Please enter the customer number, effective month & day, and class code of your policy provided in the subject section of your letter.

Error message area. Alert, you did something wrong and broke the website. This is more faux text to test alignment issues. Error message area. Alert, you did something wrong and broke the website. This is more faux text to test alignment issues.

Is the information above correct?

Yes No

Has the amount of your monthly employee payroll been affected by the COVID-19 crisis?

Yes No


You have selected "Yes" to your payroll being affected but all months entered are 100% (all payroll has continued). Please review your entries and update as appropriate.

Please check the customer number, effective date, and class code on the provided letter and try again. If you continue to experience issues accessing your information, please call our Customer Service Team at (800) 440-5020, option 4.

In order for us to ensure that the premium we ask you to pay during this period is appropriately adjusted, please enter the approximate percentage of your payroll that continued or is expected to continue during each of the months below. This should exclude any payroll that has continued for any paid furloughed workers.

Please enter a whole percentage from 0% (no payroll has continued) up through 100% (all payroll has continued).




If you wish to update these estimates as your situation evolves, please feel free to visit this site again and submit updated information. Any resulting premium impact will be reflected in future invoices.

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