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Oregon Attachment B to Application for Worker Leasing Company License

State:
Oregon
Control #:
OR-SKU-1766
Format:
Word
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Description

Attachment B to Application for Worker Leasing Company License

Oregon Attachment B to Application for Worker Leasing Company License is a document that must be submitted to the Oregon Bureau of Labor and Industries when applying for a Worker Leasing Company License. This document must be completed in its entirety and is used to provide information on the company seeking a license, its owners, and its officers. The Oregon Attachment B to Application for Worker Leasing Company License includes sections that must be filled out for the applicant company, its owners, and its officers. These sections include information such as name, address, contact information, background, financial information, and any disqualifying factors. Additionally, the document includes an attestation that all information provided is accurate and complete. There are two types of Oregon Attachment B to Application for Worker Leasing Company License: one for for-profit companies and one for non-profit companies.

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FAQ

Fill out Form 801 ?Report of Job Injury or Illness? and turn it in to your employer. Your employer should send it to its workers' compensation insurance carrier within five days of your notice. Your employer should provide you this form.

This bulletin provides updated benefit rates based on the Oregon state average weekly wage. This bulletin replaces Bulletin No. 111 dated . July 1, 2023, through June 30, 2024, the SAWW used to compute workers' compensation benefits is $1,295.86.

Your employer must send your workers' compensation claim (Form 801) to its insurer within five days of being notified of your injury. It is illegal for employers to do anything to keep employees from filing claims.

Ing to Oregon state law, all employers who have one or more employees, including full- or part-time employees, must have workers' comp insurance. Independent contractors, sole proprietors, corporate officers with at least 10% ownership of the company, and LLC members are not legally required to be covered.

Oregon law requires the worker leasing company (professional employer organization/PEO) and all of the PEO's Oregon clients to have workers' compensation insurance. The PEO must maintain coverage even if the PEO has no non-leased administrative staff in the state and all clients carry their own coverage.

The weekly payment minimum is $50 or 90 percent of the employees actual wage if it is less. The weekly maximum is $790.38, 100% of the Oregon state average weekly wage. Maximum period of payments is the length of the disability.

Once the insurer calculates your average weekly wage, it will pay you 2/3rds of that amount in time loss. Time loss is paid every two weeks. You do not pay taxes on these payments. If you have more than one job when you are injured, you must tell the insurer within 30 days of filing your claim.

More info

An applicant must file this form to obtain an initial license. OTPs must complete Attachment 3.You are revalidating your Medicare enrollment. You must complete this form if your business is a corporation. Attach a copy of your most recent tax return, entity agreement, and financial statements. Please read the instructions carefully to ensure proper completion of the application. Must complete this form. Individuals must attach a color photo to form. TDI Form NumberDescriptionFile FormatLanguageAH001Group Health Product Requirements ChecklistPDFEnglishAH005Group Health Discretionary Group ChecklistPDFEnglishAH009Group Health Specified Disease ChecklistPDFEnglish Alone does not require a Federal Firearms License).

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Oregon Attachment B to Application for Worker Leasing Company License