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Required Prerequisites

How To Apply

To apply for self-insurance status, an employer must submit the following:

After considering the application and all supporting information, the Division will approve or deny the self-insurance application.  An applicant whose request is granted will receive a Certificate of Self-Insurance, which can be renewed annually. Denied applicants have the right to appeal the decision to the Labor Commission’s Adjudication Division.

Self-Insurance Renewal

Self-insured status must be reviewed and renewed annually.  A renewal application must be submitted at least 60 days prior to the expiration of the current certificate along with a $650 nonrefundable application fee and a recent certified audit report.