Chapter 8. Office of the Director
Subchapter 2. Administration of Self-Insurance Plans
Article 2. Certificate to Self Insure

§15203.3. Resolution To Authorize Self Insurance for a Private Sector Applicant or Group Applicant.

(a) The resolution to authorize self insurance of workers' compensation required as part of the application for a certificate to self insure by any private sector applicant or private group self insurer shall be adopted by the Board of Directors of each corporation, or the general partners of an applicant partnership or joint venture, or owner of an applicant sole proprietorship, or Board of Trustees of an applicant group self insurer. The resolution to authorize self insurance shall include the following:

(1) A statement identifying the applicant by corporate or other legal name, the state of registration, and the date that the resolution was adopted;

(2) Identify by title of appointed officers or other company employees who have the authority to sign the application, execute any and all documents required for the application and do subsequent acts as required to maintain self insurance approval.

(b) If a private self insurer or group self insurer reincorporates, merges, or changes its identity, a new resolution shall be submitted to the Manager within 30 days to ratify the maintenance of the self insured's responsibility under the successor's identity. The Manager may extend the period of time for good cause.

(c) A model corporate resolution shall be included as part of the application form and the Manager shall provide separate model resolutions to self insurers which are partnerships or other non-corporate structures upon request.

(d) A group self insurer resolution Form GR-1 (Rev. 1/94) shall be attached as part of the private group employer application and executed by the group applicant Board of Trustees.

NOTE: The current group self insurer resolution, Form GR-1 (Rev. 1/94), is contained in Plate B of the Appendix following the last article of these Group 2 regulations.

NOTE: Authority cited: Sections 54, 55 and 3702.10, Labor Code. Reference: Sections 59, 3700, 3701, 3702 and 3702.10, Labor Code.

HISTORY

1. New section filed 11-21-78; effective thirtieth day thereafter (Register 78, No. 47).

2. Amendment filed 1-19-79; effective thirtieth day thereafter (Register 79, No. 3).

3. Amendment of section heading and text filed 12-22-92; operative 1-21-93 (Register 93, No. 2).

4. Amendment of section heading and text filed 6-30-94; operative 6-30-94 (Register 94, No. 26).