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, 1,066 Characters
Page Size: Letter (8 1/2" x 11")
URL

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

Download 193-AI.qxp ( 38.2 kB)


Preview 193-AI.qxp
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