Individual Retrospective Rating Plan Agreement

Individual Retrospective Rating Plan Agreement - (Forms/Publications)
Document Information
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Title Individual Retrospective Rating Plan Agreement (A fillable form - 220 KB PDF)
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.
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
Web pages Qualify for Refunds

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