Application for Extension of Rhode Island Employer Coverage
This file is an application form for employers seeking an extension of coverage under the Rhode Island Employment Security and Temporary Disability Insurance Acts. It provides necessary instructions and information on how to apply for coverage for exempt workers. This form must be completed for any employer wishing to extend coverage to certain employees.
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How do I fill this out?
To fill out this form, begin by providing the required details about your firm. Ensure all information is accurate and complete as this will assist in a smooth approval process. Finally, review the form carefully before submitting to avoid any errors.
How to fill out the Application for Extension of Rhode Island Employer Coverage?
1
Provide the name of your firm.
2
Enter your business address and type of organization.
3
Detail the principal product or service offered by your business.
4
Indicate the type of employment for which coverage is requested.
5
Sign and date the form before submission.
Who needs the Application for Extension of Rhode Island Employer Coverage?
1
Employers seeking to provide coverage to exempt workers.
2
Businesses hiring domestic service workers who may require coverage.
3
Religious organizations needing to extend insurance to their employees.
4
Firms with employees protesting extension need clarity and proper documentation.
5
Any business aiming to comply with Rhode Island Employment laws.
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What are the instructions for submitting this form?
To submit this application form, please send it to the Rhode Island Employer Tax Unit at 1511 Pontiac Avenue, Cranston, RI 02920-0942. You can also fax your application to (401) 574-8940 or contact them by phone at (401) 574-8700 for more information. Ensure you keep a copy of the submitted application for your records.
What are the important dates for this form in 2024 and 2025?
There are no specific dates for the application submission as it is an ongoing process. However, please ensure your submission aligns with any enforcement dates for coverage in 2024 and 2025.
What is the purpose of this form?
The purpose of this form is to enable employers in Rhode Island to voluntarily extend coverage under the Employment Security and Temporary Disability Insurance Acts. By filling out this application, firms can include workers that are otherwise excluded from such protections. It ensures compliance while safeguarding the rights and welfare of employees.
Tell me about this form and its components and fields line-by-line.
- 1. Name of Firm: The official name of the business or organization requesting coverage.
- 2. Business Address: The physical address where the business operates.
- 3. Type of Business Organization: The legal structure of the business (e.g., LLC, corporation).
- 4. Principal Product or Service: The main offerings or services of the business.
- 5. Type of Employment: Details about the employment type for coverage.
- 6. Number of Employees: How many employees will be covered under the extension.
- 7. Employee Protests: Information on any objections raised by employees regarding the coverage.
- 8. Family Relationship: Disclosure of any employment relationships within family members.
- 9. Date: The date when the application is filled out.
- 10. Signature: The authorized signature completing the application.
- 11. Title: The title of the person signing the application.
What happens if I fail to submit this form?
If the form is not submitted, the employer risks non-compliance with Rhode Island labor laws, leaving exempt employees without necessary coverage. Failure to provide necessary documentation can result in legal repercussions.
- Legal Compliance: Employers may face fines or penalties for not adhering to state insurance regulations.
- Employee Welfare: Exempt employees may lack important protections.
- Reputation: Companies may damage their reputation by failing to properly cover employees.
How do I know when to use this form?
- 1. Hiring Domestic Workers: When hiring exempt domestic service workers requiring insurance.
- 2. Extended Employment Coverage: To apply for coverage for employees not usually eligible.
- 3. Legal Compliance: To ensure the business meets state employment coverage requirements.
Frequently Asked Question
How do I apply for the extension?
To apply, fill out the application form completely and accurately.
What information do I need to provide?
You’ll need to provide details about your firm and the type of employment for which coverage is requested.
Can I edit the PDF online?
Yes, you can edit the PDF directly on PrintFriendly using our editing tools.
How do I share my PDF after editing?
Use the sharing options available on PrintFriendly to send your edited PDF.
Is there a minimum coverage period?
Yes, approved coverage must be for a minimum of two calendar years.
What happens after I submit my form?
Your application will be reviewed, and you will receive notification regarding its approval.
Can I save my edits on PrintFriendly?
You can download your edited documents, but please note that saving is not currently supported.
What is the purpose of this form?
The form requests for an extension of coverage for exempt workers under Rhode Island laws.
Do I need to sign the form?
Yes, a signature is required to validate the application.
Who can help me if I have questions about the form?
You can contact the Rhode Island Employer Tax Unit for assistance.
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