Get Maryland Contracting Classification Premium Adjustment Program Form

Filling out the Maryland Contracting Classification Premium Adjustment Program Form online can seem complex, but with clear instructions, it becomes manageable. This guide will walk you through each section of the form, ensuring that you complete it accurately and efficiently to apply for potential premium credits.

Follow the steps to complete the application seamlessly.

1. Press the ‘Get Form’ button to access the Maryland Contracting Classification Premium Adjustment Program Form and open it for editing.
2. Fill in the insured's name, address, city, state, and zip code at the top of the form. This information is crucial for identifying your application.
3. In the policy effective date field, enter the date when your insurance policy started. Accurate dates are essential for processing your application.
4. Provide your policy number in the designated area. This number is specific to your coverage and helps the processing agency link your application to your records.
5. Indicate the anniversary rating date, which is defined in the NCCI’s Basic Manual. This date affects your premium calculations.
6. Complete the carrier name field with information regarding your insurance carrier. This assists in determining your premium classification.
7. Answer whether this is a new business by selecting 'Yes' or 'No.' Depending on your answer, follow the instructions regarding which calendar quarter's information to submit.
8. Select the complete calendar quarter relevant to your application by circling one of the options provided (1st, 2nd, 3rd, or 4th). This choice impacts the data you report.
9. Report the total Maryland wages paid and total hours worked for the selected quarter. Ensure you exclude overtime premium pay and other specified pay types when calculating totals.
10. Provide your signature and position on the form. Your signature confirms that the information provided is accurate and true.

Complete your Maryland Contracting Classification Premium Adjustment Program Form online today to apply for eligible premium credits!