ACORD 175

Templates

ACORD 175

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Insurance

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Datapoint

Description

This is some text inside of a div block.

Employee Name

Full name of each employee covered under the policy.

Job Title

Position or role held by the employee within the organization.

Employment Status

Whether the employee is full-time, part-time, seasonal, or temporary.

Class Code

Workers’ compensation classification code assigned based on job duties.

Annual Salary

Yearly wage or salary of the employee.

Hourly Rate

Hourly pay rate if applicable.

Department

Business unit or department where the employee works.

State of Employment

Jurisdiction where the employee performs work and is covered.

Union Status

Indicates if the employee is part of a labor union.

Effective Date of Employment

Date the employee began working with the employer.

The ACORD 175 form is used to process employee-related changes within commercial insurance policies, particularly for workers’ compensation and liability coverages. Feathery’s AI automatically extracts structured data such as employee names, job titles, employment status, and compensation details, ensuring accurate updates to insurance records. It also captures classification codes, union status, and jurisdictional details to support precise policy adjustments.

This template is especially valuable for insurance carriers, brokers, and HR departments managing workforce changes that impact coverage. By automating data extraction from ACORD 175 forms, organizations can reduce manual entry errors, streamline policy change requests, and maintain compliance with employment and insurance regulations across different states and job classes.

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