This is one of the official Workers' Compensation forms for the state of Kentucky.
Kentucky Application for Split Coverage Employee Leasing is a form that is used by employers in the state of Kentucky to apply for and manage split-coverage employee leasing. This form is used to define the roles of the employer and the leasing company and the terms and conditions of the split-coverage employee leasing arrangement. The form includes information about the employer, the leased employees, and the responsibilities of the employer and the leasing company. There are two types of Kentucky Application for Split Coverage Employee Leasing: the Full-Service Employee Leasing and the Limited-Service Employee Leasing. The Full-Service Employee Leasing covers all the employer's employee leasing needs, while the Limited-Service Employee Leasing allows the employer to retain responsibility for certain aspects of the employee leasing arrangement.
