Which of the following lists the components of a WC Dec page?

• A. WC Code; Rate Per Code; Payroll $ (salary); State(s); Policy Date
• B. WC Code; Rate Per Code; Payroll $ (salary); State(s)
• C. WC Code; Rate Per Code; Policy Date; State(s)
• D. Rate Per Code; Payroll $ (salary); State(s); Policy Date

Answer: (A)

The essential pieces listed on a WC Dec page are the classification code (WC Code), the rate per code, the payroll amount (Payroll $), the state(s) where coverage applies, and the policy date. These elements together explain how the premium is calculated and the scope of coverage: the WC Code identifies the business activity, the Rate Per Code applies to that activity, the Payroll amount provides the base for the premium calculation, the State(s) show where the coverage is active (since rates can vary by state), and the Policy Date indicates the coverage period. Any list that includes all five components gives a complete picture of the declaration page. The other options miss at least one item (for example, lacking the policy date, or omitting the WC Code, or missing the payroll), so they don’t fully describe the WC Dec page.