Free 193-AI.qxp - Missouri


File Size: 38.2 kB
Pages: 1
Date: March 30, 2009
File Format: PDF
State: Missouri
Category: Workers Compensation
Author: es0691
Word Count: 152 Words, 1,051 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.dolir.mo.gov/wc/forms/193-ai.pdf

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MISSOURI DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS DIVISION OF WORKERS' COMPENSATION

TRUST QUICK REFERENCE DUE DATES

Documents required annually: Audited Financial Reports 150 days after close of fiscal year. Actuary Report Annual Reports due May 31st each year. Rates due 15 days prior to implementation. Requests for distribution of surplus funds. Proof of Insurance: Specific; Aggregate; Fidelity Bond for Trust Fund, Administrator, and Marketers; Errors and Omissions for Claims Administrator, Marketers, and Administrators; and Director & Officers Liability.

Documents required quarterly: Unaudited financial reports due 30 days following end of quarter. Summary loss report due 30 days following end of quarter. Board minutes due 30 days following all Board Meetings and Annual Trust Meeting.

All reports should be directed to:

Attn: Paula Hinshaw Division of Workers' Compensation P.O. Box 58 Jefferson City, MO 65102-0058 Phone 573-526-6021 Fax 573-751-2012 [email protected]

WC-193 (04-09) AI