Who is responsible for completing this form?
The insurer, self-insured employer or third-party administrator is responsible for completing this form.
Why is this form needed?
The purpose of the NOFC form is to notify the department the file is about to be closed. Although filing of this form is not required by statute or rule, the voluntary use of it often avoids requests from the department to the insurer after the file has been closed and shipped to off-site storage. The department uses the receipt of the form as a trigger to perform a final audit of the file for compliance with the statutes and rules.
When is this form completed?
This form is filed at the time you determine your file can be closed. Be sure all required documents have been sent to the department before filing this form.
Where is this form sent?
A copy of this form is sent to:
the Minnesota Department of Labor and Industry, Safety and Workers' Compensation Division; and