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: Workcomp@5starsp.com