This is a legal form that was released by the Pennsylvania Department of Labor & Industry - a government authority operating within Pennsylvania. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is LIBC-211I?
A: LIBC-211I is the Insurer's Initial Report of Accident & Illness Prevention Services form in Pennsylvania.
Q: What is the purpose of LIBC-211I?
A: The purpose of LIBC-211I is to report accident and illness prevention services provided by the insurer.
Q: Who needs to fill out LIBC-211I?
A: The insurer needs to fill out LIBC-211I.
Q: Are there any fees associated with filling out LIBC-211I?
A: No, there are no fees associated with filling out LIBC-211I.
Form Details:
Download a fillable version of Form LIBC-211I by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Labor & Industry.