AC3

To receive a group rating quote for the 2011-2012 Public Employer premium year, an AC-3 form must be submitted to our organization by September 1st, 2010.

By submitting the AC-3 form you are granting Hunter Consulting permission to obtain your claims history and payroll information from the Ohio Bureau of Workers' Compensation. This information is used to determine your eligibility for participation in the group rating program, as well as, to project the premium savings which you would receive should you be accepted into the program.

Should you need assistance filling out the form, or have any group rating questions, please contact Tammy in our sales department at 1-800-486-6652 ext. 114 or tpurcell@hunterconsulting.com.

Download AC-3