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Agency Schedule Detail

Authorization Number :  855-1182
Agency Series No. :  OSC-4
Status :  Active
Agency Web Link : 
Agency :  BWC
Confidential Description :  Records may include medical records, the claimant’s name, the residential address, the name of the employer, the address of the employer, the social security number and the residential telephone number.
Division :  BWCEMPS
Vital Description : 
Section :  BWCEMPSOSTC
Record Title :  Other States Coverage (OSC) Application Services Fee Documents
Revision :  0
Record Description :  Under OSC, agents who assist policyholders with applying do not receive a commission. Instead they receive a $50 application services fee for each policy placed in BWC’s OSC. Documentation is required to process the fees. Agents provide BWC with a W-9, proof of E & O coverage and copies of non-resident licenses. The processing of fees also includes working with fiscal to process the invoice, mail out checks and letters to the agents.
Retention Period Retention Justification Media Code Method of Disposal
Maintain tor 5 years. Electronic Delete
If the record is paper (hard copy), then scan and once image has been verified, shred securely. Paper Shred

Approvals

Status Name Title Date
Approved Jeff Hitch Records Coordinator 2/8/2018 11:36:00 AM
Approved Melissa Roach Records Officer 2/22/2018 8:50:00 AM
Approved Bunnie Jones Record Administrator 3/16/2018 1:09:00 PM
Approved Martin Meeks State Auditor 3/19/2018 10:33:00 AM
Approved Fred Previts State Archivist 3/21/2018 12:39:00 PM

Notes

Date Reason User

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