Employer Notice Of Divided Workforce {WKC-15783}

WKC-15783-E - EMPLOYER NOTICE OF DIVIDED-WORKFORCE UNDER S. 102.315(6)(b), WIS. STATS. This form is used by Wisconsin employers to notify the Department of Workforce Development (DWD) that they have a “divided workforce” arrangement. A divided workforce exists when an employer has two separate groups of employees: one group consisting of leased employees covered under a worker’s compensation insurance policy obtained by an employee leasing company, and a second group of non-leased employees covered under a separate worker’s compensation policy secured by the client (employer). Filing this form is required to ensure that proper insurance coverage is in place for both groups and to limit liability disputes between insurers. The form collects detailed information about the employer, the leased and non-leased employees, and both insurance policies, including a requirement to submit proof of coverage in the voluntary market. The form serves as an agreement that the employer will be financially responsible for any worker’s compensation payments required by law if a coverage dispute arises. www.FormsWorkflow.com