The Workers Compensation Application is needed for almost every business with employees. Last time I looked – and it has been a while – the magic number of employees that required you to carryworkers compensation insurance was 4. Your state or industry may be different.
The Workers Comp app is self contained and does not require the ACORD 125.
Basic Workers Comp Application forms
ACORD 130 – Workers Compensation App – all states except Florida
The Worker Compensation Application provides for workers’ compensation, employer’s liability, and voluntary compensation coverages.
ACORD 134 – Workers Comp App Supplement – Multi-state rating worksheetFlorida
The Workers Compensation Application Supplement should be used when more space is required to record rating information for multiple states.
ACORD 63 – Fraud (Some states require a state specific form)
You should have your insured sign the General Fraud Statement as a matter of course.
Some states have specific wording for their Fraud Forms. You should use any state specific form that applies instead of the general form.
ACORD 64US Workers Compensation- Terrorism Coverage Rejection
The workers Compensation Application allow your insured to reject Terrorism Coverage. Use the ACORD 60US if your insured wishes to reject Terrorism Coverage.
The following states have additional forms…
For Workers Compensation Risks which can not be written voluntarily, you need to use the Assigned Risk Application for these.
ACORD 133 Workers Compensation Insurance Plan Assigned Risk Section – Except for the following states…