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CONFIDENTIAL LOUISIANA OFFICE OF WORKERS' COMPENSATION ADMINISTRATION POST OFFICE BOX 94040 BATON ROUGE, LOUISIANA 70804-9040 EMPLOYERS APPLICATION FOR THE PRIVILEGE OF PAYING COMPENSATION PROVIDED

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What is self-insurer application - louisiana?

The self-insurer application in Louisiana is a form that must be submitted by employers who wish to self-insure their workers' compensation coverage instead of purchasing insurance from a licensed carrier.

Who is required to file self-insurer application - louisiana?

Employers in Louisiana who want to self-insure their workers' compensation coverage are required to file the self-insurer application.

How to fill out self-insurer application - louisiana?

To fill out the self-insurer application in Louisiana, employers need to provide information about their business, financial statements, safety programs, and any previous workers' compensation claims. The application can be obtained from the Louisiana Workers' Compensation Corporation (LWCC) website and must be completed accurately and submitted according to the instructions.

What is the purpose of self-insurer application - louisiana?

The purpose of the self-insurer application in Louisiana is to assess the eligibility of employers to self-insure their workers' compensation coverage. This process ensures that employers have the financial means and ability to handle any workers' compensation claims that may arise.

What information must be reported on self-insurer application - louisiana?

The self-insurer application in Louisiana requires employers to provide information about their business, including their ownership structure, financial statements, safety programs, claims history, and any existing workers' compensation insurance policies. The application may also require additional documents and disclosures as requested by the Louisiana Workers' Compensation Corporation (LWCC).

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