Fill Out Our Workers Compensation Insurance Quote Form We shop more than a dozen Minnesota Workers Compensation insurance markets to find you the very best rates and coverage. Request a Minnesota workers compensation insurance quote. Business Information Enter your full name: Company name: Mailing address: City: State: Zip Code: Email (required): E-Mail again for accuracy: Phone: Fax (optional): Currently Insured? (If yes, list carrier, and # of years continuous. If none, type NONE) List Claims & Amounts Paid Years In Business: Business Type:---ProprietorshipCorporationLLCPartnershipOther Employer ID# / EIN: Unemployment #: Business Underwriting Information Describe IN DETAIL, Your Business Operations: Payroll Class #1: List Class Code # if you know it, and describe payroll class: Insert Annual Payroll in dollars for this class here: Payroll Class #2: (if none, leave blank) List Class Code # if you know it, and describe payroll class: Insert Annual Payroll in dollars for this class here: Payroll Class #3: (if none, leave blank) List Class Code # if you know it, and describe payroll class: Insert Annual Payroll in dollars for this class here: If you have a copy of your current workers compensation policy and your loss runs, please upload and attach them here: