To receive the most accurate quote, our new pricing model may require further information to be provided such as past coverage history before quoting to determine eligibility for available discounts and rating plans.

If all of the required information is not input in our online submission tool, it may delay the ability to provide an accurately priced quote.

Best practices for submissions with less than $500,000 in standard premium

Our online submission tool requires the following information for all quoting thresholds to ensure that we have a complete picture of the business for providing the most accurate quote:

  • Business name (legal name).
  • DBA (Doing Business As) if applicable.
  • Tax ID number (FEIN, SSN, or SEIN).
  • Proposed policy inception date and policy expiration date.
  • WCIRB number.
  • Experience modification and most recently published WCIRB experience modification worksheet, if applicable.
  • Entity type.
  • Specific coverage needs (temp agency, PEO, ADR, cannabis industry).
  • Primary location address.
  • Addresses of other locations if applicable.
  • Payroll information for all locations and the number of full-time and part-time employees for each class.

Help for understanding payroll and employee counts

  • Primary employer contact information.
  • Length of time the employer has had employees.
  • Previous workers' compensation insurance information.
  • Any subcontracted work and independent contractor operations.
  • Prior State Fund policy information.
  • Detailed description of all operations, corresponding class codes, and the number of full-time and part-time employees for each class by location.

Help for understanding business operations 

  • The applicable license number required for certain businesses (CSLB, PUC, DMV/MCP, DOT, DOSH, DSS, FLC, or SPCB). The license name must exactly match the business or trade name.

Help for information on licensing

  • Minimum of four years of currently valued loss runs, if applicable, valued within 100 days of the purposed inception date (effective date) of the policy, on the carrier or Third Party Administrator (TPA) letterhead. Please enter the loss runs into the applicable fields along with the total payroll and total premium for each year. Our submission tool provides the ability to attach loss runs. Please note, five years of loss runs are required for large accounts.

Help for understanding information regarding loss runs 

  • Complete ownership information accounting for 100% ownership. If applicable, list partners, titled officers, LLC managing members, non-profit/public agency officers, and board members.

Help for understanding ownership and entities 

  • Exclusion status of each corporate officer or director, general partner, or managing member.
  • Payroll of all officers who will be included in coverage.
  • Waiver of subrogation or blanket waiver of subrogation.

Small Commercial and Middle Market Account Submissions

Each small commercial submission (up to $50,000 in standard premium) will require a post bind review after binding. Upon review, additional documentation or information may be required to more adequately define the characteristics of the risk and the scope of coverage to be provided in order to determine the appropriate price for such coverage.

Each middle market submission ($50,000 and above in standard premium) will be redirected out of our online submission tool for review by an underwriter. All of the requirements listed above will be necessary to provide an accurate quote for coverage.

Additional requirements for large account submissions (at least $500,000 in standard premium):

In addition to the requirements outlined already, submissions for large accounts will need to provide the following:

  • Five years of currently valued loss runs, valued within 100 days of the proposed inception date (effective date) of the policy, on the carrier or TPA letterhead.
  • Five years of historical payroll data and employee counts (‘estimated’ payrolls for unexpired year / ‘audited’ payrolls for prior four years).
  • Current year and prospective (upcoming) year published WCIRB Experience Modification Worksheet.
  • A loss prevention pre-coverage inspection may be required before proceeding with a quote, if it's applicable.