Workers' Comp Program BIAW

TO GET STARTED

FILL OUT THIS INQUIRY FORM TO LEARN MORE

When you complete the form, we will also provide you with a refund calculation so you can see
how much you could have earned if you were enrolled in R.O.I.I.® Select.

Please review my premium and loss information to see
if R.O.I.I.® SELECT might be a good fit for my company.

  • This is not an application for enrollment.

    Signing this release gives BIAW permission to contact anyone at the above listed company via mail, email, and phone for any BIAW-related matters.

  • Please sign the box using your mouse, finger, or stylus. We will notify you by email when we receive your submission.

111 21st Avenue SW Olympia, WA 98501 | (360) 352 - 7800 | enroll@biaw.com