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Milton Park PartnersMilton Park Partners
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Your application

Company details, the people you want covered, what you have in place today, then a signature. About 20 minutes, and you can save it and finish later.

Not sure where you fit yet? Answer a few questions first · questions? Call 943-319-5360.

Have these ready

  • Your federal EIN
  • Your Social Security number and date of birth
  • Each employee’s name, email and mobile number
  • Your workers’ comp carrier, plus the certificate and loss runs if you have them
  • The names of your current payroll and benefits providers

Trouble with the form here? Open it on its own page.

After you apply

  1. We email you a link to sign your application. Your signature confirms your information and lets us start underwriting. The application isn’t complete until it’s signed.
  2. After you sign, you and each employee you listed get two short forms by email — first their information, then a health questionnaire.
  3. Check your spam folder for those emails. They often land there. If your company filters its email, they may be held in quarantine instead, where only your IT can release them. We can’t move forward until both forms are in.
  4. Underwriting reviews, then we email your proposal and agreement to read and sign.Once you and we have both signed, your copy comes by email.