Authorization Number : 855-1190
Agency Series No. : OSC-2
Status : Active
Agency Web Link :
Agency : BWC
Confidential Description : Records may include medical records, the claimant’s name, the residential address, the name of the employer, the address of the employer, the social security number and the residential telephone number.
Division : BWCEMPS
Vital Description :
Section : BWCEMPSOSTC
Record Title : Other States Coverage (OSC) Employer Underwriting Documents
Revision : 0
Record Description : Underwriting documents including underwriting workbook (Excel), loss runs, declaration pages, experience modification worksheet(s), referral documentation to Zurich, renewal questionnaire, ERM-14, scheduled rating documentation, correspondence with employer or insurance agent.