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HABLAMOS ESPAÑOL
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Get a Quote For Your Workers Compensation
What is the legal name of your business?
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Do you operate under any DBAs (Doing Business As)?
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What is your business structure? (LLC, Corporation, Partnership, Sole Proprietor, Nonprofit, etc.)
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What is your Federal Employer Identification Number (FEIN)?
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What industry are you in?
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What services or products does your company provide?
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What year was the business established?
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What is your physical business address?
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Phone
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Email
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How many employees do you currently have? Full-time?Part-time? Seasonal or temporary?
Do you hire subcontractors or independent contractors? If yes: Do you require them to carry their own workers’ comp insurance?
What are the job duties of your employees? (This helps assign class codes)
Do any employees travel or work out of state?
Do any employees work remotely or from home?
Do employees perform any hazardous tasks? (e.g., climbing, driving, using machinery)
What is your estimated annual payroll for the next 12 months? Can you break it down by job role or department?
Do you use a payroll service provider?
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Have you had any Workers' Comp claims in the past 3–5 years? If yes: How many? What were the circumstances?
Do you have a workplace safety program in place?
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Do you conduct regular safety training or risk assessments?
Do you currently have a Workers’ Comp policy in place? If yes: Who is the carrier, and when does it renew?
Have you ever been denied Workers’ Comp coverage?
Do you need coverage for owners/officers? (Many owners opt out or need special election)
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Are you looking for specific coverage amounts or limits?
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Do you need any special endorsements? (e.g., additional insureds, waiver of subrogation)
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