Agent Resources
IS NOW JENCAP INSURANCE SERVICES.
All of our existing agent resources reside here.
For information on our Workers’ Compensation areas of expertise and custom solutions, please visit JencapGroup.com.
Agency Portal
All agents that have active Workers’ Compensation policies with Jencap Insurance Services can sign up for our agency portal. Our useful portal provides 24/7 access to the following:
Policy documents
Commission statements
Electronic upload capabilities for updated E&O and license information
*Please note if you signed up for our agency portal prior to our rebrand, you still have access and nothing has changed.
To request access to our agency portal, please email our team at documents.wc@jencapgroup.com.
To download instructions on how to use our agency portal, please click here.
For all other inquiries, please email us at marketing.wc@jencapgroup.com.
Get a Quote
Jencap’s Workers Compensation brokers understand the importance of fast and efficient quoting. Our team will respond to your quote request within hours to either confirm receipt or request any additional information that may be needed.
Please submit the following information with your quote request for the fastest quote turn around times:
Completed Acord 130 Application
Loss Runs
Experience Modification Factor
Please direct all new business quote requests to submit.wc@jencapgroup.com or send us your files through this form.
Carrier Contacts
Billing Contacts
Workers' Compensation Billing Contacts
Accident Fund: 866-206-5851
Online Payments
AIG: 800-645-2259
Online Payments
Amerisafe: 800-256-9052
Online Payments
AmeriTrust: 800-825-9489
Online Payments
American Liberty Insurance Company: 801-226-8008
Online Payments
Amtrust: 877-528-7878
Online Payments
BerkleyNet: 877-497-2637 (Inquiries)
Online Payments
Berkley Industrial: 800-448-5621
Online Payments
Berkshire Hathaway: 888-495-8949
Online Payments
BiBerk: 844-472-0967
Online Payments
Builders Mutual: 800-809-4859
Online Payments
Chubb: 800-699-9916
Online Payments
Cimarron: 833-564-3117
Online Payments
C-N-A: 877-574-0540
Online Payments
Employers: 888-682-6671
Online Payments
Encova: 844-362-6821
Online Payments
Everest: 877-604-1995
Online Payments
FFVA: 800-346-4825
Online Payments
FastComp – Clear Springs: 800-252-5059
Online Payments
First Comp: 888-500-3344
Online Payments
Guard: 800-673-2465
Online Payments
Hartford: 800-835-0385
Online Payments
ICW: 858-350-7262
Online Payments
Inspirien: 800-821-9605
Online Payments
Key Risk: 800-942-0225
Online Payments
Liberty Mutual: 877-528-7878
Online Payments
Markel: 888-500-3344
Online Payments
Michigan Commercial Insurance Mutual: 877-925-9911
Online Payments
Midwestern Insurance Alliance: 800-356-8457
Online Payments
National Liability & Fire (V3): 844-229-9288
Online Payments
Normandy: 866-688-6442
Online Payments
Old Glory: 888-838-6404
Online Payments
Prescient National Insurance (formerly Syngery): 866-710-0908
Online Payments
QBE: 800-553-4471
Online Payments
RTW: 866-319-0339
Online Payments
Sirius/Pie: 855-880-0204
Online Payments
Southeast Personnel: 866-800-0785
StoneTrust: 800-311-0997
Online Payments
Stonewood: 800-780-7454 (Inquiries)
Online Payments
Summit: 800-282-7648
Online Payments
Synchrono Group: 888-389-0439
Online Payments
Tangram: 800-676-2213
Travelers: 877-307-4202
Online Payments
United Heartland: 800-258-2667
Online Payments
Zenith: 800-440-5020
Online Payments
Claims Contacts
Workers' Compensation Claims Contacts
Accident Fund:
866-206-5851 (P)
517-316-2775 (F)
claimsexpress@accidentfund.com
Website
AIG:
866-642-5246 (P)
866-420-1404 (F)
easternwcnewloss@aig.com
Website
American Liberty Insurance Company:
866-337-0891 (P)
352-240-1203 (F)
coverage@treancorp.com
Website
Amerisafe:
800-699-6240 (P)
Website
AmeriTrust:
800-825-9489 (P)
800-603-8409 (F)
newclaim@ameritrustgroup.com
Website
Amtrust:
888-239-3909 (P)
877-669-9140 (F)
amtrustclaims@qrm-inc.com
Website
Berkley Industrial:
800-448-5621 (P)
(205) 874-8292 (F)
firstreport@berkindcomp.com
Website
BerkleyNet:
800-435-1127 (P)
866-275-6320 (F)
claims@berkleynet.com
Website
Berkshire Hathaway:
800-661-6029 (P)
800-661-6984 (F)
newclaim@bhhc.com
Website
BiBerk:
844-472-0966 (P)
203-989-2652 (F)
claims@biberk.com
Website
Builders Mutual:
800-809-4862 (P)
noticeofloss@bmico.com
Website
Chubb:
800-699-9916 (P)
800-884-3946 (F)
Website
Cimarron:
877-296-6378 (P)
704-543-0609 (F)
claims.claims@bwood.com
C-N-A:
833-366-5262 (P)
877-291-2019 (F)
reportclaim@fnolcna.com
Website
Employers:
888-682-6671 (P)
877-329-2954 (F)
customersupport@employers.com
Website
Encova:
866-452-7425 (P)
877-293-5513 (F)
claimsintake@encova.com
Website
Everest:
855-252-4695 (P)
Website
FastComp – Clear Springs:
855-252-7210 (P)
217-477-6450 (F)
fastcompnewclaims@ccmsi.com
First Comp:
800-500-3344 (P)
877-44-6806 (F)
Website
FFVA:
800-226-0666 (P)
321-214-0235 (F)
claimsnoi@ffvamutual.com
Website
Guard:
888-639-2567 (P)
570-825-0611 (F)
claims@guard.com
Website
Hartford:
800-327-3636 (P)
Website
ICW:
844-442-9252 (P)
858-436-8916 (F)
firstnotice@icwgroup.com
Website
Inspirien:
800-821-9605 (P)
Website
Key Risk:
866-687-0710 (P)
support@keyrisk.com
Website
Liberty Mutual:
866-272-9267 (P)
877-669-9140 (F)
clclaimreports@libertymutual.com
Website
Markel:
888-500-3344 (P)
855-662-7535 (F)
newclaims@markel.com
Website
Midwestern Insurance Alliance:
888-962-9942 (P)
fnol@mwiainsurance.com
Website
Michigan Commercial Insurance Mutual:
888-922-5246 (P)
941-921-0640 (F)
newclaims@mcim.com
Website
National Liability & Fire (V3):
844-229-9288 (P)
203-903-0387 (F)
claims@nlf-info.com
Website
Normandy:
833-968-7642 (P)
833-770-1220 (F)
compcare@normandyins.com
Website
Old Glory:
800-765-2412 (P)
888-667-4966 (F)
support@oldgloryinsurance.com
Website
Prescient National Insurance (formerly Syngery):
877-327-5444 (P)
Website
QBE:
844-723-2524 (P)
newlossqbe@us-qbe.com
Website
RTW:
866-620-3137 (P)
866-286-5258 (F)
claims@stateauto.com
Website
Sirius/Pie:
844-581-0828 (P)
claims@pieinsurance.com
Website
Southeast Personnel:
800-966-5562 (P)
727-682-2439 (F)
StoneTrust:
800-311-0997 (P)
866-923-1871 (F)
claims@stonetrustinsurance.com
Website
Stonewood:
866-459-1349 (P)
888-629-5821 (F)
claims@stonewoodins.com
Website
Summit:
800-762-7811 (P)
863-667-1871 (F)
Website
Synchrono Group:
800-315-6090 (P)
866-261-8507 (F)
reportaclaim@narisk.com
Website
Tangram:
800-753-6737 (P)
800-245-9927 (F)
nol@choosebroadspire.com
Website
Travelers:
800-238-6225 (P)
first.report@travelers.com
Website
United Heartland:
888-881-8242 (P)
claimsexpress@unitedheartland.com
Website
Zenith:
800-440-5020 (P)
800-440-5020 (F)
firstcallnewclaim@thezenith.com
Website
Forms and Applications
ERM Applications
State-Specific Forms
AL – DFW Credit
AL – DFW Credit-Recert
AL – Form WC14-15 – Employer Notice Include Exclude
AR – Drug Free Workplace Form
AR – Notice of Election/Revocation of Coverage
AZ – Alcohol-and Drug-Free Workplace Premium Credit Certification
AZ – Employee’s Notice Of Rejection Of Terms
CA – Accident Fund Corporate Officer and Director
CA – Accident Fund General Partners and LLC Managing Members
CA – AIG Cooperative Corporation Officer – Director
CA – AIG Corporate Officer and Director
CA – AIG General Partners and LLC Managing Members
CA – AIG Professional Corporation Owner
CA – AmeriTrust Corporate Officer and Director
CA – AmTrust Corporate Officer and Director
CA – AmTrust General Partners and LLC Managing Members
CA – BerkleyNet Cooperative Corporation Officer – Director
CA – BerkleyNet Corporate Officer, Director or Trustee
CA – BerkleyNet General Partners and LLC Managing Members
CA – BerkleyNet Professional Corporation Owner
CA – Berkshire Corporate Officers and Directors
CA – Berkshire General Partners and LLC Managing Members
CA – biBERK Corporate Officers/Directors
CA – biBERK Professional Corporation Exclusion
CA – biBERK Trusts Exclusion
CA – biBERK Cooperative Corporation Exclusion
CA – biBERK Partners and Managing Members Exclusion
CA – CNA Corporate Officer and Director
CA – CNA General Partners and LLC Managing Members
CA – Employers – All Entities
CA – Guard Cooperative Corporation Officer – Director
CA – Guard Corporate Officer and Director
CA – Guard Corporate Officer, Director or Trustee
CA – Guard General Partners and LLC Managing Members
CA – Guard Professional Corporation Owner
CA – Guard Trusts
CA – Hartford – Waiver of WC Coverage – Corporate Officers/Directors/Partners/Members/Professional Corp/C-Corp/Trust
CA – ICW – All Entities
CA – Markel Corporate Officer and Director
CA – Markel General Partners and LLC Managing Members
CA – New York Marine and General Insurance Company Officer and Director
CA – New York Marine and General Insurance Company General Partners and LLC Managing Members
CA – NL&F Cooperative Corporation Officer – Director
CA – NL&F Corporate Officer and Director
CA – NL&F General Partners and LLC Managing Members
CA – NL&F Professional Corporation Owner
CA – NL&F Trusts
CA – Pie All Entities
CA – Protective Corporate Officer and Director
CA – Protective General Partners and LLC Managing Members
CA – QBE – All Entities
CA – Waiver of Workers Compensation Coverage – Corporate Officers/Directors
CA – Waiver of Workers Compensation Coverage – General Partners & LLC Managing Members
CO – Exclusion Of Coverage Form WC43
CT – Form 6B-1 – Coverage Election Emps Of Partnership
CT – Form 6B – Coverage Election Offcr Mngr Member
CT – Form 75 – Coverage Election SProp Sing Mmbr LLC
CT – Drug And Alcohol Free Workplace Program Form
DE – Officer LCC Member Exclusion Form
FL – Form DWC-250 – Notice Election To Be Exempt
FL – Form DWC-250 – Notice Election To Be Exempt – INS
FL – Form DWC-250R – Notice Revocation Election Exempt
FL – Form DWC-251 – Notice Election Of Coverage
FL – Form DWC-251-R – Revocation Election Of Coverage
GA – Drug Free Credit Form
GA – Form WC10 – Notice Of Coverage Election Rejection
IA – 14-0061 – Exclusion
IA – Non Election Form 14-0175
ID – IC52 – Election Of Coverage Form
IL – Exclusion Corporate Officer and LLC Member
IL – Exclusion Sole Proprietor and Partners
IN – Exclusion or Election Form
KS – WC-50a – Cancellation Of KS WC-50
KS – WC-50 – Exclusion Form
KS – WC-113 – Election Of Individual
KS – WC 114 – Cancellation Of KS WC 113
LA – Exclusion or Election Form
MA – Form 153 – Corporate Officers Exemption
MD – Form C-15R – Inclusion Form
MD – WCC Exclusion Form IC-16
ME – Form WCB-2C – Application For Waiver
MI – Rejection Of Coverage Form
MO – Rejection Of Coverage LLC Forms1
MS – Rejection of Coverage Form
NC – Drug Free Workplace Form
NC – Drug Free Workplace Form – Instructions
NC/SC/VA – Notice of Election or Rejection
NE – LLC Inclusion Form
NJ – Form PP-1B – Proprietors Partners Election
NM – CID Sole Proprietor Election Form
NM – Election To Be Subject To WC Act
NM – Executive Employee Affirmative Form
NM – Revocation Of Prior Election Form
NV – Rejection of Coverage Form
NV – D-45 – Sole Proprietor Coverage
NY – Form C-105 32 – Elect SProp Partner LLC Memb
NY – Form C-105 51 – Exclude Shrhldrs And Exec Offcrs
NY – Form C-105 52 – NonProf Exclude Unslrd Exec Offcr
NY – Form C-105 53 – Revoke Election For NonProf Org
NY – Form C-105 55 – Rvk Shrhldrs ExecOffcrs Exclusion
PA – Form LIBC 509 – Ap For Exec Officer Exception
PA – Form LIBC 513 – Executive Officers Declaration
RI – Form DWC-11 – Claim Of Common Law Rights
RI – Form DWC-11C – Elect By Exempt Corp Off
RI – Form DWC-11R – Rescnd Common Law Rights Claim
SC – Form 5 – Corporate Officer Notice To Reject
TN – Form SS-4523 – Construction Exemption
TN – Form I-4 – Election Of Sole Proprietor Or Partner
TN – Form I-5 – Notice Of Withdrawal Sole Proprietor
TN – Form I-6 – Notice Of Corp Officer To Employer
TN – Form I-7 – Notice Corp Officer Rev Exemption
TN – Form I-8 – Notice Of Acceptance By Employer
VA – Notice Terminate Prior Rejection Of Cvrg
VA – Rejection Of Coverage Form
VT – Form 29 – Exclude Corp Officers Corps Ap
WV – Rejection Or Election Form