Instructions for Completing a SWIF Application
and Estimating Premium for
Workers’ Compensation Insurance

Effective April 1, 2013

The Mandatory Terrorism Endorsement (TRIA) Is: $0.05 (5 Cents)

The Mandatory Commercial Catastrophe is: $0.02 (2 cents)
The Employer’s Assessment Fee Is 2.62 percent (.0262)

To estimate your premium:

(If you have more than one classification, figure each class separately in steps 1-3, then combine)

Estimate your total gross annual payroll (12 months).
Divide total annual payroll by 100 (Payroll Amount).
Multiply payroll amount x class rate.
Multiply payroll amount x .07 (terrorism and commercial catastrophe).
Add totals for lines 3 and 4 (This is your annual estimated premium).
If the total is less than the minimum premium, you will pay the minimum, if the total is higher, you will use the higher premium. If the total is under $2,000.00 you must pay the premium in full to begin the policy.
Now multiply your premium (either the minimum or your estimate) x .0262 to calculate the Employer’s Assessment Fee.
The sum of #’s 5 and 7 is your estimated premium, which may be adjusted by an underwriter by applying an Experience Modifier or Merit Rating (if applicable) at the time of processing.

For Coverage, submit the following:

A completed, signed application*
For policies less than $2,000, total payment is required. For policies greater than $2,000, a check for 25 percent of the premium OR the minimum premium, whichever is greater, and include the Employer’s Assessment Fee, Terrorism Fee and Commercial Catastrophe Fee.
Please be prepared for a delayed response due to the high volume of applications being received at SWIF. If your application is submitted without a down payment/for a quote, it will not take effect until the day after receipt of payment.
SWIF does not offer waiver of subrogation endorsements.
If you are a Sole Proprietor, Partners of a Partnership or Members of an LLC, please complete the Voluntary Election of Coverage form accepting or declining coverage.
If you are an officer and choosing to waive your rights please submit the officer exclusion forms.
Without these forms we cannot process a policy.

*Policy will take effect the day AFTER we receive these Items in the SWIF office, unless you specify a later date. We cannot backdate a policy.

If you have any further questions, please call 570-963-4635 between the hours of 8 a.m. and 4 p.m.