ACORD 130

The ACORD 130 workers' compensation application form collects the detailed operational and payroll data insurers need to underwrite workers' comp coverage. Key information includes employee classifications, estimated annual payrolls per class, experience modification rates, and prior loss history.

For COI compliance professionals, the ACORD 130 provides context for understanding workers' compensation certificates. The classification codes and payroll exposures captured on this form directly influence the coverage terms and premiums reflected in issued policies.

When compliance teams encounter questions about a vendor's workers' compensation coverage—such as why certain operations appear excluded or why the experience modification rate seems unusual—the information originally captured on the ACORD 130 explains the underwriting basis. Understanding this form helps compliance professionals communicate effectively with vendors about ensuring their workers' comp coverage properly reflects current operations.