MEMBERSHIP APPLICATION

Membership Qualifications

The Minnesota Employers Workers Compensation Alliance is a non-profit organization dedicated to represent member companies and associations in all matters relating to the Minnesota Workers’ Compensation Act and workers’ compensatio issues in the State of Minnesota.

Membership Qualifications

Self-Insured Member:  Any company which fully self-insures its workers’ compensation liability under Minnesota law; any group of employers licensed and self-insuring their workers’ compensation liability under Minnesota law.

Insured Member:   Any company which fully insures its workers’ compensation liability under Minnesota law.

Associate Member:  Any individual or business with an interest in workers’ compensation and/or self-insurance.

Membership Application 2023
Alliance Member Testimonials

    Business Name (required)

    Name (required)

    Business Address (required)

    Business Address 2 (required)

    City (required)

    State (required)

    Zip (required)

    Phone (required)

    Fax (required)

    Your Email (required)

    Business Function

    Business Affiliation

    Number of Employees

    Self Insured (required)

    YesNo