0001379041-19-000005.txt : 20190104 0001379041-19-000005.hdr.sgml : 20190104 20190104163652 ACCESSION NUMBER: 0001379041-19-000005 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20190102 FILED AS OF DATE: 20190104 DATE AS OF CHANGE: 20190104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ormsby Lenard T CENTRAL INDEX KEY: 0001387990 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33245 FILM NUMBER: 19510585 MAIL ADDRESS: STREET 1: 10375 PROFESSIONAL CIRCLE CITY: RENO STATE: NV ZIP: 89521 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Employers Holdings, Inc. CENTRAL INDEX KEY: 0001379041 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 043850065 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 10375 PROFESSIONAL CIRCLE CITY: RENO STATE: NV ZIP: 89521 BUSINESS PHONE: 775-327-2936 MAIL ADDRESS: STREET 1: 10375 PROFESSIONAL CIRCLE CITY: RENO STATE: NV ZIP: 89521 4 1 wf-form4_154663779544245.xml FORM 4 X0306 4 2019-01-02 1 0001379041 Employers Holdings, Inc. EIG 0001387990 Ormsby Lenard T 10375 PROFESSIONAL CIRCLE RENO NV 89521 0 1 0 0 EVP, Chief Legal Officer Common Stock, par value $0.01 2019-01-02 4 F 0 1840 41.26 D 17841 D Common Stock, par value $0.01 2019-01-02 4 D 0 3319 0 D 14522 D Common Stock, par value $0.01 69425 I Ormsby Family Trust Employee Stock Option (right to buy) 24.2 2019-01-02 4 J 0 975 0 D 2022-03-10 Common Stock, par value $0.01 975.0 6825 D Employee Stock Option (right to buy) 27.72 2019-01-02 4 J 0 1773 0 D 2023-03-14 Common Stock, par value $0.01 1773.0 5319 D As a result of retirement as an executive of the Company on January 2, 2019, the Reporting Person forfeited 3,319 restricted stock units that were subject to time-based vesting. As a result of retirement as an executive of the Company on January 2, 2019, the Reporting Person forfeited the option to purchase 975 shares of common stock. As a result of retirement as an executive of the Company on January 2, 2019, the Reporting Person forfeited the option to purchase 1,773 shares of common stock. /s/ Lori A. Brown, attorney in fact 2019-01-03 EX-24 2 ormsby_poa.htm ORMSBY POWER OF ATTORNEY
LIMITED POWER OF ATTORNEY FOR
SECTION 16 REPORTING OBLIGATIONS

Know all by these presents, that the undersigned hereby makes, constitutes and
appoints Lori A. Brown as the undersigned's true and lawful attorney-in-fact, with
full power and authority as hereinafter described on behalf of and in the name,
place and stead of the undersigned to:

1. prepare, execute, acknowledge, deliver and file Forms 3, 4, and 5
(including any amendments thereto) with respect to the securities of Employers
Holdings, Inc., a Nevada corporation (the "Company"), with the United States
Securities and Exchange Commission, any national securities exchanges and the
Company, as considered necessary or advisable under Section 16(a) of the Securities
Exchange Act of 1934 and the rules and regulations promulgated thereunder, as
amended from time to time (the "Exchange Act");
2. seek or obtain, as the undersigned's representative and on the undersigned's
behalf, information on transactions in the Company's securities from any third party,
including brokers, employee benefit plan administrators and trustees, and the
undersigned hereby authorizes any such person to release any such information to
the undersigned and approves and ratifies any such release of information; and
3. perform any and all other acts which in the discretion of such attorney-in-fact
are necessary or desirable for and on behalf of the undersigned in connection with
the foregoing.

The undersigned acknowledges that:
1. this Power of Attorney authorizes, but does not require, such attorney-in-fact
to act in her discretion on information provided to such attorney-in-fact without
independent verification of such information;
2. any documents prepared and/or executed by such attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney will be in such form and will contain such
information and disclosure as such attorney-in-fact, in her discretion, deems
necessary or desirable;
3. neither the Company nor such attorney-in-fact assumes (i) any liability for the
undersigned's responsibility to comply with the requirement of the Exchange Act, (ii) any
liability of the undersigned for any failure to comply with such requirements, or
(iii) any obligation or liability of the undersigned for profit disgorgement under
Section 16(b) of the Exchange Act; and
4. this Power of Attorney does not relieve the undersigned from responsibility for
compliance with the undersigned's obligations under the Exchange Act, including, without
limitation, the reporting requirements under Section 16 of the Exchange Act.
The undersigned hereby gives and grants the foregoing attorney-in-fact full power and
authority to do and perform all and every act and thing whatsoever requisite, necessary
or appropriate to be done in and about the foregoing matters as fully to all intents and
purposes as the undersigned might or could do if present, hereby ratifying all that such
attorney-in-fact of, for and on behalf of the undersigned, shall lawfully do or cause to
be done by virtue of this Power of Attorney.

The undersigned expressly ratifies any and all actions previously taken to prepare, execute,
acknowledge, deliver and file Form 4s with respect to the securities of the Company previously
taken by the foregoing attorney-in-fact, as if they had been done or caused to be done by the
undersigned, as contemplated by this Power of Attorney.

This Power of Attorney shall remain in full force and effect until revoked
by the undersigned in a signed writing delivered to such attorney-in-fact.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as
of this 19th day of December, 2018.


/s/ Lenard T. Ormsby
Lenard T. Ormsby

STATE OF NEVADA
COUNTY OF WASHOE

On this 19th day of December, 2018, Lenard T. Ormsby personally appeared before me,
and acknowledged that he executed the foregoing instrument for the purposes therein
contained.

IN WITNESS WHEREOF, I have hereunto set my hand and official seal.


/s/ Tanya M Yamagata (Seal)
Tanya M Yamagata
Notary Public