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Workers' Compensation Programs

 
Welcome...to the Number One Insurance Agency’s Workers’ Compensation Program!  For ease of use, please read through the Table of Contents below to see what information you need and "click" on the appropriate link for quick, easy desk access. Just remember, things constantly change. We will do our best to keep this site up to date with rates, notices, underwriting changes, etc.  Thank you for your interest and we look forward to working with you!
Table of Contents
  1. Who's on our Team?
  2. Ineligible Risks
  3. How to Submit Business
  4. MA WC Rating & Inspection Bureau's: Class Code Lookup
  5. Acord 130 – Workers Compensation Application & Completion Instructions
  6. Form 153 – to Exclude Coverage for Corporate Officers
  7. Instructions on ERM 14 [read first] / ERM 14 – to Change Ownership/Entity
  8. General Information:
  9. Our Markets [Contact Information (audits, claims, service, etc.), Billing, Certificates of Insurance & Workflow]
    Prior Carrier Information:
  10. Additional Questionnaires:
  11. Waiver of Subrogation options available by carrier:
    Norfolk & Dedham –
    reviews on an individual request basis.  Please submit details of request to include the details of the job, work tasks being performed and estimated time frame.  Once reviewed by underwriting, we will inform you if available or not.
    The Hartford –
    requires an application and a premium is charged if offered:
    The Hartford’s Application for Waiver of Subrogation
    Alternative Market –
    requires an application and a premium is charged based upon type of waiver.  The carrier prefers to offer “Specific Waiver” and premium is charged at 5%/$100 of payroll for the designated class based on the “Specific Job”.  Blanket Waivers can be entertained with underwriter review and approval and the premium charge is 2% of the policy premium.
    Alternative Market's Application for Waiver of Subrogation
  12. Declination Procedures
  13. Programs' Commission Rates