Form (Wyoming): the workers' comp owner exemption
Affidavit of Coverage. Who can file it, where to get it, how to file, the fee, when it takes effect, and how often it renews — from Wyoming Department of Workforce Services, Workers’ Compensation Employer Services.
Form filing snapshot
FormForm — Affidavit of Coverage
Issuing bodyWyoming Department of Workforce Services, Workers’ Compensation Employer Services
Filing methodMake a written request using the Affidavit of Coverage supplied by the Division; Employer Services provides the form/process.
FeeNo separate filing fee verified
Common mistakeOwners are not automatically covered. Corporate officers, LLC members, sole proprietors and partners may elect personal coverage. Corporate officer coverage is tied to the office/position, not the individual.
When it takes effectOn the Division-approved effective date shown for the elected coverage.
RenewalOwner/officer elective coverage is subject to Wyoming’s minimum coverage commitment; current employer guidance requires status updates, including officer changes within 30 days.
Watch out forWyoming classifies businesses as mandatory, optional or non-liable by activity; it does not use a simple employee-count test.
Which Wyoming owners can use the Form
Sole proprietorA sole proprietor is exempt from personal workers' compensation unless optional owner coverage is elected. If elected, coverage follows the Division's written-election timing and minimum-duration rules.
LLC memberAn LLC member is exempt from personal coverage unless optional coverage is elected. DWS states that its LLC-member Affidavit of Coverage is no longer posted online and must be obtained from Employer Services.
PartnerA partner is exempt from personal coverage unless optional coverage is elected. The partnership still needs DWS to determine coverage for any employees based on the business classification.
Corporate officerCorporate officers are exempt unless optional coverage is elected. DWS ties coverage to the corporate position, not the individual; if the person holding a covered office changes, the employer must notify the Division within 30 days.
Employee threshold: Wyoming does not use a simple employee-count trigger. Workers' compensation is mandatory for employers in extra-hazardous industries identified by the business activity/NAICS classification; optional employers may elect coverage. DWS requires business registration so it can determine whether coverage is required, optional, or non-liable. In construction: Construction is evaluated through Wyoming's extra-hazardous classification system rather than a separate head-count number. A business must register and let DWS assign the applicable classification before work; do not assume that an owner exclusion makes construction operations non-liable.
Read the full context in the Wyoming workers' comp exemption guide, or run the eligibility screener to check your entity type first.
Form (Wyoming): frequently asked questions
- Where do I get the Form form in Wyoming?
- The Form (Affidavit of Coverage) is issued by Wyoming Department of Workforce Services, Workers’ Compensation Employer Services. Make a written request using the Affidavit of Coverage supplied by the Division; Employer Services provides the form/process. 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 Form in Wyoming?
- No separate filing fee has been verified for this form.
- How often does the Form exemption renew in Wyoming?
- Owner/officer elective coverage is subject to Wyoming’s minimum coverage commitment; current employer guidance requires status updates, including officer changes within 30 days. Watch out: Wyoming classifies businesses as mandatory, optional or non-liable by activity; it does not use a simple employee-count test.
Where this comes from
The Form entry is anchored to Wyoming Department of Workforce Services, Workers’ Compensation Employer Services — the state agency that issues and processes the form — not a generalized summary. Source-checked 2026-09-02.