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L Park Dr., Suite 311, Livonia, MI 48152-2686 734-462-9600 IMPORTANT: Instructions for completing this application can be found in the Michigan Workers Compensation Placement Facility s Information and Procedures Handbook. This handbook is available from the Michigan Worker s Compensation Placement Facility or at www.caom.com. This application must be typed or legibly printed in ink. Under no circumstance will coverage be bound sooner than 12:01 AM the day following receipt by MWCPF. Miss.

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How to fill out the Mwcpf online

Completing the Michigan Application for Workers’ Compensation Insurance (Mwcpf) online can simplify the process of securing necessary coverage. This guide provides a comprehensive overview of each section of the form, ensuring you have the support needed to fill it out correctly.

Follow the steps to successfully complete your Mwcpf online.

  1. Click ‘Get Form’ button to retrieve the Mwcpf and open it in the designated editor for completion.
  2. Fill in the general information section carefully. Start by entering the effective date in the designated space. Next, input the employer's name and federal employer identification number. Ensure to include a valid phone number for easier communication.
  3. Provide the mailing address along with the principal business location. If there are any other locations in Michigan, also include that information here. Make sure all addresses are complete and accurate to avoid any processing delays.
  4. Indicate the total number of employees and identify the legal status of your business. Carefully select the appropriate category (e.g., sole proprietor, partnership, corporation) and provide any additional explanations if necessary.
  5. Answer the questions regarding operations in states other than Michigan. If applicable, include the locations and insurance carrier information.
  6. Move on to the insurance record section. Indicate if there has been prior coverage in Michigan and provide the required details if the answer is yes. Include any name changes or previous business purchases if relevant.
  7. In the business principals section, list all relevant individuals, their titles, duties, and approximate annual salaries. Be sure to indicate the percentage of ownership for each individual.
  8. Describe your business operations in detail in the designated section. Include classification codes for different operations and ensure accurate payroll estimates to determine premiums.
  9. Calculate the estimated annual premium, making sure to enclose a cashier's check or another acceptable form of payment as instructed.
  10. Complete the employer's agreement by reading and signing the certification to certify the truthfulness of your application.
  11. Finally, ensure that all sections are completed and save your changes. Download, print, or share the completed form as required for submission.

Start completing your Mwcpf online today to ensure you have the necessary workers’ compensation coverage.

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Related links form

SSA-632-BK 2014 State Farm 104942.1 2001 seekers BSDM Checklist SSA-561-U2 2019

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The Michigan Worker's Compensation Placement Facility is a non-profit non-governmental association formed by the Legislature in 1982 to provide worker's compensation insurance to Michigan businesses that cannot obtain coverage from private insurers.

Your benefits continue so long as you suffer wage loss, which could be for the rest of your life.

There is a 7-day waiting period for wage loss benefit payments. If the disability lasts beyond one week, the worker is entitled to benefits as of the eighth day after the injury.

Any business with one or more employees is required to carry workers' compensation insurance in Michigan. This policy provides medical benefits for work-related injuries.

The State of Michigan does not ordinarily pay workers' compensation benefits. Most employers in Michigan purchase an insurance policy from a private insurance company or they are authorized to be self-insured. If you are injured on the job, report the injury to your employer immediately.

Weekly benefits are roughly 80 percent of your after-tax wages. If your employer will not file a claim for you, you may file form WC-117 with the Agency. If your claim is disputed by the insurance company or self-insured employer, you may need to file a form WC-104A, Application for Mediation or Hearing.

Michigan workers' compensation rates 2023 have now been published. The maximum weekly comp rate for 2023 is $1,095.00 ($56,940 annually). This is based upon 90% of the state average weekly wage, which is $1,216.18. The maximum is to limit disabled employees to what most people in Michigan are earning.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232