DWC Form 005 – Employer Notice of No Coverage or Termination of Coverage
DWC 005 Form Online
A DWC Form 005 is a standard document for transparent communication between employers and the Division of Workers Compensation in Texas. This form informs the Texas Department of Insurance that he will not provide workers’ compensation coverage or terminate the existing coverage.
It serves as a notice not to participate in the workers’ compensation program, and such employers’ decisions ensure compliance with Texas workers’ compensation law. You can click the download button below to save this fillable form immediately. Moreover, we will guide you on how to fill out this form, its purpose, and additional details for approval.
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What is the Purpose of the DWC 85 Fillable Form?
This form plays a vital role in declaring employers’ intent about workers’ compensation coverage. The following key objectives will help you understand the purpose of this form.
Legal Compliance
This form helps to ensure legal compliance with the state for employers unwilling to provide workers’ compensation coverage.
Transparency
The employers immediately send this notice to the Texas Department of Insurance, Division of Workers Compensation (TDI-DWC) to maintain transparency.
Risk Management
It ensures employers understand the responsibilities and liabilities associated with potential risks when rejecting the workers’ compensation coverage.
Record Keeping
It ensures proper record-keeping to maintain the relationship with TDI-DWC regarding the employer’s coverage decision.
How To Download DWC 005 Form Online Texas?
Visit Forms Dude
- You must type www.formsdude.com in any web browser to visit the homepage.
- Press the DWC Forms category at the menu bar to explore this form.
- Also, enter the form’s name (DWC Form 005) in the search bar.
- Click the download DWC 005 Form button to save it immediately.
- You can also fill out this form here and press the print button for an instant printout.
Step-by-Step Instructions for Filling Out the DWC Fillable Form 005
You must follow the given instructions to fill out accurately:
1- Required Statements
In this section, tick the box for no coverage or coverage termination. Then, write the policy terminated effective date, policy number, insurance company name, insurer information for termination date, and statement of reportable injuries.
2- Primary Employer Information
In this section, you must write the employer’s business name, federal employer ID number, mailing address, type, and a six-digit NAICS code.
3- Person Providing Information
Write the name, phone number, title, and email address, and get a signature with the date.
Implications for Non-Subscribers of DWC 005 Form
The employers who opt out from workers compensation coverage might faces the following consequences:
Legal Exposure
The employers have to face legal consequences by the employees after a workplace injury or illness.
Financial Liability
If any accident or injury happens at the workplace, the employer will be solo responsible for medical expenses.
Reputation Risk
The lack of liability coverage for worker’s welfare may affect the morale and retention of employers.
Injury Reporting Requirements
The non-subscribers might face delays in work progress due to the reporting of an occupational injury.
FAQs
What is the DWC Form 005?
It is a standard document used by the employers of Texas to notify the Division of Workers’ Compensation of no workers’ compensation coverage or termination of coverage.
Do I Need to Notify My Employees for Coverage Termination?
Yes, you must officially inform your employees of absence or termination of coverage.
What are the Penalties for Non-Compliance of DWC 005?
The non-compliance with this form may face fines, legal consequences, and reputation damage.
What are the Benefits of Workers’ Compensation Coverage?
Workers’ compensation coverage benefits include legal protection, employee support, simplified process, and risk mitigation