Workers' Compensation Toolkit

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This kit is provided to new workers' compensation policyholders and their agents, as well as to all current policyholders when their policies renew. It contains important claims department contact information, instructions, and forms.


Rhode Island Contact Information:

Harleysville Insurance
PO Box 244
Harleysville, PA 19438-0244
(888) 595-9876
Fax: (800) 441-4118

Agribusiness Mailing Address for Claims Related Mail
1100 Locust St., Dept 3010
Des Moines, IA, 50391-3010
Phone: (800) 228-6700
Fax: (800) 842-1482

 

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Rhode Island Compliance Information

Posting Requirements

Reporting Of Claim By Employer

Penalties for Late Reporting

Physician Selection


Posters and Publications

POSTER - WC Act Summary Required


POSTER - WC Act Summary Spanish) Required


Forms

Employer's First Report of Alleged Occupational Injury or Disease Electronic submission of FROI and SROI are mandatory by 3/1/2015. For internal use only.


Wage Statement: Full Time

Wage Statement: Part Time

Wage Statement: Seasonal






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