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Chapter 8. Office of the Director
Subchapter 2. Administration of Self-Insurance Plans
Article 13. Group Self-Insurance

New Query

§15482.1. Private Group Member Application.

(a) A complete group member application to self-insure on Form S-2B (1-2016) by each member of a group self-insurer shall include all the attachments requested in the application form itself, and, as applicable, the following:
(1) The Board of Trustees, or the Group Administrator if authorized by the group bylaws, shall evaluate potential new members by reviewing their financial statements, tax returns, credit reports, or other appropriate documentation as specified in the bylaws of the group self-insurer;
(2) A duly executed Resolution authorizing completion of the application to become self-insured as a member of the group self-insurer;
(3) A duly executed Indemnity Agreement and Power of Attorney (Form S-4 (1-2016)), as required by Section 15479 of these regulations.
(b) A separate application shall be submitted for any new or separate subsidiary or affiliate of an affiliate group self-insurer in order for it to be considered for consent to self-insure.
(c) A new application may be required whenever an existing affiliate group self-insurer reincorporates, merges, or otherwise changes ownership.
Note: Authority cited: Sections 54, 55, 59 and 3702.10, Labor Code. Reference: Sections 3700, 3700(b), 3701, 3702, 3702.5 and 6401.7(a), Labor Code.
1. New section filed 3-2-2009; operative 3-2-2009 pursuant to Government Code section 11343.4 (Register 2009, No. 10).
2. Amendment filed 12-14-2016; operative 1-1-2017 pursuant to Government Code section 11343.4(b)(3) (Register 2016, No. 51).

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