Q. Where do I get the employee leasing application?
A. The employee leasing application is on the website under the Forms link. (Form EL1 and EL2). An application can be faxed to an employer, but we cannot accept a fax or email return.
Q. How do I apply for "Split Coverage" or "Wrap Up Coverage"?
A separate insurance policy may be issued if authorized by the Commissioner of the Department of Workers' Claims. The application forms are available for download on the website. They are Form 375 (Application for Split Coverage), and Form 375 Wrap Up (Application for Split Coverage). Refer to link below:Procedures for Wrap Up (Special Projects) and Split Coverage
Q. Is coverage information for an employer available to the public?
A. An "Insurance Coverage Lookup" link is available on this website. You will need the employer name, FEIN (Federal Employer Identification Number) or policy number to search.