Form WC-105B Employer Disclosure Questionnaire - Michigan

What Is Form WC-105B?

This is a legal form that was released by the Michigan Department of Labor and Economic Opportunity - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form WC-105B?
A: Form WC-105B is the Employer Disclosure Questionnaire in Michigan Workers' Compensation.

Q: Who needs to fill out Form WC-105B?
A: Employers in Michigan who are required to carry workers' compensation insurance need to fill out Form WC-105B.

Q: What is the purpose of Form WC-105B?
A: The purpose of Form WC-105B is to collect information about an employer's workers' compensation insurance coverage and claims history.

Q: When should Form WC-105B be filled out?
A: Form WC-105B should be filled out and submitted within 20 days of receiving a request from the Michigan Workers' Compensation Agency.

Q: Are there any penalties for not filling out Form WC-105B?
A: Yes, failure to timely complete and return Form WC-105B may result in penalties and fines.

Q: What information is required in Form WC-105B?
A: Form WC-105B requires information about the employer's contact details, business activities, workers' compensation insurance carrier, policy number, and claims history.

Q: Who can I contact for assistance with Form WC-105B?
A: You can contact the Michigan Workers' Compensation Agency for assistance with completing Form WC-105B.

Q: Is Form WC-105B confidential?
A: Yes, the information provided on Form WC-105B is confidential and used only for purposes related to workers' compensation administration.