Form WC-21 Application for Self-insurance Authorization - Hawaii

Form WC-21 Application for Self-insurance Authorization - Hawaii

What Is Form WC-21?

This is a legal form that was released by the Hawaii Department of Labor & Industrial Relations - a government authority operating within Hawaii. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form WC-21?
A: Form WC-21 is an application for self-insurance authorization in Hawaii.

Q: Who needs to file Form WC-21?
A: Anyone who wants to be authorized to self-insure their workers' compensation liabilities in Hawaii needs to file Form WC-21.

Q: What is self-insurance?
A: Self-insurance is when a business or organization chooses to cover their own workers' compensation claims instead of purchasing insurance from an insurance company.

Q: Why would someone choose to self-insure?
A: Some businesses may choose to self-insure because it can be more cost-effective in the long run and allows for more control over the claims process.

Q: What information is required on Form WC-21?
A: Form WC-21 requires information such as the applicant's name and contact information, financial statements, proof of financial ability to pay claims, and details about the business or organization.

Q: Is there a fee for filing Form WC-21?
A: Yes, there is a non-refundable fee for filing Form WC-21. The fee amount may vary, so it's best to check the current fee schedule with the Department of Labor and Industrial Relations.

Q: How long does it take to process Form WC-21?
A: The processing time for Form WC-21 can vary, but it typically takes several weeks to several months. It's important to submit the application well in advance to allow for processing time.

Q: What happens after my Form WC-21 is approved?
A: After Form WC-21 is approved, the applicant will be authorized to self-insure their workers' compensation liabilities in Hawaii. They will be responsible for handling all aspects of their workers' compensation claims.

Q: What if my Form WC-21 is denied?
A: If Form WC-21 is denied, the applicant may have the opportunity to appeal the decision or explore other options for obtaining workers' compensation coverage, such as purchasing insurance from an insurance company.

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Form Details:

  • Released on October 1, 2005;
  • The latest edition provided by the Hawaii Department of Labor & Industrial Relations;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form WC-21 by clicking the link below or browse more documents and templates provided by the Hawaii Department of Labor & Industrial Relations.

Download Form WC-21 Application for Self-insurance Authorization - Hawaii

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