Streamlined ERM-14 Form Now Available

Posted Date: February 03, 2020

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).