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Provide the following details requested below.
States currently available for rating are AL, AZ, AR, GA, IN, IA, KS, KY, LA, MS, MO, NJ, NM, NC, OK, PA, SC, TN, & VA. More states coming soon.
Maximum number of classes reached.
Start typing a word in the field below to see possible class description matches.
Each person and their payroll should only be counted once. Only include those who DO NOT have their own insurance or state applicable exclusion.
Please include as much detail as possible regarding these exposures.
You will be able to select a pay plan during the application process
Adding a Waiver of Subrogation to the policy will increase the quoted premium by 2% or $250.00, whichever is higher. Be sure to include this when you upload the down payment and signed application package.
Adding a Waiver of Subrogation may add additional premium to the quote. You will be notified by the underwriter of the final premium.
You previously stated that the insured had prior coverage. Provide the info listed below for their prior policies. List up to 3.
The subcontractor info below applies ONLY to those individuals/entities that have their own workers comp policy and/or valid state exemption (if located in an applicable state). Independent contractors without other coverage or a valid exemption should be included on the application as payroll under Class 1, 2 or 3 on page one and must be covered as statutory employees – even if they receive a 1099.
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