Workers' Compensation Requirements

To ensure efficient processing, please supply all requirements listed below for workers' compensation submissions.
  • Complete ACORD application including insureds' FEIN, description of operations and description of the exact nature of work performed
  • A premium schedule from our website with the premium you need
  • A completed questionnaire
  • Any appropropriate narrative clarifying the operation and experience of the risk
  • Loss runs described in further detail below

Prior Experience/Loss Runs Requirements

In addition to the requirements listed above, the following are also required.
  • New ventures/No prior coverage or less than three years prior coverage
  • Must have at least one full-time employee other than owner(s)
  • Targeting fewer than 12 employees, unless part of a franchise program
  • Eligible business operations
    • Professional office exposures: Doctors, Dentists, Lawyers, Accountants, Insurance Agents, Computer/Programmers/Consultants
    • Beauty & Barber Shops/Salons
    • Retail Stores: Sale of new merchandise, not open after 9 p.m. and no delivery
    • Restaurants: Liquor receipts less than 50% of total receipts, not open after Midnight, no delivery and minimum premium of $1,000 in NY
    • Laundry/Dry Cleaners with no vehicle exposure
    • Franchised motels

Businesses with Prior Coverage

For retail stores, professional office exposures, motels, restaurants, laundries and beauty shops
  • Our preferred submission guidelines require that the current year, plus the past three loss runs are submitted
  • If the "preferred submissions" information is not available, we will accept the following:
    • Premiums under $5,000
    • Current year loss run
    • Loss statement for prior years if loss runs not available
  • If bureau promulgated merit credit, please provide current year loss run
  • Premiums between $5,000 and $25,000
    • If experience modification is less than 1.00, current year loss run
    • If experience modification is greater than 1.00, current year and prior three years' loss runs or current year loss run and experience modifications worksheet

For All Other Risks

  • Consideration will be given for risks in business a minimum of three years with prior coverage
  • Loss runs for current year and three prior complete years
  • Loss runs for current year plus the experience modification worksheet