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Chapter 8. Office of the Director
Subchapter 2. Administration of Self-Insurance Plans
Article 12. Claims Administration
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§15450. Certificate to Administer.

(a) A valid Certificate to Administer issued by the Manager shall be in the possession of each claims administrator, whether a person, firm, corporation, joint powers authority or self insured employer, to administer or adjust workers' compensation self insurance claims.

EXCEPTION1:An insurer admitted to transact workers' compensation insurance in California is exempt from this requirement pursuant to Labor Code Section 3702.1(a);

NOTE:An insurance company subsidiary not admitted to transact workers' compensation insurance in California and engaged in the administration or adjustment of claims for a self insured employer is not exempt.

EXCEPTION2: A private self insurer that administers its own claims and/or the claims of other private self insurers with common ownership or which are in the same Master Certificate file is exempt from this requirement.

EXCEPTION3: A joint powers authority that holds a Master Certificate of Consent to Self Insure and administers its own claims; and/or the claims of other public self insurers which have an affiliate Certificate under the same Master Certificate file number held by the joint powers authority; and/or the claims of a former member of the joint powers authority is exempt from this requirement.

EXCEPTION4:A public self insurer that administers its own agency's claims is exempt from this requirement.

(b) Application for a Certificate to Administer shall be made on forms provided by Self-Insurance Plans (Form A4-50 (Rev. 4/91)). A complete application shall include the application form, and fees in accordance with Section 15454. NOTE:The current application form is contained in Plate L of the Appendix following the last Article of these Group 2 regulations.

(1) The applicant will be notified in writing within 14 days of receipt if the application is deficient.

(2) A certificate to administer will be issued within 30 days of receipt of a complete application.

(c) The Certificate to Administer expires June 30 and reapplication must be made prior to June 1 for the subsequent renewal period. The applicant may request the Certificate to Administer to be issued for a period of 1, 2 or 3 years.

(d) Failure to comply with Articles 6 and 9 of these regulations or engaging in improper practices as described in Labor Code Section 3702(a) is good cause for revocation or non-renewal of the Certificate to Administer.

Note: Authority cited: Sections 54, 55, 59, and 3702.10, Labor Code. Reference: Sections 59, 3702 and 3702.1, Labor Code. Government Code Sections 15375, 15376.


1. New article 12 (sections 15450-15463, not consecutive) filed 1-27-86;
effective thirtieth day thereafter (Register 86, No. 5).

2. Amendment of article and section headings filed 2-19-92; operative 3-20-92
(Register 92, No. 13).

3. Amendment of subsections (a), (b)(2) and (d) filed 2-9-2006; operative 3-11-
2006 (Register 2006, No. 6).

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