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This version of the form is not currently in use and is provided for reference only. Download this version of
Form DB-150
for the current year.
Form DB-150 Application for Self-insurance - New York
What Is Form DB-150?
This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DB-150?
A: DB-150 is an application for self-insurance in New York.
Q: Who needs to fill out DB-150?
A: Any employer in New York who wants to self-insure their workers' compensation must fill out DB-150.
Q: What is self-insurance?
A: Self-insurance is when an employer bears the financial responsibility for providing workers' compensation benefits to their employees.
Q: Why would an employer choose self-insurance?
A: Employers may choose self-insurance to have more control over their workers' compensation program and potentially save on costs.
Q: What documents do I need to submit with DB-150?
A: You will need to provide various financial documents and information about your company's workers' compensation history. The specific requirements are outlined in the DB-150 instructions.
Form Details:
- Released on July 1, 2017;
- The latest edition provided by the New York State Workers' Compensation Board;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DB-150 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.
Download Form DB-150 Application for Self-insurance - New York
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