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F213-042-000 form (Washington): the workers' comp owner exemption

Application for Elective Coverage. Who can file it, where to get it, how to file, the fee, when it takes effect, and how often it renews — from Washington State Department of Labor & Industries.

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AT A GLANCE

F213-042-000 filing snapshot

FormF213-042-000 — Application for Elective Coverage

Issuing bodyWashington State Department of Labor & Industries

Filing methodSubmit the Application for Elective Coverage to L&I for an otherwise excluded owner/person.

FeeNo separate filing fee verified

Common mistakeWashington owner exclusions arise from statute/entity/management structure; F213-042-000 elects coverage and does not create the exclusion.

When it takes effect12:01 a.m. on the day after L&I receives the application unless a later effective date is requested/accepted.

RenewalContinues until cancelled under L&I elective-coverage procedures.

Watch out forF213-042-000 elects coverage for an otherwise excluded person; Washington owner exclusions arise from entity/management rules.

Which Washington owners can use the F213-042-000

Sole proprietorA sole proprietor is generally excluded from mandatory personal coverage and may elect owner coverage through L&I using F213-042-000.

LLC memberLLC treatment depends on the management structure. In a member-managed LLC, members are generally excluded unless management rights are restricted. In a manager-managed LLC, qualifying member-managers with substantial daily control may be excluded, subject to L&I's relationship/number rules; member-only or manager-only workers may require coverage.

PartnerPartners are generally excluded from mandatory personal coverage and may elect coverage through L&I using F213-042-000.

Corporate officerOnly officers meeting Washington's strict substance-over-form tests are excluded. Non-public corporations may exclude up to eight qualifying shareholder-officers with substantial daily control; public-corporation officers also must be bona fide directors/shareholders and cannot have manual labor as their primary responsibility. Family-corporation rules differ.

Employee threshold: Washington does not use a simple owner-exemption certificate or a multi-employee numerical threshold for ordinary covered work. If a business has workers who are covered under the industrial-insurance rules, it must establish an L&I workers' compensation account and report/pay premiums for those workers unless an exclusion applies. In construction: Construction classification is especially strict. A worker who supplies essentially personal labor may be covered unless the worker satisfies Washington's independent-contractor tests; construction adds a seventh requirement, including the required contractor/plumbing/electrical registration or license. Owner status and a 1099 do not replace this test.

Read the full context in the Washington workers' comp exemption guide, or run the eligibility screener to check your entity type first.

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F213-042-000 form (Washington): frequently asked questions

Where do I get the F213-042-000 form in Washington?
The F213-042-000 (Application for Elective Coverage) is issued by Washington State Department of Labor & Industries. Submit the Application for Elective Coverage to L&I for an otherwise excluded owner/person. Use the official link on this page rather than a third-party copy, which may be out of date.
Is there a fee to file the F213-042-000 in Washington?
No separate filing fee has been verified for this form.
How often does the F213-042-000 exemption renew in Washington?
Continues until cancelled under L&I elective-coverage procedures. Watch out: F213-042-000 elects coverage for an otherwise excluded person; Washington owner exclusions arise from entity/management rules.
OFFICIAL SOURCE

Where this comes from

The F213-042-000 entry is anchored to Washington State Department of Labor & Industries — the state agency that issues and processes the form — not a generalized summary. Source-checked 2026-09-02.

Other state exemption forms