1. (1) An employer that elects or is required to participate in the trust fund pursuant to Section 53-17-301 shall submit:

   1. (a) a cost sharing agreement form approved by the board;
   2. (b) a certificate of eligible employees form approved by the board that identifies the number of eligible members at the time the employer elects to participate in the trust fund; and
   3. (c) the required annual premium payment as determined by the board.
2. (2) The information described in Subsection R698-8-4(1) shall be addressed to the Commissioner's office of the Department of Public Safety, Attn. Trust Fund.

3. (3) The cost sharing agreement form shall contain the following:

   1. (a) the name, address and phone number of the employer; and
   2. (c) the name, mailing address and signature of the agency administrator completing the cost sharing agreement form.

KEY: line-of-duty death, cost sharing agreement, surviving spouse trust fund

Date of Last Change: May 22, 2025

Notice of Continuation: January 7, 2026

Authorizing, and Implemented or Interpreted Law: 53-17-301