Workers' Compensation Annual Payroll Report Instructions and Reporting Requirements for PTAs

Download the Workers' Compensation Annual Payroll Report Form

The Workers' Compensation Insurance carrier for the California State PTA is Oak River Insurance Co. Oak River requires that every PTA complete the Workers' Compensation Annual Payroll Report regardless if wages are paid or not. A copy of the Workers' Compensation Annual Payroll Report is included in this mailing, along with a sample copy of the form. Base rate will cover gross wages of all persons hired up to $1,000, including payments made to independent contractors for services performed between January 5, 2012 and January 4, 2013. Any wages in excess of the base will result in an additional premium of 3.5 percent of the wages. Forms and any additional premium are to be sent through channels and must reach the California State PTA by January 31, 2013.

On the form, list only those employees that PTA pays directly. Do NOT list names when monies are donated to a school district for employee salaries. Do NOT list company names.

• If the PTA has NOT hired employees or independent contractors, write "NO ONE PAID."
• PTA must report all paid workers. Be specific about the type of work and the dates.
• If PTA hires employees, and if an employer-employee relationship exists, the PTA, as employer, must comply with all state and federal withholding requirements.

For each employee listed on the Workers' Compensation Annual Payroll Report, PTA must also attach copies of quarterly reporting forms. The California State PTA recommends that any PTA hiring an employee or an independent contractor secure professional services for processing of wages, withholding and reporting forms. Each of the quarterly reporting forms also has an annual form due at the end of the year.

• If the total payments (gross) for ALL employees are more than $1,000, PTA will incur an additional premium. To calculate the new premium: subtract $1,000 from the total (gross) payments for all individuals paid for the period being reported; multiply the balance remaining by 3.5 percent and forward that amount through channels by the district PTA due date.

For example: $2,500 total (gross) payments, less $1,000 = $1,500 balance; $1,500 x 3.5% = $52.50. This is the premium for this PTA (see sample form enclosed).

WORKERS' COMPENSATION ANNUAL PAYROLL REPORT SAMPLE

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