Texas Administrative Code
Title 28 - INSURANCE
Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
Chapter 43 - INSURANCE COVERAGE
Section 43.5 - Notice That Employer Has Become Subscriber
Current through Reg. 49, No. 12; March 22, 2024
The notice that employer has become subscriber shall be filed with the board's Austin office by certified mail or in person within 30 days of the effective date of the policy and the notice must be completed in detail and shall include:
(1) name, address, and occupation of insured;
(2) effective date of the policy;
(3) signature of the insurance company representative;
(4) complete name of the insurance company;
(5) policy number, and if notice is a rewrite of an existing policy, this information must be included on the notice;
(6) area or location of the business;
(7) Form 154, which shall be filed for divided risk coverage; and
(8) the employer's federal tax identification number (effective 1987).
