Application for Group Membership & Authorization for Release of Insurance Data

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Título Application for Group Membership & Authorization for Release of Insurance Data (Un formulario electrónico)- 144 KB PDF)
Descripción Used by employers who want to join a retrospective rating group; also, to authorize Labor & Industries to release the employers' insurance data to the retrospective rating group they want to join.
Detalle
Número del formulario F250-016-000
Disponibilidad Online only
Palabras claves industrial insurance, premiums, reducing premiums, release information, retro, worker's compensation, workers compensation, workers' compensation
Idiomas English
Fechas válidas 04-2012
Contacto Contact Us About Retrospective Rating
Información relacionada
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