How to Get Your Experience Mod Worksheet

NCCI-States-Map-2014Your Experience Modification Worksheet provides critical calculation info for underwriters. The worksheet allows them to get a quick glance at the riskiness of your organization.

NCCI (the National Council on Compensation Insurance) manages the Workers Compensation details in most states. A few states (see map) operate their own independent bureau. And then, four states, WA, WY, ND, & OH operate the only Workers Compensation option in the state.

For Employers in NCCI States

NCCI provides a letter with 9-digit Risk ID, a “PIN” number and instructions for downloading the Experience Modification Factor Worksheet (aka: Experience Mod Worksheet) directly through their website.

In case you can not locate the letter, you may be able to find the 9-digit Risk ID on your existing policy or a prior worksheet. Alternately, you may call NCCI at 800-622-4123 and then dial option “4”, where you can receive your pin over the phone.

Experience Rating Worksheet For California Employers

If you do not have a copy of your Experience Rating Worksheet, you can request it for free from the WCIRB by filling out this form.

Jon Barron

Jon Barron

Branch Manager:
Colorado Springs, CO

(719) 488-3206 Direct