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Information Requirements
The following information is generally required:
  • Completed and signed ACORD WC Application.
  • Copy of the most recent two experience modification worksheets issued by the Workers Compensation Rating and Inspection Bureau of Massachusetts.
  • Recently valued loss runs for the current and 4 prior policy terms.
  • Complete copy of prospective member's most recent CPA prepared financial statement.
  • Employee Concentration Form (required only if prospective member has more than 250 employees at any one location).
Prospective Member Eligibility Criteria
  • Prospective member must be a private educational institution, a cultural institution, or a related organization, and must be organized as a non-profit.
  • Minimum premium - None
  • Membership in New England Educators Insurance Association.
  • A satisfactory physical prospect loss control survey may be required. Employer commitment to employee safety and WC claim cost containment must be apparent.
  • Based upon information presented in the most current CPA prepared financial statement the ratio of unrestricted net assets to standard premium must be at least 10 to 1 and the overall financial condition must be favorable.
  • Experience modification generally must be 1.00 or less. Exceptions will be considered based upon an analysis of the factor(s) causing the debit modification and the degree to which those factors still exist.
  • Overall loss experience and loss trend must be favorable during the most recent 5 years. Unfavorable experience in any given year will be analyzed to determine causes and likelihood of recurrence.
  • ISCC affords coverage for Massachusetts employees in accordance with the Massachusetts Workers' Compensation Law. Prospects with other workers' compensation exposures, such as, for example, locations in other states, must confirm that appropriate coverage for these non-Massachusetts exposures has been arranged.
  • Approval of ISCC's excess insurance carrier may be required prior to binding coverage. The underwriting referral to the excess carrier will generally require a complete underwriting file, including a loss control survey.
  • Membership requires approval by the Board of Directors.
  • Have a pro-active Safety Committee Meeting that meets at least quarterly. In the event that you have a Summer Session you will need to have at least one meeting during the summer
  • Have a modified/transitional duty program in place that will allow you to return an injured employee to his/her original position. Our claims and risk control departments will be glad to assist you in implementing this program
  • Attend at least one of the ISCC Safety Workshops which are held throughout the year
Other Requirements Prior To Binding Coverage
  • Receipt of Deposit Premium
  • Completed and signed Application and Indemnity Agreement.
  • Completed and signed Application for Membership in a Workers Compensation Self-Insurance Group (SIG Form 3).
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