Workers' compensation resource

What is an Acord 130?

The short answer

An Acord 130 is the standard workers' compensation application commonly used to collect applicant, operations, payroll, classification, prior-carrier, and coverage-request information. It is part of a submission, not a quote or proof of coverage.

Use this in practice

  • Use the current form available to you and complete known facts honestly.
  • An online intake can capture equivalent facts when the PDF is unavailable.
  • Supplemental questions may still be needed for the industry or program.

What it means for you

Employer: Your agent may prepare it; verify the business facts before submission.

Retailer: Upload it when ready or enter equivalent facts online to start review.

Wholesaler: Preserve the retail source and attach the form to the same opportunity.

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