Premium Rate Protest
If you believe there is an error in the figures used to calculate your rate, you may file a premium rate protest. We do not accept appeals of the NAICS code assigned to your business.
Business Name *
Please enter the name of the business that is protesting.
Your answer
Employer Account Number *
Please enter the employer account number of the business that is protesting.
Your answer
Contact Name *
Please enter the name of a contact that can be reached between Monday-Friday, 8am and 5pm.
Your answer
Contact Phone Number *
Please enter the phone number of a contact that can be reached between Monday-Friday, 8am and 5pm.
Your answer
Contact Email Address *
Please enter the email address of a contact that can be reached between Monday-Friday, 8am and 5pm.
Your answer
Protest Reason & Information *
Please provide information regarding the reason for protesting your rate, be specific. We do not accept appeals of the NAICS code assigned to your business.
Your answer
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