Workers Comp Quick Links

Workers Comp Online Submission
Acord Worker’s Comp Application (Acord 130)
Small Deductible Form (AR)
Small Deductible Form (OK)
Kansas Election Form
Kansas Rejection Form
ERM 14 Form
Swiss Re Audit Dispute Form
Payment Options
Certificate Request
Click on the link to the right to issue certificates of Insurance. For a User ID and Password contact Nikki Lairson, Dustin Hammond or Kelly Clark



For more info, contact a Commercial Lines Underwriter:
Kelly Clark or Dustin Hammond


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