This service provides an easy, confidential, and time-saving way for business owners to apply for workers compensation insurance coverage electronically.

Please carefully read all instructions, as they will guide you step-by-step through each page and indicate what information is required before you will be allowed to proceed.

During the completion process, please use the Previous and Next buttons located at the bottom of the page to navigate through the form. If you need to stop the process and return later, click the Stop & Return Later button. If further assistance is still needed, you may either contact us via email atUnderwriting Inquiryor visit ourContact Uspage for local and toll-free customer service phone numbers.

Once you have successfully completed all screens, you will reach the Final Verification screen. At this point, you have the opportunity to print or save electronically a completed Application for Insurance for your records (we encourage you to do this). Click Finish to proceed to the Application Received screen.

When you are directed to the Application Received screen, you will see the finishline flags. This serves as your indication that your application has been successfully submitted to WSI. Please do not mail any paper applications to WSI.

Thank you for using our online Application for Insurance. If you have any suggestions to improve this process, please visit ourContact Uspage and share your thoughts with us!