Application for Elective Coverage of Excluded Employments

Application for Elective Coverage of Excluded Employments - (Forms/Publications)
Document Information
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Title Application for Elective Coverage of Excluded Employments (84 KB DOC)
Description

Used by employers to request coverage of workers' compensation for non-mandatory employment. Shows a list of employment categories to choose from that are not included within the mandatory coverage of workers' compensation.

Detail
Form number F213-112-000
Availability
Online only. See document above to download.
Keywords community service, coverage, domestic servant, elective coverage, employment, entertainer, excluded employment, insurance agents, insurance brokers, insurance solicitors, jockey, musician, newspaper carriers, optional coverage, volunteer, volunteers
Languages English
Valid dates 12-2013
Contact information Managing Injured Workers' Claims
Web pages Insurance for Business

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