Employers Insurance Group

Program Overview

Limitations:

• Applicant must have been in business for three years with no lapse in operations
• Applicant must currently use (or be willing to switch to) Blue Shield as their Health Care Provider
• Other restrictions may apply depending upon class code - please contact your IFN representative for more information

Requirements

• Completed and signed Acord application with FEIN and full description of applicant's business and operation
• Completed supplemental questionnaire
• Four years of payroll and premium history (by year)
• Four years current valued carrier loss runs (dated within 90 days of effective date)
• Details of any claims over $20,000, with a description of insured's actions to avoid/reduce future losses of a similar nature
• Copy of the current Ex Mod worksheet for the applicant
• Bureau Inspection Report if available
• Current financial statements

Forms & Information