Submission Requirements

AEU's Submission Requirements for Accounts:

  • Completed and signed Acord Workers' Compensation Application
  • Currently valued loss runs (five years preferred)
  • Five-year gross payroll history
  • Financials
  • Current NCCI Experience Modification Worksheet

Additional information which will assist in the quoting process:

  • Details on large claims 
  • Explain any changes in operations over the last five years regarding payroll fluctuation or loss history
  • Safety programs

 

Advantage by AEU's Submission Requirements for Accounts <$150,000 in Premium: 

  • Completed and signed Acord Workers' Compensation Application
  • Currently valued loss runs (three years preferred)
  • Three-year gross payroll history
  • Current Experience Modification Worksheet

Additional information which will assist in the quoting process:

  • Details on large claims
  • Explain any changes in operations over the last five years regarding payroll fluctuation or loss history
  • Safety programs

To request a quote please contact us by clicking here