Pennsylvania Quote

1 Getting Started

2 Estimates

3 Insured Info

Getting Started
Lead State
This field is for zapier notifications only.
Business Name*
The full legal name of your business.
Contact Name*
First Last
Email*
Phone*
Rating State*
State
Business Address*
Street Address Address Line 2 City State ZIP Code

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Estimates

Fill out the fields below, and click on 'Show me the Lowest Rates' button to calculate premiums.
Industry
Choosing the right description is important for accurate pricing. Let's narrow the list by selecting an industry.
Industry Type*
Choose an industry to see some of the most common descriptions. If you don't find yours, choose "other" to see more.
Class Descriptions
Each person and their payroll should only be counted once.
Class 1 Description*
Start typing a word to see possible matches.
Class 1 Payroll
THIS FIELD CANNOT BE BLANK TO SEE RATES. $0 is ok.
# of Class 1 Full Time Employees
THIS FIELD CANNOT BE BLANK TO SEE RATES. "0" is ok.
# of Class 1 Part Time Employees
THIS FIELD CANNOT BE BLANK TO SEE RATES. "0" is ok.
Add another class code?
Class 2
Class 2 Description*
Class 2 Payroll
Class 2 FT Employees
Class 2 PT Employees
Add another class code?
Class 3
Class 3 Description*
Class 3 Payroll
Class 3 FT Employees
Class 3 PT Employees
# of Yrs with prior coverage
Total Amount of Claims in 3 yrs
Paid and Reserve Dollars- not # of claims
Total Amount of Claims in 5 yrs
Paid and Reserve Dollars- not # of claims
Is coverage currently lapsed?
Experience Mod
1.0 is Default. If you're unsure, do not change it.
Please enter a value between .6 and 2.0.
ARAP
1.0 is Default. If you're unsure, do not change it.
Please enter a value between .6 and 2.0.
What other quotes are you interested in?
Multi-policy pricing may apply
- General Liability
- Commercial Auto
- Other Commercial Policies
- Personal Home Insurance
- Personal Auto Insurance
- None
Show Me the Lowest Rates!

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Contact Info

Quoted Rates are for state minimum limits required. Let us know how you want to proceed.
Choose your preferred agent relationship.*
Brokers and Agents welcome.
Agent Name
First Last
Agent Email
Employers Liability- Each Injury per Person
Employers Liability- Each Disease
Employers Liability- Each Disease per Person
Contact Name*
First Last
Phone*
Entity Type*
Choose the type of business you have
EIN
DBA or other Trade Names you use:
(Not required)
Lead Grade
Adword/Keyword
Class 1 Description (For Admin View)
Class 2 Description (For Admin View)
Class 3 Description (For Admin View)

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Pennsylvania Quote

Getting Started

Estimates

Industry

Class Descriptions

Class 2

Class 3

Contact Info