Get Ga Wc 26

Filling out the Ga Wc 26 form is essential for insurers and self-insurers to report medical only cases and indemnity claims. This comprehensive guide will walk you through each section of the form, ensuring that you complete it accurately and effectively.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to access the Ga Wc 26 and open it in your editor.
2. In the top section labeled 'A. Insurer/Self-Insurer/Group Fund', enter the name of the insurer or self-insurer as it appears on their permit. Also, input the five-digit SBWC ID number and the reporting year.
3. Move to section 'B. Medical Only Claims'. Here, input the total number of medical only claims processed this year and the total amount paid on these claims.
4. In section 'C. Indemnity Claims', report the total number of indemnity claims for the year. Also, include the total amount of indemnity benefits paid and the total medical paid on these indemnity claims, excluding hospital payments.
5. Additionally, provide the total hospital payments related to indemnity claims. Be sure to fill in your name, contact phone number, date, address of the submitting office, and email address in the respective fields.
6. Once all sections are completed, review the information for accuracy. You can then save your changes, download a copy, print the document, or share it as needed.

Complete your Ga Wc 26 form online today to ensure timely compliance.