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Home > Employers > Online Services > CompOnline > CompOnline Registration

CompOnline Registration


If you have questions about CompOnline or the registration process, please call (952) 838-4200
or (800) 937-1181.

  Required fields in red
 

Organization information

Organization name
Policyholder number
Address
City
State
Zip code
 

CompOnline user information

Name
Title
Work Address
(if different from above)

City
State
Zip code
Phone number
Fax number
Email
 

Location information

Does the organization have multiple locations? Yes    No
Does this CompOnline user account need access to all locations? Yes    No
 
 

Access to confidential information

  Check whether the user should have access to the following information:
Confidential claim information
(only select this option if you are a claims coordinator or other type of claims authorized individual)
Specific policy & billing information
(only select this option if you are authorized to receive and review policy information for your organization)
 
Pay-as-you-go wage reporting
(only select this option if your organization is signed up for periodic wage reporting and if you are the authorized wage reporting individual for your organization)
 
Policy administrator
(only select this option if you are the authorized administrator for your organization and are requesting administrator privileges)
 

Officer/owner information

  Note that the registration process may delayed if we are unable to contact this individual for authorization.
Officer/owner name
Officer/owner title
Phone number
Fax number
Email
 

CompOnline terms and conditions

 
I accept these terms and conditions
Authorization code
Enter text shown above
        Clear this form

 

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