Quick Links
- Log-in
- Make a Payment
- Get information about self insurance and the requirements to self insure
- Apply to take the Self Insurance Administrator's examination
- Determine if an employer is self insured
- Determine if a person is a self insured administrator
- Frequently Asked Questions (FAQs)
Related Links
- Self-Insurers' Security Fund
- California Self Insurers' Association
- Self Insurance Institute of America
- California WC & Risk Conference
About OSIP
Self Insured Employers
Information and resources for private self insured employers and firms wishing to become self insured
Private/SIG Self Insurance by the Numbers – 2014
$90 Billion total self insured payroll
2.2 Million CA Public Workers covered by self insurance
3,579 CA Public Agencies self-insure WC Liabilities
5.45 Billion Estimated Claims Reserves (EFL)
1.53 Billion Medical and Indemnity Payments
93,850 Open Workers' Compensation Case
REQUIREMENTS - Learn more about the requirements to become self insured.
Roster of private self insured employers
SEARCH for self insured employers using our easy search feature.
SI EMPLOYER FORMS - Below are forms for use that are specific to self insured employers.
- Actuarial Summary and Study Amendments
- Form A4-1
Application for a private entity Certificate of Consent to Self Insure - Form A4-5
Application for a permanent certificate of consent to self insure by an interim self insurer - Form A4-50
Application for a Certificate to Administer W/C Claims - Form A4-6 (Rev 11/97)
Agreement of assumption and guarantee of workers' compensation liabilities
NOTE: This form must be submitted to SIP as a two-sided form, please print or copy it appropriately. - Corporate resolution authorizing application
- Resolution of agreement of parental assumption and guarantee
- Request for Interim Certificate
