What information is needed to submit a temporary employment agency or employee leasing company to Beacon?

You will need to submit:

• Fully completed and signed Workers Compensation Acord 130 application

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  Fully completed and signed Beacon Supplemental Application for Temporary Employment Agencies/Employee Leasing Companies (Please refer to the ‘Forms’ section of our website)

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  Full names and physical addresses of all Rhode Island client companies that the temporary employment agency/leasing company does business with

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  A copy of the executed contract between the temp agency/leasing company and each Rhode Island client company

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  Most recent experience modification worksheet

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  Recently valued, hard-copy prior carrier loss runs for the past four years

• Proof of coverage for all other states in which the temporary employment agency or employee leasing company may place employee