New Insurer's Notice of Issuance of Policy, OCR Form WC-400

A new version of the Insurer’s Notice of Issuance of Policy, OCR Form WC-400, has been created and is now available on our website.

Beginning January 1, 2017, carriers will be required to use the updated Form WC-400 when filing proof of coverage with this Agency.  This form will continue the requirements set forth in Optical Character Recognition policy of June 24, 2013.

Forms not complying with these requirements will be rejected and returned unprocessed.  To prepare for this change, you should immediately make any necessary modifications to your current systems and processes so that all forms filed will be in the correct format and will not be rejected.  Forms cannot be faxed and cannot be handwritten.  All forms must be mailed or submitted through the Data Exchange Gateway (DEG). The DEG Application provides further information.

Questions regarding these changes or what is required, should be directed to Ken Smith (517) 284-8914.

We thank you for your continued cooperation as we move through these transitions to better serve you, our customers.