PEO - Employee Leasing Forms

Posted Date: August 11, 2021

Industry Information Professional Employer Organizations (PEO)

Professional Employer Organization (PEO)—Employee Leasing Forms

Use one of the forms listed below to submit hard copy reports for audited exposure, premium, and loss information when:

A client leaves a PEO arrangement covered under a master policy and the PEO’s data provider reports to NCCI the client’s data that was developed during the employee leasing arrangement
A client is covered in Nevada under a PEO master policy, and the PEO’s data provider reports the client’s data following the reporting of the Unit Statistical data for the PEO’s policy

Refer to Part 9—Hard Copy Reporting in the Experience Rating (ER) Split Data Reporting Guide for instructions to properly complete these forms.