(a) Appeals and/or requests for hearing under this article, by an employer or aggrieved party shall be in writing and shall include the following information:
(1) Name and address of the person making the appeal or requesting the hearing (i.e. the requesting party):
(2) The specific nature of the request (for example, "This request is to review action denying revoking a certificate to administer"; or "This request is to appeal the failure to pass the self-insurance administrator's examination");
(3) A statement of the requesting party's rationale, basis, evidence, facts, reasoning, arguments, documentation, or other supporting material which establishes's and supports the position of the requesting party:
(4) A statement of whether the requesting party wishes a formal hearing or a written decision only on the matter;
(5) When a formal hearing is requested, an additional statement estimating the number of witnesses, if any, to be called by the requesting party at the hearing and the amount of time the requesting party will require to present its case at the hearing.
(b) Requests for a hearing or appeal pursuant to Section 15430 of these regulations shall be mailed or delivered to: Manager, Self-Insurance Plans, 2265 Watt Avenue, Suite 1, Sacramento, CA 95825.
(c) An appeal or request for a hearing from an employer or aggrieved party must be served upon the Director in writing within twenty-one (21) calendar days after receipt of:
(1) Notice of intention to revoke or deny a certificate to self-insure;
(2) Notice of the default of a self-insured employer or surety;
(3) Notice of a failing score on the self-insurance administrator's examination;
(4) Notice of intent to revoke a certificate to administer; or
(5) The decision by the Manager not to renew or grant a certificate to administer.
(d) A hearing on a claim that Self-Insurance Plans has not timely processed an application as required by Government Code section 15378 may be requested at any time.
(e) An appeal or request for hearing shall be deemed timely received if the request is postmarked or delivered to the Director or the Manager by the end of business on the twenty second (22nd) calendar day, after receipt of the notice or decision being appealed, as set forth in subsection (c) of this section.
(f) The written appeal or hearing request shall be:
(1) Placed in the United States mail in a fully prepaid, postmarked and sealed envelope;
(2) Delivery to an overnight mail delivery service for delivery the following day; or
(3) Delivery by messenger or in person to the Office of Self-Insurance Plans.
NOTE: Authority cited: Sections 54, 55 and 3702.10, Labor Code. Reference: Sections 59, 3700, 3701, 3701.5, 3702, 3702.1, 3702.7, 3702.9, 3702.10 and 3740-3747, Labor Code; Sections 11181-11188 and 15378, Government Code.
1. New section filed 12-17-90; operative 1-16-91 (Register 91, No. 6).
2. Editorial correction of NOTE (Register 91, No. 46).
3. Change without regulatory effect amending subsection (b) filed 10-18-95 pursuant to section 100, title 1, California Code of Regulations (Register 95, No. 42).