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How to Obtain a Policy

To apply for Workers' Compensation coverage, you may obtain an Application from one of our eight (8) District Offices, or by downloading the Application for Workers' Compensation Coverage form (SWIF-429).

Coverage will become effective at 12:01 a.m. the day following receipt of a fully completed and signed application, all required documentation, and the appropriate payment as specified herein.

Right to Audit Policy up to Three Years after the Policy Period Ends

As part of the underwriting process SWIF will estimate at the application stage the total premium due for the expected policy term. As part of the initial review process SWIF will be looking at job classifications, payroll estimates and the employment status of subcontractors or independent contractors. The premium will not be finally determined until the policy period is over and an audit is conducted. Pursuant to our policy contract, this review or audit must take place within three years of the policy period ending. At this point the information gathered at the time of application will be reviewed and analyzed. This process will include a review of the actual payroll as well as the job classifications of your employees and the employment status of any subcontractors or independent contractors you may use. Once this review is completed, a final audit billing will be determined and processed. You should be aware that you may owe SWIF additional premium based on the audit process.

READ THE FOLLOWING SWIF PAYMENT TERMS CAREFULLY


  1. All policies less than $2,000 - TOTAL PAYMENT REQUIRED.

  2. All policies $2,000 to $10,000 - 25% OF TOTAL PREMIUM, OR
    MINIMUM PREMIUM, WHICHEVER IS GREATER, with the remaining balance due in four (4) equal installments.

  3. All policies over $10,000 - 25% OF TOTAL PREMIUM, OR MINIMUM
    PREMIUM, WHICHEVER IS GREATER, with the remaining balance due in ten (10) equal installments.

Make premium payable to State Workers' Insurance Fund. Send the completed Application form and premium to:

State Workers' Insurance Fund
100 Lackawanna Avenue
P.O. Box 5100
Scranton, PA  18505-5100

Resources/Forms

Contact Information

State Workers' Insurance Fund
100 Lackawanna Avenue
P.O. Box 5100
Scranton, PA 18505-5100

Phone: (570) 963-4635
Fax: (570) 963-3079