Workers Compensation Document Center

 

Claims Kits 

National Claims Kit

 

An informational packet designed specifically for our Policyholders who have locations in multiple states across the country


PDF


ProSight Claims Kit

 

An informational packet designed specifically for our Policyholders who have locations in states across the country

 PDF


LWP Claims Kit

 

An informational packet designed specifically for our Policyholders located exclusively in California

  PDF


Gallagher Claims Kit

 

An information packet designed specifically for our Policyholders with offices in Alaska, Hawaii, Massachusetts, Montana, Nevada, New Mexico, Oklahoma, Oregon, and Texas

PDF


Coventry Primary Medical Provider Network (MPN)


     

California Policyholders Only- The MPN Packet contains information that needs to be posted at your office locations and disseminated to your Employees

PDF


 

Coventry Network Provider Search

 

Instructions on how to locate a Doctor, Hospital or other Medical Facility in the Coventry Network (CA Only)

PDF


 

DWC7 Posting Notices

 

Contains the English & Spanish Versions of the Complete DWC7 Posting Notices

PDF


 

Employer Packet

 

Instructions to our Policyholders to follow when rolling out the MPN

PDF


 

Active EE Packet (English)

 

An information packet designed for your Active Employees. The Packet contains an MPN acknowledgment form that the employee needs to sign and return to the employer (copies of the signed document should be kept in the Employee's personnel file)

PDF


 

Active EE Packet (Spanish)

 

Contains all of the same information as the Active Employee Packet in Spanish

PDF


 

New Hire Packet (English)

 

An information packet designed for your New Hires. The Packet contains an MPN acknowledgment form that the employee needs to sign and return to the employer (copies of the signed document should be kept in the Employee's personnel file)

PDF


 

New Hire Packet (Spanish)

 

Contains all of the same information as the New Hire Packet in Spanish

PDF

 

Kaiser Signature Medical Provider Network (MPN)


     

California Policyholders Only- The MPN Packet contains information that needs to be posted at your office locations and disseminated to your Employees

PDF


 

DWC7 Posting Notices

 

Contains the English & Spanish Versions of the Complete DWC7 Posting Notices

PDF


 

Employer Packet

 

Instructions to our Policyholders to follow when rolling out the MPN

PDF


 

Active EE Packet (English)

 

An information packet designed for your Active Employees. The Packet contains an MPN acknowledgment form that the employee needs to sign and return to the employer (copies of the signed document should be kept in the Employee's personnel file)

PDF


 

Active EE Packet (Spanish)

 

Contains all of the same information as the Active Employee Packet in Spanish

PDF


 

New Hire Packet (English)

 

An information packet designed for your New Hires. The Packet contains an MPN acknowledgment form that the employee needs to sign and return to the employer (copies of the signed document should be kept in the Employee's personnel file)

PDF


 

New Hire Packet (Spanish)

 

Contains all of the same information as the New Hire Packet in Spanish

PDF