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Workers' Compensation Board

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Board Assessments


50-5 Annual Private Self-Insured Assessment

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Confirmation of Submission to the Board

You will receive a no-reply email from the WCB when your email is received. If you do not receive a confirmation email, then the Board did not receive your form. Please try to attach a saved version of the form to an email to Assessments@wcb.ny.gov. If you still do not receive an email confirmation, please contact the Board by sending an email to WCBFinanceOffice@wcb.ny.gov.

Questions may be sent to: WCBFinanceOffice@wcb.ny.gov