Serving Connecticut's Healthcare Employers For Over 25 Years

How to Obtain a Quote

The Trust accepts Acord applications for new business submissions. All new business submissions should contain the following:

  • Completed Acord Commercial Insurance Application
  • Completed Acord Workers Compensation Applications (Note that the Trust caps each individual's payroll at $50,000 per year so please adjust payrolls accordingly, including executive officers.)
  • Clerical payroll (8810) must be broken out seperately regardless of governing code(s) used.
  • Current Experience Modification Worksheet, if applicable
  • Currently valued loss runs for the past 5 years including current year
  • Any available brochures or literature describing applicants services or programs
  • If quote is to include commission or to be quoted on a net basis
  • Prospect's website if there is one

Quotes can be provided very quickly once the above information is received. Send all information to the marketing department via fax 203-294-4816, or email shippee@wctrust.com or cramer@wctrust.com or by mail to the following address: Workers. Compensation Trust, P.O. Box 5042, Wallingford, CT 06492. Attention, Nathan Shippee, Executive Director, Marketing

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