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Download Application for Limited Elective Coverage for Licensed Pony Riders (F250-026-000) – Department of Labor and Industries (Washington) form. Fill Out The Application For Limited Elective Coverage For Licensed Pony Riders - Washington Online And Print It Out For Free.Elective coverage is available for the exemptions describe below. Please review your business entity type in 1, 2, or 3 and complete both pages of this form. No premise coverage afforded. Please complete and return to your District Horse Council. Arkansas Insurance Department. Subsidiaries of Chubb Limited providing insurance and related services. 440.585 Workers' compensation group self-insurance fund application disclosure. Wilkins Live Stock Insurance has been offering the best possible coverage at the lowest rate for your horses, alpacas, llamas and more.