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  • Pa Libc-372 2017

Get Pa Libc-372 2017-2025

FEIN: Applicant/Employer Name:Initial Application for Safety Committee Certification (LIBC372)www.dli.pa.govHealth and Safety DivisionAuxiliary aids and services are available upon request to individuals.

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Sole-Proprietors and Partners who include themselves on workers' compensation coverage must use a minimum payroll amount of $54,548 and a maximum amount of 135,200 for rating their overall workers' compensation cost.

Workers' Compensation is tax-free. In Pennsylvania, the weekly compensation rate amounts to 66% of the injured worker's average weekly wage if they earned between $810.76 and $1,621.50 prior to the injury.

Adjustment necessary to bring executive officers to corporate minimum payroll (currently all executive officers have a minimum payroll of $56,212.00 annually or $1,081.00 per week effective 4/1/2021 and maximum payroll $140,000.00.

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.

(3) Workers compensation insurance with statutory benefits as required by Pennsylvania law; employers liability insurance with minimum limits of: $ 100,000 each accident for bodily injury by accident; $ 100,000 each employee for bodily injury by disease; and $ 500,000 policy limit for bodily injury by disease.

Contact Information E-MAIL: ra-li-bwc-helpline@pa.gov. WC CLAIMS INFORMATION HELPLINE. Toll free inside PA: 1-800-482-2383. Local calls and calls from outside PA: 717-772-4447. WC EMPLOYER HELPLINE. All calls: 717-772-3702. ... BUREAU OF WORKERS' COMPENSATION. 651 Boas Street, 8th Floor.

Workers' compensation coverage is mandatory for most employers under Pennsylvania law. Employers who do not have workers' compensation coverage may be subject to lawsuits by employees and to criminal prosecution by the commonwealth.

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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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