This form is used for Wisconsin Worker's Compensation insurance carriers to provide information to the Wisconsin Department of Workforce Development (DID). This information includes basic information about the company, contact information, business type, policy type, policy limits, and Third Party Administrators (TPAs). TPAs are companies that specialize in administering workers’ compensation claims in the state of Wisconsin. The form also provides a section to update any changes in information that have been made since the last submission. The form requires that the following information be provided: company name, contact information, business type, policy type, policy limits, and TPA information (if applicable). The form also requires that TPAs provide their contact information, the services they provide, and a list of the specific Wisconsin counties where they offer services.
Wisconsin This form is used for collecting pertinent information from new Worker's Compensation insurance carriers as well as updating changes in information. The form also provides a section to submit or update information pertinent to Third Party Administrators
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FAQ
Under the Worker's Compensation Act (Act), you must carry worker's compensation insurance if you do any one of the following: Employ 3 or more full-time or part-time employees. You must have insurance on the day you employ the third person.
The ultimate answer to how long you can receive workers' compensation benefits, of course, is that you can receive them for life if your injury qualifies.
To file a claim, an injured worker must: complete an Uninsured Employers Fund Claim Application (by calling (608) 266-3046 and requesting the UEF application form be mailed to them)
If you still have UI questions, please contact the UI Help Center at (414) 435-7069 or toll-free (844) 910-3661 during business hours.
To file a claim, an injured worker must: complete an Uninsured Employers Fund Claim Application (by calling (608) 266-3046 and requesting the UEF application form be mailed to them)
Wisconsin Employers that meet specific requirements are required to carry Worker's Compensation insurance unless they qualify for Self-Insured status. Employers receive the assurance they will not be sued for damages, medical care and lost wages if their employees get injured while working.
Worker's compensation is protection mandated by Wisconsin law for a worker and his or her dependents against injury and death occurring in the course of employment. It is not health insurance and is not intended to compensate for disability other than disability caused by injury arising out of employment.