Extract data from ACORD 171MI (2005/01) - Michigan Application for Exclusion of Executive Officers. Get data in JSON format to autofill another form, store in a database, or convert to AL3 using WinsurTech solutions.
The ACORD 171MI (2005/01), titled Michigan Application for Exclusion of Executive Officers, is an insurance form used in Michigan for businesses seeking to exclude certain executive officers from mandatory workers' compensation coverage. Michigan allows specific executive officers or owners of a business to opt out of workers' compensation if they meet eligibility requirements. This form requires detailed information about the officers requesting exclusion and the business itself. By completing ACORD 171MI, companies can formally petition to exclude qualifying executives from coverage, helping reduce their workers' compensation costs while aligning with Michigan's regulations.