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** Submission to Tennessee and biBERK required by 07/02/22 **
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Owner and Officer Exclusions Form
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Your business owner(s) have declined Workers’ Compensation coverage, and we need:
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Complete and submit form
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Your exclusion form must be obtained from the Tennessee Workers Compensation Exemption Board:
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Important coverage considerations
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Business owners may elect to be included in or excluded from Workers' Compensation insurance coverage.
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Included owners are covered at the state minimum allowable payroll, generally resulting in a higher policy premium.
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Rejecting coverage helps reduce the premium, but the excluded owner cannot receive policy benefits.
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biBERK Insurance Services, 1314 Douglas St. #1400 Omaha, NE 68102
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Privacy Policy
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