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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 Packages- 12 Equal Installs

Non-construction risks only.

Workers Compensation Information:

 Owners Wages for Workers' Compensation

Individuals and Partners

$36,600.00- annual (effective 04.01.10)

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

LLC Members

Statutorily excluded.  Partnership status.  Treated as employee.

Applies to members devoted full-time to business.

Members may elect to be exempt.

Corporate Officers: Corporations

$18,148- Min Annual Payroll (effective 04.01.10).

Executives may be excluded by endorsement.

 General Liability Information:

 Owners Wages for General Liability:

Individuals and Partners

$24,800- flat annual (effective 07.01.84).

Corporate Officers & LLC Members

$24,800- flat annual (effective 07.01.84).

NC Resources & Links:

 NC Workers Compensation Forms:

State of North Carolina

http://www.ncgov.com/

Work Comp Bureau: 919.582.1056

Department of Commerce

http://www.nccommerce.com/

Mailing Address:
4301 Mail Service Center
Raleigh, North Carolina 27699-4301
 

Street Address:
301 North Wilmington Street
Raleigh, NC 27020-0571
(919) 733-4151
E-mail: info@mail.commerce.state.nc.us

North Carolina Industrial Commission

http://www.ic.nc.gov/

Mailing Address:
4340 Mail Service Center
Raleigh, North Carolina 27699-4340
 

Street Address:
Dobbs Building (sixth floor)
430 North Salisbury Street
Raleigh, North Carolina 27603-5937
(919) 807-2500, Fax: (919) 715-0282, InfoSpec@ic.nc.gov,

Fraud: fraudcomplaints@ic.nc.gov, Safety: safety@ic.nc.gov
Fraud Investigations Section: (888) 891-4895 (in North Carolina)

fraudcomplaints@ic.nc.gov

http://www.ic.nc.gov/ncic/pages/fraud.htm

Safety Education Section: (919) 807-2603

safety@ic.nc.gov

http://www.ic.nc.gov/ncic/pages/safety.htm

Workers’ Compensation Information Specialists Section

(formerly Ombudsman Section): (800) 688-8349 InfoSpec@ic.nc.gov

http://www.ic.nc.gov/ncic/pages/ombudsmn.htm

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.