Submission and Quote Requirements

1. Submissions

   A complete submission is required for the underwriter to quote.

   A complete submission is defined as a submission that provides, in the discretion of the State Fund underwriter, sufficient information to define the characteristics of the risk, scope of coverage to be provided, and the appropriate price for such coverage. Brokers must utilize State Fund’s PriceNow online submission tool, which requires the following information:

   • Brokerage name
   • Producer name
   • Producer email
   • Producer phone
   • Applicant legal name
   • DBA/Trade name
   • Legal entity type
   • Tax ID number (FEIN, SEIN, or SSN)
   • Years in business
   • Mailing address and zip code
   • Phone number and email address
   • Locations (physical addresses with zip codes)
   • Employer’s primary contact information (name, phone, email)
   • Proposed effective date, proposed expiration date, and Anniversary Rating Date
   • Payroll exposure for the four previous years
   • Exposure for each location: class code of employee duties, number of employees, and estimated annual payroll/remuneration
   • Comprehensive and detailed description of operations
   • Complete ownership information accounting for 100% of ownership. If applicable, list partners, title officers, LLC managing members, non-profit/public agency officers, and board members.
   • Exclusion status of each corporate officer or director, general partner, or managing member.
   • License information for business required by CSLB, DMV, PUC, DIR, and Farm Labor Contracting
   • Questions completed
   • Past coverage history for the immediately preceding 4 years including, but not limited to, currently-valued loss runs for each year. Starting with applications submitted on or after April 1, 2016 (regardless of effective date), State Fund’s new requirement will be that loss runs are valued within 100 days of the proposed inception date (effective date) of the policy on carrier letterhead.
     
     

   Additional documentation or information may be required prior to quoting of a specific risk in order to adequately define the characteristics of the risk, the scope of coverage to be provided, and the appropriate price for such coverage. Further information such as additional past coverage history may be required to determine eligibility for available discounts and rating plans.

   Any submission not entered through PriceNow is considered not received by State Fund. Broker of Record Letters, if applicable, must be attached to the submission entered through PriceNow to be considered received.

   Submissions are considered received when the Broker electronically submits the application through State Fund’s online submission tool and receives the system identification number and email confirmation, subject to State Fund’s business hours and receipt policies. State Fund’s business day ends at 5:00 p.m. Pacific Time (PT). Business transactions received on a weekend, State or Federal holiday, or after 5:00 p.m., will be considered received by State Fund on the next business day.

   Once a submission is received, any subsequent submissions without a Broker of Record letter attached will be immediately closed and the broker will be notified. Any future submissions will need to be re-submitted via PriceNow including an attached Broker of Record letter.

   ADDITIONAL REQUIREMENTS FOR LARGE ACCOUNT SUBMISSIONS ($500,000 Standard Premium and above, effective 4/1/2017)

   • Most recently published WCIRB Experience Modification worksheet
   • Detailed description of operations per job function and location(s)
   • 5 years of currently valued loss runs dated within 100 calendar days of the inception date of the policy (4 full years plus the unexpired year)
   • 5 years of historical payroll data (audited, not estimated payroll)
   • For applicants leaving self-insurance: their most recent Actuarial Report (of their self-insured loss experience)
     
     
2. Submission Date

   State Fund accepts submissions up to 90 calendar days prior to the proposed effective date of the policy. Submissions must be made via the PriceNow online submission tool. All submissions are subject to the Underwriting Rules set forth by State Fund.

   The Submission Date is determined by when a Broker electronically submits the application through PriceNow and receives the system identification number.

   Submissions received on the same business day, at the same time, will be considered simultaneous submissions, and a Broker of Record letter will be required from the Employer.
   
   In the event of a simultaneous submission, the State Fund recognized Broker of Record shall be the Broker who submits the submission and Broker of Record letter.

   If multiple simultaneous submissions also include Broker of Record letters, State Fund will contact the Employer to determine the Broker of Record for the account.

   Any submission input prior to 90 calendar days of the proposed policy effective date will not be accepted.

3. Quotes: Broker of Record
   1. Quotes Requested 90 Calendar Days to 16 Calendar Days Prior to Inception
      
      (In the event that the policy has not already bound.)
      
      If a submission with an attached Broker of Record letter for an account with an established Anniversary Rating Date (ARD) is received by State Fund from a Broker other than the first Broker of Record on a submission for quoting, a notification letter will be sent electronically by State Fund to the first Broker. It will be necessary for the insured to provide a rescission letter to State Fund dismissing the second Broker of Record in order for the first Broker to retain Broker of Record status. In the event a rescission letter is not received the second Broker will be provided with a quote no sooner than 10 calendar days after the date of the letter of notification to the first Broker.
      
      
   2. Quotes Requested 15 Calendar Days or Less Prior to Inception Date
      
      (In the event that the policy has not already bound.)
      
      If a submission with an attached Broker of Record Letter for an account with an established Anniversary Rating Date (ARD) is received by State Fund from a Broker other than the first Broker of Record on a submission for quoting, a notification letter will be sent electronically by State Fund to the first Broker and a quote will be released to the second Broker immediately. Even so, it will be necessary for the insured to provide a rescission letter to State Fund dismissing the second Broker of Record in order for the first Broker to be recognized as the Broker of Record.
      
      
   3. Quotes Requested Less Than 10 Calendar Days Prior to Inception Date
      
      If your new submission and Broker of Record letter for an account with an established Anniversary Rating Date (ARD) are received less than 10 calendar days from the proposed effective date, your Broker of Record letter will not be processed and your submission will be closed. After the policy has bound, you may resubmit your Broker of Record letter and it will be processed as a mid-year change.
      
      
4. Expired Quotes

   Once a quote has expired or has been closed on a Broker submission, Broker must provide a new
   complete submission. Broker cannot use the expired or closed quote to bind the risk.

   Rev. 12/21/2016