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Washington Self-Insurance Electronic Data Reporting System (SIEDRS) Enrollment Form

State:
Washington
Control #:
WA-SKU-3959
Format:
PDF
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Description

Self-Insurance Electronic Data Reporting System (SIEDRS) Enrollment Form The Washington Self-Insurance Electronic Data Reporting System (SIDES) Enrollment Form is an online form used by employers in Washington State to register their self-insured health plans with the Washington State Department of Labor & Industries. This form is required in order for employers to comply with the reporting requirements of the SIDES. The form is used to provide information about the employer's plan, including plan documents, contact information, and other related information. The form can be completed online or printed and mailed to the Department. There are two types of Washington Self-Insurance Electronic Data Reporting System (SIDES) Enrollment Form: the Initial Enrollment Form and the Renewal Enrollment Form. The Initial Enrollment Form is used to register a new self-insured health plan, while the Renewal Enrollment Form is used to renew an existing self-insured health plan.

The Washington Self-Insurance Electronic Data Reporting System (SIDES) Enrollment Form is an online form used by employers in Washington State to register their self-insured health plans with the Washington State Department of Labor & Industries. This form is required in order for employers to comply with the reporting requirements of the SIDES. The form is used to provide information about the employer's plan, including plan documents, contact information, and other related information. The form can be completed online or printed and mailed to the Department. There are two types of Washington Self-Insurance Electronic Data Reporting System (SIDES) Enrollment Form: the Initial Enrollment Form and the Renewal Enrollment Form. The Initial Enrollment Form is used to register a new self-insured health plan, while the Renewal Enrollment Form is used to renew an existing self-insured health plan.

How to fill out Washington Self-Insurance Electronic Data Reporting System (SIEDRS) Enrollment Form?

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Washington Self-Insurance Electronic Data Reporting System (SIEDRS) Enrollment Form