Application for Elective Coverage of Excluded Employments


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Title Application for Elective Coverage of Excluded Employments
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.

Document number F213-112-000
How to get this document
Alt Language(s)
Valid dates 12/2013
Contact information Managing Injured Workers' Claims
Websites Insurance for Business

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