- Get Actuarial Summary Form
- Get information about self insurance and the requirements to self insure
- Apply to become self insured
- Get information on posting a security deposit for self insurance
- Complete my Self Insurer's Annual Report
- Apply to take the Self Insurance Administrator's examination
- Determine if an employer is self insured
- Access self insurance regulations
- Receive notices about OSIP rulemaking
- Determine if a person is a self insured administrator
Office of Self Insurance Plans (OSIP)
Self Insurance Groups
The Office of Self Insurance Plans (OSIP) authorizes qualified employers to provide their own coverage for workers’ compensation liabilities. Small and medium-sized businesses have the option of joining with others in the same industry to self insure their workers’ compensation liability as a group. All Self Insurance Groups (SIGs) must be approved by OSIP and are required to post a security deposit covering a minimum of 135% of their estimated future liabilities. As of August 2011, California had a total of 31 SIGs. California has one of the largest self insurance programs in the nation and has some of the strongest regulations designed to ensure the system protects both employers and employees.
GROUP ROSTER – This link will provide a list of all Self Insured Groups and their individual affiliate members within California.
OSIP SIG AGGREGATE STATISTICS – From the 2011 Annual Report as of August 1, 2012
GROUP AGGREGATE STATISTICS – This link will provide a table of aggregate statistics of all California Groups.
GROUP FORMS - Below are forms for use that are specific to groups.
- Form A4-3 (1/94) ( pdf format, 89K)
Application for a certificate of consent to self insure by a group of employers
- Form A4-3M (1/94) ( pdf format, 88K)
Application for an affiliate certificate of consent to self insure as a member of a group self insurer
- Form A4-5 ( pdf format, 431K)
Application for a permanent certificate of consent to self insure by an interim self insurer
- Form A4-7 ( pdf format, 244K)
Request for Interim Certificate for a Group Member
- Actuarial Summary