StateFund First

StateFund First has made it easy for you to submit your workers’ compensation business. You have a choice of 2 different methods:

• Online Download Submission (Preferred!) – StateFund First has the ability to receive your applications directly from your agency management system.

  Upload Submission Instructions

• Online Application – If your agency does not have an agency management system, you may prefer to complete an application online.

  Manual Submission Instructions

• Submission Tips

  Business Operations and Proper Classifications

  License and Payroll

  Entity Types and Eligibility for Exclusion

  Entering and Attaching Loss Runs

• Applications

  ACORD WC Application 

  State Fund Supplemental Application

  Trucking Questionnaire

  USL&H Application

  USL&H Questionnaire

  Athletic Team Questionnaire

  Medical Marijuana Questionnaire

  Domestic Care Supplemental

  Movie Production Questionnaire

  SCIF – Employees Supplemental Aircraft Questionnaire

  SCIF – Pilot Supplemental Aircraft Questionnaire 

  Agriculture Supplemental Questionnaire

  Construction Supplemental Questionnaire

  General Supplemental Questionnaire

  Manufacturing Supplemental Questionnaire

  Rental Property Owner or Operator Supplemental Questionnaire

  Hotel Motel Supplemental Questionnaire

  Janitorial Supplemental Questionnaire

  Landscaping Supplemental Questionnaire

  Restaurants Supplemental Questionnaire

  Towing Supplemental Questionnaire

  Automotive Services Supplemental Questionnaire

• Waiver and AI Request Form

  Waiver and Al Request Form

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