Workers’ comp · For contractors and owners who hire
Workers’ comp application.
The questions the workers’ comp carriers ask, across five sheets: the business, locations and payroll by class, owners and officers, the carriers’ underwriting questions, and coverage and history. The questions change with your answers. Answer what you can and send it from the review sheet. Our brokerage takes it to market and comes back with quotes, or with questions.
Plan on 20 to 35 minutes for one trade and one location, with a payroll report to hand. Your answers are kept in this browser tab only, with no account. Closing the tab clears them, so gather your documents first (the checklist lists them).
* Insurers need this to quote. You can send with blanks; we’ll ask for the rest.
What to have on hand: a payroll report by job and your current policy (4 things)
Most of it comes off your payroll records, your current policy and the loss runs from your carrier. Answer counts assume one trade, one location and no claims history.
A payroll report by jobAnnual payroll and headcount for each kind of work, at each location.
Your owners and officersEach one’s title, ownership share and duties, and whether they are included or excluded. A Social Security number is optional here.
Your current policyThe declarations page and, if you have one, the experience mod worksheet.
Loss runsFive years of workers’ comp claims history from your current carrier. You can send them after by replying to your confirmation email.
Start from your documents
Pre-fill this application from your documents
Drop a payroll report, your current policy or loss runs. We fill in answers you’ve left blank, and you check each one before you send.
Drag files here, or
PDF, photo (JPG, PNG, HEIC), Excel .xlsx, Word .docx, text or CSV. Up to 4 MB a file (larger photos are shrunk to fit), 12 files in all.
Good documents for this application
A payroll report by job
Your current policy
Loss runs
Files are read to fill in answers and are not kept. An AI provider reads them under terms that don’t let it train on them.
Application
Workers’ comp application
Sheets
05
One trade, no claims
about 79 answers, 61 required
Subs, a mod and claims
about 105 answers, 75 required
Status
Your answers go to Light RFP when you press Send. Files you drop in are read to fill in answers, and not kept.
Files you drop in fill in answers you’ve left blank.
WC-01
Business
Who is applying, what the business does, and how to reach you.
0/17required answered
Applicant
As it appears on your tax filings.
If applicable.
If: Has a FEIN
Nine digits. The carriers key the account on it.
years
Counting experience before this business was founded. A new business is rated on it.
If you have one.
Four digits, if you know it. Some carriers and bureaus key on SIC rather than NAICS; we look it up otherwise.
For a contractor: the kind of work, residential or commercial, new construction or service, the equipment you run, and what you subcontract out. The class codes are chosen from this.
$
The last twelve months, or your estimate for the first year.
employees
Contact
Other contacts
The auditor calls this person. Leave blank if it is the contact above.
Leave blank if it is the contact above.
Leave blank if it is the contact above.
After you send
From application to bound policy.
1
Class codes
Every carrier rates off its own class-code catalogue. We choose the code at each carrier by hand before anything is submitted, because a wrong one misprices the policy or looks like a decline.
2
Quotes
Each carrier answers on its own schedule. We show you the offers you can accept, side by side: the premium, whether the insurer is licensed in your state or writes surplus lines, and anything the underwriter still wants.
3
Bind
Pick one, confirm the effective date and the owner elections, and the policy, the certificate and a payment link are issued. Pay-as-you-go billing is set up with your payroll provider at this point if you want it.
Send us a payroll report and the loss runs and we’ll fill this in with you.
Rather go through it on a call? Schedule a call, or write to Light RFP’s insurance team: insurance@lightrfp.com
