• 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, 2024—Due April 1, 2025
C1 Calendar-Accident Year Call for Compensation Experience Valued as of December 31, 2024 — Due April 1, 2025
P2 Large Deductible Policy Year Call for Compensation Experience Valued as of December 31, 2024 — Due April 1, 2025
C2 Large Deductible Calendar-Accident Year Call for Compensation Experience Valued as of December 31, 2024 — Due April 1, 2025
SR Supplemental Call for Schedule Rating Premium Adjustments — Due April 1, 2025
RR Reconciliation Report for Calendar Year 2024 Data Call — Due April 1, 2025
LL Large Loss and Catastrophe Call — Due April 1, 2025
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