Resources | FAQs

Manage your work comp policy with confidence.

Click on a topic to see the list of frequently asked questions.

If you have additional questions please contact us or call 1.800.442.0593.

Work Comp Basics
Work Comp Benefits
Claims Pay Portal for Worker Benefits
Classification and Payroll Reporting
Reporting and Managing Claims
Medical Care
Nurse Triage & Telehealth
Return to Work
Work Comp Basics

You might. Specific coverage requirements vary by state, and generally depend on how many employees you have in your company. Visit our Basics of Workers Compensation page to find your state’s requirements.

It’s easy. Simply get in touch with your insurance agent, and let them know you’d like Previsor as your workers compensation carrier. They’ll take it from there. Don’t have an agent? Click here to find an agent near you.

Your workers compensation premium is calculated based on three factors:

  • Your company’s total payroll, often called remuneration as it includes all forms of compensation
  • Your employee job classifications
  • Your experience modification factor, or e-mod

Your e-mod, or experience modification factor, is one of the primary measurements we use to determine what you pay for coverage. It is calculated by the National Council on Compensation Insurance (NCCI) by comparing the expected losses within your industry with your actual losses. If your losses are lower than expected, your e-mod will be less than 1.00, which will reduce your premium. If they are greater than expected, your e-mod will be greater than 1.00, increasing your premium.

Most states use the NCCI’s e-mod calculation, but your specific calculation and e-mod eligibility requirements may vary.

Remuneration, common called payroll, is another key used in calculating your premium. It includes wages, commissions, bonuses, overtime pay, holiday pay, vacations and sicknesses, payment for piecework, value of housing, cafeteria plans and other forms of compensation.

The best way to control your premium cost is to build a safety culture in your organization and prevent injuries in the first place. Check out our safety resources as a starting point to helping your employees do their jobs safely – and with confidence.

If injuries do occur, managing claims costs can help you keep your e-mod low. Programs like telehealth and drug and alcohol testing can reduce the cost of claims and lower premiums over time.

The Certificate of Insurance, or COI, is evidence that your workers compensation is valid and currently protecting your employees. It shows the name of the certificate holder, the policyholder, insurance company, policy number, type of insurance coverage and policy effective dates. The COI will also indicate whether the owner is covered by the policy. It’s the certificate holder’s responsibility to ensure this certificate is up-to-date and signed.

Not always. For an injury to be covered under your workers compensation policy, the injury must arise from and have occurred within the scope of the employee’s job duties.

Under very specific conditions, yes. For occupational diseases to be covered by a work comp policy, the disease must have arisen out of the scope of the employee’s normal job duties. If work-related exposure is found to be main cause, and meets the requirements of an injury, it may be covered. If work is merely a triggering or precipitating factor, the condition will likely not be covered under a work comp policy.

Most states require workers compensation information to be posted in a common area. To download the posters required for your state, visit our virtual claims kit.


MEM and Previsor policies will be set up to renew at the end of the policy term automatically. Two exceptions include policies greater than $100k and Argonaut Insurance policies as they require special handling. 

The renewal process begins 45 days before the policy effective date and continues on the following timeline until 20 days after.  

  • 45 Days Before – Renewal quote emailed to the agent and available in the portal.  
  • 30 Days Before – Renewal notice mailed to the policyholder and available in the portal.  
  • Policy Effective Date – Policy renewed and emailed to the agent.  
  • 1 Day After – Invoice emailed to the policyholder and available in the portal.  
  • 20 Days After – Payment due or Auto Pay automatically drafted.  

Yes, policyholders can opt out of auto-renewals by contacting Customer Care at 800.442.0593 or 

Policyholders who opt out of auto-renewals will follow this timeline: 

  • 45 Days Before – Renewal quote emailed to the agent and available in the portal.  
  • 30 Days Before – Renewal notice mailed to the policyholder and available in the portal.  
  • Policy Expiration Date – Payment must be made before the policy expiration date, or the policy expires.  

If a policyholder is on Auto Pay and opts out of auto-renewal, the Auto Pay must also be deactivated. 


Make payments 24/7 online using our secure portal or by phone at 1.800.442.0593, M-F 8 a.m. 5 p.m. except for holidays. We accept MasterCard, Visa, Discover, and electronic check.  

Mail payments to:
Missouri Employers Mutual
PO Box 801768
Kansas City, MO 64180-1768

Address overnight payments to:
Missouri Employers Mutual
101 N. Keene St.
Columbia, MO 65201

MEM Customer Care at 1.800.442.0593 or Please have your policy or account number available.

At MEM, we want you to understand exactly what you’re paying for. Some common policy charges you may see on your billing statement include:  

  • Audit Premium – Premium based on the results of an audit that reflects an adjustment to the original estimated premium for the policy year. Adjustments are based on actual payroll and classification exposure.  
  • Expense Constant – An administrative fee applied to every policy for the cost of initializing the policy at the beginning of each policy term. The cost varies by state.    
  • Late Reporting Fee – A per policy fee is assessed when payroll reports are submitted past the due date.  
  • Payment Reversal Fee/Returned Check Fee – A per policy fee of $20 is assessed if your check is returned unpaid for any reason. Returned checks may be re-presented electronically.  
  • Policy Late Fee – A per policy fee of $25 is assessed if the outstanding balance is not received by the due date.  
  • Premium – Work comp premiums are tied directly to payroll totals. Amounts are based on every $100 of payroll in each employee class code.  
  • Service Fee – A per policy fee of $5 is assessed when a billing statement is generated with outstanding premium due.  
  • Terrorism Premium – A federally mandated surcharge of two percent of every $100 of payroll to cover losses that may occur in the event of certified acts of terrorism. 

A description of all charges can be found by viewing the back of your billing statement.  

Yes, in some states we are required to charge the following fees:  

  • Administrative Surcharge – Missouri law requires MEM to collect and forward this surcharge to the state.  
  • Catastrophe Surcharge – This charge covers the losses that may occur in the event of catastrophe (other than Certified Acts of Terrorism) as defined in your policy.  
  • Illinois WC Commission Operations Surcharges (IOC) – Illinois law requires Previsor to collect and forward this surcharge to the Illinois Department of Insurance.  
  • Missouri Second Injury Fund Surcharge (SIF) – Missouri law requires MEM to collect and forward this surcharge to the state. The rate is determined annually by the Department of Labor, Division of Workers’ Compensation.  

We have several payment plans designed with you in mind to choose from. For more information, see our payment options 

Balance Due 
Annual Installment  N/A  Prepaid  
Two Installment  50%  50% Due in 5 Months 
Four Installment  25%  3 Installments Bill Every Other Month 
Six Installment  15%  5 Installments Bill Every Other Month 
Nine Installment  15%  8 Installments Bill Every Month 
Twelve Installment  8.33%  11 Monthly Installments 
Self-Reporting Monthly 15% Collateral  Monthly 
Self-Reporting Monthly | Auto Pay No Collateral Monthly
Self-Reporting Quarterly 50% Collateral  Quarterly 
Self-Reporting Quarterly| Auto Pay No Collateral  Quarterly 
Pay as You Go | Auto Pay  No Collateral  Weekly, Bi-Weekly, Semi-Monthly, or Monthly


The number of payment installments can be changed midterm, however the payment plan type cannot be changed.  

Ex. Switching from an installment payment plan to a reporting payment plan. 

Your billing statement cycle is dependent on the payment plan and payment method selected for your policy. 

Collecting collateral is necessary to protect us (as the insurer) from the risk of providing coverage for which a premium has not yet been collected. You will pay premium based on your reporting period once your actual payroll is determined. The collateral serves as a deposit for the coverage during this initial period. 

To eliminate the collateral requirement we offer annual premium, installment, and new Auto Pay Monthly or Auto Pay Quarterly payment plans. View our payment plans. 

In all cases, collateral is transferred to the new policy term at renewal. If your policy changes from reporting to annual prepaid or installments, the collateral is transferred to the down payment at renewal. Collateral on your billing statement reflects the collateral charge for the policy term. Collateral adjustment is the transfer of collateral held from one year to the next.  

Auto Pay involves transferring funds from one bank account to another. This lets you quickly and securely pay your premium and gives you the most payment options.  

MEM and Previsor Insurance policies can enroll in Auto Pay at any time with an annual, installment, or reporting payment plan, regardless of premium size. Argonaut policies are not eligible.   

View our payment plans or log in to your account to sign up.

The amount debited via Auto Pay is the total amount due that appears on your billing statement. Additional charges, such as audit or endorsement amounts, will be debited as they appear on your statement.  

All amounts will be debited on the stated due date. However, a billing statement with less than $10 due will not be debited from your bank account.  

We will make two attempts to collect payment. If both attempts are unsuccessful, we will reverse the payment, charge a $20 payment reversal fee, and begin our standard delinquency process.  

MEM and Previsor payroll reporting plans include convenient automatic bill payment options. When you select an Auto Pay reporting payment plan there is no collateral required and service fees are waived.  

When you pay using Auto Pay, your premium and related charges are automatically drafted from your bank account according to the frequency of the payroll reporting plan you choose.

Billing statements are created at an account level and include all transactions for multiple policies and policy terms.  

Credits will be applied to any outstanding balance, including amounts owed on previous policy terms, future installments, and/or premium reports. Any credit remaining is refunded to the policyholder, producer, or finance company after the final audit is completed.  

Work comp small deductible plans are policies that help employers better control their insurance costs. By agreeing to a deductible, the employer retains some financial responsibility for claims but gets coverage at a discount. 

A higher deductible usually results in a lower premium. The risk, however, is that you owe your insurer the deductible whenever it pays a claim. 

For more information see Small Deductible Plans 

Yes, paying by check authorizes MEM to use the information to make a one-time electronic funds transfer from your account, or to process the payment as a check transaction. Funds may be withdrawn from your account as soon as the same day we receive your check. You do not receive a check back from your banking institution if an electronic funds transfer took place.  

A change made to your policy that can result in either a debit or credit to your account. Any endorsement amounts bill based on your current payment plan and are included on your billing statement.  

Contact Customer Care at or by phone at 1.800.442.0593. 

If payment is not received by the due date, the company may, based on provisions set forth in the policy, terminate your coverage. Any payments received after the cancellation date are applied toward outstanding balances. Once a policy is cancelled and audited, we refund any credit applicable or bill you for any unpaid premium and any other charges. If you do not pay the final amount due by the due date or make acceptable payment arrangements, the matter may be referred to a third party for collection.  

If your contact information has changed, please email Customer Care at with your updated information 

Work Comp Benefits

Workers compensation benefits are considered reportable but not taxable in most states. Please consult your tax professional for details.

The injured worker should contact Claims Care at 800.442.0593 as soon as they know about the change. Failure to notify us about changes related to the claim could result in delayed benefit payments.  

Employees who suffer a disabling workplace injury or occupational disease exposure that temporarily prevents them from working may be eligible for temporary total disability, or TTD. TTD is generally awarded for the time employees receive treatment and are restricted from work by a physician or an authorized treating physician. TTD benefits are typically two-thirds of an employee’s average weekly wage. Many states limit benefits to a certain amount per week and number of weeks.

We usually average the employee’s wages for the 13 weeks immediately preceding the injury to calculate an average weekly wage. The compensation rate equals two-thirds of the average weekly wage up to the maximum rate. There is a three-day waiting period before benefits are initiated. However, there are exceptions, and this calculation can vary by state 

An injured employee’s prescription eligibility will be reviewed monthly to ensure they receive the proper recovery medications. Any changes to an employee’s condition or medication needs will be reported to the pharmacy by the physician.  

Yes. The workers compensation statute allows for the payment of permanent partial disability (PPD) to compensate an injured worker for the permanent effects of a work-related injury. A certified physician must determine permanent partial disability. The permanent partial disability determination could vary by state.  

The answer to this question may depend on your circumstances. Contact contact Claims Care at 800.442.0593 for advice specific to your situation.  

This will be determined on a case-by-case basis between you and MEM. Contact the claims representative assigned to the claim to discuss the reason for termination and to determine if temporary total disability (TTD) payments should continue. If you have questions, please review this aspect of your policy with your corporate counsel.  

Claims Pay Portal for Worker Benefits

You’ll receive an email from with a link to our payment portal within one business day. For security purposes, you will need to validate the following information about your claim:

  • Claim number
  • Date of injury
  • Last four digits of your social security number

When you have a work comp claim with MEM, you have three options to receive your claim payments:

  • Debit card: funds deposited directly into your bank account via your debit card (recommended, quickest method)
  • Direct deposit (ACH): funds deposited directly into your bank account via a checking account and routing number
  • Check: physical check mailed to you

The payment portal has privacy and security safeguards to protect your information. The payment portal also conforms to industry security standards (such as requirements of the Gramm-Leach-Bliley Act, the Payment Card Industry Data Security Standards and the rules governing the ACH Network). You should only log on to the payment portal from a personal or non-public computer.

Please ensure the information you enter is correct and that you log in within ten days of receiving the email. 

If you see a page that says you’re locked out, you have exceeded your login attempts or access expired. If you continue to need help, contact Claims Care at 800.442.0593. 

A confirmation page will display after you have submitted your payment type. You will also receive an email.

You have seven calendar days to submit through the online portal process. After seven days, your access will expire, and a member of our claims team will contact you to discuss another form of payment or a reissue of electronic funds.  

If your name or address is incorrect and you’ve chosen check as your payment method, please contact Claims Care at 800.442.0593 so we can update our system.

Yes, an employee payment method can be changed to any available option.

The time it takes to receive your payment depends on the payment method selected. The fastest method is to send the payment directly to a debit card, which can be obtained in 30 minutes. A mailed check can take up to 15 days.

If you have not received your payment using the payment method within the timeline on the question above, please contact Claims Care at 800.442.0593 

You can select your payment method from your mobile phone or personal tablet. For security purposes, it is recommended that devices should have a firewall and antivirus software installed. Message and data usage fees may apply. Check with your wireless provider for more information.  

Financial limits for each payment type:

Check No limit
ACH No limit
Direct to debit $50,000

For direct to debit, your bank may have a lower limit. Please check with your bank for more information.

Classification and Payroll Reporting

The calculation used for company owners and officers varies by state and can change each year. It is generally indexed to the average wage, as determined by each state’s insurance-governing department.

If a subcontractor is injured on the job, they will be treated as an employee of the general contractor for workers compensation purposes. While they may not be required by law to carry insurance on themselves, they can submit claims on a general contractor’s policy. Therefore, policyholders are charged a premium for the amount paid to subcontractors who can’t provide a valid workers compensation certificate of insurance. Learn more about subcontractor classification.

Report overtime payroll at the straight hourly rate. The proper way to report time-and-a-half payroll is to divide the total overtime payroll by 3 and subtract that amount from the gross payroll. To report double-time payroll, divide the payroll by 2 and subtract that amount from the gross payroll.

Payroll records must show overtime pay, separately by employee or in summary by classification in order to be deducted.

In some cases, yes. Typically, if employees are not engaged in construction work, they will be classified in the highest-rated classification for the work they perform. When performing construction work, wages may be divided into the appropriate classifications, provided the division is reflected in the original payroll records, in dollar amounts.

If wage divisions aren’t properly documented, employees’ wages will be classified in the highest-rated classification for the work they perform.

In general, no. The clerical classification code (8810) is a standard exception code, so division of payroll is not allowed. The only exception to this rule is for payroll for covered business owners, in which 10 percent of their payroll can be allocated to the clerical class code.

NOC means, “Not otherwise classified.” You can use this code when there is not a classification that closely matches your operation in the Scopes Manual.

MEM Pay as You Go is a payment plan that pays workers compensation premiums based on real-time payroll wages. 

MEM Pay as You Go is powered by InsurePay® and allows you to pay premiums based on actual payroll using one of the following options: 

Reporting is completed on the InsurePay Pay as You Go portal. InsurePay automatically drafts payments for payroll reports, upfront premiums and policy changes.   

Pay as You Go is available to all MEM and Previsor policyholders, regardless of whether they utilize a payroll provider or self-report, as there is no premium size limit. Argonaut policies are not eligible at this time. 

Let your agent know you are interested in Pay as You Go when beginning your new policy or before your next renewal. You cannot opt into the Pay as You Go payment plan midterm.   

There is no collateral, down payment, or monthly installment fee to use Pay as You Go. InsurePay® automatically drafts payments for payroll reports, upfront premiums and policy changes.   

Policyholders can choose from 2000+ approved payroll service companies, or InsurePay will contact their preferred payroll provider to complete an application.  

If a payroll provider is utilized, the provider is notified of registration and granted access to the policy on the InsurePay Pay as You Go portal 

You can report wages through an approved payroll vendor. Or you can self-report by either manually entering payroll data or uploading an approved Excel file into the InsurePay Pay as You Go portal. 

A payroll report can be revised on the Pay as You Go InsurePay portal for two days or until the following report in the schedule has been submitted. Once the timeframe for revisions has passed, corrections need to be made at the audit.  

It is important to let us know if you have no payroll for a pay period. You or your payroll service provider should log in to the Pay as You Go InsurePay portal, select Enter Payroll and input Zero Payroll.  

InsurePay® automatically drafts payments for payroll reports, upfront premiums, and policy changes via ACH or credit card. MEM bills directly for audit balances. To have MEM payments automatically drafted, complete the EFT enrollment form and send it to MEM Customer Care.  

Payments are automatically drafted and applied within two days from when payroll is reported. Your MEM account balance will reflect the payment within five business days.  

Audits are still required, but Pay as You Go should minimize audit discrepancies 

Reporting and Managing Claims

As a policyholder, you can report a claim online or call anytime at 800.442.0593. You can also fax the injury report to 800.224.0597. To download injury reporting forms, visit our virtual claims kit 

Initially, all we need to know is the:

  • Basic contact information for the company.
  • Injured employee’s name, social security number, state of hire and phone number.
  • Date the injury occurred.
  • Brief description of what happened.

You can follow up later with injury details, the injured worker’s employment status and treatment information. Report the claim online or call anytime at 800.442.0593. You can also fax the injury report to 800.442.0597. 

To help your employee return to work quickly and reduce costs, we encourage you to report injuries within 24 hours. Missouri law requires employers to report injuries within five days, but state reporting laws vary, so check with your Division of Workers Compensation 

Yes. All work-related injuries, regardless of severity, should be reported to MEM. We will then report injuries to the state, as required. This allows the state to track workplace injuries accurately 

You should always file a claim with us if your employee is injured at work. However, you can file a report-only claim if it involves three days or less of lost time and no permanent disability. The benefit of a report-only claim is that it doesn’t impact your e-mod and, therefore, your insurance premium. In Missouri, employers can self-pay up to $3,600 in medical costs on report-only claims. If you wish to self-pay, confirm your eligibility with your claims representative when you report the claim.  

It is difficult to estimate an injury’s exact effect on your e-mod and your premium. Your e-mod factor is based on your losses for the past three years, not including the most recent year, so a claim in 2024 will not impact your e-mod until 2026. The National Council on Compensation Insurance adjusts e-mod calculations each year to anticipate both a company’s losses and the losses of all businesses within the industry.  

If you do not have your claims representative’s name or contact information, contact Claims Care at 800.442.0593. 

We mail the injured worker a confirmation letter with the claim number on the business day after the claim is entered into our system. Your employee should have received this letter if your claim is medical only or lost time. They will not receive a confirmation letter for a report only claim. If you need your claim number, contact Claims Care at 800.442.0593.

Your claims representative is available by phone or text to help in many ways:

  • Evaluate your claim and explain next steps
  • Explain your benefits
  • Coordinate your care
  • Process payments for medical treatment
  • Process payments for lost wages, if applicable
  • Answer your questions
  • Update your employer

The medical provider should send all medical bills related to the injury directly to MEM at PO Box 12250, Overland Park, KS 66282. We will evaluate each medical bill and, once approved, issue payment directly to the provider.

If you or an employee receives any medical bills for the injury, please mail them to us at PO Box 12250, Overland Park, KS 66282. We will evaluate each medical bill and, once approved, issue payment directly to the provider.

No, you are not responsible for any outstanding balances for treatment related to a compensable injury or illness. If you receive an outstanding balance notice, please contact your claims representative.

Medical Care

The rules vary from state to state. In some states, you have the right to direct medical care for your employees. In others, your employees can choose from an employer-specified network. While others are free to choose their provider. Check your Division of Work Comp website to learn about your state’s employee rights.  

If you can direct care in your state, you should designate your network or company physician and communicate this decision to all employees. If an injury occurs and no physician or network has been designated, you should still direct medical care according to your state’s laws.  

In Missouri, employers have the right to direct medical care. To find a provider in MEM’s network, use this lookup tool through our medical network partner, CorVel.  

They should bring the following information to the appointment:

  • Any medical records or films related to the injury
  • List of current medications
  • Work status report
  • Job description

The employee should also provide the medical facility with their claim number and MEM’s mailing address to send medical bills: PO Box 12250, Overland Park, KS 66282-2250

Yes, the employee should provide your claims representative with a status update after each appointment. They can answer any questions about the claim and will work with you and the injured worker through recovery and return to work. The only exception is that if an attorney represents an employee, there cannot be any direct contact between the employee and the claims representative assigned to the claim. 

Sometimes, a claims representative will assign a nurse case manager to the file to assist with medical management. The nurse can help:  

  • Ensure the employee gets the right treatment at the right time
  • Coordinate the treatment plan
  • Facilitate a safe return to work

Employers can provide injured employees with a pharmacy benefit coupon that lets them fill prescriptions pertaining to the injury with no out-of-pocket expense. Once we determine claims eligibility, the employee will receive a prescription card to cover ongoing medications View the pharmacy card 

Nurse Triage & Telehealth

MEM’s 24/7 work injury line offers nurse triage powered by MedCor, which partners with Concentra to provide telemedicine services. 

For triage, injured employees speak to Medcor’s specially trained health professionals, who work under the direction of a full-time medical director board-certified in emergency medicine. Health professionals use proprietary software and patented triage methods to assess injuries and make the best recommendations for care. For telemedicine, injured workers speak to clinicians trained to deliver quality occupational health care  

Medcor has a staff of bi-lingual English/Spanish health professionals and in-house Spanish translators. For other languages, a translation service can be brought into a call. Over 200 languages are available. 

Absolutely. The service does not deny employees their right to medical care; however, it is intended to provide employees with evidence-based clinical information to aid them in making the best medical care decisions. In states/jurisdictions where the employer dictates treatment, Medcor appropriately educates the employee on the state’s special requirements. 

No further information is necessary. Medcor will automatically fax an injury alert form to the designated medical facility before the injured employee arrives. 

You should follow your procedures for managing injured minors. Medcor does not require parental consent for triage, but medical providers at offsite facilities may require it before treating minors. 

All calls are digitally recorded for quality assurance and to accurately document the facts of the injury. Callers are notified that the call is recorded and consent to the recording by participating. 

No. You should follow your company guidelines for non-work injuries. 

Concentra Telemed® is a telemedicine platform for employees with relatively minor work injuries. It allows our clinicians to evaluate, diagnose, and treat employees via video to minimize lost duty time and productivity losses when an employee is sent to a nearby medical facility. 

Concentra Telemed can treat minor injuries that don’t require an in-person physical examination. These include: 

Initial Injuries 

  • Grade I/II upper/lower extremity strains/sprains 
  • Minor neck and back strains/sprains 
  • Bruises/contusions 
  • Minor burns 
  • Abrasions/scrapes 
  • Contact dermatitis/rashes 
  • Tendonitis/repetitive-use injuries 
  • Bloodborne pathogen exposures


(When recovery is progressing, and hands-on procedures are not needed) 

  • Some wound and laceration checks 
  • Second-degree burns 
  • Moderate cervical and low back injuries 
  • Significant sprains, strains and contusions 
  • Routine post-operative checks 

After signing up on their computer or smartphone, an employee will be “checked in” by a telemedicine care coordinator. This care coordinator will ask about their injury and medical history and why the employee requests to see the clinician. This will help determine if the employee needs in-person treatment instead so care is not delayed. 

If the visit is appropriate for telemedicine, the employee will be sent to a virtual waiting room. The employee can set up a text alert to be notified when the clinician is ready and proceed with their appointment. Then, the employee will be connected to the next available Concentra clinician for treatment. 

After the appointment, the employee will be “checked out” from the virtual visit. Any necessary follow-up care will be scheduled. The appropriate forms will be generated and sent to the appropriate contacts. 

We recommend offering employees a quiet, private location where no one can hear the employee or view the employee’s device.  

Employees can access Concentra Telemed by visiting from their computer or mobile device or downloading the Concentra mobile app from Google Play or the Apple App Store. 

Yes. Concentra Telemed is HIPAA-compliant and designed to transmit patient information securely. We do not store patient records or video visits 

Return to Work

Modified duties are tasks an injured worker can complete with restrictions provided by the authorized treating physician during recovery. Your claims representative will work with you and the medical provider to determine whether temporary modified duties are a good fit for your employee.

While assigned to modified or transitional duty, an employee may be paid temporary partial benefits (TPD) at two-thirds of the difference between pre-accident wages and the wage the employee should earn post-accident. The claims representative assigned to the claim will discuss the payment method.

Transitional duty allows injured workers to return to work safely and successfully by modifying their job duties. The employee enjoys the self-esteem that comes from working and may be able to return to full salary, while the employer can curb claims costs. Learn more about a return to work program.

Yes, absolutely. This helps you stay up to date on an employee’s progress. More importantly, it shows that you care and keeps the employee in the loop, which are critical parts of the recovery process.  

Once employees have been released for work, even for modified duty, they should notify you immediately. You can discuss any necessary or mandated restrictions—our return to work coordinator can help. Once employees are released back to full work duty, they are no longer eligible for temporary total disability (TTD) or temporary partial disability (TPD) benefits.  


Abuse happens when someone uses the system in a way other than the intended purpose (to help an employee recover from an injury and return to work). Fraud involves blatantly false statements or representations to obtain or deny any benefit. Workers compensation fraud can come from various sources, including employers, employees, agents, etc.  

Any abuse or fraud within the workers compensation system can affect your premiums and even the availability of coverage or treatment. View examples of work comp fraud. 

As an employer, you play a significant role in preventing and identifying fraud and abuse, including maintaining open communication with employees about the seriousness of making false claims. You should:

  • Verify all certificates of insurance with subcontractors to ensure they are valid and have been properly issued.
  • Investigate all causes of work-related injuries.
  • Report work comp claims immediately to your insurance company.
  • Check in with injured employees on disability at different times of the day to ensure they are home.
  • Ensure your agent is listing proper job classifications and payroll accurately.
  • Encourage your employees to report suspected cases of fraud.

View more tips to prevent fraud.

When you suspect fraud, contact us using the online form or by calling 800.442.0593. You may also contact the Fraud and Noncompliance Unit of your state’s Department of Labor.  

No. Surveillance should be left to the insurance company or a hired contractor. Any recordings you collect on your own may be inadmissible in court.  

You can request a statewide criminal record history on any job candidate or current employee from your state’s Criminal Records Division. No permission is required 

We do not recommend this approach. Terminating an employee before an investigation may expose you to more risk. Be sure to contact your attorney and insurer before you act 

Always ask for copies of any subcontractor’s COI. Often, the easiest way to get these is by contacting the subcontractor’s agent. To verify, ask the agent or contact the carrier on the certificate to confirm that coverage will be effective when the services are used and paid for. This is important because you could be liable for claims involving a subcontractor’s injury 

Report fraud to our Special Investigative Unit online or by calling 800.442.0593. We will investigate and keep the employer advised of the case’s progress 


Your business is constantly changing. Our premium consultation services ensure premiums are paid based on actual payroll as it evolves and grows. We conduct state bureau-required audits for customers to verify correct payroll and classification information. This allows us to help you account for business changes like employee turnover or growth. 

At the inception of your work comp policy, your premium is estimated based on estimated wages. We calculate your actual wages at the end of your policy period. One of our consultants conducts the audit via phone, mail, online, virtual, or a physical visit to your site. How your audit is completed depends on several factors, including your company’s size and potential exposures. 

For some new policyholders, we perform a new business consultation within the first three months of the policy. This is an excellent opportunity to ask questions about payroll classifications and records to ensure proper classification and avoid surprises (like higher-than-expected rates) with the final audit.  

We complete state-required audits and follow the rules and regulations for determining work comp premiums established by the National Council on Compensation Insurance (NCCI) and approved by state insurance regulators.  

Good record-keeping can save your business time and money during the audit process. At the beginning of the process, your consultant informs you precisely what records you need during the audit. View our Audit Checklist to help you plan for your audit in advance  

Gross wages can include any pre-tax deductions; salary, hourly, commission, bonus, piecework, overtime pay, vacation, holiday, sick, incentive pay, housing, and car allowance, whether in money or otherwise. 

Yes, your Premium Consultant will give you some additional time to obtain the appropriate certificates of insurance (COI). However, requesting a certificate from a subcontractor when the work is performed rather than during an audit is recommended. If a valid COI is not obtained, the subcontractor will be included in the audit, and an appropriate premium will be assessed

The audit must be processed within 120 days of policy expiration per insurance regulations. You can expect to receive the results within 2 to 3 weeks of the audit appointment.  

During the audit appointment, your consultant will discuss differences in the audited payroll versus the estimated or reported payroll. This is an excellent opportunity to ask questions and ensure you understand any discrepancies.  

Once the audit is submitted, an Explanation of Audit (EOA) is generated, reflecting the final premium determination and any adjustments to payroll or class codes. Copies of the EOA are mailed to policyholders, emailed to agents, and are available in the portal.  

The audit process is complete. If the audit results in a bill, you will receive a new billing statement with the amount and the due date. You also receive a new billing statement displaying the credit amount if the audit results in a credit.  

Yes, we offer payment plans on audit balances. For an audit payment plan, please contact Customer Care at 800.442.0593 or  

Policyholders and agents can contact Customer Care at 800.442.0593 or to obtain audit worksheets.


First, contact your auditor to discuss the audit results. If you still disagree with the audit findings, submit a detailed explanation/description of your concerns and any supporting documentation to 

The audit may be reopened and reviewed by an auditor or audit manager. In the meantime, if you receive an audit billing statement, the amount and due date remain the same until the review is complete. The dispute of an audit does not delay the premium due date.  

A voluntary audit is when an audit is closed using the estimated payroll figures initially provided by your agent. However, if you prefer an audit using your actual payroll figures, email to help you through the process. 

Per NCCI rules, if you do not comply with the audit, you may be charged an Audit Noncompliance Charge (ANC), and the policy may be subject to cancellation.  

The ANC allows insurance companies to charge up to two times the initially estimated premium when a policyholder is non-compliant with a work comp policy audit request. 

  • Exposure:  Refers to payroll.
  • Payroll:  Money or substitutes for money, payable by the employer for services of individuals who could receive workers compensation benefits.
  • Premium:   Dollar amount charged for coverage based on payroll calculated on applicable classification codes and rates.
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