Michigan Workers Compensation Insurance Application 2026

1. Click ‘Get Form’ to open the Michigan Application for Workers’ Compensation Insurance in our editor.
2. Begin by filling out the General Information section. Enter the effective date, employer name, federal employer identification number, and contact details including phone number and mailing address.
3. Proceed to indicate your legal status by selecting one of the options provided (e.g., Sole Proprietor, Corporation). Ensure you check if operations exist outside Michigan.
4. In the Insurance Record section, answer questions regarding previous coverage and any name changes. Provide necessary details if applicable.
5. List all business principals in the designated section, including their titles and ownership percentages. Attach any required exclusion forms if needed.
6. Complete the Premium Calculation section by describing your business operations and providing payroll information. Make sure to assign classification codes as necessary.
7. Finally, review all sections for completeness before signing the Employer’s Agreement at the end of the form.

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