Office of Self Insurance Plans (OSIP)


SIG Self-Insurance by the Numbers - 2016

$5.2 Billion total self-insured payroll
302,010 CA Workers covered by self-insurance
22 CA Groups are active self-insurers
1,782 CA Group members are active self-insurers
$146 Million Estimated Claims Reserves (EFL)
$103 Million Medical and Indemnity payments
5,034 Open Workers’ Compensation cases

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 their actuarial determined liabilities. 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 FORMS - Below are forms for use that are specific to groups.

  • Form S-1 (1-2016)
    Group master application for certificate of consent to self-insure
  • Form S-2A (1-2016)
    Group affiliate member interim application
  • Form S-2B (1-2016)
    Application for affiliate certificate of consent to self-insure as a member of a group self-insurer
  • Form S-3 (1-2016)
    Corporate resolution
  • Form S-4 (1-2016)
    Indemnity agreement and power of attorney
  • Form S-5 (1-2015)
    Agreement of assumption and guarantee of workers’ compensation liabilities for group and affiliate members
  • Form S-6 (1-2016)
    Agreement and undertaking for security deposit