Safety Program Premium Credit
Florida employers are permitted to implement a Safety Program and are eligible to receive up to a 2% premium credit on a qualified program. A self-insurer that implements such a program, and provides the application to the Division, is also eligible to receive this premium credit. The Division applies this credit while imputing a premium to determine the Workers’ Compensation Administration Trust Fund and Special Disability Trust Fund assessments. In order to receive a Safety Program Premium Credit, please verify that the program meets the requirements in the Safety Program Premium Credit rule below and complete the form.
Form:
- DFS-F2-SI-9 (Word), Self-Insurer Certification of Workplace Safety Program Premium Credit
Rule:
- Safety Program Premium Credit (69L-5.221, F.A.C.)
Florida Statute:
- Employer workplace safety program in rate setting; program requirements; rulemaking. (Section 440.1025, F.S.)
Mailing Address:
- Self-Insurance Unit
Division of Workers’ Compensation
Florida Department of Financial Services
200 East Gaines Street
Tallahassee, Florida 32399
Email:
Contact Us:
- Dwayne Manning (850) 413-1784