Skip to content
Software
Our Platform
PrimePay HR
Comprehensive solution for SMBs, efficient and insight-focused
PrimePay Payroll
Automated, compliant, with employee self-service capabilities
Features
Employee Self-Service
Benefits Admin
Time & Attendance
Position Management
Performance Management
Applicant Tracking
Learning Management
HR Reporting
Who We Serve
Industry
Retail
Non-Profits
Food Service
Healthcare
Manufacturing
Franchise
Partners
Overview
CPAs
Brokers
Banks
Financial Advisors
Client Experience
Client Stories
Institute for Advanced Study
Research organization with +150 employees, saving 60 hours with PrimePay HR
Solution Group
Environmental organization with 65 employees, simplifying with PrimePay HR
WE Inc.
Non-profit with +60 employees, saving an FTE with PrimePay Payroll
Archdiocese of Philadelphia
Non-profit with +5,500 employees, standardizing their process with PrimePay HR and Payroll
More Details
Happy Client Methodology
All Case Studies
Reviews
Resources
Company
About Us
Leadership Team
News & Press
Careers
Referral
Resources
HR Pro Shop
Collection of resources for HR Leaders to sharpen skills
Payroll Pro Shop
A resource hub on everything payroll, tax, and compliance
Our Blog
Webinars
eBooks
White Papers
Tools
Calculators
Wage & Tax Portal
Support
PrimePay Login
Support Center
Contact Us
Pricing
Book a Demo
Login
Take a Tour
PrimePay
Software
Our Platform
PrimePay HR
Comprehensive solution for SMBs, efficient and insight-focused
PrimePay Payroll
Automated, compliant, with employee self-service capabilities
Features
Employee Self-Service
Benefits Admin
Time & Attendance
Position Management
Performance Management
Applicant Tracking
Learning Management
HR Reporting
Who We Serve
Industry
Retail
Non-Profits
Food Service
Healthcare
Manufacturing
Franchise
Partners
Overview
CPAs
Brokers
Banks
Financial Advisors
Client Experience
Client Stories
Institute for Advanced Study
Research organization with +150 employees, saving 60 hours with PrimePay HR
Solution Group
Environmental organization with 65 employees, simplifying with PrimePay HR
WE Inc.
Non-profit with +60 employees, saving an FTE with PrimePay Payroll
Archdiocese of Philadelphia
Non-profit with +5,500 employees, standardizing their process with PrimePay HR and Payroll
More Details
Happy Client Methodology
All Case Studies
Reviews
Resources
Company
About Us
Leadership Team
News & Press
Careers
Referral
Resources
HR Pro Shop
Collection of resources for HR Leaders to sharpen skills
Payroll Pro Shop
A resource hub on everything payroll, tax, and compliance
Our Blog
Webinars
eBooks
White Papers
Tools
Calculators
Wage & Tax Portal
Support
PrimePay Login
Support Center
Contact Us
Pricing
Book a Demo
Login
Take a Tour
Workers' Compensation Form
Workers Compensation Form - 2
Contact Information
Business Details
Insurance Details
Certification
Contact Information
Contact Name
*
Contact Name
First
First
Last
Last
Email Address
*
Enter Email
Confirm Email Address
*
Confirm Email
Phone
*
Physical Business Address
*
Physical Business Address
Physical Business Address
Physical Business Address
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
Mailing Address (*If different than Physical Business Address.)
Mailing Address (*If different than Physical Business Address.)
Mailing Address (*If different than Physical Business Address.)
Mailing Address (*If different than Physical Business Address.)
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
If you are human, leave this field blank.
Next →