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Workers’ Compensation

California MPN

The Hartford’s California Workers’ Compensation Medical Provider Network

This website is a resource to help you set up and maintain The Hartford's California Workers' Compensation Medical Provider Network at your workplace.

Implement the MPN

To implement the MPN, follow the steps below for all California locations whether you are a new or existing Hartford customer.

STEP 1

Read the Employer MPN Implementation Guide. It explains the CA MPN and your role in its implementation.

Employer MPN Implementation Guide

STEP 2

Print the DWC-7 state-required posting notice. Most of the MPN information has been filled out for you. Please fill in the remaining items. The MPN effective date is the date you fully implement the MPN for your company. Refer to your policy to fill in the writing company on the “Workers’ compensation insurer” line, and for your policy expiration date. Click here to find the nearest information and assistance officer. When complete, post the DWC-7 form in a place frequented by your employees.

DWC-7

DWC-7 (Spanish) 

STEP 3

Post the “Complete Written Employee Notification” document next to the DWC-7 form.

Complete Written Employee Notification (ENG and SPAN)

STEP 4

If you are implementing a new MPN, please distribute the “MPN Implementation Notice” to all employees. If you had an MPN prior to starting coverage with The Hartford, please follow the steps below as appropriate:

  • If it has been 60 days or less since starting coverage with The Hartford, please distribute the “MPN Change Notification” to all employees AND distribute the “Termination and Cessation Notice” to all employees with an existing covered injury.
  • If it has been more than 60 days since starting coverage with The Hartford, please distribute the “MPN Implementation Notice” to all employees AND distribute the “Termination and Cessation Notice” to all employees with an existing covered injury.

MPN Implementation Notice (ENG and SPAN)

MPN Change Notification (ENG and SPAN)

MPN Termination and Cessation Notice (ENG and SPAN)


Maintaining the MPN

After completing steps 1-4 above, your MPN Implementation is complete. To maintain your MPN, please follow the steps below, on an ongoing basis:

At time of injury:

1. Provide the "DWC-1 Employee Claim Form and Notice of Potential Eligibility."

DWC1 Claim Form 

2. Provide the “Complete Written Employee Notification.”

Complete Written Employee Notification (ENG and SPAN)

Upon hiring a new employee:

1. Give new employee a copy of the “Implementation Notice.”

MPN Implementation Notice (ENG and SPAN) 

2. Provide the “Time of Hire Pamphlet"

Time of Hire Pamphlet (ENG and SPAN)

 

Helpful Links and Documents

 

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