• Acknowledgment Form
 

Basic Detail Note:   You need to provide the NCCI number, not the NAIC number when entering group and carrier ids.

Group/Carrier Code:  
Carrier Name:  
Address:  
City:  
State:   Zip:  
Contact Information:
First Name:   Last Name:  
Title: Department:
Email:    
Telephone No:
- -
Extension:

Carrier Calls

CALL TYPE WILL REPORT NO EXPERIENCE TO REPORT
P1 Policy Year Call for Compensation Experience Valued as of December 31, 2018—Due April 1, 2019
C1 Calendar-Accident Year Call for Compensation Experience Valued as of December 31, 2018 — Due April 1, 2019
P2 Large Deductible Policy Year Call for Compensation Experience Valued as of December 31, 2018 — Due April 1, 2019
C2 Large Deductible Calendar-Accident Year Call for Compensation Experience Valued as of December 31, 2018 — Due April 1, 2019
SR Supplemental Call for Schedule Rating Premium Adjustments — Due April 1, 2019
RR Reconciliation Report for Calendar Year 2018 Data Call — Due April 1, 2019
LL Large Loss and Catastrophe Call — Due April 1, 2019
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