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MINNESOTA WORKERS' COMPENSATION ASSIGNED RISK PLAN APPLICATION FOR WORKERS' COMPENSATION INSURANCE COVERAGE IS DESIRED* Effective Date Send to: Minnesota Workers' Compensation Insurers Assn., Inc.

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What is 04-01- assigned risk plan?

The 04-01 assigned risk plan is a state-mandated program that provides workers' compensation coverage to employers who are unable to obtain coverage in the standard insurance market.

Who is required to file 04-01- assigned risk plan?

Employers who cannot secure workers' compensation coverage through the standard insurance market are required to file the 04-01 assigned risk plan.

How to fill out 04-01- assigned risk plan?

To fill out the 04-01 assigned risk plan, employers need to provide information about their business, including the number of employees, nature of work, payroll details, and previous insurance coverage history.

What is the purpose of 04-01- assigned risk plan?

The purpose of the 04-01 assigned risk plan is to ensure that all employers have access to workers' compensation coverage, even if they are considered high-risk or have been denied coverage in the standard market.

What information must be reported on 04-01- assigned risk plan?

Employers filing the 04-01 assigned risk plan must report details such as their business name, address, contact information, number of employees, payroll records, and previous insurance history.

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