Alliance Notification Instructions for New Members
These instructions walk Fund Workers' Compensation members through the required steps of notifying their employees about the Political Subdivision Workers' Compensation Alliance
Welcome to the Political Subdivision Workers’ Compensation Alliance (Alliance). This direct contracting program provides medical treatment to your injured employees. Here is all the information you will need to start using the program. Please note: This program applies only to workers’ compensation claims.
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This information is exclusively for Fund members with Workers' Compensation coverage.
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Bona Fide Offer of Employment Template
When the doctor clears your injured employee to return to work, use this template to issue a bona fide offer of employment that meets state requirements.
Employee Acknowledgement of Alliance Direct Contracting Program
Employees must sign this form acknowledging they understand how to receive health care in the Political Subdivision Workers’ Compensation Alliance. Available in English and Spanish.
Employee Incident Investigation Worksheet
Uncover and correct the root causes of workplace accidents to reduce the risk of them happening again.