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Available Programs:

 Carrier Risk Tolerance:

Pay As You Go Workers' Compensation

N/A  Monopolistic State.

Direct Bill Work Comp

N/A  Monopolistic State.

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

LLC Members

Corporate Officers: Corporations

 General Liability Information:

 Owners Wages for General Liability:

Individuals and Partners

Corporate Officers & LLC Members

ND Resources & Links:

 ND Workers Compensation Forms:

State of North Dakota

http://www.nd.gov/

Workforce Safety & Insurance

http://www.WorkforceSafety.com/

1600 East Century Avenue, Suite One
Bismarck, North Dakota 58506-5585
(800) 777-5033, (701) 328-3800; Fax: (701) 328-3820

Fraud: (800) 243-3331

Safety and Loss Prevention: (701) 328-3886

TDD: (701) 328-3786
E-mail: WorkforceSafety@wcb.state.nd.us
 

Workforce Safety & Insurance Board of Directors
Post Office Box 2174
Bismarck, North Dakota 58502-2174

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.