The NCCI ERM-14 form reports a change in business ownership to the National Council on Compensation Insurance so it can recalculate your workers’ compensation experience rating modification factor. You must file it within 90 days of the effective date of the change, using either NCCI’s free online Experience Rating Ownership Submission (EROS) portal or the PDF version sent by email, fax, or mail. A principal of the business — not your insurance agent — has to sign it.
When You Have to File
Four kinds of transactions trigger the filing requirement, and more than one can apply to the same deal. You check each one that fits in Section B of the form.
- A sale or transfer of ownership interest, including stock purchases and partner buyouts, whether partial or complete.
- A sale or transfer of physical assets where the buyer takes over the operations, the workforce, and the equipment without buying stock.
- A merger or consolidation that combines two or more entities into one surviving entity.
- A name or legal entity change — a sole proprietorship incorporating, an LLC converting to a corporation, or simply a change of legal name.
The obligation applies even if your business is not currently experience-rated. If your payroll sits below the eligibility threshold today, NCCI still wants the ownership data on file for when you qualify later.
The 90-Day Deadline and the Cost of Missing It
Your workers’ compensation policy requires you to report ownership changes within 90 days of their effective date. The requirement is built into the policy through the 90-Day Reporting Requirement — Notification of Change in Ownership Endorsement, and it is codified in NCCI’s Experience Rating Plan Manual.
NCCI treats a failure to report within 90 days as potential experience rating modification evasion. Unreported changes often surface during the annual premium audit, when the carrier reviews owner and officer data. Once NCCI finds the change, it recalculates your mod and applies the new factor retroactively to the effective date of the ownership change. That adjustment runs in either direction: you may owe a surprise additional premium, or you may get a refund you could have been collecting all along.
Incomplete filings also cause delays. The form warns that missing information or a missing signature may result in the form being returned. The usual culprits are ownership percentages that do not total 100 percent, a missing FEIN, a skipped common-ownership section when entities share owners, and a signature from an agent rather than a principal.
How to Fill Out the Form
Before you start, pull your articles of incorporation, partnership agreements, purchase-and-sale contracts, and the declarations page from your most recent workers’ comp policy. Stopping mid-form to hunt for a FEIN or policy number is where mistakes happen.
Section A: Contact Information
Enter the name, employer, phone number, and email of the person completing the form. NCCI calls this person the submitter. You also identify your relationship to the business — owner, officer, insurance agent, or other representative. NCCI will use this contact for follow-up questions, so give a phone number and email you actually monitor.
Section B: Transaction Information
Check each transaction type that applies and enter the effective date of each. The effective date anchors every future experience rating calculation tied to this change. Use the actual closing date of the deal or the date the legal conversion took effect, not the date you are filling out the form.
Section C: Description of Transaction
Write a plain-language summary of what happened. A straightforward stock sale needs only a few sentences: who sold, who bought, what percentage, and when. For layered transactions — a merger followed by a name change and a shift from partnership to LLC, for instance — give each step its own short paragraph. If you run out of room, attach a continuation on the employer’s letterhead signed by an owner, partner, member, or executive officer of one of the entities involved.
Section D: Business Entity Information
This is the longest section. You complete one column for each entity involved, with room on the form for three; photocopy page two if you need more. For every entity, provide:
- The full legal name — not a trade name or DBA.
- The physical street address, city, state, and zip code.
- The legal status: sole proprietorship, partnership, corporation, LLC, trust, joint venture, or other. More than one may apply, and foreign corporations should be noted.
- An ownership breakdown listing every individual owner, partner, or member and their percentage. The percentages for each entity must total 100 percent. For corporations, list anyone holding 5 percent or more of voting stock along with the number of shares.
- The nine-digit FEIN.
- The nine-digit NCCI Risk ID number, if one has been assigned. Your carrier or agent can look this up.
- The most recent workers’ compensation policy number, with any prefixes or suffixes.
- The effective date of that policy.
- A contact name, phone number, and email for someone at the entity who can answer ownership questions.
If the same individual holds a stake in both the predecessor and the successor, you also complete the common-ownership section. NCCI uses that information to decide whether the entities should be combined for experience rating, which affects your modification factor directly.
Section E: Certification
An owner, partner, member, or executive officer of one of the entities must sign. The signature certifies that the information is complete and correct. An insurance agent or broker cannot sign on behalf of the business.
How to Submit the Form
NCCI accepts the ERM-14 through four channels. The online tool is the fastest route to a confirmed submission.
- The EROS tool at ncci.com walks you through each section with built-in guidance. When the submitter finishes, NCCI emails a link to the certifier for an electronic signature, and the completed form and attachments go to NCCI automatically. It is free for both affiliates and non-affiliates.
- By email, fill out the PDF, print and sign it, scan it with any attachments, and send it to customer_service@ncci.com.
- By fax, send the signed form and attachments to 561-893-1191.
- By mail, send to NCCI, 901 Peninsula Corporate Circle, Boca Raton, FL 33487-1362.
You can also submit the same ownership information as a narrative letter on the employer’s letterhead signed by a principal, provided it covers every data point the form asks for. The structured form is easier for NCCI to process, so a narrative letter usually works best as a supplement for complicated transactions rather than a stand-alone filing.
If Your Business Operates in a Non-NCCI State
NCCI administers experience rating in most states, but eleven run their own independent rating bureaus: California, Delaware, Indiana, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Pennsylvania, and Wisconsin. If you operate in any of these, you may need to file ownership information with the state bureau instead of, or in addition to, NCCI.
The process varies. Pennsylvania’s Compensation Rating Bureau uses its own version of the ERM-14. California’s Workers’ Compensation Insurance Rating Bureau no longer accepts paper; ownership changes have to go through the WCIRB Connect online portal. Businesses operating in both NCCI and independent-bureau states typically file with each separately.
Four states — Ohio, North Dakota, Washington, and Wyoming — run monopolistic state funds where private workers’ comp insurance is not available. The ERM-14 process does not apply there. Ownership changes are reported directly to the state fund.
What Happens After You File
NCCI reviews a complete submission to determine how the ownership change affects your experience rating. A clean stock purchase with no overlapping entities turns around relatively quickly. Multi-entity mergers and combinability questions across related companies take longer, and NCCI may ask for additional documentation such as tax returns or corporate bylaws to verify ownership percentages in complex structures. Respond quickly; every delay pushes back the revised mod.
When the review is finished, NCCI issues a revised modification factor that reflects the new structure, your carrier receives the updated mod, and your premium is adjusted. If a predecessor’s loss history travels with the transaction, as commonly happens in asset purchases where the buyer continues the same operations, that history folds into the successor’s rating. Buyers in asset deals should pay close attention, because inheriting a poor loss record can raise premiums substantially. Negotiating indemnification from the seller for pre-closing claims is standard practice for that reason.