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Texas Workers Compensation Self-Insurance Group (SIG) Notification Form

State:
Texas
Control #:
TX-FIN468-WC
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PDF
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Workers Compensation Self-Insurance Group (SIG) Notification Form
The Texas Workers Compensation Self-Insurance Group (SIG) Notification Form is a document used to notify the Texas Department of Insurance of an organization's intent to join the Texas Workers Compensation Self-Insurance Group. The form requests general information about the organization, such as the company name, contact information, type of organization, and number of employees, and must be filled out and submitted to the Texas Department of Insurance in order to apply for membership in the self-insurance group. There are three types of Texas Workers Compensation Self-Insurance Group (SIG) Notification Form: Initial Application, Renewal Application, and Amendment Application. The Initial Application is used by new applicants to apply for membership in the group, the Renewal Application is used by existing members to renew their membership, and the Amendment Application is used to update information or request a change in the membership status of an existing member.

The Texas Workers Compensation Self-Insurance Group (SIG) Notification Form is a document used to notify the Texas Department of Insurance of an organization's intent to join the Texas Workers Compensation Self-Insurance Group. The form requests general information about the organization, such as the company name, contact information, type of organization, and number of employees, and must be filled out and submitted to the Texas Department of Insurance in order to apply for membership in the self-insurance group. There are three types of Texas Workers Compensation Self-Insurance Group (SIG) Notification Form: Initial Application, Renewal Application, and Amendment Application. The Initial Application is used by new applicants to apply for membership in the group, the Renewal Application is used by existing members to renew their membership, and the Amendment Application is used to update information or request a change in the membership status of an existing member.

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FAQ

In order to opt out of workers' compensation, an employer has to take these four steps: File DWC Form-005 with the Texas Division of Workers' Compensation annually stating that the employer is a non-subscriber. Notify employees in writing at the time of their hire that the employer is a non-subscriber.

Self-Insured Group. Private Insurance Carrier. The initial cost may be attractive, but it may hide the greater risk taken. After joining the group, you assume equal risk to pay for claims of other SIG members, even if you're a business with a good safety program and a minimal loss history.

How much will I get paid? SIBs are 80% of what you get when you subtract the difference between 80% of your average weekly wage (AWW) and any wages you got after your work-related injury. If you get paid during a 13-week qualifying period, those wages are subtracted from your SIBs.

Do I have to have workers' compensation insurance? Texas doesn't require most private employers to have workers' compensation. But private employers who contract with government entities must provide workers' compensation coverage for the employees working on the project.

Certain types of workers, usually considered independent contractors, may be found to be employees in Texas, if they are under the employer's direct control. This would mean they have to be covered for workers' comp and receive the same right to elect workers' compensation coverage.

More info

Workers Compensation SelfInsurance Groups. Workers' Compensation Self-Insurance Group (SIG).Workers' Compensation Insurance in Washington State. â–« Review your insurance coverage and reporting requirements. Enter the self-insured company's formal name. Certain injured civilian employees to receive full compensation. -37.5. Verification Form for Workers Compensation Self-Insured Groups". Workers' Compensation. Generally, employers who join to form a SIG must be homogeneous,. Who is eligible for Worker's Compensation Benefits?

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Texas Workers Compensation Self-Insurance Group (SIG) Notification Form