Request a Workers' Comp Quote | Client Care Insurance

It is our commitment to improve your bottom-line. Please provide the following information to help us understand your needs. We will follow up with you to explore the potential discounts which may be applied to your premium.

If your current premium is over $25,000 a year, I’ll send you the Ultimate Guide to Workers Compensation Insurance.

* Your Name

* Company, Corp or DBA Name

* Mailing Address

* Email Address

* Phone Number

Fax Number

FEIN #

If you currently carry Workers Compensation coverage, please answer the additional questions below to help us discover potential discounts which may be applied to your premium. If not, just skip to the bottom and press Submit.

Entity Type

Current Carrier(s), last 4 years

Renewal Date

Policy Number

Experience Mod (if known)

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Is health coverage offered to employees?

What % does the employer pay?

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California Class Code # (see list below) or Description

Estimated Annual Payroll

California Class Code # (see list below) or Description

Estimated Annual Payroll

California Class Code # (see list below) or Description

Estimated Annual Payroll

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Do you have staff in another state?

What State?

Out-of-State Class Code # (see list below) or Description

Estimated Annual Payroll

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Additional Comments

* = required

>> Look up a Class Code Number

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