MD WCC INSURANCE INFORMATION REPORT IC-1
Deadline - Friday, September
the 2013 Online Annual Insurance Information Report IC-1 -
If you have additional questions, please contact
the IC&R Division directly.
Telephone, (410) 864-5293, outside Baltimore Metro area toll free (800) 492-0479
selecting extension 5293 when prompted.
Download the Formatta Filler software for Windows/PC to complete
the online form.
Instructions for the
2013 Online Annual Insurance Information Report IC-1 PDF
Updates/changes, technical information
& requirements, instructions, software, tips and tools.
INSURANCE INFORMATION REPORT
Worksheet for IC-1 2013 Fillable
This may be used as a worksheet for the online report.
INFORMATION REPORT WCC Form IC-1 2013 Instruction Manual- PDF
Detailed information about the report's requirements.
Additional Payroll Offices fillable PDF for attachment.
PDF files created by software included
with some multifunction scanners create a PDF file that cannot
be processed by our system.
Any attached files available in native MS Office format, such as
Excel or Word should be used in lieu of the scanned PDF file.
Alternatively, you may use another file format, such as JPG or
GIF, as output from your scanner to attach to our WebForms.
If you have resident PC software to create PDF files, such as
full Adobe Acrobat or a PDF print driver, you may "reprint" the
scanner output via this software to create a compliant file.
A reliable freeware option is cutePDF
The software installs and behaves like a physical printer to
create the PDF file. You may open your scanner-created PDF in
Adobe Reader, select Print, select the cutePDF printer and save
the output file to your PC. You can then attach the file which
will process in our Online Services.
FORMS FILED WITH THE DIVISION
You may not submit these
forms via email or email attachment; the signed original must be
mailed to the WCC at the address provided on the form (footer).
Some PDF forms can be completed in Adobe® Reader
or you may use the typewriter tool if available in your
installed Adobe Reader version. Forms submitted to WCC must be current and as provided;
altered, incomplete, unauthorized or obsolete forms are returned without processing.
Effective September 1, 2013 - To facilitate the prompt
filing and review of workers’ compensation form filings, and
to reduce the significant quantities of paper currently used
in the review process, the Maryland Workers’ Compensation
Commission utilizes the System for Electronic Rate and Form
Filings (SERFF), developed by the National Association of
At present, the Commission will continue to accept
paper filings but insurers and authorized filers are
encouraged to transition to the use of SERFF as soon as
Workers’ compensation form filings must be made with the
Maryland Workers’ Compensation Commission. The Commission
does not charge a filing fee for workers’ compensation
Workers’ compensation rate and rule filings must
be made with the Maryland Insurance Administration, which
also utilizes the SERFF platform.
Filers not yet using SERFF may enroll by contacting SERFF
at 1-816-783-8787 or by e-mail at firstname.lastname@example.org.
Insurers and other filers needing additional information
about SERFF may visit
www.serff.com. Filers are encouraged to take formal
training so they can fully utilize the SERFF system. Contact
information regarding training can be found at the SERFF
website at www.serff.com/training.
Insurers using authorized filers to make filings on their
behalf should immediately notify those entities so that they
can arrange to be SERFF compliant.
Questions may be submitted in writing to the attention of
State Workers' Compensation Commission, 10 East Baltimore
Street, Baltimore, Maryland, 21202 Attention -Steven Jones,
Director, Insurance, Compliance and Reporting Division, via
email@example.com or by calling Mr. Jones at
RELATED LAWS & REGULATIONS
Complete statutes and regulations are available online.
Certificate of Compliance: Code of Maryland, Labor & Employment Article, Workers' Compensation §9–105
Covered Employee: Code of Maryland, Labor & Employment Article, Workers' Compensation §9-202
Site of Employment: Code of Maryland, Labor & Employment Article, Workers' Compensation §9-203
Corporate or Limited Liability Company Officer: Code of Maryland, Labor & Employment Article, Workers' Compensation §9-206
Sole Proprietor: Code of Maryland, Labor & Employment Article, Workers' Compensation §9-227
Governmental Self-insurance Group: Code of Maryland, Labor & Employment Article, Workers' Compensation §9-404
Self-insurance by Individual Employer: Code of Maryland, Labor & Employment Article, Workers' Compensation §9-405:
Governmental Group Self-Insurance: COMAR 14.09.02.01 through 14.09.02.08
Individual Employer Self-Insurer: COMAR 14.09.10.01 through 14.09.10.12
OTHER RELATED MATERIALS AND
FORMS BACK TO TOP OF THIS PAGE
Compliance Audit Procedures Guide (Attachment H) -
a reference material for self-insured employers and vendors
that provide audit services to the Commission. The guide
contains explanations regarding the completion of the IC-1
report as well as sample audit reports.
The MD WCC Employer's Posting Notice (form C-24) - (Version 11/2007) English/Spanish PDF for printing via Adobe® Reader (325 KB).
The MD WCC Employers' Posting Notice is 8.5" X 14" and MUST be printed on 8.5" X 14" (legal size) goldenrod or yellow paper. Laser printer or clear photocopier versions are recommended for printed durability and legibility. Default resolution for this printing is 600 dpi (dots per inch). The statutory requirement is "as provided by the MD WCC", hence reduced size or otherwise altered reproductions from the original/default specifications will not constitute statutory compliance. The Notice is to be posted in a conspicuous location at each worksite and must include the complete employer/insurer information in the lower left corner where indicated.
ADDRESS OR INFORMATION CHANGE