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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 only

Commercial Insurance- Standard Lines

Most Risks

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

Sole-proprietors and Partners are statutorily excluded from work comp coverage. Covered only if endorsed on policy at flat $49,800.00- Min Annual Premium (01.01.10).

LLC Members

Corporate Officers: Corporations

If 1 owner only (100% stock), then may elect to exclude coverage.

If multiple owners, then statutorily included:

$18,980- Min Annual Payroll/$150,980 Max (as of 01.01.10)

*Notes

Source:  Indiana Workers Comp Rating Bureau

 General Liability Information:

 Owners Wages for General Liability:

Individuals and Partners

$27,300- flat annual (effective 07.01.84).

Corporate Officers & LLC Members

$27,300- flat annual (effective 07.01.84).

IN Work Comp Resources & Links:

 IN Workers Compensation Forms:

State of Indiana

http://www.in.gov/

Workers’ Compensation Board of Indiana

http://www.in.gov/workcomp/

Government Center South
402 West Washington Street, Room W-196
Indianapolis, Indiana 46204
 

(317) 232-3808; Claims/Statistics: (317) 233-4930

Fax: (317) 233-5493;

Insurance: (317) 233-3910;

Ombudsman: (800) 824-COMP (2667), (317) 232-5922

Indiana Compensation Rating Bureau (ICRB)

http://www.icrb.net

Street Address:
5920 Castleway West Drive
Indianapolis, Indiana 46250
 

Mailing Address:
Post Office Box 50400
Indianapolis, Indiana 46250
(800) 622-4208, (317) 842-2800; Fax: (317) 842-3717
E-mail: icrb@icrb.net

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.