The Michigan Self-Insured Group Notice of Acceptance of Membership (fill-in form) is used by employers who are self-insured and provide coverage for their employees in the state of Michigan. This form is used to notify the Michigan Self-Insured Group (MSI) of an employer's intent to become a member of the group. The form contains information on the employer, the type of coverage, the number of employees, and the start and end dates of the coverage. The form also requires a signature from the employer and the MSI's acceptance of the employer's application. There are two types of Michigan Self-Insured Group Notice of Acceptance of Membership (fill-in form): one for initial applications and one for renewals of membership.
Michigan Self-Insured Group Notice of Acceptance of Membership (fill-in form)
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Self-Insured Group Notice of Acceptance of Membership (fill-in form)
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Corporations, limited liability companies and partnerships must either have a workers' compensation policy or a Notice of Exclusion Form, WC-337, on file with this office. The owner(s) are considered an employee(s) of the business.
Your employer only has to pay what is required under the Michigan workers compensation law. Medical treatment under workers compensation can include doctor visits, physical therapy, surgery, hospital stays and medications.
Be aware that there are exemptions to the state law, such as: Agricultural employers, unless they have three or more employees working more than 35 hours a week for 13 weeks. Domestic workers, like housekeepers. Partners and officers of a partnership and corporation.
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.
Michigan law requires employers to have workers' comp insurance for independent contractors. It only takes 1 employee working 35 hours or longer for 13 weeks or more to trigger this requirement. Failure to have workers' comp could result in civil and criminal penalties. Workers' comp benefits must also still be paid.
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.
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ALE Members that offer health coverage through an employer-sponsored, self-insured health plan must complete. Self-insured group health plans will use Forms 1094-B and.B to report information about covered individuals. Employers insured for disability benefits through an insurance carrier or Board-approved self-insurance. This form is not filed. This page provides a glossary of insurance terms and definitions that are commonly used in the insurance business. Have your employer complete Part B, Employer's Statement. Mail the form to your employer's TDI insurance company if your employer is not self-insured. This page provides a glossary of insurance terms and definitions that are commonly used in the insurance business. Giving the completed form to your employer opens your workers' compensation case.