Carrier Elections

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The WCRB has the responsibility to track carrier activity with regard to:
  • Terrorism
  • Catastrophe (other than Certified Acts of Terrorism)
  • Premium Discount
  • Short-Rate Cancellation Penalties [approved effective 7-20-04]
  • Installment Fees [approved effective 12-27-00]
  • Waiver of Our Right to Recover from Others [approved 10-1-08]

To update our current records, each member company is required to complete and submit; submissions by group will not be accepted.

The WCRB would like to thank you in advance for your time and consideration in your response.

Please provide the following information:

Effective Date of Change:
Carrier Name:  
Contact Name/Position:  
Carrier Code: Enter NCCI/Bureau code Only
E-mail Address:
Phone Number: () -
1. We are charging per $100 of payroll for Terrorism coverage.
2. We are charging per $100 of payroll for Catastrophe coverage.
3. What premium discount table are you using? -
4. Are you applying the short-rate cancellation penalty?
5. What, if any, is your Installment Fee? $.00  
6. How do you charge for Waiver of our Right to Recover from Others?

7. Are you electing NOT to participate in the Wisconsin Apprenticeship Program?
8. Anything else you would like to share with WCRB?
The above elections are effective for at least one year and must be applied uniformly to all worker’s compensation policies issued by the above named company. Any change to the above election must be filed with the WCRB prior to implementation.
  • The Terrorism charge cannot be a fraction of the approved range.
  • Carriers applying the $0.01 per $100 of payroll charge for catastrophe must attach the Catastrophe (other than Certified Acts of Terrorism) Premium Endorsement and report the charge under statistical code 9741. It is the option of the carrier to show statistical code 9741 if no charge is being applied. Regardless of whether or not the carrier charges for the exposure, if a loss defined under Catastrophe occurs, the loss will not be used in ratemaking or the calculation of the experience modification.