Policyholder Data Products

Policyholder data products include:

  • Experience Rating Worksheets 
    ($17 per worksheet)
    An experience rating worksheet contains a summary of payroll and claim data for a policyholder that is used in the calculation of the policyholder's experience modification. When an experience rating worksheet is published by the WCIRB, a copy is sent to a policyholder's insurer. Additional copies are available from the WCIRB upon request. A policyholder is entitled to receive one copy of its current experience rating worksheet each year at no cost. See the Policyholder Experience Rating Worksheet Request Form for details.
  • Inspection Reports 
    ($10 per report, per location) Policyholder Product Order Form
    An inspection report contains a description of an employer's business processes that is prepared by the WCIRB after an inspection of the employer’s premises for classification assignment purposes. A copy of an inspection report is sent to the policyholder and its insurer once the report is complete. Additional copies are available from the WCIRB upon request.

  • Unit Statistical Reports 
    ($8 per report) Policyholder Product Order Form 
    A unit statistical report is submitted to the WCIRB by a policyholder's insurer and includes detailed premium, payroll and claim information for a policy. Copies are available from the WCIRB upon request.

A policyholder may request its unit statistical reports or additional copies of its experience rating worksheets or inspection reports by submitting the Policyholder Product Order Form (Form 801). The policyholder's insurer of record may also use Form 801 to obtain this information. A policyholder can authorize other individuals and entities to obtain its information by completing the authorization section of the form. See Form 801 instructions for details.

Access to Policyholder Data Products for Insurers, Agents and Brokers via WCIRB Connect®

Insurers, agents and brokers who are authorized WCIRB Connect users can obtain experience rating worksheets, inspection reports and the Comprehensive Risk Summary report for a policyholder without charge by requesting that the WCIRB obtain authorization digitally from the policyholder. Such requests must be submitted through WCIRB Connect. Get More Details

Experience rating worksheets and inspection reports are available in WCIRB Connect to the insurer of record without any policyholder authorization requirement, and to agents and brokers after uploading documents to WCIRB Connect verifying them as the policyholder's agent or broker of record.