Workers Compensation
Applications and Forms
In order to apply for or maintain a self-insured workers' compensation license, please visit the Comprehensive Online Regulatory & Enforcement (CORE) website at https://core.tn.gov or select the below link affiliated with the application type you wish to submit. Please note that all applications, associated supporting documents, and fee payments must be submitted electronically through CORE (unless otherwise noted).
- Licensed Insured
- Licensed Pools Self-Insured Workers' Compensation:
- Licensed Single Employer Self-Insurer Workers' Compensation:
- Single Employer- New Admission Application [CORE]
- Single Employer- Replacement Certificate of Authority [CORE]
- Single Employer-Add Subsidiary [CORE]
- Single Employer-Canceled Subsidiary [CORE]
- Single Employer-Name Change [CORE]
- Name Change Requirements [pdf]
- Single Employer-Address Change [CORE]
- Single Employer-Security Review [CORE]
- Single Employer - Withdrawal/Surrender [CORE]
- Single Employer-Merger [CORE]
- Merger Requirements [pdf]
- Single Employer- Renewal Application [CORE]
- Single Employer - Payroll and NCCI Reporting [CORE]
- Single Employer-Fiscal Year End Filing [CORE]
- Single Employer-Premium Tax Requirement [CORE]
- Single Employer-Update Third Party Administrator Agreement [CORE]
- Update TPA Requirements [pdf]
- Single Employer-Update Excess Policy [CORE]
- Service of Process [pdf]
- Tennessee Summary of Supporting Information Form [pdf]
- General Contractor Notice For Commercial Construction Projects [pdf]
Notices and Other Information
- Sample Commercial CSP Policyholder Notice
- 2025 Workers Compensation Appeal Hearing Dates [pdf]
- 2025 Order Approving Workers' Compensation Voluntary Market Loss Cost Filing [pdf]
- 2025 Order Approving Workers' Compensation Assigned Risk Rate Filing and Loss Cost Multiplier [pdf]
- Procedures for Addressing Workers' Compensation Premium Disputes [pdf]
- 2022 ACWC Market Conditions Presentation [pdf]
- Workers' Compensation Loss Cost Multipliers [pdf]
- NCCI Contracting Group Classification Codes [pdf]
- How to Buy WC Insurance and How to Access the Tennessee Residual Market