We will require a complete submission to determine if we have a potential worker’s compensation market for the risk. Below is a checklist to ensure you have included all required documentation:
- ACORD 130 WC Application
- Detailed Description of Operations
- Supplemental Application (may be required based on industry and/or premium size)
- Current Experience Modification Worksheet, if applicable/available
- 3-4 Years currently valued loss runs within 90 days of effective date
Email submissions to:
CA & Western States (AK, AZ, CO, HI, ID, MT, NM, NV, OR & UT): workcompsf@5starsp.com
All Other States: workcomp@5starsp.com