KEMI works with agents throughout Kentucky and in other states to meet the needs of our customers. If you can’t find the answer to your question here, contact us and we will be happy to serve you.

Questions from Agents

  • Fully completed Acord 130 or Online Application via
  • Three years of currently valued loss runs from the previous carrier if prior coverage existed.
  • Last three completed payroll audits (if previously insured by a self-insured group fund)
  • Corporations and Limited Liability Companies must be active, and in good standing, with the Kentucky Secretary of State.
  • Federal identification (FEIN) numbers are required for businesses operating as Partnerships, Corporations and Limited Liability Companies.

For coal mine submissions, the following forms are also required (forms require Adobe Acrobat Reader and open in separate window, please have pop up blockers disabled):

In the event multiple submissions are received, the agency submitting the first complete submission will be recognized as the Agent of Record.

Effective January 1, 2024, the payroll amount for an included sole proprietor, partner, or member of an LLC is $52,900. For included officers of a corporation, the minimum payroll is $52,000; the maximum payroll is $213,200. These amounts are based on NCCI Basic Manual Rules and are subject to change.

Applicants may be eligible for a payment plan. If an applicant is interested in a payment plan, contact us.

The earliest possible effective date of coverage is the day following receipt of: properly completed applications, compliance with all underwriting requests/requirements, and the required premium.

1. If post office postmark — the date following postmark.
2. If postage meter — the date received by KEMI.
3. If carrier other than U.S. Mail — the date received by KEMI.
4. If hand delivered by agent, applicant, or courier — the date following date received by KEMI.
5. If submitting an online application — the date after submission.

Only KEMI can bind coverage.

The KEMI workers’ compensation policy provides coverage for Kentucky benefits as provided by the extraterritorial provisions of the Kentucky Workers’ Compensation Act, KRS 342.670.

All waivers of subrogation for worker’s compensation insurance are prohibited in the Commonwealth of Kentucky per KRS 342.700 (3).

Applications for certification of the drug-free workplace are currently being accepted by the state of Kentucky. To learn more about this certification, click here. If the program is certified by the state of Kentucky, the business must submit proof of the certification to KEMI to receive a credit on its workers’ compensation premium. The program and certification must remain in place for the entire policy term to earn the premium credit.

To request audit worksheets, submit one of the following:

  • Written request signed by an officer/owner of the business; or
  • A completed Audit Worksheet Release Form signed by an officer/owner of the policyholder

The Special Fund Assessment is a surcharge imposed by the Commonwealth of Kentucky per Kentucky Revised Statute 342.122 on workers’ compensation insurance premiums to fund and pre-fund the workers’ compensation benefit liabilities of the Special Fund and help finance the state workers’ compensation program. The full amount of the assessment collected by KEMI is transferred to the Kentucky Workers’ Compensation Funding Commission.

The assessment applies to:

  • Premiums received by every insurance company that writes workers’ compensation policies for businesses and organizations in Kentucky.
  • Every self-insured group in Kentucky.
  • Every Kentucky employer carrying its own workers’ compensation risk.

Additional questions concerning the Special Fund Assessment may be directed to the Division of Workers’ Compensation Funds at (502) 564-5467.

To request policy cancellation, submit one of the following:

  • Completed Acord Form 35 – Cancellation Request/Policy Release
  • Written notice which should include the effective date of cancellation and the reason for cancellation. The notice must be signed by an officer/owner of the policyholder; or
  • Click here and complete the KEMI Policy Cancellation Request Form