Oklahoma Qualified Employer Notification Form

Entity Mandating Notice: Oklahoma Insurance Department.

Applicability: An employer that voluntarily elects to be exempt from the state Administrative Workers' Compensation Act and become a qualified employer under the Oklahoma Employee Injury Benefit Act.

Distribution Specifications: An employer must provide written notification to employees at the time of hire or at the time of designation as a qualified employer that it is a qualified employer, that it does not carry workers' compensation insurance coverage and that such coverage has terminated or been cancelled. The qualified employer must also post the employee notification at conspicuous locations at the employer's places of business as necessary to provide reasonable notice to all employees.

Obtaining This Notice: An employer may download this model notice directly from the Oklahoma Insurance Department's website.

Additional Resources

Oklahoma Insurance Department