410-268-6868
|
info@insuranceforce.net
Submit How’s My Driving Report
Safety Training Classes
Industries
Electrical
HVAC
Life Sciences
Landscaping
Painters
Subscribe
About
Mission Statement
Our History
Our Team
Dain Caplan
Jackie Niblock
Jen Scaturro
Kate Noble
Maggie Taylor
Matthew Stangle
Melissa Tarawali
Morgan Holmes
Natasha Skinner
Ryan Stangle
Published Articles
Blog
Sitemap
Employee Benefits
Group Benefits
Individual Insurance
Health Care Reform Guide
Health & Wellness
Compliance Checklist
Benefits Trend Report
Business Insurance
Industries
Electrical
HVAC
Life Sciences Insurance
Landscaping
Painters
Types of Insurance
Our Process
Risk Management
Safety Program
Submit Driving Report
Auto Fleet Program
Workers’ Comp.
Access Your Policy
HR
HR Client Login
HR Support Services
COVID-19
Contact Us
Request a Consultation
Individual Insurance Quote
Workers’ Comp Quote
Workers’ Compensation Quote
Home
Workers’ Compensation Quote
Workers’ Compensation Quote
Matthew Stangle
2012-12-06T23:19:13-05:00
The questions below will help faciliate a workers compensation quote. Additional information may be required for a more accurate and bindable quote.
Name
Email
Company
Entity Type
Corporation
Partnership
Individial
Limited Liability Co
Non-Profit Corporation
Non-Profit Limited Liability Co
I Don't Know
Year Business Established
Federal ID Number
Requested Effective Date of WC Policy
Number of Employees
I Have Employees That Live and/or Work OUTSIDE of Maryland
Yes
No
Owners / Officers
Under Maryland law, (1) any officer of a close corporation whether incorporated in Maryland or elsewhere; (2) any member of an LLC; (3) any member of a P.A.; or (4) up to five officers of any other corporation, can elect to exclude themselves from Workers’ Compensation coverage. Sole Proprietors and Partners are automatically excluded and must elect to include themselves.
Name
Title
% of Ownership
Include (I) or Exclude (E)
Estimated Payroll
i.e. MD, Clerical, $120,000 // Common Job Class Descriptions: Clerical, Outside Sales, Driver, Service, Installation
State
Job Class Description
Annual Payroll
The Payroll Figures Above Include or Exclude Owners/Officers?
Yes, owner/officers' payroll is INCLUDED
No, owners/officers' payroll is EXCLUDED
Number of WC losses in last 3 years:
0
1
2
3
4
5 or more
Approximate Dollar Amount of Losses Paid