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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

$40,404- Min Annual Payroll (effective 10.01.07).

LLC Members

Statutorily excluded.  Partnership status.  Treated as employee.

Subject to same rules as partners.

Members engaged in a vocation, profession, or business on a substantial full-time basis are statutorily excluded. 

May elect coverage.

Corporate Officers: Corporations

$12,116- Min Annual Payroll (effective 10.01.07).

Executives may be excluded by endorsement.

 General Liability Information:

 Owners Wages for General Liability:

Individuals and Partners

$31,600- flat annual (effective 07.07.84).

Corporate Officers & LLC Members

$31,600- flat annual (effective 07.07.84).

WI Resources & Links:

 WI Workers Compensation Forms:

State of Wisconsin

http://www.wisconsin.gov/state/home

Department of Workforce Development

http://www.dwd.state.wi.us/

Workers’ Compensation Division

http://www.dwd.state.wi.us/wc/default.htm

Mailing Address:
Post Office Box 7901
Madison, Wisconsin 53707-7901
 

Street Address:
Room C100
201 East Washington Avenue
Madison, Wisconsin 53703
(608) 266-1340; Fax: (608) 267-0394; Fraud (608) 261-8486

Workers’ Compensation Advisory Council

http://www.dwd.state.wi.us/wc/councils/wcac/default.htm

(608) 266-6841
Frances Huntley-Cooper, Chairman

Wisconsin Compensation Rating Bureau

https://www.wcrb.org/WCRB/wcrbhome.htm

Mailing Address:
Post Office Box 3080
Milwaukee, WI 53201-3080
 

Street Address:
20700 Swenson Drive, Suite 100
Waukesha, Wisconsin 53186
(262) 796-4540, Fax: (262) 796-4400

Wisconsin Labor and Industry Review Commission

http://www.dwd.state.wi.us/lirc/
 

Mailing Address:
Post Office Box 8126
Madison, Wisconsin 53708-8126
 

Street Address:
Wisconsin Public Broadcasting Building
3319 West Beltline Highway
Madison, Wisconsin
(608) 266-9850 Fax: (608) 267-4409
E-mail: dwdlirc@dwd.state.wi.us

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.