Missouri Application For Authority To Self Insure

State:
Missouri
Control #:
MO-SKU-2163
Format:
PDF
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Description

Application For Authority To Self Insure The Missouri Application For Authority To Self Insure (MOA-SSI) is a document used by employers in the state of Missouri to self-insure their employees or workers for workers compensation insurance. The application is used to provide the Missouri Department of Labor and Industrial Relations with the necessary information to determine the employer's eligibility for self-insurance. The MOA-SSI comprises two parts: Part A, which includes employer information and Part B, which includes employee/worker information. The application must be completed in its entirety and submitted to the Missouri Department of Labor and Industrial Relations. Upon approval of the application, the employer will be authorized to self-insure and will receive a Certificate of Authority. There are two types of Missouri Application For Authority To Self Insure: 1. The Standard Application For Authority To Self Insure: This is the standard application used by employers to self-insure their employees/workers. 2. The Alternative Application for Authority To Self Insure: This is an alternative application used by employers who have the ability to meet certain requirements that are not required for the standard application.

The Missouri Application For Authority To Self Insure (MOA-SSI) is a document used by employers in the state of Missouri to self-insure their employees or workers for workers compensation insurance. The application is used to provide the Missouri Department of Labor and Industrial Relations with the necessary information to determine the employer's eligibility for self-insurance. The MOA-SSI comprises two parts: Part A, which includes employer information and Part B, which includes employee/worker information. The application must be completed in its entirety and submitted to the Missouri Department of Labor and Industrial Relations. Upon approval of the application, the employer will be authorized to self-insure and will receive a Certificate of Authority. There are two types of Missouri Application For Authority To Self Insure: 1. The Standard Application For Authority To Self Insure: This is the standard application used by employers to self-insure their employees/workers. 2. The Alternative Application for Authority To Self Insure: This is an alternative application used by employers who have the ability to meet certain requirements that are not required for the standard application.

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Missouri Application For Authority To Self Insure