Request a Proposal

Proposal Procedure

To obtain a proposal for workers’ compensation coverage, you must first complete the following forms:

2019 Estimated Payroll Guidelines
• Letter of Authority

The 2019 Estimated Payroll Guidelines can be used if you have questions about filling out the form.  Please remember to enter the effective date of coverage.  This will help determine the prorated premium.

Next, prepare the Letter of Authority and return to MBWCF.  This letter allows the Fund to access your workers compensation loss history so we can determine your experience modification factor.  New members that have a .95 experience modification factor or lower qualify for a premium off-set discount during the first year of coverage. This discount has been instituted to provide a reduction in initial costs because new members are not eligible to receive distributions from the Fund until their second or third year of enrollment. For more information on how experience modification factors are calculated please see the Resources page.

The estimated premium statement we provide to you will show your annual and pro-rated premiums.

For questions or clarification, please contact Natisha Jorae at 517-342-9062.