Public Employers Election To Self-Insure {IC50e} | Pdf Fpdf Doc Docx | Illinois

 Illinois   Workers Comp 
Public Employers Election To Self-Insure {IC50e} | Pdf Fpdf Doc Docx | Illinois

Last updated: 8/18/2025

Public Employers Election To Self-Insure {IC50e}

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Description

IC50e - PUBLIC EMPLOYER’S ELECTION TO SELF-INSURE. Pursuant to 745 ILCS10/9-103, a local public entity may insure itself under the Illinois Workers’ Compensation and Occupational Diseases Acts. Every January 1st, within 30 days, the entity shall file with the Illinois Workers’ Compensation Commission a report indicating its election to self-insure. This form serves as that report. www.FormsWorkflow.com

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