27 (4 inactive) SPCs. The SPCs assume workers' compensation insurance, healthcare professional liability insurance or a combination of the two from our Workers' Compensation Insurance and Specialty P&C segments. As of March 31, 2022, there were two SPCs that assumed both workers' compensation insurance and healthcare professional liability insurance and one SPC that assumed only healthcare professional liability insurance.
Segment results reflects our share of the underwriting and investment results of the SPCs in which we participate, and included the following:
Three Months Ended March 31
($ in thousands)20222021Change
Net premiums written$25,217 $22,188 $3,029 13.7 %
Net premiums earned$19,314 $15,884 $3,430 21.6 %
Net investment income112 221 (109)(49.3 %)
Net investment gains (losses)(711)987 (1,698)(172.0 %)
Other income1 — — %
Net losses and loss adjustment expenses(11,491)(9,425)(2,066)21.9 %
Underwriting, policy acquisition and operating expenses(4,369)(5,025)656 (13.1 %)
SPC U.S. federal income tax expense (1)
(642)(356)(286)80.3 %
SPC net results2,214 2,287 (73)(3.2 %)
SPC dividend (expense) income (2)
(2,367)(1,742)(625)35.9 %
Segment results (3)
$(153)$545 $(698)(128.1 %)
Net loss ratio59.5%59.3%0.2 pts
Underwriting expense ratio22.6%31.6%(9.0 pts)
(1) Represents the provision for U.S. federal income taxes for SPCs at Inova Re, which have elected to be taxed as a U.S. corporation under Section 953(d) of the Internal Revenue Code. U.S. federal income taxes are included in the total SPC net results and are paid by the individual SPCs.
(2) Represents the net (profit) loss attributable to external cell participants.
(3) Represents our share of the net profit (loss) of the SPCs in which we participate.


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Premiums Written
Premiums in our Segregated Portfolio Cell Reinsurance segment are assumed from either our Workers' Compensation Insurance or Specialty P&C segments. Premium volume is driven by five primary factors: (1) the amount of new business written, (2) retention of the existing book of business, (3) premium rates charged on the renewal book of business and, for workers' compensation business, (4) changes in payroll exposure and (5) audit premium.
Gross, ceded and net premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums written$28,369 $25,151 $3,218 12.8 %
Less: Ceded premiums written3,152 2,963 189 6.4 %
Net premiums written$25,217 $22,188 $3,029 13.7 %
Gross Premiums Written
Gross premiums written reflected reinsurance premiums assumed by component as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Workers' compensation$21,488 $20,682 $806 3.9 %
Healthcare professional liability6,881 4,469 2,412 54.0 %
Gross Premiums Written$28,369 $25,151 $3,218 12.8 %
Gross premiums written for the three months ended March 31, 2022 and 2021 were primarily comprised of workers' compensation coverages assumed from our Workers' Compensation Insurance segment. Workers' compensation gross premiums written increased during the three months ended March 31, 2022 as compared to the same period of 2021 driven by an increase in audit premium billed to policyholders and new business written, partially offset by renewal rate decreases of 3%. Healthcare professional liability gross premiums written increased during the three months ended March 31, 2022 as compared to the same period of 2021 driven by the effect of tail coverage premium primarily related to one program in which we do not participate, which resulted in $3.0 million of one-time premium written and fully earned. We retained 100% of the eight workers' compensation programs and one healthcare professional liability program up for renewal during the three months ended March 31, 2022.
New business, audit premium, retention and renewal price changes for the assumed workers' compensation premium is shown in the table below:
Three Months Ended March 31
($ in millions)20222021
New business$1.1 $0.8 
Audit premium$1.6 $0.2 
Retention rate (1)
92 %92 %
Change in renewal pricing (2)
(3 %)(5 %)
(1) We calculate our workers' compensation retention rate as annualized expiring renewed premium divided by all annualized expiring premium subject to renewal. Our retention rate can be impacted by various factors, including price or other competitive issues, insureds being acquired, or a decision not to renew based on our underwriting evaluation.
(2) The pricing of our business includes an assessment of the underlying policy exposure and market conditions. We continue to base our pricing on expected losses, as indicated by our historical loss data.
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Ceded Premiums Written
Ceded premiums written were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Ceded premiums written$3,152 $2,963 $189 6.4 %
For the workers' compensation business, each SPC has in place its own external reinsurance coverage. The healthcare professional liability business is assumed net of reinsurance from our Specialty P&C segment; therefore, there are no ceded premiums related to the healthcare professional liability business reflected in the table above. The risk retention for each loss occurrence for the workers' compensation business ranges from $0.3 million to $0.4 million based on the program, with limits up to $119.7 million. In addition, each program has aggregate reinsurance coverage between $1.1 million and $2.1 million on a program year basis. Premiums ceded under our SPC reinsurance treaty are based on premiums written during the treaty period. The change in ceded premiums written during the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected the change in workers' compensation gross premiums written and the impact of rate increases under the external reinsurance treaty. External reinsurance rates vary based on the alternative market program.
Ceded Premiums Ratio
Ceded premiums ratio was as follows:
Three Months Ended March 31
20222021Change
Ceded premiums ratio14.7%14.3%0.4 pts
The above table reflects ceded premiums as a percent of gross premiums written for the workers' compensation business only; healthcare professional liability business is assumed net of reinsurance, as discussed above. The ceded premiums ratio reflects the weighted average reinsurance rates of all SPC programs. The increase in the ceded premiums ratio for the three months ended March 31, 2022 primarily reflected an increase in reinsurance rates.
Net Premiums Earned
Net premiums earned consist of gross premiums earned less the portion of earned premiums that the SPCs cede to external reinsurers. Because premiums are generally earned pro rata over the entire policy period, fluctuations in premiums earned tend to lag those of premiums written. Policies ceded to the SPCs are twelve month term policies and premiums are earned on a pro rata basis over the policy period. Net premiums earned also include premium adjustments related to the audit of workers' compensation insureds' payrolls. Payroll audits are conducted subsequent to the end of the policy period and any related adjustments are recorded as fully earned when reported, which can result in further fluctuation in earned premium.the current period.
Gross, ceded and net premiums earned were as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Gross premiums earnedGross premiums earned$20,385 $28,196 $(7,811)(27.7 %)Gross premiums earned$21,664 $17,967 $3,697 20.6 %
Less: Ceded premiums earnedLess: Ceded premiums earned4,535 6,195 (1,660)(26.8 %)Less: Ceded premiums earned2,350 2,083 267 12.8 %
Net premiums earnedNet premiums earned$15,850 $22,001 $(6,151)(28.0 %)Net premiums earned$19,314 $15,884 $3,430 21.6 %
The decreaseincrease in grossnet premiums earned during the three months ended March 31, 2022 primarily reflected the aforementioned effect of $3.0 million of tail premium fully written and earned during the current period and the increase in audit premium billed to policyholders, partially offset by the pro rata effect of a reduction in net premiums written during the preceding twelve months.
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Losses and Loss Adjustment Expenses
The following table summarizes the calendar year net loss ratios by separating losses between the current accident year and all prior accident years. The current accident year net loss ratio reflected the aggregate loss ratio for all programs. Loss reserves are estimated for each program on a quarterly basis. Due to the size of some of the programs, quarterly loss results can create volatility in the current accident year net loss ratio from period to period.
Calendar year and current accident year net loss ratios for the three months ended March 31, 2022 and 2021 were as follows:
Three Months Ended March 31
20222021Change
Calendar year net loss ratio59.5 %59.3 %0.2  pts
Less impact of prior accident years on the net loss ratio(5.0 %)(9.6 %)4.6  pts
Current accident year net loss ratio64.5 %68.9 %(4.4  pts)
The current accident year net loss ratio decreased 4.4 percentage points for the three months ended March 31, 2022 as compared to the same period of 20202021. The decrease in the current accident year net loss ratio for the three months ended March 31, 2022 primarily reflected the effect of reinstatement premiums earned during eachfavorable trends in prior accident year claim results and their impact on our analysis of the first quarterscurrent accident year loss estimate, partially offset by the continuation of 2021intense price competition and 2020 (see previous discussion under the heading "Gross Premiums Written"). After removing the effect of the reinstatement premiums from both periods, gross premiums earned decreased $6.6 millionresulting renewal rate decreases in the 2021workers' compensation business.
Calendar year incurred losses (excluding IBNR) ceded to our external reinsurers decreased $2.8 million for the three months ended March 31, 2022 as compared to the same period of 2021. Current accident year ceded incurred losses (excluding IBNR) increased $0.1 million for the 2022 three-month period as compared to the same period of 2021.
We recognized net favorable prior year reserve development of $0.9 million for the three months ended March 31, 2022 as compared to $1.4 million for the same period of 2021. The net favorable prior year reserve development for the three months ended March 31, 2022 related entirely to workers’ compensation business, which reflected overall favorable trends in claim closing patterns primarily in accident years 2019 and 2020. The decrease in gross premiums earned duringnet favorable prior year reserve development for the three months ended March 31, 2021 was drivenalso related entirely to the workers’ compensation business which primarily reflected overall favorable claim trends in claim closing patterns in accident years 2018 and 2019.
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Underwriting, Policy Acquisition and Operating Expenses
Our Segregated Portfolio Cell Reinsurance segment underwriting, policy acquisition and operating expenses were comprised as follows:
Three Months Ended March 31
($ in thousands)20222021Change
DPAC amortization$5,294 $4,636 $658 14.2 %
Policyholder dividend expense66 173 (107)(61.8 %)
Other underwriting and operating expenses(991)216 (1,207)(558.8 %)
Total$4,369 $5,025 $(656)(13.1 %)
DPAC amortization primarily represents ceding commissions, which vary by program and are paid to our Workers' Compensation Insurance and Specialty P&C segments for premiums assumed. Ceding commissions include an amount for fronting fees, commissions, premium taxes and risk management fees, which are reported as an offset to underwriting, policy acquisition and operating expenses within our Workers' Compensation Insurance and Specialty P&C segments. In addition, ceding commissions paid to our Workers' Compensation Insurance segment include cell rental fees which are recorded as other income and claims administration fees which are recorded as ceded ULAE within our Workers' Compensation Insurance segment.
Other underwriting and operating expenses primarily include bank fees, professional fees and changes in the allowance for expected credit losses. The decrease in other underwriting and operating expenses for the three months ended March 31, 2022 as compared to the same period of 2021 primarily reflected the change in our allowance for expected credit losses related to the collection of customer accounts that were previously written off.
The decrease in policyholder dividend expense for the three months ended March 31, 2022 as compared to the same period of 2021, related primarily to one SPC program, in which we do not participate.
Underwriting Expense Ratio (the Expense Ratio)
The underwriting expense ratio included the impact of the following:
Three Months Ended March 31
20222021Change
Underwriting expense ratio, as reported22.6%31.6%(9.0 pts)
Less: impact of audit premium on expense ratio(2.0%)(0.3%)(1.7 pts)
Underwriting expense ratio, excluding the effect of audit premium24.6%31.9%(7.3 pts)
Excluding the effect of audit premium, the underwriting expense ratio decreased for the 2022 three-month period. The decrease in the underwriting expense ratio for the 2022 three-month period primarily reflected the change in the allowance for expected credit losses and policyholder dividend expense, as discussed above.
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Segment Results - Lloyd's Syndicates
Our Lloyd's Syndicates segment includes the results from our participation in Syndicate 1729 somewhat offset byand Syndicate 6131 at Lloyd's of London.In addition to our participation in Syndicate results, we have investments in and other obligations to our Lloyd's Syndicates consisting of a Syndicate Credit Agreement and FAL requirements. For the 2022 underwriting year, our FAL was comprised of investment securities and cash and cash equivalents deposited with Lloyd's which at March 31, 2022 had a fair value of approximately $37.0 million, as discussed in Note 3 of the Notes to Condensed Consolidated Financial Statements. The discussion in our Segment Operating Results under the same heading in Item 7 of our December 31, 2021 report on Form 10-K includes additional information regarding our participation.
We normally report results from our involvement in Lloyd's Syndicates on a quarter lag, except when information is available that is material to the current period. Furthermore, the investment results associated with our FAL investments and certain U.S. paid administrative expenses are reported concurrently as that information is available on an earlier time frame.
To support and grow our core insurance operations, we reduced our participation in the results of Syndicate 1729, to 5% from 29%, and Syndicate 6131, to 50% from 100%, for the 2021 underwriting year. Due to the quarter lag, this reduced participation was not reflected in our results until the second quarter of 2021. Our participation in the results of Syndicate 1729 for the 2022 underwriting year remains unchanged from the 2021 underwriting year at 5%. Effective January 1, 2022, Syndicate 6131 ceased underwriting on a quota share basis with Syndicate 1729 as Syndicate 6131's applicable business is retained within Syndicate 1729 beginning with the 2022 year of account. The results from our participation in Syndicate 6131 from open underwriting years prior to 2022 will continue to earn out pro rata effectover the entire policy period of higherthe underlying business. Due to the quarter lag, our ceased participation in Syndicate 6131 will not be reflected in our results until the second quarter of 2022.
In addition to the results of our participation in Lloyd's Syndicates, as discussed above, our Lloyd's Syndicates segment also includes 100% of the results of our wholly owned subsidiaries that support our operations at Lloyd's. For the three months ended March 31, 2022 and 2021, the results of our Lloyd's Syndicates segment were as follows:
Three Months Ended March 31
($ in thousands)20222021Change
Gross premiums written$5,817 $14,102 $(8,285)(58.8 %)
Less: Ceded premiums written223 2,217 (1,994)(89.9 %)
Net premiums written$5,594 $11,885 $(6,291)(52.9 %)
Net premiums earned$7,746 $15,850 $(8,104)(51.1 %)
Net investment income211 729 (518)(71.1 %)
Net investment gains (losses)(399)(115)(284)(247.0 %)
Other income134 221 (87)(39.4 %)
Net losses and loss adjustment expenses(4,763)(12,967)8,204 (63.3 %)
Underwriting, policy acquisition and operating expenses(2,709)(6,591)3,882 (58.9 %)
Segment results$220 $(2,873)$3,093 107.7 %
Net loss ratio61.5%81.8%(20.3 pts)
Underwriting expense ratio35.0%41.6%(6.6 pts)
Premiums
Net premiums written at the Syndicatesdecreased during the preceding twelve months, primarily property insurance and casualty coverages.
The decrease in ceded premiums earned during the 20212022 three-month period as compared to the same period of 2020 was2021 driven by our decreased participation in Syndicatethe results of Syndicates 1729 and 6131 for the 2021 underwriting year, partially offset by thevolume increases on renewal business and renewal pricing increases, primarily on casualty and property insurance coverages, as well as new business written, primarily on specialty property coverages. Net premiums earned decreased $8.1 million during the 2022 three-month period as compared to the same period of 2021 primarily attributable to the pro rata effect of an increasea reduction in net premiums ceded under reinsurance arrangementswritten during the preceding twelve months.
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Net Losses and Loss Adjustment Expenses
Losses for the period were primarily recorded using the loss assumptions by risk category incorporated into the business plans submitted to Lloyd's for Syndicate 1729 and Syndicate 6131 with consideration given to loss experience incurred to date. The assumptions used in each business plan were consistent with loss results reflected in Lloyd's historical data for similar risks. The loss ratios may fluctuate due to the mix of earned premium and the timing of earned premium adjustments (see discussion in this section under the heading "Net Premiums Earned"). Premium and exposure for some of Syndicate 1729's insurance policies and reinsurance contracts are initially estimated and subsequently adjusted over an extended period of time as underlying premium reports are received from cedants and insureds. When reports are received, the premium, exposure and corresponding loss estimates are revised accordingly. Changes in loss estimates due to premium or exposure fluctuations are incurred in the accident year in which the premium is earned.
The following table summarizes calendar year net loss ratios by separating losses between the current accident year and all prior accident years. Net loss ratios for the period were as follows:
Net Loss RatiosNet Loss Ratios
Three Months Ended March 31Three Months Ended March 31
20212020Change20222021Change
Calendar year net loss ratioCalendar year net loss ratio81.8%67.2%14.6 ptsCalendar year net loss ratio61.5 %81.8 %(20.3  pts)
Less: impact of prior accident years on the net loss ratioLess: impact of prior accident years on the net loss ratio9.7%(1.5%)11.2 ptsLess: impact of prior accident years on the net loss ratio19.7 %9.7 %10.0  pts
Current accident year net loss ratioCurrent accident year net loss ratio72.1%68.7%3.4 ptsCurrent accident year net loss ratio41.8 %72.1 %(30.3  pts)
ForThe decrease in the calendar year net loss ratio for the three months ended March 31, 2021, the current accident year net loss ratio increased 3.4 percentage points2022 as compared to the same period of 2020. The increase in2021 was primarily driven by the current accident year net loss ratio was driven byimpact of certain property and catastrophe related losses.
losses incurred during the prior year period and, to a lesser extent, decreases to certain loss estimates during the first quarter of 2022, partially offset by unfavorable prior year development. We recognized $1.5 million of unfavorable prior year development during each of the three months ended March 31, 2022 and 2021. The unfavorable prior year development for the three months ended March 31, 2021 as compared to $0.3 million of favorable prior year development for the same period of 2020. The unfavorable development
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recognized during the three months ended March 31, 20212022 was driven by higher than expected losses and development on certain large claims, primarily catastrophe related losses, which resulted in unfavorable development with respect to a previous year of account.
We have exposures to potential COVID-19 claims through our participation in Syndicates 1729 and 6131. During the three months ended March 31, 2021, we recognized losses related to COVID-19 of approximately $0.8 million, net of reinsurance, primarily in Syndicate 6131's contingency and Syndicate 1729's casualty books of business. Please see the "Insurance Regulatory Matters" section in Part 1, Item 1 in our December 31, 2020 report on Form 10-K for additional information.losses.
Underwriting, Policy Acquisition and Operating Expenses
Underwriting, policy acquisition and operating expensesFor the 2022 three-month period, the underwriting expense ratio decreased by $2.6 million for the 2021 three-month period6.6 percentage points as compared to the same period of 2020 and2021 which primarily reflected our decreased participation in Syndicate 1729.
For the three months ended March 31, 2021, the underwriting expense ratio was unchanged from the same periodimpact of 2020 driven by lower operating expenses due to our reduced participation in Syndicate 1729, offset by a decrease in net premiums earned, as previously discussed.
Investments
Syndicate 1729's fixed maturities portfolio includes certain debt securities classified as trading securities. Investment results associated with these fixed maturity trading securities are reported on the same quarter lag. The decrease in net investment income for the 2021 three-month period as compared to the same period of 2020 was primarily attributable to lower average investment balances and lower yields, primarily from investment-grade corporate debt securities. The lower average investment balances for the 2021 three-month period were driven by the return of approximately $32.3 million of cash and cash equivalents from our FAL balances given the reduction in our participation in the results of Syndicate 1729 for the 2020 underwriting year (see Note 6 of the Notes to Consolidated Financial Statements in our December 31, 2020 report on Form 10-K). In addition, we expect to receive a return of approximately $24 million of FAL given our additional reduction in our participation in the results of Syndicate 1729 and Syndicate 6131 for the 2021 underwriting year. Due to the quarter lag, operating expenses incurred during the first quarter of 2022 primarily were related to the 2021 underwriting year as previously discussed,for which our participation is anticipated to further impact our segment's5% and 50% in Syndicate 1729 and Syndicate 6131, respectively, whereas the net investment incomepremiums earned during the same period also includes premium from other open underwriting years in future periods.
Taxes
The results of this segment are subject to U.K. income tax law.which we participate at a higher degree.
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Segment Results - Corporate
Our Corporate segment includes our investment operations, other thanincluding the investment operations of NORCAL for the three months ended March 31, 2022 and excluding those reported in our Segregated Portfolio Cell Reinsurance and Lloyd's Syndicates segments interest expense and U.S. income taxes as discussed in Note 1418 of the Notes to Condensed Consolidated Financial Statements. Our CorporateStatements in our December 31, 2021 report on Form 10-K. In addition, this segment also includes corporate expenses, interest expense, U.S. income taxes and non-premium revenues generated outside of our insurance entitiesentities. Segment results for the three months ended March 31, 2022 exclude transaction-related costs and corporate expenses.the associated income tax benefit related to the NORCAL acquisition as we do not consider these items in assessing the financial performance of the segment (for additional information on the NORCAL acquisition see Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K). Segment results for our Corporate segment were net earnings of $19.6$6.0 million for the three months ended March 31, 20212022 as compared to a $4.0$19.6 million net loss for the same period of 20202021 and included the following:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Net investment incomeNet investment income$14,067 $19,417 $(5,350)(27.6 %)Net investment income$20,120 $14,067 $6,053 43.0 %
Equity in earnings (loss) of unconsolidated subsidiariesEquity in earnings (loss) of unconsolidated subsidiaries$6,788 $(1,562)$8,350 (534.6 %)Equity in earnings (loss) of unconsolidated subsidiaries$7,620 $6,788 $832 12.3 %
Net realized gains (losses)$7,977 $(25,547)$33,524 131.2 %
Net investment gains (losses)Net investment gains (losses)$(12,396)$7,977 $(20,373)(255.4 %)
Other incomeOther income$1,894 $633 $1,261 199.2 %Other income$2,065 $1,894 $171 9.0 %
Operating expenseOperating expense$7,175 $4,827 $2,348 48.6 %Operating expense$8,739 $7,175 $1,564 21.8 %
Interest expenseInterest expense$3,212 $4,129 $(917)(22.2 %)Interest expense$4,441 $3,212 $1,229 38.3 %
Income tax expense (benefit)Income tax expense (benefit)$736 $(12,047)$12,783 (106.1 %)Income tax expense (benefit)$(1,770)$736 $(2,506)(340.5 %)
Net Investment Income, Equity in Earnings (Loss) of Unconsolidated Subsidiaries, Net Realized Investment Gains (Losses)
Net Investment Income
Net investment income is primarily derived from the income earned by our fixed maturity securities and also includes dividend income from equity securities, income from our short-term and cash equivalent investments, earnings from other investments and increaseschanges in the cash surrender value of BOLI contracts, net of investment fees and expenses. Net investment income for the three months ended March 31, 2022 also includes income earned, net of investment fees and expenses, from investments acquired from NORCAL on May 5, 2021.
Net investment income (loss) by investment category was as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Fixed maturitiesFixed maturities$14,725 $16,931 $(2,206)(13.0 %)Fixed maturities$21,100 $14,725 $6,375 43.3 %
EquitiesEquities694 1,909 (1,215)(63.6 %)Equities701 694 1.0 %
Short-term investments, including OtherShort-term investments, including Other198 1,342 (1,144)(85.2 %)Short-term investments, including Other405 198 207 104.5 %
BOLIBOLI444 456 (12)(2.6 %)BOLI(47)444 (491)(110.6 %)
Investment fees and expensesInvestment fees and expenses(1,994)(1,221)(773)63.3 %Investment fees and expenses(2,039)(1,994)(45)2.3 %
Net investment incomeNet investment income$14,067 $19,417 $(5,350)(27.6 %)Net investment income$20,120 $14,067 $6,053 43.0 %
Fixed Maturities
Income from our fixed maturities decreasedincreased during the 20212022 three-month period as compared to the same period of 20202021 driven by higher average investment balances primarily dueattributable to the addition of fixed maturity securities valued at $1.1 billion to our portfolio on May 5, 2021 as a result of the NORCAL acquisition (see Note 2 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 2021 report on Form 10-K for additional information). The increase in income from our fixed maturities during the 2022 three-month period was partially offset by lower yields from our corporate debt securities partially offset by higherand, to a lesser extent, state and municipal bonds. As a result of the NORCAL acquisition, average investment balances. Average investment balances were approximately 7%66% higher for the 20212022 three-month period as compared to the same period of 2020. The decline in income from our fixed maturities during the 2021 three-month period also reflected2021; excluding the impact of capital planning in anticipationthe acquisition, average investment balances were approximately 6% higher.
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Average yields for our fixed maturity portfolio were as follows:
Three Months Ended March 31Three Months Ended March 31
20212020 20222021
Average income yieldAverage income yield2.6%3.4%Average income yield2.3%2.6%
Average tax equivalent income yieldAverage tax equivalent income yield2.7%3.4%Average tax equivalent income yield2.3%2.7%
Equities
Income from our equity portfolio decreased during the 2021 three-month period as compared to the same period of 2020 which reflected a decrease in our allocation to this asset category.
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Short-term Investments and Other Investments
Short-term investments, which have a maturity at purchase of one year or less are carried at fair value, which approximates their cost basis, and are primarily composed of investments in U.S. treasury obligations, commercial paper and money market funds. Income from our short-term and other investments decreasedincreased during the 20212022 three-month period as compared to the same period of 2020,2021 primarily attributabledue to lower yields givenincome contributed by investments acquired from NORCAL.
BOLI
We hold BOLI policies that are carried at the actions takencurrent cash surrender value of the policies, which includes the BOLI policies acquired from NORCAL. All insured individuals were members of ProAssurance or NORCAL management at the time the policies were acquired. The cash surrender value of our BOLI policies decreased for the 2022 three-month period as compared to the same period of 2021 driven by the Federal Reserve to aggressively reduce interest rates in response to COVID-19.policies acquired from NORCAL.
Equity in Earnings (Loss) of Unconsolidated Subsidiaries
Equity in earnings (loss) of unconsolidated subsidiaries was comprised as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
All other investments, primarily investment fund LPs/LLCsAll other investments, primarily investment fund LPs/LLCs$9,974 $3,103 $6,871 221.4 %All other investments, primarily investment fund LPs/LLCs$10,008 $9,974 $34 0.3 %
Tax credit partnershipsTax credit partnerships(3,186)(4,665)1,479 (31.7 %)Tax credit partnerships(2,388)(3,186)798 (25.0 %)
Equity in earnings (loss) of unconsolidated subsidiariesEquity in earnings (loss) of unconsolidated subsidiaries$6,788 $(1,562)$8,350 534.6 %Equity in earnings (loss) of unconsolidated subsidiaries$7,620 $6,788 $832 12.3 %
We hold interests in certain LPs/LLCs that generate earnings from trading portfolios, secured debt, debt securities, multi-strategy funds and private equity investments. The performance of the LPs/LLCs is affected by the volatility of equity and credit markets. For our investments in LPs/LLCs, we record our allocable portion of the partnership operating income or loss as the results of the LPs/LLCs become available, typically following the end of a reporting period. The increaseOur investment results from our portfolio of investments in LPs/LLCs for the 2022 three-month period included additional earnings of approximately $0.4 million from acquired interests in four LPs as a result of the NORCAL acquisition. Excluding NORCAL, our investment results from our portfolio of investments in LPs/LLCs for the 20212022 three-month period as compared to the same period of 2020 was2021 decreased $0.4 million primarily due to higherlower earnings from a few LPs/LLCs.an LP/LLC.
Our tax credit partnership investments are designed to generate returns in the form of tax credits and tax-deductible project operating losses and are comprised of qualified affordable housing project tax credit partnerships and a historic tax credit partnership. We account for our tax credit partnership investments under the equity method and record our allocable portion of the operating losses of the underlying properties based on estimates provided by the partnerships. For our qualified affordable housing project tax credit partnerships, we adjust our estimates of our allocable portion of operating losses periodically as actual operating results of the underlying properties become available. The primary benefit of credits and losses from our historic tax credit partnership are earned in a short period with potential for additional cash flows extending over several years, and the remaining operating losses were recognized in 2020.years. The results from our tax credit partnership investments for the three months ended March 31, 20212022 reflected lower partnership operating losses as compared to the same period of 2020.2021.
The tax benefits received from our tax credit partnerships, which are not reflected in our investment results, above, reduced our tax expense in 20212022 and 20202021 as follows:
Three Months Ended March 31Three Months Ended March 31
(In millions)(In millions)20212020(In millions)20222021
Tax credits recognized during the periodTax credits recognized during the period$3.4 $4.5 Tax credits recognized during the period$1.2 $3.4 
Tax benefit of tax credit partnership operating lossesTax benefit of tax credit partnership operating losses$0.7 $1.0 Tax benefit of tax credit partnership operating losses$0.5 $0.7 
The tax credits generated from our tax credit partnership investments of $3.4$1.2 million for the three months ended March 31, 20212022 were deferred and arefor use in future periods due our expected consolidated loss calculated on a tax basis. For the three months ended March 31, 2021 the tax credits generated from our tax credit partnership investments of $3.4 million were deferred to be utilized in future periods. Not included in the table above is $2.0 million of tax credits recaptured from the 2019
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tax year during the three months ended March 31, 2022 due to the carryback of our estimated NOL for the three months ended March 31, 2022 to the 2021 tax year. The recaptured tax credits were earned in 2019 but not utilized until 2021 due to NOL's generated in both 2019 and 2020. As of March 31, 2022, we had approximately $49.9 million of available tax credit carryforwards generated from our investments in tax credit partnerships which we expect to utilize in future periods.
Tax credits provided by the underlying projects of our historic tax credit partnership are typically available in the tax year in which the project is put into active service, whereas the tax credits provided by qualified affordable housing project tax credit partnerships are provided over approximately a ten year period.
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Non-GAAP Financial Measure – Tax Equivalent Investment Result
We believe that to fully understand our investment returns it is important to consider the current tax benefits associated with certain investments as the tax benefit received represents a portion of the return provided by our tax-exempt bonds, BOLI, common and preferred stocks, and tax credit partnership investments (collectively, our tax-preferred investments). We impute a pro forma tax-equivalent result by estimating the amount of fully-taxable income needed to achieve the same after-tax result as is currently provided by our tax-preferred investments. We believe this better reflects the economics behind our decision to invest in certain asset classes that are either taxed at lower rates and/or result in reductions to our current federal income tax expense. Our pro forma tax-equivalent investment result is shown in the table that follows as well as a reconciliation of our GAAP net investment result to our tax equivalent result.
Three Months Ended March 31
(In thousands)20212020
GAAP net investment result:
Net investment income$14,067 $19,417 
Equity in earnings (loss) of unconsolidated subsidiaries6,788 (1,562)
GAAP net investment result$20,855 $17,855 
Pro forma tax-equivalent investment result$22,883 $23,871 
Reconciliation of pro forma and GAAP tax-equivalent investment result:
GAAP net investment result$20,855 $17,855 
Taxable equivalent adjustments, calculated using the 21% federal statutory tax rate
State and municipal bonds115 161 
BOLI118 121 
Dividends received3 73 
Tax credit partnerships1,792 5,661 
Pro forma tax-equivalent investment result$22,883 $23,871 


Three Months Ended March 31
(In thousands)20222021
GAAP net investment result:
Net investment income$20,120 $14,067 
Equity in earnings (loss) of unconsolidated subsidiaries7,620 6,788 
GAAP net investment result$27,740 $20,855 
Pro forma tax-equivalent investment result$25,383 $22,883 
Reconciliation of pro forma and GAAP tax-equivalent investment result:
GAAP net investment result$27,740 $20,855 
Taxable equivalent adjustments, calculated using the 21% federal statutory tax rate
State and municipal bonds133 115 
BOLI(12)118 
Dividends received 
Tax credit partnerships*(2,478)1,792 
Pro forma tax-equivalent investment result$25,383 $22,883 
*Due to our expected consolidated loss calculated on a tax basis for the three months ended March 31, 2022, the tax credits recognized from our tax credit partnership investments were deferred to be utilized in future periods; however, during the three months ended March 31, 2022, we recaptured a portion of tax credits earned in 2019, that were utilized in 2021, as a result of our expected carry back of our 2022 NOL to the 2021 tax year, resulting in a current tax expense related to tax credit partnerships.
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Net Realized Investment Gains (Losses)
The following table provides detailed information regarding our net realized investment gains (losses).
Three Months Ended March 31Three Months Ended March 31
(In thousands)(In thousands)20212020(In thousands)20222021
Total impairment losses
Corporate debt$ $(1,817)
Portion of impairment losses recognized in other comprehensive income before taxes:
Corporate debt 654 
Net impairment losses recognized in earnings (1,163)
Gross realized gains, available-for-sale fixed maturitiesGross realized gains, available-for-sale fixed maturities4,163 2,279 Gross realized gains, available-for-sale fixed maturities$1,105 $4,163 
Gross realized (losses), available-for-sale fixed maturitiesGross realized (losses), available-for-sale fixed maturities(187)(1,403)Gross realized (losses), available-for-sale fixed maturities(1,094)(187)
Net realized gains (losses), equity investmentsNet realized gains (losses), equity investments4,156 15,197 Net realized gains (losses), equity investments(693)4,156 
Net realized gains (losses), other investmentsNet realized gains (losses), other investments3,196 48 Net realized gains (losses), other investments650 3,196 
Change in unrealized holding gains (losses), equity investmentsChange in unrealized holding gains (losses), equity investments(3,788)(35,225)Change in unrealized holding gains (losses), equity investments(10,252)(3,788)
Change in unrealized holding gains (losses), convertible securities, carried at fair value as a part of other investmentsChange in unrealized holding gains (losses), convertible securities, carried at fair value as a part of other investments(190)(5,273)Change in unrealized holding gains (losses), convertible securities, carried at fair value as a part of other investments(2,475)(190)
OtherOther627 (7)Other363 627 
Net realized investment gains (losses)$7,977 $(25,547)
Net investment gains (losses)Net investment gains (losses)$(12,396)$7,977 
We did not recognize any credit-related impairment losses in earnings or non-credit impairment losses in OCI for the three months ended March 31, 2021. For the three months ended2022 or March 31, 2020, we2021.
We recognized credit-related impairment$12.4 million of net investment losses in earningsduring the 2022 three-month period which include approximately $8.8 million of $1.2 million and non-credit impairmentnet investment losses in OCI of $0.7 million. The credit-related impairment lossesduring the 2022 three-month period related to four corporate bondsinvestments acquired from NORCAL. Net investment losses during the 2022 three-month period were driven by unrealized holding losses resulting from changes in the energy, consumer, and entertainment sectors. The non-credit related impairment losses related to three corporate bonds in the energy and consumer sectors.
fair value of our equity investments. We recognized $8.0 million of net realized investment gains during the 2021 three-month period, driven primarily by realized gains on the sale of certain available-for-sale fixed maturities and equity investments. We recognized $25.5 million of net realized investment losses during the 2020 three-month period driven by the impact of decreases in fair value on our equity portfolio of $35.2 million and convertible securities of $5.3 million due to the disruptions in global financial markets related to COVID-19 during the first quarter of 2020.
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Operating Expenses
Corporate segment operating expenses were comprised as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Operating expensesOperating expenses$9,719 $9,093 $626 6.9 %Operating expenses$10,681 $9,719 $962 9.9 %
Management fee offsetManagement fee offset(2,544)(4,266)1,722 (40.4 %)Management fee offset(1,942)(2,544)602 (23.7 %)
TotalTotal$7,175 $4,827 $2,348 48.6 %Total$8,739 $7,175 $1,564 21.8 %
Operating expenses increased $1.0 million during the 20212022 three-month period as compared to the same respective period of 20202021 primarily due to an increase in professional fees,compensation-related costs and, to a lesser extent, share-based compensation expenses, partially offset by a decrease in compensation-related costs.professional fees. The increase in professional feescompensation-related costs during the 20212022 three-month period was driven by an increase in transaction-relatedsegment headcount due to the addition of Corporate NORCAL employees. Subsequent to acquisition on May 5, 2021, compensation-related costs associated withof all NORCAL employees were reported in our acquisition ofSpecialty P&C segment. Beginning in 2022, compensation-related costs for Corporate NORCAL (see Note15 ofemployees are reported in our Corporate segment. In addition, the Notes to Condensed Consolidated Financial Statements). The decreaseincrease in compensation-related costs duringalso reflected higher amounts accrued for performance-related incentive plans due to our improved performance metrics. The increase in share-based compensation expense in the 20212022 three-month period was driven by a reduction in headcount as a resultattributable to the effect of the 2020 organizational restructuring and, to a lesser extent, a decreaseincorporation of certain NORCAL employees into our share-based compensation plans beginning in employer contributions to the ProAssurance Savings Plan (see Note 17 of the Notes to Consolidated Financial Statements in our December 31, 2020 report on Form 10-K).2022.
Operating subsidiaries within our Specialty P&C segment and our Workers' Compensation Insurance segmentssegment are charged a management fee by the Corporate segment for services provided to these subsidiaries. The management fee is based on the extent to which services are provided to the subsidiary and the amount of premium written by the subsidiary. Under the arrangement, the expenses associated with such services are reported as expenses of the Corporate segment, and the management fees charged are reported as an offset to Corporate operating expenses. Fluctuations in the amount of premium written by each subsidiary can result in corresponding variations in the management fee charged to each subsidiary during a particular period. Due to continued organizational structure enhancements in our Specialty P&C segment during 2020,2021 as well as operational alignments as a result of the integration of NORCAL, the extent to which services are provided by the Corporate segment to the operating subsidiaries within thatthe Specialty P&C segment decreased further effective January 1, 2021.2022. Accordingly, we reduced the fee charged to the operating subsidiaries within the Specialty P&C segment during the 20212022 three-month period. Also effective January 1, 2022, the management agreement included operating subsidiaries of NORCAL contributing to $0.6 million of additional management fees in the current period. There were no changes to the extent to which
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services are provided by the Corporate segment to the operating subsidiaries within our Workers' Compensation Insurance segment in 2021.2022.
Interest Expense
Consolidated interest expense for the three months ended March 31, 20212022 and 20202021 was comprised as follows:
Three Months Ended March 31Three Months Ended March 31
($ in thousands)($ in thousands)20212020Change($ in thousands)20222021Change
Senior Notes due 2023Senior Notes due 2023$3,357 $3,357 $— — %Senior Notes due 2023$3,357 $3,357 $— — %
Revolving Credit Agreement (including fees and amortization)214 184 30 16.3 %
Contribution Certificates (including accretion)(1)
Contribution Certificates (including accretion)(1)
1,853 — 1,853 nm
Revolving Credit Agreement (including fees and amortization)(2)
Revolving Credit Agreement (including fees and amortization)(2)
246 214 32 15.0 %
Mortgage Loans (including amortization)Mortgage Loans (including amortization)148 293 (145)(49.5 %)Mortgage Loans (including amortization) 148 (148)nm
(Gain)/loss on interest rate cap(Gain)/loss on interest rate cap(507)295 (802)(271.9 %)(Gain)/loss on interest rate cap(1,015)(507)(508)(100.2 %)
Interest expenseInterest expense$3,212 $4,129 $(917)(22.2 %)Interest expense$4,441 $3,212 $1,229 38.3 %
(1) Includes accretion of approximately $0.5 million for the three months ended March 31, 2022 which is recorded as an increase to interest expense as a result of the difference between the recorded acquisition date fair value and the principal balance of the Contribution Certificates associated with our acquisition of NORCAL.
(1) Includes accretion of approximately $0.5 million for the three months ended March 31, 2022 which is recorded as an increase to interest expense as a result of the difference between the recorded acquisition date fair value and the principal balance of the Contribution Certificates associated with our acquisition of NORCAL.
(2) Primarily reflects unused commitment fees as there were no outstanding borrowings during either period.
(2) Primarily reflects unused commitment fees as there were no outstanding borrowings during either period.
Consolidated interest expense decreasedincreased during the three months ended March 31, 20212022 as compared to the same period of 20202021 driven by the addition of interest expense on the Contribution Certificates associated with our acquisition of NORCAL on May 5, 2021 (see Note 2 of the Notes to Consolidated Financial Statements in our December 31, 2021 report on Form 10-K). The increase in consolidated interest expense for the 2022 three-month period was partially offset by the change in the fair value of our interest rate cap and, to a lesser extent, lower interest expense on our Mortgage Loans. The interest rate cap is designated as an economic hedge of interest rate risk associated with our variable rate Mortgage Loans. Our Mortgage Loans accrue interest at three-month LIBOR plus 1.325%, and the decrease in interest expense during the three months ended March 31, 2021 as compared to the same period of 2020 was primarily due to a decrease in the average three-month LIBOR. Interest expense on our Revolving Credit Agreement for the three months ended March 31, 2021 and 2020 primarily reflected unused commitment fees as there were no outstanding borrowings during either period.cap. See further discussion of our outstanding debt in Note 107 of the Notes to Condensed Consolidated Financial Statements and further discussion of our interest rate cap agreement and Contribution Certificates in Note 113 and Note 13 of the Notes to Consolidated Financial Statements in our December 31, 20202021 report on Form 10-K.
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Taxes
Tax expense allocated to our Corporate segment includes U.S. tax only, which would include U.S. tax expense incurred from our corporate membership in Lloyd's of London. The U.K. tax expense incurred by the U.K. based subsidiaries of our Lloyd's Syndicates segment is allocated to that segment. The SPCs at Inova Re, one of our Cayman Islands reinsurance subsidiaries, have each made a 953(d) election under the U.S. Internal Revenue Code and are subject to U.S. federal income tax; therefore, tax expense allocated to our Corporate segment also includes tax expense incurred from any SPC at Inova Re in which we have a participation interest of 80% or greater as those SPCs are required to be included in our consolidated tax return. Consolidated tax expense (benefit) reflects the tax expense (benefit) of both segments and the tax impact of items excluded from segment reporting, as shown in the table below:
Three Months Ended
March 31
Three Months Ended
March 31
(In thousands)(In thousands)20212020(In thousands)20222021
Corporate segment income tax expense (benefit)Corporate segment income tax expense (benefit)$736 $(12,047)Corporate segment income tax expense (benefit)$(1,770)$736 
Lloyd's Syndicates segment income tax expense (benefit) (29)
Income tax expense (benefit) - transaction-related costs*Income tax expense (benefit) - transaction-related costs*(247)— 
Consolidated income tax expense (benefit)Consolidated income tax expense (benefit)$736 $(12,076)Consolidated income tax expense (benefit)$(2,017)$736 
*Represents the income tax benefit associated with the transaction-related costs related to our acquisition of NORCAL that are not included in a segment as we do not consider these costs in assessing the financial performance of any of our operating or reportable segments. See Note 11 of the Notes to Condensed Consolidated Financial Statements for a reconciliation of our segment results to our consolidated results.
*Represents the income tax benefit associated with the transaction-related costs related to our acquisition of NORCAL that are not included in a segment as we do not consider these costs in assessing the financial performance of any of our operating or reportable segments. See Note 11 of the Notes to Condensed Consolidated Financial Statements for a reconciliation of our segment results to our consolidated results.
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Listed below are the primary factors affecting our consolidated effective tax rate for the three months ended March 31, 20212022 and 2020.2021. The comparability of each factor's impact on our effective tax rate is affected by the consolidated pre-tax incomeloss recognized during the three months ended March 31, 20212022 as compared to the consolidated pre-tax lossincome recognized during the same period of 2020.2021. Factors that have the same directional impact on income tax expense in each period have an opposite impact on our effective tax rate due to the effective tax rate being calculated based upon a pre-tax incomeloss during the three months ended March 31, 20212022 versus the pre-tax lossincome during the same period of 2020.2021. These factors include the following:
Three Months Ended March 31Three Months Ended March 31
2021202020222021
($ in thousands)($ in thousands)Income tax (benefit) expenseRate ImpactIncome tax (benefit) expenseRate Impact($ in thousands)Income tax (benefit) expenseRate ImpactIncome tax (benefit) expenseRate Impact
Computed "expected" tax expense (benefit) at statutory rateComputed "expected" tax expense (benefit) at statutory rate$1,77921.0 %$(7,146)21.0 %Computed "expected" tax expense (benefit) at statutory rate$(1,171)21.0 %$1,77921.0 %
Tax-exempt income (1)
Tax-exempt income (1)
(186)(2.2 %)(280)0.9 %
Tax-exempt income (1)
(95)1.7 %(186)(2.2 %)
Tax creditsTax credits(3,374)(39.8 %)(4,471)13.1 %Tax credits(1,205)21.6 %(3,374)(39.8 %)
Non-U.S. operating resultsNon-U.S. operating results6037.1 %186(0.5 %)Non-U.S. operating results(46)0.8 %6037.1 %
Tax deficiency on share-based compensation2973.5 %405(1.2 %)
Tax rate differential on loss carryback %(1,424)4.2 %
Tax deficiency (excess tax benefit) on share-based compensationTax deficiency (excess tax benefit) on share-based compensation340 (6.1 %)2973.5 %
Change in uncertain tax positionsChange in uncertain tax positions570.7 %712(2.1 %)Change in uncertain tax positions21 (0.4 %)570.7 %
Estimated annual tax rate differential (2)
Estimated annual tax rate differential (2)
2,08724.6 %— %
Estimated annual tax rate differential (2)
  %2,08724.6 %
OtherOther(527)(6.2 %)(58)0.1 %Other139 (2.4 %)(527)(6.2 %)
Total income tax expense (benefit)Total income tax expense (benefit)$736 8.7 %$(12,076)35.5 %Total income tax expense (benefit)$(2,017)36.2 %$736 8.7 %
(1) Includes tax-exempt interest, dividends received deduction and change in cash surrender value of BOLI.
(2)Represents the tax rate differential between our actual effective tax rate for the three months ended March 31, 2021 and our projected annual effective tax rate as of March 31, 2021 as calculated under the estimated annual effective tax rate method. There was no tax rate differential recorded for the three months ended March 31, 20202022 as we usedutilized the discrete effective tax rate method at March 31, 2022 (see further discussion in the first quarter of 2020Critical Accounting Estimates section).
For the three months ended March 31, 2022, we utilized the discrete effective tax rate method for recording the provision (benefit) for income taxes which treats the income tax expense (benefit) for the period as if it were the income tax expense (benefit) for the full year and determines the income tax expense (benefit) on that basis (see further discussion on this method in the Critical Accounting Estimates section under the heading "Estimation of Taxes/Tax Credits" in our). For the three months ended March 31, 2020 report on Form 10-Q).
The2021, the provision (benefit) for income taxes and the effective tax rate forwere determined utilizing the three months ended March 31, 2021estimated annual effective tax rate method which is determined based upon our current estimate of our annual effective tax rate at the end of each quarterly reporting period (the projected annual effective tax rate) plus the impact of certain discrete items that are not included in the projected annual effective tax rate. See further discussion around the methods utilized to compute interim taxes under the heading "Estimation of Taxes/Tax Credits" in the Critical Accounting Estimates section. Our effective tax rates for both the 20212022 and 20202021 three-month periods were different from the statutory federal income tax rate of 21% primarily due to the benefit recognized from the tax credits transferred to us from our tax credit partnership investments. We recognized tax credits of $3.4$1.2 million and $4.5$3.4 million during the three months ended March 31, 20212022 and 2020,2021, respectively. While projected tax credits for 20212022 are less than 2020,2021, they continue to have a significant impact on the effective tax rate for the 20212022 three-month period. For the 2020 three-month period, our effective tax rate was also affected by the additional tax rate differential of 14% on the carryback of our 2019 NOL to the 2014 tax year as a result of changes made by the CARES Act to the NOL provisions of the tax law.
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Our effective tax rate for the 2021 three-month period, as shown in the table above, differed from our projected annual effective tax rate of (38.4 %) as of the first quarter of 2021(38.4%) due to certain discrete items. These discrete items increased our effective tax rate by 47.1% for the 2021 three-month period mainly due to the treatment of net realized investment gains. When we utilize the estimated annual effective tax rate method, net realized investment gains orand losses are treated as discrete items and reflected in the effective tax rate in the period in which they are included in income. This treatment of net realized investment gains of $8.0 million in our Corporate segment for the three months ended March 31, 2021 accounted for an increase of 19.8% in the projected annual effective tax rate. The remaining discrete items that affected our effective tax rate for the 2021 three-month period were comprised of individually insignificant components.
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ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK.
We believe that we are principally exposed to threetwo types of market risk: interest rate risk credit risk and equity pricecredit risk. We have limited exposure to foreign currency risk as we issue few insurance contracts denominated in currencies other than the U.S. dollar and we have few monetary assets or obligations denominated in foreign currencies.
Interest Rate Risk
Investments
Our fixed maturities portfolio is exposed to interest rate risk. Fluctuations in interest rates have a direct impact on the market valuation of these securities. As interest rates rise, market values of fixed income portfolios fall and vice versa. Future market interest rates are particularly uncertain at this time given the abrupt interest rate cuts made by the Federal Reserve in response to the COVID-19 pandemic. Certain of the securities are held in an unrealized loss position; we do not intend to sell and believe we will not be required to sell any debt security held in an unrealized loss position before its anticipated recovery.
The following tables summarize estimated changes in the fair value of our available-for-sale fixed maturity securities for specific hypothetical changes in interest rates by asset class at March 31, 20212022 and December 31, 2020.2021. There are principally two factors that determine interest rates on a given security: changes in the level of yield curves and credit spreads. As different asset classes can be affected in different ways by movements in those two factors, we have separated our portfolio by asset class in the following tables.
Interest Rate Shift in Basis PointsInterest Rate Shift in Basis Points
March 31, 2021March 31, 2022
($ in millions)($ in millions)(200)(100)Current100200($ in millions)(200)(100)Current100200
Fair Value:Fair Value:Fair Value:
Fixed maturities, available-for-sale:Fixed maturities, available-for-sale:Fixed maturities, available-for-sale:
U.S. Treasury obligationsU.S. Treasury obligations$110 $105 $103 $101 $96 U.S. Treasury obligations$245 $235 $226 $217 $209 
U.S. Government-sponsored enterprise obligationsU.S. Government-sponsored enterprise obligations13 12 11 12 11 U.S. Government-sponsored enterprise obligations18 17 17 16 16 
State and municipal bondsState and municipal bonds368 337 322 309 282 State and municipal bonds536 514 492 471 451 
Corporate debtCorporate debt1,588 1,481 1,429 1,380 1,284 Corporate debt2,029 1,948 1,870 1,797 1,727 
Asset-backed securitiesAsset-backed securities748 715 698 676 632 Asset-backed securities1,163 1,130 1,096 1,061 1,026 
Total fixed maturities, available-for-saleTotal fixed maturities, available-for-sale$2,827 $2,650 $2,563 $2,478 $2,305 Total fixed maturities, available-for-sale$3,991 $3,844 $3,701 $3,562 $3,429 
Duration:Duration:Duration:
Fixed maturities, available-for-sale:Fixed maturities, available-for-sale:Fixed maturities, available-for-sale:
U.S. Treasury obligationsU.S. Treasury obligations2.362.322.272.232.18U.S. Treasury obligations4.174.094.023.953.88
U.S. Government-sponsored enterprise obligationsU.S. Government-sponsored enterprise obligations1.551.922.822.972.93U.S. Government-sponsored enterprise obligations2.523.013.163.223.22
State and municipal bondsState and municipal bonds4.714.524.374.524.71State and municipal bonds4.074.134.254.374.46
Corporate debtCorporate debt3.673.593.513.463.39Corporate debt4.114.104.084.033.96
Asset-backed securitiesAsset-backed securities2.362.422.873.253.41Asset-backed securities2.542.773.013.163.23
Total fixed maturities, available-for-saleTotal fixed maturities, available-for-sale3.403.333.393.483.50Total fixed maturities, available-for-sale3.643.713.783.813.80

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Interest Rate Shift in Basis PointsInterest Rate Shift in Basis Points
December 31, 2020December 31, 2021
($ in millions)($ in millions)(200)(100)Current100200($ in millions)(200)(100)Current100200
Fair Value:Fair Value:Fair Value:
Fixed maturities, available-for-sale:Fixed maturities, available-for-sale:Fixed maturities, available-for-sale:
U.S. Treasury obligationsU.S. Treasury obligations$113 $110 $107 $104 $102 U.S. Treasury obligations$260 $249 $239 $229 $219 
U.S. Government-sponsored enterprise obligationsU.S. Government-sponsored enterprise obligations13 13 12 12 12 U.S. Government-sponsored enterprise obligations21 21 20 20 19 
State and municipal bondsState and municipal bonds361 347 333 320 308 State and municipal bonds564 541 519 498 478 
Corporate debtCorporate debt1,427 1,377 1,329 1,284 1,241 Corporate debt2,063 1,979 1,899 1,821 1,748 
Asset-backed securitiesAsset-backed securities704 690 677 659 639 Asset-backed securities1,211 1,186 1,157 1,123 1,087 
Total fixed maturities, available-for-saleTotal fixed maturities, available-for-sale$2,618 $2,537 $2,458 $2,379 $2,302 Total fixed maturities, available-for-sale$4,119 $3,976 $3,834 $3,691 $3,551 
Duration:Duration:Duration:
Fixed maturities, available-for-sale:Fixed maturities, available-for-sale:Fixed maturities, available-for-sale:
U.S. Treasury obligationsU.S. Treasury obligations2.652.602.562.512.46U.S. Treasury obligations4.424.334.254.184.10
U.S. Government-sponsored enterprise obligationsU.S. Government-sponsored enterprise obligations1.801.772.112.993.14U.S. Government-sponsored enterprise obligations1.581.632.642.842.85
State and municipal bondsState and municipal bonds4.074.013.963.913.88State and municipal bonds4.224.204.264.364.49
Corporate debtCorporate debt3.623.523.443.403.35Corporate debt4.174.134.134.144.11
Asset-backed securitiesAsset-backed securities2.292.232.342.863.21Asset-backed securities2.332.252.673.133.39
Total fixed maturities, available-for-saleTotal fixed maturities, available-for-sale3.273.193.163.283.34Total fixed maturities, available-for-sale3.643.583.713.863.93
Computations of prospective effects of hypothetical interest rate changes are based on numerous assumptions, including the maintenance of the existing level and composition of fixed income security assets, and should not be relied on as indicative of future results.
Certain shortcomings are inherent in the method of analysis presented in the computation of the fair value of fixed rate instruments. Actual values may differ from the projections presented should market conditions vary from assumptions used in the calculation of the fair value of individual securities, including non-parallel shifts in the term structure of interest rates and changing individual issuer credit spreads.
At March 31, 2021,2022, our fixed maturities portfolio includes fixed maturities classified as trading securities which do not have a significant amount of exposure to market interest rates or credit spreads.
Our cash and short-term investments at March 31, 20212022 were carried at fair value which approximates their cost basis due to their short-term nature. Our cash and short-term investments lack significant interest rate sensitivity due to their short duration.
Debt
Our Mortgage Loans are exposed to interest rate risk as they accrue interest at three-month LIBOR plus 1.325%. However, a 1% change in LIBOR will not materially impact our annualized interest expense. Additionally, we have economically hedged the risk of a change in interest rates in excess of 1% on the Mortgage Loans through the purchase of an interest rate cap derivative instrument, which effectively caps our annual interest rate on the Mortgage Loans at a maximum of 3.675% (see Note 11 of the Notes to Consolidated Financial Statements in ProAssurance's December 31, 2020 report on Form 10-K for additional information). The fair value of the interest rate cap is not materially impacted by a 1% change in LIBOR; however, the carrying value of the interest rate cap is impacted by future expectations for LIBOR as well as estimations of volatility in the future yield curve.
Our Revolving Credit Agreement is exposed to interest rate risk as it is LIBOR based and a 1% change in LIBOR will impact annual interest expense only to the extent that there is an outstanding balance. For every $100 million drawn on our Revolving Credit Agreement, a 1% change in interest rates will change our annual interest expense by $1 million. Any outstanding balances on the Revolving Credit Agreement can be repaid on each maturity date, which has typically ranged from one to three months. As of March 31, 2021,2022, no borrowings were outstanding under our Revolving Credit Agreement.
Defined Benefit Pension Plan
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TableWe are exposed to certain economic risks related to the costs of Contentsour defined benefit pension plan, including changes in discount rates for high quality corporate bonds and changes in the expected return on plan assets. See further discussion in our December 31, 2021 report on Form 10-K within Item 7, Management's Discussion and Analysis, in the Critical Accounting Estimates section under the heading "Pension."
Credit Risk
We have exposure to credit risk primarily as a holder of fixed income securities. We control this exposure by emphasizing investment grade credit quality in the fixed income securities we purchase.
As of March 31, 2021, 94%2022, 91% of our fixed maturity securities were rated investment grade as determined by NRSROs, such as Fitch, Moody’s and Standard & Poor’s. We believe that this concentration in investment grade securities reduces our exposure to credit risk on our fixed income investments to an acceptable level. However, investment grade securities, in spite of
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their rating, can rapidly deteriorate and result in significant losses. Ratings published by the NRSROs are one of the tools used to evaluate the creditworthiness of our securities. The ratings reflect the subjective opinion of the rating agencies as to the creditworthiness of the securities; therefore, we may be subject to additional credit exposure should the ratings prove to be unreliable.
We also have exposure to credit risk related to our premiums receivable and receivables from reinsurers; however, to-date we have not experienced any significant amount of credit losses. At March 31, 2021,2022, our premiums receivable was approximately $211$261 million, net of an allowance for expected credit losses of approximately $6$8 million. See Note 1 of the Notes to Condensed Consolidated Financial Statements in our December 31, 2021 report on Form 10-K for further information on our allowance for expected credit losses related to our premiums receivable. Our receivables from reinsurers (with regard to both paid and unpaid losses) approximated $404$479 million at March 31, 20212022 and $399$466 million at December 31, 2020.2021. We monitor the credit risk associated with our reinsurers using publicly available financial and rating agency data. We have not historically experienced material credit losses due to the financial condition of a reinsurer, and as of March 31, 20212022 our expected credit losses associated with our receivables from reinsurers were nominal in amount.
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ITEM 4. CONTROLS AND PROCEDURES.
The principal executive officer and principal financial officer of the Company participated in management’s evaluation of our disclosure controls and procedures (as defined in SEC Rule 13a-15(e)) as of March 31, 2021.2022. ProAssurance’s disclosure controls and procedures are designed to reasonably assure that information required to be disclosed by us in reports we file or submit under the Exchange Act is accumulated and communicated to our management as appropriate to allow timely decisions regarding disclosure and is recorded, processed, summarized and reported within the time periods specified in the Securities and Exchange Commission’s rules and forms. Based on that evaluation, the principal executive officer and principal financial officer have concluded that our disclosure controls and procedures are effective.
The Company completed its acquisition of NORCAL on May 5, 2021 and has not yet included NORCAL in management's assessment of the effectiveness of our internal controls over financial reporting. We are currently integrating NORCAL into our compliance programs and internal control processes. Accordingly, pursuant to the SEC's general guidance that an assessment of a recently acquired business may be omitted from the scope of an assessment for one year following the acquisition, the scope of management's assessment of the effectiveness of the Company's disclosure controls and procedures does not include NORCAL. NORCAL constituted approximately 30.8% of ProAssurance's total assets (inclusive of acquired intangible assets) as of March 31, 2022, and approximately 27.8% of ProAssurance's total revenue for the three months ended March 31, 2022. NORCAL will be included in management's assessment of the effectiveness of the Company's internal controls over financial reporting as of December 31, 2022.
Changes in Internal Control over Financial Reporting
There have been no significant changes in our internal controls over financial reporting that have materially affected, or are reasonably likely to materially affect, those controls during the quarter.
PART II. OTHER INFORMATION
ITEM 1. LEGAL PROCEEDINGS.
See Note 86 of the Notes to Condensed Consolidated Financial Statements.
ITEM 1A. RISK FACTORS.
Our results may differ materially from those we expect and discuss in any forward-looking statements. The principal risk factors that may cause these differences are described in "Item 1A, Risk Factors" in our December 31, 2021 report on Form 10-K and other documents we file with the SEC, such as our current reports on Form 8-K. There arehave been no material changes to the "Risk Factors" disclosed in Part 1, Item 1A of ProAssurance's December 31, 20202021 report on Form 10-K.
ITEM 2. UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS.
(a)Not applicable.
(b)Not applicable.
(c)Information required by Item 703 of Regulation S-K.
PeriodTotal Number of Shares PurchasedAverage Price Paid per ShareTotal Number of Shares Purchased as Part of Publicly Announced Plans or ProgramsApproximate Dollar Value of Shares that May Yet Be Purchased Under the Plans or Programs* (In thousands)
January 1 - 31, 20212022— N/A— $109,643
February 1 - 28, 20212022— N/A— $109,643
March 1 - 31, 20212022— N/A— $109,643
Total— $—— 
*Under its current plan begun in November 2010, the Board has authorized $600 million for the repurchase of common shares or the retirement of outstanding debt. This is ProAssurance’s only plan for the repurchase of common shares, and the plan has no expiration date.
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ITEM 6. EXHIBITS
Exhibit Number Description
Amendment No. 1 to amended and restated Revolving Credit Agreement, dated as of April 19, 2021, between ProAssurance and U.S. Bank N.A., Wells Fargo Bank N.A., Keybank N.A., Regions Bank, Trust Bank, Cadence Bank N.A., and First Horizon Bank
Certification of Principal Executive Officer of ProAssurance as required under SEC rule 13a-14(a).
Certification of Principal Financial and Accounting Officer of ProAssurance as required under SEC rule 13a-14(a).
Certification of Principal Executive Officer of ProAssurance as required under SEC Rule 13a-14(b) and Section 1350 of Chapter 63 of Title 18 of the United States Code, as amended (18 U.S.C. 1350).
Certification of Principal Financial and Accounting Officer of ProAssurance as required under SEC Rule 13a-14(b) and Section 1350 of Chapter 63 of Title 18 of the United States Code, as amended (18 U.S.C. 1350).
XBRL Instance Document
XBRL Taxonomy Extension Schema Document
XBRL Taxonomy Extension Calculation Linkbase Document
XBRL Taxonomy Extension Definition Linkbase Document
XBRL Taxonomy Extension Labels Linkbase Document
XBRL Taxonomy Extension Presentation Linkbase Document

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SIGNATURE
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.
PROASSURANCE CORPORATION
May 7, 20219, 2022
 
/s/    Dana S. Hendricks
Dana S. Hendricks
Chief Financial Officer
(Duly authorized officer and principal financial officer)
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