Mandated Forms
State regulations mandate employers to provide certain information to their employees. State Fund provides this information in the form of posters and brochures as a service to our customers. Employers are required to distribute the information to workers in the following instances.
Distribute this brochure to existing employees prior to implementation of the approved MPN. Also, provide to each new employee at the time of hire and to each injured employee at the time of injury:
Provide this brochure to each new employee at the time of hire:
Post this notice immediately, in both English and Spanish, after writing the name of the MPN physician on both versions. Keep the notices posted in a conspicuous location at all times:
State Fund policyholders may obtain print versions of these materials by contacting the Customer Service Center.
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