Workers Compensation Exemption Forms by State

Department:

Alabama Department of Labor

Form Name:

Workers' Compensation Exemption Information

Requirements:

Employers with fewer than 5 employees are exempt from coverage requirements

Department:

Alaska Department of Labor

Form Name:

Workers' Compensation Forms

Requirements:

Business owners with 10%+ ownership are automatically exempt

Department:

Arizona Industrial Commission

Form Name:

Employee Rejection of Terms Forms

Requirements:

Employees may reject workers compensation coverage terms

Department:

Arkansas Workers' Compensation Commission

Form Name:

Corporate Officer Exemption

Requirements:

Corporate officers owning 10% or more may exempt

Department:

California Department of Industrial Relations

Form Name:

Notice of Election to be Subject to or Excluded from Workers' Compensation

Requirements:

Corporate officers may elect exemption with conditions

Department:

Colorado Division of Workers' Compensation

Form Name:

Corporate Officer Election Form

Requirements:

Corporate officers may elect exemption annually

Department:

Connecticut Workers' Compensation Commission

Form Name:

Election to be Excluded from Coverage

Requirements:

Corporate officers and LLC members may exempt

Department:

Delaware Department of Labor

Form Name:

Corporate Officer Exemption Election

Requirements:

Officers with 10% or more ownership may exempt

Department:

Florida Division of Workers' Compensation

Form Name:

Notice of Election to be Exempt (Online Application)

Requirements:

Corporate officers may apply for exemption online

Department:

Georgia State Board of Workers' Compensation

Form Name:

Election to Reject Workers' Compensation Coverage

Requirements:

Sole proprietors and partners may reject coverage