PLN04
This notice must be used to report to the injured employee/representative the approval of LIBs.
PLN04S
Esta notificación debe de utilizarse para informar al empleado lesionado/representante sobre la aprobación de los LIBs.
PLN07
This notice must be used to report to the injured employee/representative and the beneficiaries/representatives (if applicable) when the insurance carrier is changing the payment of one income benefit type to another or to death benefits.
PLN07S
Esta notificación debe de utilizarse para informar al empleado lesionado/representante y a los beneficiarios/representantes (si es que aplica) cuando la aseguradora va a cambiar el pago de un tipo de beneficio de ingreso a otro o a beneficios por causa de muerte.
DWC105
Insurance companies undergoing inspections by the Texas Department of Insurance, Division of Workers’ Compensation (DWC) required by 28 Texas Administrative Code Section 166.5 (Inspections of Adequacy of Accident Prevention Facilities and Services) must file the DWC Form-105. Insurance companies are responsible for timely and accurately filing the DWC Form-105.
DWC109
An insurance company writing workers’ compensation insurance in Texas must file the DWC Form-109 with DWC as an annual report of its accident prevention services. Insurance companies must file the DWC Form-109 accurately and on time. A DWC Form-109 is considered filed with DWC only when it contains all required information.
PLN12
Instructions to the insurance carrier: Notice of Potential Entitlement to Workers’ Compensation Death Benefits (PLN-12) 28 Texas Administrative Code (TAC) Sections 124.8 and 132.17 The insurance carrier must use this notice to notify a person identified as a potential beneficiary about their potential entitlement to receive death benefits and how to file a claim for […]
PLN12s
Instrucciones para la aseguradora: Notificación de Posible Derecho para Recibir Beneficios de Compensación para Trabajadores por Causa de Muerte (PLN-12) Código Administrativo de Texas No. 28 (28 Texas Administrative Code –TAC, por su nombre y siglas en inglés) Secciones 124.8 y 132.17 La aseguradora debe de usar esta notificación para notificar a la persona identificada […]