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Workers Compensation

Workers Compensation

We have 6 workers compensation carriers to accommodate your clients up to $500,000 in premium.

Coverage is currently available in the State of California only.

Program Features:

  • up to 10% commission
  • A+, A- and B+ rated, admitted carriers
  • Direct bill
  • $1,000 minimum premium for most class codes
  • New ventures acceptable for many class codes

Submission Requirements:

  • ACORD 130
  • Federal Employer Identification Number required for all submissions
  • Loss runs for each year of prior WC coverage (up to 5 years for maximum credits) valued within 90 days of effective date
  • WC Supplemental Application - 2006
  • If applicant is a new venture or has not had prior workers compensation coverage, please also provide the WC New Venture Questionnaire
More Information:
Forms, Applications and Guidelines below require the free Adobe Acrobat Reader. If you do not have the Acrobat Reader installed on your computer, go to the Adobe Acrobat Reader website to download.
Forms and Applications
ACORD Workers Compensation Application
WC Pre-Qualification Questionnaire (not required for all accounts)
Check-By-Fax Authorization
WC Supplemental Application - 2006
WC New Venture Questionnaire
Underwriting Guidelines
WC Classification Guide and Eligibility