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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

Pending info.

LLC Members

Pending info.

Corporate Officers: Corporations

Pending info.

 General Liability Information:

 Owners Wages for General Liability:

Individuals and Partners

Pending info.

Corporate Officers & LLC Members

Pending info.

RH Resources & Links:

 RH Workers Compensation Forms:

State of Rhode Island

http://www.state.ri.us/

Workers’ Compensation Court

http://www.courts.state.ri.us/workers/defaultnew-workers.htm

One Dorrance Plaza
Providence, Rhode Island 02903
(401) 458-5000, Fax: (401) 222-3121

Medical Advisory Board

http://www.courts.ri.gov/workers/medical/medical-advisory.htm

One Dorrance Plaza
Providence, Rhode Island 02903
(401) 458-3460

Workers’ Compensation Advisory Council
194 Smith Street
Providence, Rhode Island 02908
(401) 751-7100

Department of Labor and Training

http://www.dlt.ri.gov/

1511 Pontiac Avenue
Cranston, Rhode Island 02920-4407
(401) 462-8000

Workers’ Compensation Division

http://www.dlt.ri.gov/wc/

Street Address:
1511 Pontiac Avenue, Building 69, Second Floor
Cranston, Rhode Island 02920-0942
 

Mailing Address:
Post Office Box 20190
Cranston, Rhode Island 02920-0190
(401) 462-8100, Fax: (401) 462-8105, TDD: (401) 462-8006

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.