Individual Retrospective Rating Plan Agreement
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
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| Title |
Individual Retrospective Rating Plan Agreement (A fillable form - 220 KB PDF)
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| Description | Used by employers to set up an agreement between them and L&I authorizing their participation in retrospective rating. | |
| Detail | ||
| Form number | F250-003-000 | |
| Availability | Online only. See document above to download. |
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| Keywords | individual, industrial insurance, reducing premiums, retro, worker's compensation, workers compensation, workers' compensation | |
| Languages | English | |
| Valid dates | 04-2012 | |
| Contact information |
Contact Us About Retrospective Rating
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| Web pages | Qualify for Refunds | |
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