Rule 20-1-1.8 - Posting Notice of Coverage Every employer operating under the provisions of the Mississippi Workers' Compensation Law shall keep in a conspicuous place in and about its place of business a "Notice of Coverage" form which measures at least 8 1/2 inches by 11 inches and which contains the following information:
I. The name, address and telephone number of the workers' compensation insurance carrier for the employer, or a statement that the employer is self-insured, if applicable; II. The name, address and telephone number of the third party administrator, if any, or other office responsible for processing and paying the workers' compensation claims on behalf of the carrier or self-insured employer; III. The effective dates of the workers' compensation insurance coverage or the self-insurance certificate of authority which the employer maintains; IV. The name of the person or representative affiliated with the employer to whom employees should provide notice of their injuries or illnesses; and V. A statement that any person who willfully makes any false or misleading statement or representation for the purpose of obtaining or wrongfully withholding any benefits or payment under the Mississippi Workers' Compensation Law may be charged with violation of Miss. Code Ann. Section 71-3-69 and upon conviction be subjected to the penalties therein provided. Miss. Code Ann. § 71-3-85.