Code of Massachusetts Regulations › 452 CMR - DEPARTMENT OF INDUSTRIAL ACCIDENTS › Title 452 CMR 8.00 - Office Of Investigations › Section 8.06 - Exemption of Corporate Officers or Directors

Current through Register 1525, July 5, 2024
(1) Pursuant to M.G.L. c. 152, § 1(4), a
			 corporate officer or director who owns at least 25% of the issued and
			 outstanding stock in a corporation may elect to be exempted from the provisions
			 of M.G.L. c. 152. Said exemption may only be exercised if the corporate
			 officer(s) or director(s) submits a waiver of his or her rights to any claim as
			 delineated in M.G.L. c. 152. This waiver shall be in the form of an affidavit
			 promulgated by the DIA and known as Form 153:
Affidavit of Exemption
			 for Certain Corporate Officers
and may be submitted
			 electronically.
(2) To be valid,
			 all corporate officers and directors who own 25% or more of the issued and
			 outstanding shares of the corporation must be named on the Form 153. There can
			 be no more than four corporate officers or directors named on the Form 153. All
			 corporate officers or directors named on the Form 153 must attach their
			 signatures to the document for it to be considered valid. The information
			 contained on the Form 153 provided by the corporate entity will be checked
			 against the articles of incorporation and the annual report on file with the
			 Secretary of the Commonwealth. Should the information contained in the Form 153
			 not match the information contained in the documents on file with the Secretary
			 of the Commonwealth, the Form 153 shall be rejected and the exemption will not
			 apply.
(3) Not all corporate
			 officers and directors need to exercise their right of exemption from the
			 provisions of M.G.L. c. 152 for the exemption to be valid. If one or more of
			 the corporate officers or directors who are eligible for the exemption decide
			 not to waive their rights to workers' compensation, they must do so by marking
			 the box located beneath their signature on the Form 153 which states "I wish
			 not to exercise my right of exemption." If any of the corporate officers or
			 directors have signed the Form 153 and indicated that they will not exercise
			 the right of exemption, then workers' compensation coverage must be in place
			 for those non-exempted corporate officers or directors per M.G.L. c. 152,
			 § 25A. Failure to do so shall be deemed a violation of the statute and the
			 corporation will be subject to the fines and penalties delineated in M.G.L. c.
			 152, § 25C. Whether or not an eligible corporate officer or director
			 exercises their right of exemption, ALL eligible officers or directors must
			 attach their signatures to the Form 153 as a condition of the form being
			 approved by the DIA.
(4) Upon
			 review and approval of the Form 153 by the DIA, the corporate officer(s) or
			 director(s) named therein shall be deemed exempt from the provisions of M.G.L.
			 c. 152. If the corporation carries workers' compensation insurance, the
			 corporation must provide a copy of the approved Form 153 to the insurance
			 carrier as proof that the named corporate officer(s) or director(s) have been
			 properly exempted and that workers' compensation coverage is no longer required
			 for those persons. Where the Form 153 is submitted in paper form, the
			 corporation will be provided a copy of the approved Form 153; a self-addressed
			 stamped return envelope should be included with the Form 153 submission for
			 this purpose. An approved Form 153 will be marked as such in the upper right
			 hand corner of the form and will indicate the date of approval and the initials
			 of the Director of the DIA and/or his or her designee. Notwithstanding any
			 earlier date indicated on an approved Form 153, the effective date of the
			 requisite changes to any existing workers' compensation policy shall be either:
(a) the next policy effective date following
			 the carrier's receipt of the approved Form 153; or
(b) the day following the carrier's receipt
			 of the approved Form 153 along with a written request that the election be made
			 effective mid-term.