How to Get Your Experience Modification 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, AAI

Branch Manager at Merriam Insurance Agency
7900 East Union Avenue, Suite 1100
Denver, Colorado 80237

(719) 488-3206 Direct

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