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The document is an application form for elective coverage under Washington's Industrial Insurance laws, specifically for sole proprietors, partners, corporate officers, and LLC members/managers. It outlines eligibility criteria for coverage, reporting requirements for hours worked, and the process for electing or canceling coverage. The form requires signatures from all individuals electing coverage and provides instructions on how to submit the completed application.

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How to get workers comp in Washington state?

Washington State does not allow private workers compensation coverage. You must purchase your coverage from LI or be a certified self-insured employer.

Who pays WA workers compensation tax?

Employers are responsible for paying all premiums due. However, in Washington State workers may also pay a share of the total hourly rate through payroll deduction.

What is the waiting period for workers comp in Washington state?

If you miss work because of your injury and your doctor certifies you are unable to work, LI or your self-insured employer may pay for a portion of your lost wages, called time‑loss compensation. However, the first 3 days immediately following your injury are considered a waiting period.

How do I verify workers comp coverage in Washington state?

Workers Comp Verification The state of Washington provides a free online tool for verifying workers compensation insurance coverage. Anyone can search by business name or FEIN. The results will only show the business name and policy number for employers who have coverage in the state being searched.

Who pays for workers compensation in Washington?

Employers purchase coverage through the Department of Labor Industries (LI). LI manages all claims and pays benefits out of an insurance pool called the Washington State Fund. The fund is financed by premiums paid by employers and employees, not by general revenue taxes.

How to get workers compensation in Washington state?

Employees may also file a claim form online at or by phone at 1-877-561-FILE (3453). Workers compensation claims must be filed within one year of an injury, and within two years of being notified that an illness is work-related.

How much does workers comp cost in Washington state?

How much does workers compensation insurance cost in Washington? Estimated employer rates for workers compensation in Washington are $1.34 per $100 in covered payroll. Your cost is based on a number of factors, including: Payroll.

Get the up-to-date Application for Elective Coverage (F213-042-000). Application for Elective Coverage (F213-042-000) 2025 now

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How to get workers comp in Washington state?

Who pays WA workers compensation tax?

What is the waiting period for workers comp in Washington state?

How do I verify workers comp coverage in Washington state?

Who pays for workers compensation in Washington?

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How to get workers compensation in Washington state?

How much does workers comp cost in Washington state?

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Get the up-to-date Application for Elective Coverage (F213-042-000). Application for Elective Coverage (F213-042-000) 2025 now

Here's how it works

How to quickly redact Application for Elective Coverage (F213-042-000). Application for Elective Coverage (F213-042-000) online

See more Application for Elective Coverage (F213-042-000). Application for Elective Coverage (F213-042-000) versions

Complete this form in 5 minutes or less

Got questions?

How to get workers comp in Washington state?

Who pays WA workers compensation tax?

What is the waiting period for workers comp in Washington state?

How do I verify workers comp coverage in Washington state?

Who pays for workers compensation in Washington?

Related Searches

People also ask

How to get workers compensation in Washington state?

How much does workers comp cost in Washington state?

Related links

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