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Ce-200 PDF Form: What You Should Know

Please read and understand the instructions (not print) below before you complete the application. The applications must be signed by the business owner. The instructions do not cover all the steps of the required process, they are just the minimum steps.  In the event of a delay in obtaining a Certificate, applicants should file their application by contacting the Workers' Compensation Board no later than 24 hours after the first notice of re-exam was issued (if required). What happens if the employer fails to return the Certified form to the Workers' Compensation Board within 21 days after receiving it or if there is no response to the certified application by the board and the applicant has complied with all requirements, it will be returned to the applicant on his or her next paycheck. The application fee will be returned to a refund address on file with the Workers' Compensation Board. Please consult your workers' compensation attorney to find out if this is a valid procedure. There will be a hearing before a representative of the Board within 15 days of receipt of the application fee. The written response and supporting documentation, along with a summary of all fees paid and the reasons for payment, will be made a part of the record of the hearing. After consideration of the summary of evidence, the decision will be mailed to the applicant with a copy of the decision. C.WPA.CERTIFICATE OF ASSURANCE/INSURANCE REQUIRED For persons operating and/or who provide services in New York State (including Nassau and Suffolk Counties), the Certificate of Insurance or Insurance Identification Number is required. Please call our office directly at or write the office. A. A Certificate of Insurance or Insurance Identification Number for every worker or firm that provides services for the NYS, including Nassau and Suffolk Counties, in all of its businesses To obtain a Certificate of Insurance or Insurance Identification Number (CIO), click on the link below: . You must provide a copy of the current Certificate; a current Certificate of Insurance showing the current year in which the insurance premium was paid(s); the name and address of the insurance company; the name of any agent for service of process; and the number of the certificate(s) on file with the Board. B.

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FAQ - Ce-200 form PDF

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