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What is Insurer Change Notice

The Insurer's Notice of Name or Address Change (Form BWC-403) is a business form used by employers in Michigan to notify the Bureau of Workers' Disability Compensation about name and address changes.

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Who needs Insurer Change Notice?

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Insurer Change Notice is needed by:

Employers in Michigan changing their business name
Insurance companies representing Michigan-based businesses
Human resources departments overseeing worker compensation filings
Business owners managing address updates
Consultants assisting businesses with regulatory compliance

Comprehensive Guide to Insurer Change Notice

What is the Insurer's Notice of Name or Address Change?

The Insurer's Notice of Name or Address Change is a vital form utilized in Michigan, specifically designed to inform the Bureau of Workers’ Disability Compensation about any changes to an employer's name or address. This notification is essential for maintaining accurate records within the workers’ compensation system, ensuring that all correspondence and legal documentation reach the correct entity. Given Michigan's regulatory framework, businesses must comply with the requirement to update their name or address to avoid potential issues that could arise from outdated information.

Purpose and Benefits of the Insurer's Notice of Name or Address Change

Timely updates through the Insurer's Notice of Name or Address Change are crucial for businesses to remain compliant with state regulations. This form not only eliminates confusion but also ensures that employers receive important communications from the Bureau. Key benefits for employers include:

Ensuring regulatory compliance and avoiding penalties.
Fostering clear communication channels with the state.
Facilitating timely processing of workers’ compensation claims.

By completing this business name change notification promptly, businesses position themselves for smoother operations.

Who Needs the Insurer's Notice of Name or Address Change?

Employers and insurance companies are the primary audience for the Insurer's Notice of Name or Address Change. Scenarios requiring this form include significant business changes such as a merger, a rebranding initiative, or a relocation that affects the business address. Companies must ensure they are filing the insurance company name change appropriately to maintain accurate records.

Eligibility Criteria for Submitting the Insurer's Notice of Name or Address Change

To submit the Insurer's Notice of Name or Address Change, specific eligibility criteria must be met. Typically, employers must be actively engaged in business operations and covered under Michigan’s workers’ compensation. Conditions that allow for submission include having a valid Federal Identification Number, and the business must not have any unresolved legal issues impacting their insurance standing.

How to Complete the Insurer's Notice of Name or Address Change Online (Step-by-Step)

Filling out the Insurer's Notice of Name or Address Change online is straightforward. Follow these steps:

Access the appropriate online platform for the form.
Enter your Federal ID Number in the designated field.
Fill in the complete name and address of your business.
Specify the effective date of the change.
Provide the insurance company's name and address details.
Sign the form electronically, ensuring an authorized representative reviews it.

Make sure to verify all entries before submission to avoid common errors.

Common Errors and How to Avoid Them When Filling Out the Insurer's Notice of Name or Address Change

While completing the Insurer's Notice of Name or Address Change, several common errors can hinder the submission process. These may include:

Incorrect Federal ID Number entry.
Failing to provide the effective date of the change.
Submitting without an authorized signature.

To avoid these pitfalls, ensure all information is accurate and thoroughly review the completed form for any inaccuracies.

Submission and Delivery Methods for the Insurer's Notice of Name or Address Change

Employers can submit the Insurer's Notice of Name or Address Change through various methods. Options include:

Submitting online using the official platform.
Mailing the completed form to the Bureau of Workers' Disability Compensation.

Be aware of any submission fees, deadlines, or processing times that may apply to ensure timely compliance.

What Happens After You Submit the Insurer's Notice of Name or Address Change?

Upon submission of the Insurer's Notice of Name or Address Change, a confirmation is typically issued. To track the status of your submission:

Utilize any available online tracking tools provided by the Bureau.
Expect a notification confirming the changes have been processed.

This follow-up is essential for maintaining accurate records and ensuring compliance.

Security and Compliance When Handling the Insurer's Notice of Name or Address Change

Handling sensitive information on the Insurer's Notice of Name or Address Change requires strict adherence to security protocols. Ensuring data protection is critical, especially in compliance with regulations like HIPAA and GDPR. pdfFiller is dedicated to safeguarding user information with robust security measures including:

256-bit encryption for data protection.
Regular audits to maintain compliance.
Commitment to user privacy and secure document handling.

Employing secure methods keeps sensitive business information safe throughout the process.

Your Efficient Solution for Completing the Insurer's Notice of Name or Address Change

To simplify the process of filling out the Insurer's Notice of Name or Address Change, pdfFiller offers features that streamline form management. Users can take advantage of:

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Leveraging pdfFiller's capabilities ensures a hassle-free experience when managing critical business forms.

Last updated on Apr 30, 2026

How to fill out the Insurer Change Notice

1.

Start by accessing the Insurer's Notice of Name or Address Change (Form BWC-403) on pdfFiller. You can do this by searching for the form name in the pdfFiller search bar.
2.

Once the form is loaded, navigate through the document to locate each blank field. You will find editable areas designated for inputting necessary information.
3.

Before filling out the form, gather all required details including your Federal Identification Number, business's current and former name or address, and the effective date of the change.
4.

Input the required information in the respective fields. Ensure that all entries are accurate and correspond to the exact changes you are reporting.
5.

After completing all fields, take a moment to review the entered information. Verify that the business name, address, and other details are correct.
6.

Once verified, locate the 'Authorized Signature' field. This section needs to be completed and signed by a designated person authorized to make changes for your business.
7.

With the form thoroughly completed and signed, look for options to save your work. Choose to save your form as a PDF in your desired location.
8.

You can now download the filled form for submission. Alternatively, if you're ready, submit it directly through pdfFiller as per the submission guidelines provided.

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Who is required to file the Insurer's Notice of Name or Address Change?

Any business operating in Michigan that has a name or address change must file the Insurer's Notice of Name or Address Change. This form is mandatory for compliance with regulations set by the Bureau of Workers' Disability Compensation.

What details do I need to fill out the form?

To complete the Insurer's Notice of Name or Address Change, you need your Federal Identification Number, the current and former name and address of your business, an effective date for the changes, and the signature of an authorized representative.

How do I submit the completed form?

Once the form is completed and signed, it should be submitted to the Bureau of Workers' Disability Compensation. This can typically be done by mailing a physical copy or using electronic submission methods available through the Bureau.

Are there deadlines for submitting this form?

While specific deadlines may vary, it's critical to submit the Insurer's Notice of Name or Address Change promptly after any name or address changes occur to ensure regulatory compliance and proper communication with the Bureau.

What are common mistakes to avoid when completing the form?

Common mistakes include providing incorrect names or addresses, neglecting the authorized signature, and missing the effective date of the changes. Always double-check all inputs for accuracy before submission.

How long does it take for the department to process the form?

Processing times can vary based on the Bureau's workload. Generally, it can take several weeks to update records once the Insurer's Notice of Name or Address Change is submitted, so it's advisable to file promptly.

Is notarization required for this form?

No, notarization is not required for the completion of the Insurer's Notice of Name or Address Change. However, an authorized representative must sign the form to validate the information provided.