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Online Payment Options

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For an explanation of each payment reason, click the appropriate option below.

  1. Second Injury Fund Assessment

  2. Self-Insurance Application Fee

  3. Self-Insurance Renewal Fee

  4. Self-Insurance Late Fee

  5. Payment for Copies

  6. Civil Penalties

  7. Mediation Fee

  8. Failure to Provide Proof of Coverage

  9. Provider Application Fee

  10. Workers Comp Policy Fee