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The Texas Notice form, officially known as the DWC Form-005, is a document that employers in Texas must file to notify the Division of Workers' Compensation about their workers' compensation insurance status. This form is crucial for indicating whether an employer has no coverage or has terminated existing coverage. Proper submission of this form ensures compliance with Texas labor laws and helps protect both employers and employees.

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The Texas Notice form, officially known as the DWC Form-005, serves a critical function for employers in the state regarding workers' compensation coverage. This form must be submitted by any employer who either does not have workers' compensation insurance or has terminated their existing coverage. It requires specific details, including effective dates, the employer's business information, and a statement indicating whether coverage is absent or has been terminated. Employers must also report any significant workplace injuries or diseases that occurred since the last notice. This includes instances of death or injuries that resulted in an employee being absent from work for more than one day. The form must be filled out accurately and submitted within designated timeframes to avoid administrative penalties. Employers can submit the form electronically, via fax, or by mail, and it must be updated annually or when specific changes occur, such as hiring new employees or changing insurance status. Understanding the requirements and processes associated with the Texas Notice form is essential for compliance and ensuring the safety and well-being of employees.

Dos and Don'ts

When filling out the Texas Notice form, attention to detail is crucial. Here are ten guidelines to follow, as well as some pitfalls to avoid:

  • Do ensure that all effective dates are within a one-year period.
  • Do select the correct statement regarding your workers' compensation coverage status.
  • Do provide accurate policy information, including the termination date and insurer details.
  • Do notify employees of any coverage changes within the required timeframes.
  • Do complete all fields in the form, including the Federal Employer ID number.
  • Don't leave any required fields blank; this can lead to delays or penalties.
  • Don't submit the form late; adhere to the specified deadlines for filing.
  • Don't forget to keep copies of submitted forms for your records.
  • Don't overlook the need to provide a notice to employees in multiple languages if necessary.
  • Don't assume that you are exempt from filing without confirming your employee status.

Get Answers on Texas Notice

Who must file the DWC Form-005?

The DWC Form-005 must be filed by employers who either do not have workers' compensation insurance or have terminated their workers' compensation insurance coverage. If your only employees are exempt from coverage under the Texas Workers' Compensation Act, such as certain domestic workers or specific farm and ranch workers, you do not need to file. Not filing when required could lead to administrative penalties for the employer.

How do I file the DWC Form-005?

Employers can submit the DWC Form-005 in several ways:

  • Electronically through the TDI website at TDI website .
  • By faxing the form to (512) 804-4146.
  • By mailing the form to the address provided at the top of the form.

When do I file the DWC Form-005?

You need to file a separate DWC Form-005 whenever any of the following conditions occur:

  • Annually between February 1st and April 30th of each calendar year.
  • Within 30 days of hiring your first employee, unless this date falls between February 1st and April 30th.
  • Within 10 days of receiving a request from DWC to file the form.
  • Within 10 days after notifying your insurance carrier of coverage termination, unless you purchase a new policy or become a certified self-insurer.

How do I determine my filing start date?

The filing start date is typically May 1, unless:

  1. You have never filed a DWC Form-005, in which case the start date is the first day you did not have coverage.
  2. You terminated your workers' compensation insurance, then the start date is the first date you did not have coverage.
  3. You hired your first employee, then the start date is the first day that employee started working.

How do I determine my filing period end date?

The filing period end date is usually April 30, unless you purchased or plan to purchase a workers' compensation insurance policy. In that case, the end date is the last date you did not have coverage.

What is a NAICS code?

The NAICS code, pronounced "nakes," is a six-digit code that classifies your business. You can find this code in:

  1. Block 5 of your Unemployment Quarterly Report (Form C-3) from the Texas Workforce Commission.
  2. Multiple Worksite Report - BLS 3020 from the U.S. Bureau of Labor Statistics.

For further assistance, visit the NAICS web page at naics.com and use the "NAICS Keyword Search" to find your code.

Are any fields on the DWC Form-005 optional?

No, all fields on the DWC Form-005 must be completed each time you file. This includes:

  • Effective dates in Section I.
  • Policy and insurer information, along with notification dates in Section II.
  • A selection from Section III regarding reportable injuries or diseases.
  • All primary employer fields in Section IV.

Note that the signature field in Section V is not required when filing online.

How/when must a non-subscriber notify employees that workers' compensation coverage is not provided?

Employers must post the Notice to Employees Concerning Workers' Compensation in Texas in the workplace. This notice should be available in English, Spanish, and any other common languages among employees. You must provide this notice:

  • At the time of hire.
  • When you elect not to have workers' compensation insurance.
  • Within 15 days of notifying the insurance carrier about terminating coverage.
  • Within 15 days of cancellation by the insurance company.

The required notice can be found on the TDI website.

Are non-covered employers required to file other forms with TDI-DWC?

Yes, if you have five or more employees and do not have workers' compensation insurance, or if you have employees who have waived coverage, you must file the DWC Form-007. This form is required if:

  • A work-related death occurred.
  • An employee was absent from work for more than one day due to a work-related injury.
  • You became aware of an occupational disease.

The DWC Form-007 should be filed no later than the 7th day of the month following any of these events. You can obtain this form from the TDI website.

How to Use Texas Notice

Completing the Texas Notice form is an important step for employers regarding their workers' compensation coverage. After filling out the form, it must be submitted to the Texas Department of Insurance, Division of Workers' Compensation. This process ensures that the state is informed about the status of your insurance coverage.

  1. Enter Effective Dates: In Section I, provide the start and end dates for the coverage period (mm/dd/yyyy). Ensure these dates do not exceed one year.
  2. Select Coverage Status: In Section II, choose whether the employer does not have coverage or has terminated coverage. Fill in the effective termination date, policy number, insurance company name, date insurer was informed, and date employees were notified.
  3. Report Injuries or Diseases: In Section III, indicate whether there have been any reportable injuries or diseases since the last notice. Select 'Yes' or 'No' accordingly.
  4. Provide Employer Information: In Section IV, fill in the employer's business name, federal employer ID number, mailing address, business type, and six-digit NAICS code. If applicable, include the name, ID number, and address of each Texas business location.
  5. Fill Out Contact Information: In Section V, provide the name and telephone number of the person providing the information. If applicable, include their title, email address, and signature, along with the date of signature.

Once the form is completed, it can be submitted electronically, via fax, or by mail to the address provided at the top of the form. Be sure to keep a copy for your records. Timely submission is crucial to avoid potential penalties.

Common mistakes

Filling out the Texas Notice form can be a straightforward process, but several common mistakes can lead to complications. One significant error occurs when individuals fail to provide the effective dates correctly. The form requires that the effective dates do not exceed a one-year period. If the dates are not entered accurately, it can result in delays or even penalties for the employer.

Another frequent mistake is in the Statement of No Coverage section. Employers must clearly select whether they do not have coverage or have terminated their existing coverage. Failing to make this selection or marking both options can create confusion and may lead to the form being rejected. It’s crucial to ensure that this section is completed with precision to avoid administrative issues.

In addition, many people overlook the requirement to provide complete information in the Primary Employer Information section. All fields, including the Federal Employer ID Number and the business mailing address, must be filled out accurately. Missing or incorrect details can hinder the processing of the form and may result in additional follow-up requests from the Division of Workers' Compensation.

Lastly, individuals sometimes forget to include their contact information in the section for the person providing information. This includes the name, telephone number, and email address. Without this information, the agency may struggle to reach the employer for any clarifications or additional requirements, which could lead to unnecessary delays in processing the notice.

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