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For assistance or you may email the forms to workerscomp cslb ca gov.
Workers compensation certificate of insurance california. On other pages you ll find we provided you with some real world information as to the effect certificates have on any workers compensation policy. California employer fact sheet for employers. The standard acord 130 application form for workers comp coverage in california. The system is unable to submit your data at this time.
Pane 1 pane 2 pane 3 pane 4 pane 5 pane 6 pane 7. California application for exclusion of officers and. You ll learn what a certificate is what a certificate of insurance can and cannot do what information is provided on a certificate who needs a certificate of insurance and how to secure one. When an employer cancels a workers compensation policy in the middle of a policy year mid term in order to secure insurance with another company or to close a business the insurance company will return any unexpired or unearned premium on a pro rata basis unless the insurer discloses to the policyholder in accordance with california.
For the purpose of submitting a certificate of workers compensation insurance to the cslb the cslb has created an online form that allows users to submit information that will automatically update the license record. Ca acord 130 workers compensation application. Pane 0 online submission. Please wait 10 minutes then try again.
Also information on insurance companies licensed to sell workers compensation insurance and an online rate comparison of the top 50 workers compensation insurers can be accessed on the california department of insurance cdi web site at www insurance ca gov. The office of self insurance plans osip is a program within the director s office of the department of industrial relations dir responsible for the oversight and regulation of workers compensation self insurance within california.
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