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Find savings in minutes.

1. What is the name of your Business?

2. Contact Information

3. What's the legal structure of your business?

4. On average, how many employees will your business have over the next 12 months?

Exclude: Officers, owners and partners.

Include: Contractors who don't have workers compensation insurance.



5. What's the total amount you expect to pay your employees over the next 12 months, excluding owners, officers and partners?

What is the primary type of work, cook or mason?

(Include employees but exclude consultants and tips. Your payroll determine your coverage needs.)

6. What is the primary type of work your business does?

Type in keyword to find the best description, or enter the 4-digit class code from your workers comp policy declarations page.

7. Does your business currently have workers compensation insurance?

if yes than proceed to step 8, else fill the 9th step

8. How long has your business continuously had workers compensation insurance?

9. How many workers compensation claims or work-related injuries has the business had in the past 3 years?

if none, enter 0

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