AC-3 Form

To Save Up To 51% on your BWC annual Premium.

AC3 - Temporary Authorization to Review Information

Complete the following to determine your eligibility for group rating. Compensation Solutions Inc. provides this service with no charge or obligation.

If you wish to mail or fax an AC-3 form please remit to the following address:
Compensation Solutions Inc.
Atten: Group Rating
6375 Shier Rings Rd Suite G
Dublin, Ohio 43016

Fax: (888) 776-7741

*(denotes required field)

Contact Name