The Pennsylvania Supplemental Information Addendum to Application as a Group Workers' Compensation Fund is a document required by the Pennsylvania Workers' Compensation Board for employers to complete when applying for a group workers' compensation fund. This addendum is used to provide additional information to the Board that is relevant to the employer's operations and workers' compensation eligibility. It includes a variety of information including the employer's organizational structure, details of the employer's safety program, and a list of all employees and their job descriptions. The addendum also includes a description of the employer's claims management system, a description of the employer's risk management strategy, and any additional information the employer would like to provide. There are two types of Pennsylvania Supplemental Information Addendum to Application as a Group Workers' Compensation Fund: the Standard and the Expanded. The Standard Addendum is used when the employer is applying for a Basic Group workers' compensation fund, while the Expanded Addendum is used when the employer is applying for an Enhanced Group workers' compensation fund.
Pennsylvania Supplemental information Addendum to Application as a Group Workers' Compensation Fund
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How to fill out Pennsylvania Supplemental Information Addendum To Application As A Group Workers' Compensation Fund?
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