Until you've been through one, it's hard to understand how disruptive and complex the whole process can be on your small business. But COSE's team gives you the level of expert claims management experience that will have you prepared for anything.
In addition to prepaid legal defense representation from Ross, Brittain & Schonberg Co., LPA and access to COSE's SafetyPlus discount workplace safety products, services and education tools, you’ll have peace of mind in knowing the best workers’ comp protection team in Cleveland, Ohio is working for you. For additional information on the COSE Workers’ Compensation program, call or visit cose.org/workerscomp.
| Take a few minutes to fill out this AC-3 form for your quote on low-cost workers' compensation insurance. We will contact you shortly to verify that your submission has been received. You can also click HERE to download a printable PDF version of the AC-3 form. |
 I understand that this authorization is limited and temporary in nature and will expire on February 28, 2012 or automatically nine months from date received by the Employer Services or Self-Insured Section, whichever is appropriate. In either case length of authorization will not exceed nine months. Typing your name above constitutes electronic signature. |
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This is to certify that COSE Compensation Services (ID No. 218265-80) including its agents or representatives identified to you by them, has been retained to review and perform studies on certain workers’ and workmans’ compensation matters on your behalf.
The limited letter of authority provides access to the following types of information relating to your account:
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The authorization does NOT include authority to:
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