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Employers Reciprocal Coverage Election Supplemental Attachment RTS6A R. 01/13 Rule 73B10.037 Florida Administrative Code This form must be attached to each copy of the Employers Reciprocal Coverage

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How to fill out employer s reciprocal coverage

01

Obtain the necessary forms: Contact your employer's insurance provider or the state's workers' compensation agency to obtain the required forms for filling out employer's reciprocal coverage.

02

Fill out the employee information: Provide the necessary details about the employee who requires reciprocal coverage, such as their full name, job title, and contact information.

03

Provide employer information: Enter the employer's details, including their business name, address, and contact information.

04

Specify the coverage period: Indicate the start and end date for the reciprocal coverage period.

05

Provide insurance details: Fill in the insurance policy number and the name of the insurance carrier providing the coverage.

06

Submit the form: Once complete, submit the filled-out form to the designated recipient or department, as specified by your employer or the workers' compensation agency.

07

Keep copies for record-keeping: Make sure to retain a copy of the form for your own records and reference.

Who needs employer s reciprocal coverage?

01

Employers with employees working in states that require reciprocal coverage

02

Companies with employees who frequently travel or work temporarily in other states

03

Employers with out-of-state branches or operations

04

Businesses engaged in interstate commerce

05

Employers seeking to comply with state workers' compensation laws and avoid penalties

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What is employer's reciprocal coverage?

Employer's reciprocal coverage is a form of workers' compensation insurance that provides coverage for employees who work in multiple states.

Who is required to file employer's reciprocal coverage?

Employers who have employees working in multiple states are required to file employer's reciprocal coverage.

How to fill out employer's reciprocal coverage?

Employer's reciprocal coverage can be filled out by providing information about the company, the employees, and the states in which they work.

What is the purpose of employer's reciprocal coverage?

The purpose of employer's reciprocal coverage is to ensure that employees who work in multiple states are covered by workers' compensation insurance.

What information must be reported on employer's reciprocal coverage?

Employer's reciprocal coverage must include information about the company, the employees, and the states in which they work.

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