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INSURANCE, COMPLIANCE & REPORTING

MD WCC INSURANCE INFORMATION REPORT IC-1
Deadline - Friday, September 6, 2013

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.

Use of SERFF for WC Form Filings – Effective September 1, 2013

  • 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 Insurance Commissioners.

  •  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 possible.

  • Workers’ compensation form filings must be made with the Maryland Workers’ Compensation Commission. The Commission does not charge a filing fee for workers’ compensation forms.
    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 serffmkg@naic.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 to formfilings@wcc.state.md.us or by calling Mr. Jones at 410-864-5298.

RELATED LAWS & REGULATIONS Complete statutes and regulations are available online.

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.

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