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Our offices are currently working remotely to keep our staff safe and healthy to help eliminate the spread of the COVID-19 virus. We continue to retrieve voicemails and emails, so business is not interrupted. Should you have any questions, please feel free to contact us.

Request Quote: Workers Compensation Insurance Program

    * denotes required fields

    Company:

    Address:

    Address II:

    City:

    State:

    Zip:

    Contact Person:

    Title:

    Phone:

    Fax:

    Email:*

    Current Insurance Carrier:

    Or Self Insured/Trust:

    Renewal Date:

    Number of Employees:

    Codes & Payroll Estimates:

    Experience Modification and or RB File #:


    (Construction Only), PAP Credit:

    To receive accurate and up-to-date information regarding your potential Workers’ Compensation Insurance coverage, please provide us with the following:

    • Number of business locations and the number of employees at each location
    • 3 year payroll audits*
    • 5 year loss runs by year*
    • 5 year premium history*

    * Depending on how long the company has been in the business ** Note: If you consider obtaining an individual insurance, i.e. non-group one, in addition to the above, please complete " NYSIF: Application for New York Workers' Compensation and Employers' Liability Insurance"

    Let GCG Risk Management determine a quote for your workers compensation insurance. Just fill out the form above as accurately as possible and we will contact you with information regarding your workers compensation insurance quote.