Kentucky Labor Cabinet - Department of Workers' Claims


Please Note

We are a service company that can help you file with the Kentucky Labor Cabinet - Department of Workers' Claims. We are not associated with this nor any other government agency. We offer paid services and software to help you file. You are not required to purchase our service to file - you may file directly with this agency without using our service.


Contact Information

Physical address:
657 Chamberlin Avenue
Frankfort, KY 40601

Phone: (502) 564-5550

Web: Home
Email: Kimberly.McKenzie@ky.gov

Licenses

We track the following licenses with the Kentucky Labor Cabinet - Department of Workers' Claims in order to provide compliance services to our clients. As a client, you see this and other reference data in License Manager in-line with your licenses.

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Kentucky Employee Leasing Company Registration

Agency:Kentucky Labor Cabinet - Department of Workers' Claims
Law:

KRS § 342.615

Fact Checked:5/18/21

Initial Registration

Form:

Employee Leasing Application

Agency Fee:

$0

Notes:
  • Must report workers’ compensation policies issued to the employee leasing company or its predecessor(s) that have been cancelled or non-renewed within the last five (5) years
Required Attachments:
  • List, by jurisdiction, of each and every name Lessor has operated under in preceding five years including any
    alternative names and names of predecessors or successors
  • List of each and every person or entity currently owning a five percent or greater interest in the employee leasing company
  • List of each and every person or entity formerly owning a five percent or greater interest in the employee leasing company or its predecessors, successors or alter egos in the preceding five years
Fact Checked:5/18/21

Registration Renewal

Form:

Employee Leasing Application (Renewal)

Agency Fee:

$0

Due:

Annually

Required Attachments:
  • List, by jurisdiction, of each and every name Lessor has operated under in preceding five years including any
    alternative names and names of predecessors or successors
  • List of each and every person or entity currently owning a five percent or greater interest in the employee leasing company
  • List of each and every person or entity formerly owning a five percent or greater interest in the employee leasing company or its predecessors, successors or alter egos in the preceding five years
Fact Checked:5/19/21

Supplemental Reporting
Lessee Information Disclosure

Form:

Form EL-2: Lessee Information Form

Agency Fee:

$0

Due:

Within 90 days of initial registration and every 6 months from the anniversary of the registration.

Notes:

Every Kentucky Lessee whose workers' compensation insurance coverage for leased employees, as required by KRS 342.340 and KRS 342.640, is provided by an insurance policy in the name of the Employee Leasing Company or related entity must submit this form periodically.

Fact Checked:5/18/21

Kentucky Utilization Review/Medical Bill Audit Certification

Type of Review:

Workers' Compensation Utilization Review

Agency:Kentucky Labor Cabinet - Department of Workers' Claims
Fact Checked:7/26/18

Initial Registration

Form:

Utilization Review/Medical Bill Audit Application

Agency Fee:

$0

Original Ink:Not required
Notarize:Not required
Fact Checked:7/26/18

Registration Renewal

Form:

Utilization Review/Medical Bill Audit Application (Renewal)

Agency Fee:

$0

Due:

4 years from the date of submission.

Original Ink:Not required
Notarize:Not required
Fact Checked:7/26/18

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