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City of Austin P.O. Box 1088 Austin TX 78767CNI 90 04 0112 InsuredPOLICYHOLDER NOTICE COMPANY CONTACT INFORMATION In the event you need to contact someone about this policy for any reason, please
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Obtain a copy of the master workers compensation rocip form.
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Fill out your personal information accurately, including your name, address, and contact details.
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Provide your employment details, such as the name of your employer, job title, and period of employment.
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Indicate the date and location of the accident or injury.
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Describe the nature of the accident or injury in detail, including the body part affected and the circumstances leading up to it.
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Attach any relevant medical records, diagnostic reports, or witness statements as supporting documentation.
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Who needs master workers compensation rocip?

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Workers who have suffered an occupational injury or illness and are seeking compensation are the ones who need to fill out the master workers compensation rocip form.
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The Master Workers Compensation ROCIP, or Roll-Over Coverage Insurance Program, is a program that allows qualifying employers to transfer their workers' compensation insurance coverage when they have a change in ownership or structure.
Employers who are part of a qualifying project and have a change in ownership or structure are required to file the Master Workers Compensation ROCIP.
To fill out the Master Workers Compensation ROCIP, employers must provide information about the new ownership or structure, the existing workers' compensation policy, and any relevant details about the project.
The purpose of the Master Workers Compensation ROCIP is to ensure that employees continue to have adequate workers' compensation coverage during a change in ownership or structure of a project.
Information such as details about the new ownership or structure, the existing workers' compensation policy, and any relevant project details must be reported on the Master Workers Compensation ROCIP.
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