Skip Navigation Links  

Underwriting Tools and Forms

Applications and Forms

The WCRIBMA's frequently used forms: Assigned Risk Pool Application, Employee Leasing Supplemental Application, Temporary Employment Affidavit, ERM-14 - Confidential Request for Information, Massachusetts Assigned Risk Pool - Request for Certificate of Insurance, Construction Classification Premium Adjustment Program Application, and Request for Massachusetts Qualified Loss Management Program Assigned Risk Credit are available for viewing and downloading.

To submit an Assigned Risk Pool Application through OAR (Online Assigned Risk) go to the OAR home page to log in. You must be a member of the WCRIBMA’s website to use OAR. The Group Membership application is available on the home page through the Online Assigned Risk Enrollment Information link.


Assigned Risk Application Calculator

This tool calculates assigned risk premium based on the classes, payrolls and values entered.


Circular Letters

Circular Letters from 2004 forward are available.


Classification Revision History

A list of Circular Letters announcing the establishment of new class codes, elimination of class codes, and other classification changes.


Filed and Approved Endorsements

A list of endorsements filed and approved by the Division of Insurance for use in Massachusetts.


Manuals - Rates - Rating Values

The Massachusetts Workers' Compensation and Employers Liability Insurance Manual, the Massachusetts Master Alphabetical Classification Index (MACI) and the Massachusetts Workers' Compensation Statistical Plan are available in Adobe PDF format.

Also included in the Manual tools are the Massachusetts State Rule Exceptions and Massachusetts User's Guide Exceptions for the NCCI's Experience Rating Plan Manual  and the Massachusetts State Special Rules for the NCCI's Retrospective Rating Plan Manual.

Instructions are provided for ordering the following NCCI Manuals:

  • Experience Rating Plan Manual for Workers Compensation and Employers Liability Insurance
  • Forms Manual of Workers Compensation and Employers Liability Insurance
  • Retrospective Rating Plan Manual for Workers Compensation and Employers Liability Insurance
  • Scopes TM Manual / Scopes of Basic Manual Classifications

Special Bulletins

Special Bulletins from 2004 forward are available.

 

Resources

Residual Market Premium Algorithm / Calculator

Voluntary Market Premium Algorithm / Calculator

Class Code Lookup

Experience Rating, ARAP and
Merit Rating Calculator

Experience Rating History

Online MCCPAP - Construction Credit Application

Workers' Compensation Classification
Request Form

The Workers' Compensation Rating and Inspection Bureau of Massachusetts
101 Arch Street, 5th Floor
Boston, MA 02110