Request Your Free Workers’ Comp Insurance Quote

To request a quote, please complete the form below and attach your most recent policy declarations page; if you are a broker, you can attach a completed ACORD. You can also include your most recent premium audit and last five years of loss runs to expedite a review of your submission by our Safety Group underwriter.

You can also fax your information to (518) 465-7960 or email Virginia (vhitchcock@retailcouncilnys.com) or Ken (krutsky@retailcouncilnys.com).

What to expect from your quote >

Business Name*

Contact Name*

Business Street Address*

City / State / Zip*

Telephone Number*

Email Address*

How Did You Hear About Us?

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Attach Your declaration page


What to expect from your quote

Our quote will take into account your payroll and current experience rating, as well as any applicable discounts and a potential year-end dividend. Once we receive your policy information, we will contact you within two business days with a provisional quote. We will show you all the costs involved to be a member of our Safety Group: [Hint: there are no hidden fees].

Your information is strictly confidential. The Retail Council does not share any of your data.