Resources

Employer

Employment Compliance Requirements and Information - information about Fair Credit Reporting Act ("FCRA") regulations and other compliance requirements.

Sample Disclosure & Release for Employment Customers:

The Disclosure & Release documents are samples only, and are not meant to provide legal advice of any kind.

MVR monitoring forms

As a Verisk client, you can activate DriverAdvisor Monitoring with a single click.

For the states of Arkansas, Idaho, and Oklahoma, you’ll first need to complete a state access form. For access in states where alternate data sources are used to complete the monitoring process, you’ll need to complete a driver monitoring data source form.

Insurance

Verisk requires several forms to establish an account. We provide all the information you need to help you get started. From documentation on our services to ordering your first report and beyond, we’re here to guide you.

You may email completed documents to information@iix.com. A representative will contact you upon receipt of your documents.

Insurance MVR monitoring forms

Driver Monitoring is a featured product of Verisk's transportation employment screening suite and is available in more than 40 states. As a Verisk client, you can activate Driver Monitoring with a single click.

For the states of Arkansas, Idaho, Oklahoma, and Utah, you’ll first need to complete a state access form. For access in states where alternate data sources are used to complete the monitoring process, you’ll need to complete a driver monitoring data source form.

Access the form

Insurance MVR monitoring forms

Employer: MVR State Forms

Insurance: MVR State Forms

Additional resources

Authorization agreement for Automated Clearing House (ACH) debit
Use the ACH Authorization Form to pay your monthly invoice with an ACH debit.

Account updates
Use the Account Change Form to make address, contact, or ExpressNet administrator changes on an existing account.

California EPN

Please note, California has different requirements regarding the monitoring process and how records are obtained and secured as compared to other states. Please maintain the EPN record for only as long as your business purpose requires.

To view a list of frequently asked questions and answers provided by the California EPN authority, click California EPN FAQ .

The EPN Program was established to provide employers and regulatory agencies with a means of promoting driver safety through the ongoing review of driver records. An employer enrolled in the EPN Program is assigned a requester code. The requester code is added to an employee’s driver license record. When the employee’s record has an action/activity recorded on it, a driver record is generated and sent to the employer on file.

Employers must enroll any driver employed for the operation of any vehicle if the driver is required to have any of the following:

Class A
Class B
Class C with Hazardous Materials Endorsement
Class C with Special Certificates issued
Any driver of a passenger vehicle having a seating capacity of not more than 10 (including the driver) operated for compensation by a charter-party
Passenger stage corporation with a certificate of public convenience and necessity or permit issued by PUC

New EPN Users

To view a list of frequently asked questions and answers provided by the California EPN authority, click California EPN FAQ.

Employers must enroll any driver employed for the operation of any vehicle if the driver is required to have any of the following:

Class A
Class B
Class C with Hazardous Materials Endorsement
Class C with Special Certificates issued
Any driver of a passenger vehicle having a seating capacity of not more than 10 (including the driver) operated for compensation by a charter-party carrier of passengers
Passenger stage corporation with a certificate of public convenience and necessity or permit issued by PUC

Employers can include non-mandated drivers in the program, but must have a signed release on file to do so. Employers can utilize form INF 1101 (AUTHORIZATION FOR RELEASE OF DRIVER RECORD) for the release.

Forms Needed

Steps to Follow

Employers who are new to the California EPN program must possess a state-issued EPN Requester Code. If the employer has not yet acquired a state-issued EPN Requester Code for use with the EPN program, please follow all steps below:

Complete Form INF 1104
1. Fill out all sections
2. Do not fill out the Requester Code at the top right
Complete Form INF 2110
1. Fill out only Section 1
2. Do not input a Requester Code in Section 1 as the state has not generated one for you at this time
3. This form is what designates Verisk to act as the employer’s EPN agent
After completing the above form, please forward the original copies with the "wet" signature by mail to:
1. Verisk/Insurance Information Exchange
  Attn: Government Relations
  1574 Crescent Pointe Parkway
  College Station, TX 77845
Once the forms are received, we will complete INF 2110, Section 2 and forward the originals, by Federal Express Standard, to the EPN Program office for processing.
The following will occur once the forms are received at the state:
1. Verify the employer is not currently set up with an EPN Requester Code and then hand off to the EPN IT department for set up
2. The EPN IT department will electronically establish the new EPN Agent/Employer relationship
3. Notify the employer of its EPN Requester Code via mail
4. Notify Verisk that the employer set up has been completed
Verisk will notify the employer that the state has completed its set up
Employer can now maintain its employees through our platform

Transfer EPN Users

To view a list of frequently asked questions and answers provided by the California EPN authority, click California EPN FAQ.

Forms Needed

Steps to Follow

Employers who are currently issued an EPN Requester Code and are processing through the state or another vendor should perform the following to establish a new EPN Agent:

Obtain a billing statement from the EPN Program office
1. Phone number - 916-657-6346
2. Verify there are no outstanding balances
3. All outstanding balances must be handled before an EPN Agent change can occur
Complete Form INF 2110
1. Fill out only Section 1
2. The information in Section 1 must be as it is recorded with the EPN Program office. This information can be located on any EPN MVR printout
3. This form is what designates Verisk to act as the employer’s EPN agent
If any information has changed (address, phone, contact, etc.), complete Form INF 4 and send in with other paperwork
If processing with another authorized agent, and not with the state, the employer must terminate the relationship
1. Send a notice of termination to the current EPN agent, providing 30 days notice of cancellation
2. Forward a copy of the termination notice, along with the other paperwork, to Verisk
After completing the above form, please sign, scan and email a copy of the form to iiXGovRelations@iso.com.
Once the forms are received, we will complete INF 2110, Section 2 and forward the form via email to the EPN Program office for processing.
1. This packet will also include a copy of the termination letter with the employer’s current agent.
2. The current EPN agent must contact the EPN Program office 1-2 days before the scheduled termination date to verify cancellation of services.
The following will occur once the forms are received at the state:
1. Verify the employer is not currently set up with an EPN Requester Code and then hand off to the EPN IT department for set up
2. The EPN IT department will electronically establish the new EPN Agent/Employer relationship
3. Notify Verisk that the employer set up has been completed
4. Send Verisk the current driver list on file
We will notify the employer that the EPN Program Office has completed its set up
Employer can now maintain its employees through Verisk’s platform

Adding or Removing Drivers

Adding or removing drivers to the EPN Program

There are two types of licensed drivers that can be added to the EPN Program - California licensed drivers and Out-of-State licensed drivers

Forms Needed

INF 1102 - Commercial Employer Pull Notice Enrollment of Out of State Licensed Drivers

California Licensed Drivers

To add/remove drivers that possess a CA driver’s license, use ExpressNet’s add/delete option for DriverAdvisor
Changes done in ExpressNet are sent to the EPN Program automatically
Drivers should be added to ExpressNet once they have been formally hired and deleted upon termination from employment

Out-of-state Licensed Drivers

Adding Out-of-state Licensed Drivers

Any out-of-state driver who is considered a mandated driver by statute, and drives in California a minimum of 30 days in a six-month period, should be added to the EPN Program.
Out-of-state drivers will be assigned a ’license number’ (Index Number) beginning with an ’X’
Activity is added to the record in the same manner it is for in state licensed drivers
There is not a way to electronically add out-of-state drivers to the EPN Program through an electronic means. To add out-of-state drivers, perform the following:
- Complete Form INF 1102
- After completing the above form, please forward the original copies with the "wet" signature by mail to:
  - Verisk/Insurance Information Exchange
    Attn: Government Relations
    1574 Crescent Pointe Parkway
    College Station, TX 77845
- Once the form is received, Verisk will forward the original, by Federal Express Standard, to the EPN Program office for processing
- The state will create a driver record in its system with an index number beginning with ’X’
- The state will notify Verisk once the out-of-state driver(s) have been added to the employer’s account
- Verisk will notify the employer
- The employer can now maintain its employees through our platform

Deleting Out-of-state Licensed Drivers

Employers wishing to delete out-of-state license drivers from the EPN program can simply disable monitoring for the driver in ExpressNet
The removal from the EPN Program will be processed automatically

Employer Account Changes

EPN Program employer account changes

To view a list of frequently asked questions and answers provided by the California EPN authority, click California EPN FAQ .

How to Update Contact Information on Employer Pull Notice Account

Form Needed

INF 4 - Employer Pull Notice Change Of Account Information

Steps to Follow

If an employer needs to update/change its account information on file with the EPN Program office, it should do the following:

Complete Form INF 4
After completing the above form, please forward the original copies with the "wet" signature by mail to:
1. Verisk/Insurance Information Exchange
  Attn: Government Relations
  1574 Crescent Pointe Pkwy
  College Station, TX 77845

Once the form is received, Verisk will forward the original, by Federal Express Standard, to the EPN Program office for processing.

This is to be used when any changes occur to the company name, address, phone number or contact person.

The INF 4 must be submitted by the employer within 10 days of the change.

How to Close Employer Pull Notice Account

INF 1112 – Request for Closure of Employer Pull Notice Account Form and Instructions

Steps to Follow

If an employer wishes to close its Employer Pull Notice Account with the EPN Program office, it should do the following:

Complete Form INF 1112
After completing the above form, please forward the original copies with the "wet" signature by mail to:
Verisk/Insurance Information Exchange
Attn: Government Relations
1574 Crescent Pointe Pkwy
College Station, TX 77845
Once the form is received, Verisk will forward the original, by Federal Express Standard, to the EPN Program office for processing.

Employer Responsibilities

EPN Program employer responsibilities

Employer acknowledges and understands that:

Utilizing an EPN Agent does not absolve the Employer of any responsibility for compliance with the provisions described in the CVC Section 1808.1.
Hereinafter all record information will be exclusively forwarded to the EPN Agent, Employer will not have the option of requesting record information to be sent to the Employer's place of business until this authorization is rescinded.
Upon obtaining the services of an EPN Agent, Employer must notify DMV (by telephone or fax) and request a billing statement of all unpaid charges. EPN Agent will then submit total payment of unpaid balance, on Employer's behalf, enabling the EPN Agent to begin with a new billing cycle and balance.
Employer agrees to notify DMV, in writing, at least 2 weeks prior to terminating the services of the EPN Agent. Upon receipt of notification all record information will revert back to the Employer's address of record.
Employer acknowledges that DMV records contain restricted information, and Employer has read and understands the provisions of CVC Section 1808.47.
Employer and EPN Agent understands and acknowledges that any failure to maintain confidentiality is both civilly and criminally punishable pursuant to CVC Sections 1808.45 and 1808.46.
Employer understands, acknowledges and agrees to absolve and hold harmless the department in any failure on the part of the EPN Agent's non-compliance of agreements established as a result of this process.
Employer understands, acknowledges and agrees to absolve and hold harmless the department in any failure on the part of the EPN Agent for non-receipt of driver record information in a timely manner.
Should the Department of Motor Vehicles (DMV) cancel, revoke, or terminate the EPN Agent's authority to obtain DMV records, the EPN Agent/Employer relationship shall immediately be dissolved and EPN Agent must return all DMV records back to the Employer’s address of record within 48 hours.
EPN Agent will submit this Authorization form to DMV, and a copy of the Authorization form containing the Employer's signature must be retained at the Employer’s place of business, and made available upon request to DMV Audit staff and the California Highway Patrol.
DMV record information must be presented in its entirety either in the pre-approved hardcopy format as provided by DMV to the EPN Agent, or if electronic, the date and unique identifier of the individual reviewing the driver record must be placed on the electronic records received from DMV at the time first reviewed. The identifiers must be permanent and unalterable.