NCCI is pleased to announce a new, simplified two-page ERM-14 form, based on Item Filing E-1406—Revisions to the ERM-14 Form and Rule 3-A in the Experience Rating Plan Manual.
As a result, the
Experience Rating Ownership Submission tool now streamlines your application process even further. The two-page writable PDF is also available under Frequently Accessed Forms on
Use the new form to update your submissions.
Texas Note: Please continue to use the four-page form for reporting ownership changes, mergers, consolidations, or a combination of entities operating only in Texas.
For more information, please contact our Customer Service Center at 800-NCCI-123 (800-622-4123).