1

2

3

4

5 (4)

6 (1)

7 (1)

8

Non-Employee Leasing Policy

Employee Leasing Policy For Leased Workers of Multiple Client Companies

Employee Leasing Policy For Non-Leased Workers of Employee Leasing Company

Client Company Policy For Leased Workers of Client Company

Employee Leasing Policy For Leased Workers of a Single Client Company

Client Company Policy For Non-Leased Workers of Client Company

Client Company Policy For Leased And Non-Leased Workers of Client Company

Employee Leasing Policy For Leased Workers of Multiple Client Companies

Vol

AR

Vol

AR

Vol

AR

Vol

AR

Vol

AR

Vol

AR

Vol

AR

Alabama

x

x

x

x

x

x

x

x

x

Alaska*

x

Arizona

x

x

x

x

x

x

x

Arkansas

x

x

x

x

x

x

x

x

x

California

x

x

x

x

x

x

Colorado

x

x

x

x

x

Connecticut

x

x

x

x

x

x

x

x

x

x

District of Columbia

x

x

x

x

x

x

x

x

x

Delaware

x

x

x

Florida

x

x

x

x

x

x

x

x

x

Georgia

x

x

x

x

x

Hawaii*

x

Idaho**

x

x

x

x

Illinois

x

x

x

x

x

x

x

Indiana

x

x

x

x

x

x

x

x

x

Iowa

x

x

x

x

x

x

x

x

x

Kansas

x

x

x

x

x

x

x

x

x

Kentucky

x

x

x

x

x

x

x

Louisiana

x

x

x

x

x

Maine

x

x

x

x

x

x

x

x

x

Maryland

x

x

x

x

x

x

x

x

x

Massachusetts

x

x

x

x

x

Michigan

x

X

X

X

X

X

X

X

X

Minnesota

x

x

x

x

x

x

x

Mississippi

x

x

x

x

x

x

x

x

x

Missouri

x

x

x

x

x

x

x

x

x

Montana

x

x

x

x

x

x

x

Nebraska*

x

Nevada

x

x

x

x

x

x

x

New Hampshire

x

x

x

x

x

x

x

x

New Mexico

x

x

x

x

x

x

x

x

x

New York

x

x

x

x

x

x

North Carolina

x

x

x

x

x

x

x

x

x

x

Oklahoma*

x

Oregon

x

x

x

x

x

x

x

x

x

Pennsylvania

x

x

x

Rhode Island

x

x

x

x

x

x

x

x

x

South Carolina

x

x

x

x

x

x

x

x

x

South Dakota

x

x

x

x

x

x

x

x

x

Tennessee

x

x

x

x

x

x

x

x

x

Texas

x

x

x

x

Utah

x

x

x

x

x

Vermont

x

x

x

x

x

x

x

x

x

Virginia

x

x

x

x

x

x

x

x

x

West Virginia*

x

Wisconsin

x

x

x

x

x

x

x

x

x

x

x

x

x

Note:

The Employee Leasing Policy Type Code is N/A for NJ as noted in the WCIO Workers Compensation Data Specifications Manual.

* For AK, HI, NE, OK, and WV, there are no voluntary or assigned risk market policy employee leasing rules

**There are no voluntary market policy employee leasing rules for ID

For NCCI jurisdictions and multi-state policies, report the Employee Leasing Policy Type Code that represents the state with the highest payroll

Legend:

Vol

Voluntary Business Market

AR

Assigned Risk / Involuntary Business Market

2

Employee Leasing Policy For Leased Workers of Multiple Client Companies

3

Employee Leasing Policy For Non-Leased Workers of Employee Leasing Company

4

Client Company Policy For Leased Workers of Client Company

5 (4)

Employee Leasing Policy For Leased Workers of a Single Client Company

6 (1)

Client Company Policy For Non-Leased Workers of Client Company

7 (1)

Client Company Policy For Leased And Non-Leased Workers of Client Company

8

Employee Leasing Policy For Leased Workers of Multiple Client Companies

( )

Applicable Code for policies with Policy Effective Date prior to 1/1/07

Effective: 04/01/10