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MEMORANDUM NO. 2022-14
Automated Form 6B Filing Process
| TO: | Administrative Law Judges, District Administrators, Advisory Board, Legal Advisory Panel, Medical Advisory Panel, Employees, Employers, Insurance Carriers, Claimants, Attorneys and Unions |
| FROM: | Stephen M. Morelli, Chairman |
| DATE: | December 15, 2022 |
| RE: | Automated Form 6B Filing Process |
The Workers’ Compensation Commission (WCC) is pleased to announce the automated Form 6B filing process is now available and can be accessed at: https://forms.office.com/g/MPrz0UL2sr.
Additionally, Forms 6B, 6B-1 and 75 have been updated to reflect Memorandum No. 2022-02.
How it works:
Effective December 15, 2022, a link to a Microsoft Form is available on the Commission’s website for the submission of WCC’s Electronic Form 6B. The Form will look like this:
An employee (or the employee's authorized representative) who is an officer of a corporation or a member of a limited liability company (LLC) can use this form to elect to be excluded from workers’ compensation insurance coverage or revoke any previous election of exclusion.
The information submitted on this form will automatically be securely processed and any of the email addresses entered on the form will receive a confirmation email like this from WCC.Forms@ct.gov:
This email confirms that WCC has received and filed the coverage election form and should be accepted and used in the same manner as a date stamped copy of a Form 6B.
Questions and Answers
Question: Who can use this form?
Answer: Any employee who is an officer of a corporation or a member of a limited liability company (LLC) can use this form to elect to be excluded from workers’ compensation insurance coverage or revoke any previous election of exclusion. The employee can also choose to have an authorized representative file the form on their behalf, such as a legal or insurance representative. For auditing purposes, it is the responsibility of the authorized representative to document that they received permission to submit the form on the employee’s behalf.
Question: Do I have to use this form?
Answer: No. WCC will continue to accept these forms via mail or email, at WCC.Forms@ct.gov, pursuant to Memorandum 2022-02.
Question: Will the confirmation email be accepted for premium determination and audit purposes?
Answer: WCC has been in contact with the Connecticut Insurance Department and NCCI to ensure any necessary guidance is updated to reflect this new submission process. Further questions on premium determination or auditing should be directed to the insurance carrier, Connecticut Insurance Department or NCCI, as applicable.
Question: What if I submit a form and don’t receive a response?
Answer: If you submit a form and do not receive a response from WCC within a few minutes, you should check your email’s SPAM or Junk Folder to see if it is there. If it is not in this folder, you should try resubmitting the form and ensure the email address you enter is accurate. If you continue to have issues, you can contact WCC.Forms@ct.gov for assistance or submit the Form 6B via mail or email, at WCC.Forms@ct.gov, pursuant to Memorandum 2022-02.
Question: Where will the link be posted on the agency’s website?
Answer: The link to the electronic form is available on several places on the Commission’s website, including in a Memorandum on the homepage, in the Workers’ Compensation Forms page, in the Coverage Elections Forms page, and as a service under Online Services.
Question: Can I submit other coverage elections forms through this process?
Answer: No. Currently only Forms 6B can be submitted electronically using this process. WCC will continue to analyze if this submission method is suitable for Forms 6B-1, Forms 75 or other administrative forms. Forms 6B-1 and 75 can continue to be submitted via mail or email, at WCC.Forms@ct.gov, pursuant to Memorandum 2022-02. Forms 6B will also continue to be accepted via mail or email pursuant to Memorandum 2022-02.
Question: When will other WCC Forms be available for electronic submission?
Answer: WCC cannot offer a timeline of when other forms will be available to be submitted electronically. WCC continues to work with various partners on improving technological capabilities and is dedicating resources to greatly enhance our ability to service the public.
Question: Will my information be stored securely?
Answer: Yes. All information which is received is stored using Microsoft Cloud Services.
Question: What will happen to the Form(s) 6B I have previously submitted?
Answer: WCC will maintain a copy and record of all previously submitted Forms 6B.
Other questions? Contact WCC at WCC.Forms@ct.gov or (860) 493-1500.