Cancellation of Elective Coverage for Excluded Employments

Cancellation of Elective Coverage for Excluded Employments - (Forms/Publications)
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Title   Cancellation of Elective Coverage for Excluded Employments (123 KB PDF)
Description

Used by employers to get the categories of employment that are not considered mandatory to have workers' compensation. If they had elected to have coverage this form is used to cancel previously elected coverage of workers' compensation.

Detail
Form number F213-005-000
Availability
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Keywords exempt, industrial insurance, insurance coverage, insurance reporting, non mandatory, non-mandatory, optional coverage, volunteers, worker's compensation, workers compensation
Languages English
Valid dates 10-2002
Contact information Managing Injured Workers' Claims
Related information
Documents

Cancellation of Elective Coverage for Excluded Employments


Application for Elective Coverage - Sole Proprietor, Partners, For-Profit Corporate Officers, or Member/Managers of Limited Liability Company (LLC)


Application for Elective Coverage of Excluded Employments


Application for Exclusion/Inclusion - Mandatory Coverage (Family Farm)


Web pages Insurance for Business

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