Workers' Compensation Insurance Guidance
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Advisory guidance governing marketing and use of contingent workers' compensation endorsements, occupational injury/accident or disability policies, and plans claiming ERISA exemption; affects insurers, agents, producers, employers and principals doing business in Nebraska.
No material clinical or coverage changes in this revision.
NDOI Enforcement and Coverage Expectations
NDOI enforcement and compliance criteria
NDOI position and enforcement expectations:
Required Forms and Marketing Restrictions for Insurers and Agents
Use NDOI‑approved workers' compensation forms/endorsements
Insurers must use policy forms and endorsements that have been approved by the Nebraska Department of Insurance for workers' compensation. The Department considers use of unapproved policy forms/endorsements a violation of the Property and Casualty Rate and Form Act and will take administrative action, including penalties up to $1,000 per violation.
- Endorsements sold must be written/underwritten by an insurer licensed in Nebraska to transact workers' compensation business and must use NDOI-approved forms.
- Use of unapproved forms/endorsements is a violation subject to administrative action and penalties up to $1,000 per violation.
Do not market substitute or ERISA‑claimed plans as workers' compensation
Do not market occupational injury/accident or disability policies or plans claiming ERISA exemption as replacements or alternatives to Nebraska workers' compensation coverage. The NDOI considers such marketing a violation of the Unfair Insurance Trade Practices Act and will take administrative action, including penalties up to $1,000 per violation and possible license suspension or revocation.
- Certificates of insurance based on occupational injury/accident or disability policies are not evidence of workers' compensation coverage.
- Plans alleging ERISA exemption may be engaged in unauthorized insurance; agents/brokers may be liable for unpaid claims and face disciplinary sanctions.
Key Definitions
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