Other States' Coverage Application Steps

If you have operations or employees outside the state of Oklahoma, CompSource’s Other States' Coverage program allows you to secure all workers’ compensation insurance coverage needs through us.

Step one:
Review the Other States' Coverage Program Guidelines for eligibility requirements and program exclusions.

Step two:
Complete an Acord 130 Workers’ Compensation Application form and the CompSource Supplemental Application form.

Step three:
Must have a minimum of three years in business or provide a written verification of management experience in similar business: i.e. resume.

Step four:
Provide currently valued loss information (valued no earlier than 90 days prior to requested effective date). The loss information must be from an insurance carrier for the current year and immediate preceding three years and shall be verifiable.

An underwriter may contact you after receiving your application if additonal information is needed.

To submit an out of state insurance request, please complete the form below.




Questions regarding the Other States' Coverage program can be directed to CompSource's underwriting department by calling (405) 232-7663, ext. 5102 or
(800) 347-3863, ext. 5102.