Workers' Compensation FAQ for Insurance Agents

We've built our intake to be the path of least resistance in the workers' comp market. With just three pieces of information — the insured's legal name, FEIN, and a plain-English description of operations — Justin can quickly assess class code, state, and operational profile against our carrier appetites and tell you whether there's a path forward and what direction to take. Most competing wholesalers will ask you to chase a complete submission packet just to find out if they have a market. We won't. Once appetite is confirmed and we're moving toward a quote, we'll need the standard submission documents (see the next question) — but you won't have to assemble the whole packet just to start the conversation.

Once we've confirmed appetite and you're ready to move toward a quote, here's the standard package: a signed and current ACORD 130 application, 3–5 years of currently-valued loss runs (including reserves on open claims), the most recent experience modification factor worksheet if one applies, a brief narrative on operations and safety controls, payroll by class code, and any state-specific supplementals (e.g., California WCIRB classification questions, New York DOL forms). The submission requirement isn't us being picky — every carrier in every state requires these items before issuing a quote. Our promise is simpler: we'll do everything we can with what you have first, and we'll only ask for what's truly needed to get the carriers to a price.

We're not premium-restricted in the strictest sense — we'll look at any risk that's a good fit for our carrier appetites. That said, our highest quote-and-bind rate comes from accounts in these ranges: non-contractor / non-construction risks at roughly $5,000+ in annual premium, and contractors and construction-related risks at roughly $10,000+ in annual premium. These aren't hard cutoffs — interesting smaller risks with good loss history and clean class codes still get a look. Below those ranges, the carrier work-to-premium ratio gets challenging (underwriting time, servicing requirements, and audit complexity are roughly the same regardless of premium size), so very small accounts often face longer cycle times or declinations. If you're working a smaller account and you're not sure, send the basics anyway — we'll tell you fast whether to invest the time.

Workers' compensation is an admitted-market product in every state. Every carrier writing WC must file rates and forms with the state's Department of Insurance — there is no surplus-lines workers' comp market. What changes from risk to risk is which segment of the admitted market your placement lands in. The voluntary market is where appointed admitted carriers write business at their filed rates; this is where most accounts belong. The Assigned Risk Plan (ARP) is the state-administered residual market of last resort for employers who can't get voluntary coverage; rates are set by the state, payment terms are restrictive, and carrier service is minimal. The wholesale broker's value is finding voluntary carrier appetite for accounts your direct markets won't touch. Coverage is comparable; price, payment terms, and service are not.

The experience modification factor (E-Mod) compares an employer's actual loss history against expected losses for similarly-classified employers in the same state. 1.00 is the industry average. A 1.25 mod means your client pays 25% MORE than the manual base rate; a 0.85 mod means 15% LESS. Why this matters in real dollars: a client with a 1.50 mod paying $100,000 of manual premium is actually paying $150,000. Improving that mod by even 0.10 (down to 1.40) saves them $10,000 a year — and makes you the hero on renewal. Mods above 1.30 also signal to underwriters that the risk needs careful review, which is when your direct markets start declining and wholesale becomes the right path. Mods are computed by the state's rating bureau using 3 years of payroll and claim history (excluding the most recent year, which is still developing).

This is one of the most common pain points for agents working a new submission. The mod worksheet is published by the state rating bureau (NCCI for most states; independent bureaus for the other eleven) and contains every claim and payroll detail used in the calculation. Two practical paths to obtain a copy: (1) The insured can contact the bureau directly (NCCI or their state's independent bureau) and request a copy — they may need to pay a fee to the bureau to receive it. (2) If you are the incumbent agent, you can request a copy from the current carrier — the carrier has the worksheet on file and will share it with the agent of record. This is usually the fastest route on renewal business. If you're working a new opportunity and you're not the incumbent, the practical move is to ask the insured to pull the worksheet from the bureau or from their current carrier and pass it along to you.

ERM-14 is the NCCI form used to report and process a change of ownership for an insured business — sales, mergers, restructurings, ownership stake changes. It is NOT a form used to change an experience modification factor (a common misconception). The bureau uses the ERM-14 to determine whether the new entity inherits the prior entity's experience modification factor or starts fresh with a new mod, based on the state's ownership-change rules. What this means in practice: if your client has gone through a sale, partnership change, or restructuring, an ERM-14 filing tells the bureau what happened and how to treat the mod going forward. Outcomes can be surprising — sometimes the new entity inherits a good mod, sometimes a bad one, sometimes the bureau aggregates related entities under "common majority interest" rules. Bring ownership-change scenarios to us early; the mod implications are often the biggest variable in pricing the renewal, and getting the filing right matters.

An experience mod isn't a sentence — it's a 3-year rolling window that can be improved with focus. The two highest-leverage moves: (1) Reduce claim frequency, especially small claims. The mod formula weights frequency more heavily than severity at the low end — three $5,000 claims hurt a mod more than one $15,000 claim. A real safety program (employee training, hazard ID, near-miss reporting, supervisor accountability) drives frequency down over time. (2) Aggressive return-to-work programs. The longer an open claim sits, the more reserves push the mod up. Modified-duty programs that bring an injured worker back to the workplace (even on tasks unrelated to their normal job) cap lost-time exposure and accelerate claim closure. Bonus lever: audit the worksheet itself — claims sometimes appear in the wrong policy period or carry over-reserved values that should be challenged with the carrier. The agent angle: making safety and return-to-work part of your account-management conversation is how you protect renewals and deliver real value to your client. Lower mod = lower premium = a happier client at every renewal — and a longer relationship for you.

Four states — North Dakota (WSI), Ohio (BWC), Washington (L&I), and Wyoming (DWC) — operate state-fund monopolies. Employers there MUST buy WC through the state fund; private-market coverage isn't available. What this means for your placement: if your client has any employees in any of these four states, you CANNOT include that state on your master multi-state policy. The exposure must be covered separately through the state fund (which the agent assists with). Critical follow-on: your client should still buy Employers Liability "Stop-Gap" coverage from a private carrier to fill the gap, because state funds typically EXCLUDE EL — leaving the employer exposed to suits brought outside the WC system (third-party-over actions, dual capacity claims, loss of consortium). Coordinating state-fund WC + private Stop-Gap + traditional voluntary WC for the remaining states is exactly the kind of complex placement we handle routinely.

The Longshore and Harbor Workers' Compensation Act (USL&H) extends federal workers' comp benefits to maritime employees who don't qualify under the Jones Act — typically dock workers, longshoremen loading and unloading vessels, ship repairers, harbor construction crews, and marina operations staff. The danger for the agent: standard state WC policies exclude USL&H exposure by default. If your client has even one employee performing maritime work and you wrote only a standard state policy, that employee is uninsured for their actual exposure — and you have a serious E&O issue when a claim happens. USL&H must be added by endorsement (where the state carrier allows) or written as a separate USL&H policy. Stakes: uninsured USL&H penalties run $10,000+ per employee per day, plus full benefit liability falling on the employer. When in doubt — ask. We can place USL&H standalone or coordinate it alongside the state WC carrier.

A ghost policy is a monoline workers' comp policy for a sole proprietor or single-member LLC with no employees, used to satisfy a general contractor's certificate-of-insurance requirement or a municipal licensing rule. Honest answer about wholesale: obtaining a ghost policy can be difficult, and the wholesale market generally does not write them — the premium is too low (typically $650–$1,200 minimum) to justify the underwriting and servicing work, and the product creates administrative friction. Our recommendation for the agent: apply on the insured's behalf through your state's Assigned Risk Plan administrator. The ARP process is designed for these placements; most states issue ghost policies within a few business days at the published minimum premium. (An insured can't bind insurance without an agent — this is the agent's job.) Some retail agents have appointments with carriers that still write minimum-premium ghost policies in the voluntary market — check there first. We're not the right channel for this product, and we'd rather tell you that up front than make you wait three days to hear it.

Most multi-state placements use a single WC policy with each state of operation listed in Item 3.A (states with primary coverage and state-specific endorsements) or Item 3.C ("other states" coverage providing limited automatic coverage outside 3.A states). For the four monopolistic states, you'll need a separate state-fund policy — those exposures can't ride on the master policy. For states with significant payroll, the carrier may require dedicated class-code schedules and separate experience modification factors. The agent's job: identify every state where the insured has employees — full-time, contracted long-term, or even occasional travelers — and make sure each state appears in the right Item on the policy. Missing a state on Item 3.A means coverage may be denied in that state if a claim happens there. Multi-state coordination is one of the most common reasons retail agents bring an account to wholesale; we'll help map exposure to coverage state-by-state.

NCCI (National Council on Compensation Insurance) is the rating organization for 36 states + the District of Columbia. It publishes the loss costs, class codes, experience modification factors, and standard policy forms used by carriers in those states. Eleven states operate independent bureaus with their own class codes (often overlapping NCCI codes but with state-specific additions), separate filing schedules, and unique experience rating methodologies: WCIRB (CA), NYCIRB (NY), NCRB (NC), PCRB (PA), NJCRIB (NJ), WCRIBMA (MA), MWCIA (MN), CAOM (MI), ICRB (IN), DCRB (DE), WCRB (WI). Texas works through TDI filings. Why it matters to your submission: applying NCCI class codes or NCCI mod assumptions to a risk in an independent bureau state produces wrong numbers. Underwriters in those states expect submissions that reference the state bureau's published values, and a submission that doesn't tells the underwriter you may not understand the state. Our interactive bureau map links every state to its bureau and state WC department.

Premium audits reconcile estimated payroll on the policy to actual payroll for the policy period. Disputes typically come from: (a) misclassified payroll (employees coded under the wrong class code — common when a job role bridges two classes), (b) payroll that was excluded but shouldn't have been or vice versa (officers, owners, overtime premium), (c) subcontractor payroll incorrectly added back as "uninsured subcontractor exposure" when the sub actually had valid coverage, or (d) overtime premium portion not properly excluded where state law allows it. Your action plan: gather actual payroll records by job role and pay period, request a copy of the auditor's worksheet showing exactly how each pay-period item was classified, and submit a written re-audit request through us. We escalate directly with the carrier's audit unit. Why wholesale escalation helps: most state DOI rules require carriers to respond within 30–60 days; a wholesale broker with active business with the carrier can push for response timelines that a single retail agent on the phone often can't get. Don't pay a disputed bill before reviewing the worksheet.

We write what most retail markets won't. Categories we routinely handle: roofing, tree service, demolition, oil & gas drilling, mining, long-haul trucking (fleet and owner-operator), EMS / ambulance, security firms (including armed guards), recycling and scrap metal, cannabis operations (cultivation, manufacturing, distribution, retail), USL&H exposures, professional sports and entertainment, amusement and adventure operations, and temporary staffing in light industrial. How to think about this as the agent: if your direct market just declined a risk specifically for the class code, that's typically where we start. We won't always have a market — some risks really do belong in the assigned risk plan — but the wholesale channel sees these classes every day and knows where appetite exists when it exists. Send the basics and we'll tell you fast.

Monthly Self-Reporting (MSR) and Pay-As-You-Go (PAYGO) are different names for the same premium-billing structure: the insured pays each pay period based on actual payroll, instead of paying estimated annual premium upfront with a year-end audit true-up. (Carriers use the terms interchangeably — we use both so agents recognize the concept whichever name they've heard.) The benefit to your client: no large deposit premium, no surprise audit bill at year-end, and cash flow that scales with actual payroll. The majority of the carriers we represent offer MSR / PAYGO options, often integrated directly with the insured's payroll provider so the reporting happens automatically each pay cycle. Excellent fit for any client with variable payroll: construction, temporary staffing, seasonal businesses, and growing employers where payroll changes month to month. The agent angle: on a price-sensitive new-business case, leading with MSR/PAYGO availability can be the difference between a yes and a "we'll think about it." Always worth raising on the first conversation.

When you submit a workers' comp risk to us, here's what happens: You (the retail agent) send the submission package. We review appetite across our carrier panel — many of which you'd have no direct path to write with on your own. We route to the carriers most likely to write the risk based on class code, state, mod, and loss profile. We negotiate terms with underwriting. We present quote options back to you. You take it from there with the client — present, deliver, service the policy. The retail agent keeps the client relationship and the day-to-day service role; we handle the carrier-side mechanics. Your client never sees us as a separate party. The benefit to you: expanded markets without adding direct carrier appointments, faster turnaround on hard-to-place risks, and a specialist who lives in WC every day so you don't have to learn state-bureau differences, class-code disputes, and multi-state coordination from scratch.

With a complete submission in our hands: 24–72 hours for most carriers in standard appetite. With incomplete data, expect a quick request for missing items — that adds 2–5 business days depending on response speed. For very complex placements (large multi-state with high mod, monopolistic-state coordination, USL&H with specialty carriers), 5–10 business days is typical. The fastest path: once we've confirmed appetite, send the ACORD 130, 5 years of currently-valued loss runs, current mod worksheet, narrative on safety controls, and any state-specific supplementals all on day one — don't trickle documents one at a time. Complete clean submissions go to the top of the underwriter's stack. If we've told you on day one we're not going to be able to place the risk, you can move on quickly — that's worth more than waiting a week to hear no.

High-deductible WC means the insured self-funds the first $X per claim — commonly $25,000, $50,000, $100,000, $250,000, or higher — with the carrier handling claims above that retention. Premium drops significantly because the carrier's risk is capped. Right fit when: large stable payroll (typically generating $1M+ in annual standard premium), strong cash flow to fund the deductible side of claims, established claims management (in-house staff or via a third-party administrator), and a favorable historical loss ratio suggesting the insured can outperform the manual rate. Wrong fit when: small or growing businesses where two or three large claims in a year could exhaust working capital — the deductible savings aren't worth the cash-flow risk. For the agent: if a client is asking about "self-insurance" or saying their premium is too high relative to their actual claim experience, high-deductible is the conversation to have. Send us the basics and we'll model it for your client to see whether the math actually works in their favor.

This is one of the toughest classes in the workers' comp market and one of the most-misunderstood by agents — so let's break down what's actually happening. The core mismatch: a typical GC lists only 8810 (clerical office staff) and 5606 (executive supervisor — construction, outside) as their direct class codes. On paper that's a small, low-rate exposure — maybe $300,000 of combined clerical and supervisor payroll at low rates, producing a few thousand dollars of premium. But the actual exposure is the subcontractors doing the framing, roofing, electrical, drywall, HVAC, and other physical work — none of whom appear on the GC's payroll. The premium the carrier collects is tiny relative to the liability they're underwriting. Why this becomes the carrier's problem: under state workers' comp statutes, if a subcontractor's policy lapses (even by a single day), is cancelled, or never existed in the first place, and the sub's employee is injured on the GC's project, the claim defaults back onto the GC's policy. The GC's carrier becomes the responsible payor for an injury caused by someone they never collected premium on. How carriers respond: (1) they price for this exposure — actual premium often runs several times what "just the listed payroll" would suggest, (2) they require strict subcontractor documentation — current certificates of insurance for every sub on every project, GC-side audit of sub coverage at the start of each engagement, additional insured + waiver of subrogation endorsements, indemnification language in the subcontract, and (3) many carriers simply decline to write GCs unless the GC has a documented sub-tracking system that demonstrates discipline. What this means for your submission: when you bring us a GC, the carriers won't just ask about payroll — they'll ask about sub-management practices. Reality check on our appetite: we don't write many GCs in the wholesale market — the class is genuinely tough across the industry. The GCs we DO write tend to have meaningful payroll under actual contracting class codes (carpentry, framing, masonry, etc.), not just 8810 and 5606. A GC with real trade payroll on the books has skin in the game, demonstrable operations beyond a paper company, and a more underwriteable profile. If your insured is essentially a paper GC with only supervisor and office payroll and 100% of physical work pushed to subs, we're often not the right channel — those typically belong in the assigned risk plan or a specialty market that prices for the structure. Bring us the GC story and we'll tell you fast whether it's a fit.