Standard Info needed for Quoting MULTI-STATE Large Accounts

Here is a helpful guideline of what we will need from you, in order to get your multi-state Large Account submissions quoted.  By sticking to this timeline, you will be helping us ensure that we get you your quote by the time you need to present to your client.

Click here to view as a separate pdf.

*6 weeks before Need-by Date:

  • A WCIRB Inspection Report, if available (only if California is one of the states).
  • Summary of the operations and safety practices.
  • Acord 130. (Note: To comply with Florida requirements, if any Florida payroll involved, a notarized FL Acord will be required if bound.)
  • Supplemental Application. (Note: A class specific supplemental may be required such as for electroplating, trucking, and funeral risks.)
  • 2009-2014 Loss Runs valued within 90 days of the effective date.
  • Loss runs must list in which state the incident occurred.
    • If possible, please provide a spreadsheet when loss history is extensive.
      • Please note that the valuation date of the spreadsheet should match the valuation date of the loss run documents.
  • 2009-2014 expiring premiums, separated by CA & Non-CA.
  • 2014 & 2013 WCIRB Ex-Mod worksheets (only if California is one of the states).
  • 2014 & 2013 NCCI Ex-Mod worksheets.
    • If there is a delay with the release of a mod, please provide an esti-mod and explain the reason for delay.
  • 2009-2014 payrolls by class, separated by state.
  • Building information – number of stories high, year built and construction type?

*4 weeks before Need-by Date:

  • Please provide the following information regarding claims with incurred amounts of $25k and above. 
    • Injury details if they are not listed in the loss runs.
    • Please state whether repeat claimants are active employees.
       -- What is the termination date, if they are no longer with the company?
    • What corrective actions have been taken?

*2 weeks before Need-by Date:

  • A copy of the insured’s most recently audited or reviewed financial statements.
    • Balance Sheet(s).
    • Statement(s) of Income.
    • Statement(s) of Cash Flows.


Additional Questions-

  • Do you control this account?  If so, for how many years?
  • Is the incumbent carrier offering renewal?
    • If account is non-renewed, please explain reason for non-renewal.
  • Is it written on a Loss Sensitive Program e.g. Deductible Program, Retro?
    • If yes, please provide details.
  • What is your target including taxes and fees?
    • At what commission level?
  • Where has the account been marketed to?
  • What is your need by date?
Posted on January 21, 2014 .