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Approved Class Codes - 2008 |
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Approved
Class Codes -
2007 |
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Approved
Class Codes -
2006 |
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Employee
Agreement
Agreement to Kansas
benefits when working in other states. |
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Employee Agreement-Spanish Agreement o Kansas
benefits when working in other states. |
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ERM-14
NCCI ownership
information change |
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GWC-3
NEW - fill out
online and print!! Kansas
Insurance Department - Individual
Application for Membership In A Group
Funded Workers' Compensation Pool.
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GWC-9 Kansas Insurance
Department - Financial Statement
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KWC-1101a
NEW - fill out online and print!!
First Report of
Injury |
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KWC-50
State
of Kansas, Department of Human Resources,
Division of Workers Compensation Election
not to accept coverage under Kansas
Workers Compensation act by employee who
owns 10% or more of corporate stock or
corporate employer |
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KWC-50a
State
of Kansas, Department of Human Resources,
Division of Workers Compensation
Cancellation of Election not to accept
coverage under the Kansas Workers
Compensation act by employee who owns 10%
or more of corporate stock or corporate
employer. |
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KWC-51
State
of Kansas, Department of Human Resources,
Division of Workers Compensation Election
of Employer to cover Employee under
Kansas Workers Compensation Act where
employer has less than $20,000 payroll or
is agricultural pursuit.
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KWC-51a
State
of Kansas, Department of Human Resources,
Division of Workers Compensation
Cancellation of Election of Employer to
cover Employee under Kansas Workers
Compensation Act where employer has less
than $20,000 payroll or is agricultural
pursuit. |
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KWC 113
State of Kansas, Department of Human
Resources, Division of Workers
Compensation Election of Individual,
Partner or Self-Employed individual to
come within the provisions of the Kansas
Workers Compensation Act.
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KWC114
State of Kansas, Department of Human
Resources, Division of Workers
Compensation Cancellation of Election of
Individual, Partner or Self-Employed
individual to come within the provisions
of the Kansas Workers Compensation Act. |
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Policy and
Procedures
Kansas
Building Industry Worker's Compensation
Fund Policy and Procedures
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Subcontractor Agreement |
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Underwriting Questionnaire If you do not
submit the application with an Acord form we will need
this questionnaire. |
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USERRA
Form The
Uniformed Services Employment and Reemployment Rights
Act EMPLOYERS ARE REQUIRED TO POST THIS FORM |
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The following forms are
available to download in PDF, Portable Document
Format. Adobe Acrobat Reader is required to view
documents. This software is
FREE.
