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Available Programs:

 Carrier Risk Tolerance:

Pay As You Go Workers' Compensation

All risks acceptable:  low, medium, and high.

Includes risks such as contractors, trucking, roofing, and temporary staffing.

Direct Bill Work Comp

All risks acceptable:  low, medium, and high.

Pay As You Go General Liability

Contractor and service risks acceptable:  low, medium, and high.

Commercial Insurance- Standard Lines

Limited

Commercial Packages- 12 Equal Installs

Non-construction risks only.

PaySmart Payroll & Insurance Management

Available

Workers Compensation Information:

 Owners Wages for Workers' Compensation

Individuals and Partners

$31,200.00- annual (effective 01.01.08).

Sole-proprietors and Partners covered only if endorsed on policy.

LLC Members

The treatment of LLC's has not been addressed by the state of Arizona.

Corporate Officers: Corporations

$17,940- Min Weekly Payroll (effective 10.01.07).

Executives may be excluded by endorsement.

*Notes

 General Liability Information:

 Owners Wages for General Liability:

Individuals and Partners

$26,400- flat annual (effective 07.01.84).

Corporate Officers & LLC Members

$26,400- flat annual (effective 07.01.84).

AZ Work Comp Resources & Links:

 AZ Workers Compensation Forms:

State of Arizona

http://www.state.az.us/

 
Industrial Commission of Arizona

http://www.ica.state.az.us/
 

800 West Washington
Phoenix, Arizona 85007
or
Post Office Box 19070
Phoenix, Arizona 85005-9070
 

(602) 542-4411, Fax: (602) 542-7889;

Ombudsman: (602) 542-4538, Fax: (602) 542-4350

Industrial Commission Review Board

State Compensation Fund (SCF Arizona)

http://www.scfaz.com/

3031 North Second Street
Phoenix, Arizona 85012

(602) 631-2000; Fax: (602) 631-2213

Acord 130 Form

Certificate Request Form

ERM-14 Form

Order Loss Runs (Example)

NCCI Mod Authorization

* Information contained herein is based on the most accurate data as of the time of posting.  Please check with you states Division of Workers' Compensation Insurance for the most up to date information and to verify accuracy.