facilitating premium payments
New Account Form
RPM Payment Authorization Agreement
RPM provides Pay-As-You-Go Services for policyholders that have secured coverage with one of the insurance carriers listed below. RPM works on behalf of the policyholder to facilitate premium payments based upon actual payroll.
If a policyholder is interested in authorizing RPM to commence services on behalf of their policy, they simply need to provide the information below. If the policyholder would prefer to complete a paper copy of the RPM Authorization Form, click the button below.