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New York State Workers Compensation Board The Licensed Representative Examination Process I. Written Examination In order to become a New York State Workers Compensation Board Licensed Representative,
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New York State Workers' Compensation Form C-105.2 is a report that tracks workers' compensation coverage for employees in the state of New York.
Employers with employees covered by workers' compensation insurance in the state of New York are required to file Form C-105.2.
Employers can fill out Form C-105.2 manually or electronically through the New York State Workers' Compensation Board website.
The purpose of Form C-105.2 is to ensure that employees have adequate workers' compensation coverage in case of a work-related injury or illness.
Form C-105.2 requires information such as employer name, address, federal ID number, insurance carrier, policy number, coverage dates, and employee details.
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