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This document is a supplemental application for LUBA Workers' Comp coverage under the USL&H act, requiring specific details about the work and the reason for the coverage request.
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How to fill out luba workers comp uslh
How to fill out LUBA WORKERS’ COMP USL&H SUPPLEMENTAL APPLICATION
01
Begin by reviewing the application form to understand all required sections.
02
Fill out the company's basic information, including name, address, and contact details.
03
Provide details about the nature of your business and the services you offer.
04
Specify the number of employees and their job classifications.
05
Indicate the total payroll for the reporting period.
06
List any subcontractors used and their respective insurance details.
07
Complete any additional sections regarding safety programs or loss history.
08
Review the completed application for accuracy and completeness.
09
Sign and date the application before submission.
Who needs LUBA WORKERS’ COMP USL&H SUPPLEMENTAL APPLICATION?
01
Businesses engaged in maritime activities that utilize employees under the U.S. Longshore and Harbor Workers' Compensation Act (USL&H).
02
Employers that require workers' compensation insurance specific to the USL&H regulations.
03
Companies with employees working on docks, harbors, or vessels in U.S. waters.
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What is LUBA WORKERS’ COMP USL&H SUPPLEMENTAL APPLICATION?
The LUBA WORKERS’ COMP USL&H SUPPLEMENTAL APPLICATION is a form required for businesses that operate in specific marine or waterfront activities, providing additional details to assess workers' compensation insurance coverage under the Longshore and Harbor Workers' Compensation Act.
Who is required to file LUBA WORKERS’ COMP USL&H SUPPLEMENTAL APPLICATION?
Employers who have employees engaged in maritime employment, particularly in longshore or harbor work, are required to file the LUBA WORKERS’ COMP USL&H SUPPLEMENTAL APPLICATION.
How to fill out LUBA WORKERS’ COMP USL&H SUPPLEMENTAL APPLICATION?
To fill out the LUBA WORKERS’ COMP USL&H SUPPLEMENTAL APPLICATION, accurately provide information related to the business activities, the number of employees, the type of maritime work being performed, and any other relevant details as requested in the form.
What is the purpose of LUBA WORKERS’ COMP USL&H SUPPLEMENTAL APPLICATION?
The purpose of the LUBA WORKERS’ COMP USL&H SUPPLEMENTAL APPLICATION is to gather necessary information that helps insurers assess the risk and determine the appropriate coverage and premiums for businesses involved in maritime activities.
What information must be reported on LUBA WORKERS’ COMP USL&H SUPPLEMENTAL APPLICATION?
The LUBA WORKERS’ COMP USL&H SUPPLEMENTAL APPLICATION requires reporting information such as the nature of the business operations, employee job titles, the number of employees working in applicable roles, and details about subcontractors or any additional work performed in maritime environments.
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