Premium Payment Options
Direct Bill Policies & Monthly Reporting
AMERISAFE Workers' Comp policies are written on a Direct Bill basis, and all payments are made directly to AMERISAFE. We understand the fluctuations in payrolls due to peaks and valleys in a client's business cycle and have adopted Monthly Reporting as the primary method of payment. With monthly reporting, you pay the actual premium based on the payroll for the month. Annual payments are also available should that better suit your needs.
This feature includes payments for annual premiums, deposit premiums, monthly premiums, and account balances. Detailed instructions are located here.
Check-By-Phone 800-256-9052 ext. 2286
1. Call AMERISAFE at 800-256-9052, and ask for the Cash Coordinator.
2. The Cash Coordinator will fax an Authorization Agreement regarding your bank account.
3. Fax the completed Authorization Agreement to AMERISAFE, along with the monthly report or invoice and a copy of the voided check.
4. AMERISAFE will electronically forward the information to your bank to withdraw the amount authorized from your account.
Please choose the correct form below:
Mail your monthly report and payment to:
If you do not have a fax machine, please call the Cash Coordinator who will explain your options to you.