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Ontario Signatories Only

Engagers with Ontario productions who insure their production crew through WSIB will be required to complete and submit the Workplace Safety & Insurance Board (WSIB) Employer by Application – Entertainment Industry Form. Please forward the completed form to WSIB. This form opts performers out of WSIB coverage.

The WSIB Employer by Application-Entertainment Industry Form can be downloaded at the link that follows:  

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  Guidelines

GUIDELINES FOR COMPLETING THE WSIB EMPLOYER BY APPLICATION - ENTERTAINMENT INDUSTRY FORM.

In order to ensure that coverage is in place for all performers working in Ontario, benefits are being provided through the Accident on Set program under the National Commercial Agreement.

WSIB (Workplace Safety & Insurance Board) requests notification when you use WSIB for your crew coverage but exclude performers. This notification is provided to them through the use of the WSIB Employer by Application – Entertainment Industry Form.

  1. Provide your WSIB account number;
  2. Provide a brief description of your business. This may be the same information as provided on earlier submissions;
  3. Indicate where business activities occur. This will usually be “Anywhere in Ontario”;
  4. Indicate effective date of the change, which is the later of December 1, 2008, being the date the NCA was ratified, or the date you became a signatory of the NCA;
  5. Include the employer legal name and address;
  6. Sign and date the form.

You will notice that the form has already been completed to indicate that all performers are to be excluded from WSIB coverage.