1. Workers’ Compensation Reporting Form
How to effectively complete the workers’ compensation payroll reporting form

2. The Reporting Form Workbook
Helpful Hint: Use the arrow key or page up/down to review a slide.

3. Big Picture: Purpose of Reporting Form
Workers Compensation insurance is paid based on payroll. The formula (factors and discounts) is preset at the beginning of the Fund (policy) year.
Reporting form provides members with efficient way to calculate their portion of the cost for coverage.
Accurate reporting means less adjustments at the end of the year.

4. Instructions Page
Let us know how we can help.

5. Call the Fund if these are not correct
Common Issues
Make sure you have this year’s form…
And, the correct member (all are preset)…
Call the Fund if these are not correct

6. Select the Month
Helpful Hint: To avoid confusion, the sheet is limited to this Fund year only.

7. Complete Yellow Sections Only
Helpful Hint: Let Fund know how to contact the person completing.

8. Center Employee Payroll
Helpful Hint: Count all workers including clients paid minimum wage or above. Contact Fund if a new classification is needed.

9. Center Employee Payroll
Helpful Hint: For overtime pay, do not include the stipend for “overtime” just use the regular rate. In other words, do not include the “half” of the “time-and-a-half.”

10. Other Coverage Options
Helpful Hint: These will be blocked out if the member did not elect the coverage at renewal.

11. Other Coverage Options
Helpful Hint: The beginning and ending dates for each week are merely suggested and can be overwritten to match the member’s work week.

12. Other Coverage Options
Helpful Hint: Enter the number of officials and volunteers for each week.

13. Other Coverage Options
Helpful Hint: “Client Employees: # of All Other” means clients who are paid less than minimum wage and are not considered “piece rate.” Clients paid minimum wage, and above, are counted as employees.

14. Factors, Discounts and Rates = DONE
Helpful Hint: The calculation is complete. You only need to remit payment for the amount shown.

15. Approve and Remit Payment
Helpful Hint: As a separation of duties to protect the Fund, all payments to the Fund are processed by the Association’s office (Texas Council (not the Fund)).

16. Workers’ Compensation Reporting Form
Thank You!!!