WORKERS’ COMPENSATION (WC):

Copy of WC Declaration Sheet (WC codes and experience modifications):

Three (3) years of WC Loss Runs

UNEMPLOYMENT COMPENSATION:

Copy of State Unemployment Tax Return

BENEFITS:

Copy of current Health Insurance Invoice (include dental, life insurance, disability (if applicable)

Over 100 Employees – Claims experience for previous twelve (12) months

Census

Previous Health Rates or Renewal Rates

If currently with a PEO, please provide copy of payroll register in lieu of current health invoice

Summary Plan Description for Health Insurance.