(a) Each member of a group self-insurer shall execute an Indemnity Agreement and Power of Attorney Form S-4 (1-2016).
(b) The Indemnity Agreement and Power of Attorney shall contain, in substance, the following provisions:
(1) An agreement under which each member of a group self-insurer agrees to assume and discharge, jointly and severally, any compensation liability under Labor Code Section 3700-3705 of any and all other employers that are parties to the group self-insurer indemnity agreement;
(2) The agreement provides that, in addition to the rights of the group self-insurer to enforce the indemnity agreement in the event of a failure of the group self-insurer to enforce such rights after reasonable notice to the group self-insurer, the Director of Industrial Relations independently shall have the right to enforce the indemnity agreement on behalf of the group self-insurer including the joint and several liability of group members for payment of all compensation liabilities under the indemnity agreement and the liability of group members for any unpaid contributions and assessments;
(3) Provisions requiring that the Board of Trustees of the group self-insurer designate and appoint a Group Administrator empowered to accept the service of process on behalf of the group members and authorized to act for and bind the group self-insurer and all group members in all transactions relating to or arising out of the operation of the group self-insurer;
(4) Provisions for the right of the Director of Industrial Relations to substitute an outside Conservator for the Group Administrator;
(5) A provision granting full power of attorney and signature authority to the Group Administrator of the group self-insurer to execute documents, enter contracts, accept service of process on behalf of the group self-insurer, and conduct the general business of the group self-insurer, and, that said signature of the Group Administrator shall bind each and every group member jointly and severally. Note: A copy of S-4 (1-2016), Indemnity Agreement and Power of Attorney is available from the Chief and is available at http://www.dir.ca.gov/osip and is contained in the Appendix following Article 12 of Chapter 8, Subchapter 2.
Note: Authority cited: Sections 54, 55 and 3702.10, Labor Code. Reference: Sections 3700, 3701, 3701.5, 3702, 3702.1, 3702.2, 3702.3, 3702.5, 3702.7 and 3702.10, Labor Code.
1. New section filed 6-30-94; operative 6-30-94 (Register 94, No. 26).
2. Amendment filed 3-2-2009; operative 3-2-2009 pursuant to Government Code section 11343.4 (Register 2009, No. 10).
3. Amendment of subsections (a) and (a)(5) filed 12-14-2016; operative 1-1-2017 pursuant to Government Code section 11343.4(b)(3) (Register 2016, No. 51).