Benefit Management Services of Ohio, Inc.
They have an experienced, courteous, and professional staff, and they have helped our company to effectively manage our workers’ compensation claims and control our premium costs.”
John S. Santisi – President
Phoenix Supermarkets, Inc.

PROGRAMS - GROUP RATING - AC-3 FORM INFORMATION

Only 3 Easy Steps To Apply For Workers' Compensation Discounts By Submitting An AC-3 Form:

1. Fill out all information below:

Policy Number:
Company Name:
DBA:
Name:
Title:
Address:
City:
State:
Zip:
Phone #:
Fax #:
Email:

2.  Click on the "AC-3 Form" button.  This will bring up the AC-3 form on the next screen.

3.  Print and sign the AC-3 form and fax to BMSO.  Fax number can be found on the
     AC-3 form.  Use the browser "BACK" button to return to this page.

 

 

 

 

Benefit Management Services of Ohio, Inc. © 2011 
Workers' Compensation Specialists - Healthcare Plans
Business & Personal Insurance - 401k Plans