Application for Group Membership & Authorization for Release of Insurance Data

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Title Application for Group Membership & Authorization for Release of Insurance Data
Description 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.
Document number F250-016-000
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Keywords industrial insurance, premiums, reducing premiums, release information, retro, worker's compensation, workers compensation, workers' compensation
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Valid dates 04/2012
Contact information Contact Us About Retrospective Rating
Related information
Documents Application for Group Retrospective Rating
Websites Qualify for Refunds

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