SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Mosher Ronald F

(Last) (First) (Middle)
10375 PROFESSIONAL CIRCLE

(Street)
RENO NV 89521

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Employers Holdings, Inc. [ EIG ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
05/26/2011
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock, par value $0.01 05/26/2011 A 3,680(1) A $0 18,681 D
Common Stock, par value $0.01 10,000 I By Ronald F. Mosher Retirement Trust
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. Represents restricted stock units that vest on May 26, 2012.
Remarks:
Exhibit List Exhibit 24 -- Limited Power of Attorney for Section 16 Reporting Obligations
/s/ Lenard T. Ormsby, attorney in fact 05/27/2011
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.
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                                                                                            Exhibit 24.1
                                        LIMITED POWER OF ATTORNEY FOR
                                       SECTION 16 REPORTING OBLIGATIONS
      
               Know all by these presents, that the undersigned hereby makes, constitutes and
       appoints Lenard T. Ormsby and Lori A. Brown, and each of them, 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 their 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 his or 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.
      
               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 28th day of May, 2009.
      
       /s/ Ronald F. Mosher
       Ronald F. Mosher
      
      
       STATE OF NEVADA
      
       COUNTY OF WASHOE
      
               On this 28th day of May, 2009, Ronald F. Mosher 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
       Tanya M. Yamagata
       Notary Public
      
       My Commission Expires: July 27, 2011