Workers' Compensation Insurance Quote

Shucks...we don't have any options in your state at this time. We're adding new states soon, so please check back again.

Let's start with your name.

Business Name(Required)

State

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Zip Code

Use the zip code for the primary business location

Class Description	Payroll	Actions

There are no Classes.

Placeholder - Min Subtotal

LCM - Low

Erie Co of NY

LCM - Mid

Erie Flagship

LCM - High

Erie Exchange

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How many years have you been in business?(Required)

Include your experience as a sole proprietor if you have recently formed a new entity.

How many years of experience do you have in the industry?(Required)

Years of experience prior to starting your business.

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Class Description 1

Search to select the job description that matches best. If you have multiple descriptions to include, start with the one that has the highest amount of payroll and then add the others separately.

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Class Code 1

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What is the annual W2 Payroll for the business?

Please enter a number greater than or equal to 0.

Enter "0" if you don't have any W2 payroll.

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To include any owner(s) in coverage, enter their total annual payroll?

Please enter a number greater than or equal to 0.

To EXCLUDE the owner(s) from coverage, enter "0".

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What is the annual Uninsured 1099 Payroll for the business?

Please enter a number greater than or equal to 0.

Enter "0" if you don't have any uninsured 1099 payroll. This would mean Just remember, all workers comp policies are audited each year. Without proof of insurance for those 1099 subs, it will automatically be added to your policy. Make sure you get and maintain proof of coverage for all subs.

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Class 1 Payroll

It's ok to enter "0" if you don't have payroll and you are excluding coverage for the owner(s). Just don't forget to include 1099 labor as payroll if your subs don't have their own insurance.

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Class 1 Loss Cost

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Class 1 Subtotal - Low

Class 1 Subtotal - Mid

Class 1 Subtotal - High

Class 1 Min - Low

Class 1 Min - Mid

Class 1 Min - High

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Option 1

pending
Low

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Medium

pending
High

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Add a 3rd Class

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Class 3

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Class Description 3

Search to select the job description that matches best.

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Class Code 3

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What is the annual W2 Payroll for the business?

Please enter a number greater than or equal to 0.

Enter "0" if you don't have any W2 payroll.

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To include any owner(s) in coverage, enter their total annual payroll?

Please enter a number greater than or equal to 0.

To EXCLUDE the owner(s) from coverage, enter "0".

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What is the annual Uninsured 1099 Payroll for the business?

Please enter a number greater than or equal to 0.

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Class 3 Payroll

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Class 3 Loss Cost

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Class 3 Subtotal - Low

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Class 3 Subtotal - Mid

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Class 3 Subtotal - High

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Class 3 Min - Low

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Class 3 Min - Mid

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Class 3 Min - High

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Add a 4th Class

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Class 4

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Class Description 4

Search to select the job description that matches best.

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Class Code 4

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What is the annual W2 Payroll for the business?

Please enter a number greater than or equal to 0.

Enter "0" if you don't have any W2 payroll.

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To include any owner(s) in coverage, enter their total annual payroll?

Please enter a number greater than or equal to 0.

To EXCLUDE the owner(s) from coverage, enter "0".

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What is the annual Uninsured 1099 Payroll for the business?

Please enter a number greater than or equal to 0.

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Class 4 Payroll

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Class 4 Loss Cost

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Class 4 Subtotal - Low

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Class 4 Subtotal - Mid

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Class 4 Subtotal - High

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Class 4 Min - Low

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Class 4 Min - Mid

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Class 4 Min - High

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Add a 5th Class

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Class 5

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Class Description 5

Search to select the job description that matches best.

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Class Code 5

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What is the annual W2 Payroll for the business?

Please enter a number greater than or equal to 0.

Enter "0" if you don't have any W2 payroll.

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To include any owner(s) in coverage, enter their total annual payroll?

Please enter a number greater than or equal to 0.

To EXCLUDE the owner(s) from coverage, enter "0".

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What is the annual Uninsured 1099 Payroll for the business?

Please enter a number greater than or equal to 0.

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Class 5 Payroll

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Class 5 Loss Cost

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Class 5 Subtotal - Low

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Class 5 Subtotal - Mid

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Class 5 Subtotal - High

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Class 5 Min - Low

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Class 5 Min - Mid

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Class 5 Min - High

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Do you need to add a Waiver of Subrogation?

Yes

If you're not sure- answer "no". This would be a very specific requirement from a customer that you wouldn't need to add unless it was requested.

Experience Modification Factor

Please enter a number from .5 to 1.5.

This number is calculated based on your premium and claims history. If you don't know it or this is a new business, the default is 1.0.

Total Payroll

Incr Limit Factor - 500k

Incr Limit Factor - 1m

WOS Factor

WOS Minimum

Manual Premium - Low

Manual Premium - Mid

Manual Premium - High

WOS Premium - Low

WOS Premium - Mid

WOS Premium - High

Standard Premium - Low

Standard Premium - Mid

Standard Premium - High

Stock Premium Discount - Low

Stock Premium Discount - Mid

Stock Premium Discount - High

Expense Constant - Low

Expense Constant - Mid

Expense Constant - High

Calculated Premium - Low

Calculated Premium - Mid

Calculated Premium - High

Min Premium - Low

Min Premium - Mid

Min Premium - High

Terrorism - Low

Terrorism - Mid

Terrorism - High

Catastrophe - Low

Catastrophe - Mid

Catastrophe - High

Total WC Premium - Low

Total WC Premium - Mid

Total WC Premium - High

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GL Section

Copied from GL quote form

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Business Description

Choose the description that best describes your operations. Try typing a keyword or term to narrow the choices.

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ESB Code

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GL Code

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Class1 Industry

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Exposure Basis

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W2 Payroll

NOT including 1099 payroll or owners

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Uninsured 1099 Labor Cost

Be sure to account for all 1099 individuals or businesses that do NOT have their own insurance.

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Active Owner Payroll

You must include a minimum of $10,000 payroll per 'Active' owner and you must have at least 1 active owner.

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Exposure

Hidden total referenced in other fields

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Class Description (2)

Choose the description that best describes your operations. Try typing a keyword or term to narrow the choices.

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ESB Code2

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GL Code2

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Exposure Basis2

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Please enter a number from 1 to 100000000000.

Indicate the amount of exposure for this class

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Class Description (3)

Choose the description that best describes your operations. Try typing a keyword or term to narrow the choices.

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ESB Code3

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GL Code3

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Exposure Basis3

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Please enter a number from 1 to 100000000000.

Indicate the amount of exposure for your chosen operations.

Address(Required)

Street Address City State Zip Code

Phone

Additional Policy Types

Select other policies you are interested in. You'll have an opportunity to quote them separately.

Commercial Auto

General Liability

Other Commercial Policy

Personal Home or Auto

Life Insurance

Workers’ Compensation Insurance Quote

Shucks...we don't have any options in your state at this time. We're adding new states soon, so please check back again.

- Based on the payroll and class selections for your business, your premium should fall in the following range.

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Option 1

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Class 2

Class 2 Subtotal Range

Class 3

Class 4

Class 5

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