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Workers' Compensation Insurance Notice (English and Spanish). Your employer is insured by: Insurer.Street and Number. City. To drop the coverage, the employer must file a Notice of Withdrawal from Coverage of the Tennessee Workers' Compensation Law (Form I-3) with the Bureau. Workers' compensation insurance is required for most employers performing work in Virginia. Obtain and maintain workers' compensation insurance. Display a Notice to Employer of Injury Poster (WC 50) at all times. Why is Covered California noticing Employers? In the event that an employee of an Applicable Large Employer (ALE with over 50 applicable full-time equivalent. This applies to all employers, regardless of whether the employees are part-time, full-time, or family members.