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FAXAQUOTE ECA Division 14350 Proton Road / Dallas, Texas 75244, Phone: (972 9312026 or (800 2995250, Fax: (972 9312126, Email: txnonsubscriberpolicy gaic.com Please remit this form along with a copy
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Who needs non-subscriber supplemental - bsr:

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Employers who choose not to subscribe to workers' compensation insurance in states where it is not mandatory may need to fill out the non-subscriber supplemental - bsr form.
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Non-subscriber employers in states that require reporting workplace injuries or accidents to a central authority may need to complete this form for each incident.
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It is important for employers to consult their state's regulations and requirements to determine if they need to fill out the non-subscriber supplemental - bsr form.
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Non-subscriber supplemental - bsr refers to a form that non-subscribers of worker's compensation insurance in Texas are required to file.
Employers in Texas who choose to not carry worker's compensation insurance are required to file non-subscriber supplemental - bsr.
Non-subscriber supplemental - bsr can be filled out electronically on the Texas Department of Insurance website or submitted via mail.
The purpose of non-subscriber supplemental - bsr is to report any work-related injuries or illnesses that occur to employees of non-subscribers.
Information such as the employee's name, date of injury, description of injury, and any medical treatment received must be reported on non-subscriber supplemental - bsr.
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