Self-Insurance Groups

<!doctype html>  <html lang="en"> <head> <meta charset="utf-8">   <title>Self-Insurance Groups</title>   <meta name="Author" content="Self Insurance Plans (SIP)" /> <meta name="Description" content="Self Insurance Plans (SIP)" /> <meta name="Keywords" content="Self Insurance Plans (SIP)" />   <meta charset="utf-8"> <meta name="Author" content="State of California" /> <meta name="Description" content="State of California" /> <meta name="Keywords" content="California, government" /> <meta http-equiv="X-UA-Compatible" content="IE=edge"> <meta name="HandheldFriendly" content="True"> <meta name="MobileOptimized" content="320"> <meta name="viewport" content="width=device-width, initial-scale=1.0, minimum-scale=1.0"> <meta property="og:image" content="https://as-cdt-pub-migr-betaws-ww-p-001-stage.azurewebsites.net/images/social_media_preview_image.png" />  <link href="https://fonts.googleapis.com/css?family=Roboto:400,500,700" rel="stylesheet"> <link href="https://california.azureedge.net/cdt/statetemplate/6.1.0/css/cagov.core.css" rel="stylesheet"> <link href="/css/ca.gov.css" rel="stylesheet" /> <link href="https://california.azureedge.net/cdt/statetemplate/6.1.0/css/colortheme-oceanside.min.css" rel="stylesheet"> <link href="/css/custom.css" rel="stylesheet"> <link rel="stylesheet" type="text/css" href="/css/print.css" media="print">  <script defer crossorigin="anonymous" src="https://alert.cdt.ca.gov"></script>  <script type="text/javascript" src="https://lwda-prod.ochat.osaas.app/embed/DIR-1655436669699"></script> <link rel="apple-touch-icon-precomposed" sizes="100x100" href="/images/apple-touch-icon-precomposed.png"> <link rel="icon" sizes="192x192" href="/images/apple-touch-icon-192x192.png"> <link rel="apple-touch-icon-precomposed" sizes="180x180" href="/images/apple-touch-icon-180x180.png"> <link rel="apple-touch-icon-precomposed" sizes="152x152" href="/images/apple-touch-icon-152x152.png"> <link rel="apple-touch-icon-precomposed" sizes="144x144" href="/images/apple-touch-icon-144x144.png"> <link rel="apple-touch-icon-precomposed" sizes="120x120" href="/images/apple-touch-icon-120x120.png"> <link rel="apple-touch-icon-precomposed" sizes="114x114" href="/images/apple-touch-icon-114x114.png"> <link rel="apple-touch-icon-precomposed" sizes="72x72" href="/images/apple-touch-icon-72x72.png"> <link rel="apple-touch-icon-precomposed" href="/images/apple-touch-icon-57x57.png"> <link rel="shortcut icon" href="/images/apple-touch-icon-57x57.png"> <link rel="apple-touch-icon" href="/images/apple-touch-icon.png"> <link rel="shortcut icon" href="/favicon.ico">       <script async src="https://www.googletagmanager.com/gtag/js?id=UA-3419582-30"></script> <script> window.dataLayer = window.dataLayer || []; function gtag() { dataLayer.push(arguments); } gtag('js', new Date()); gtag('config', 'UA-3419582-2'); //statewide GA property gtag('config', 'UA-3419582-30'); //please update state department UA code in line below before deployment gtag('config', 'UA-5092920-1'); //un-comment line and update UA code to add a third GA property var getOutboundLink = function (url) { gtag('event', 'click', { 'event_category': 'navigation', 'event_label': 'outbound link: ' + url, 'transport_type': 'beacon', 'event_callback': function () { document.location = url; } }); } var trackDownload = function (filename) { gtag('event', 'click', { 'event_category': 'download', 'event_label': 'file: ' + filename, 'transport_type': 'beacon', 'event_callback': function () { document.location = url; } }); } </script>  <script async src="https://www.googletagmanager.com/gtag/js?id=G-75V2BNQ3DR"></script> <script> window.dataLayer = window.dataLayer || []; function gtag() { dataLayer.push(arguments); } gtag('js', new Date()); gtag('config', 'G-69TD0KNT0F'); // statewide GA4 Property ID gtag('config', 'G-9C30LB4KFJ'); // update individual agency GA4 Property ID code before deployment </script>   </head> <body class="two-column">  <style> .utility-header .social-media-links .sm-icons { padding: 6px 0 0 10px; } .utility-header .social-media-links .sm-icons a { margin: 0 0 0 3px; } .utility-header .social-media-links .sm-icons a span[class^="ca-gov-icon-"] { color:#fff !important; } .utility-header .social-media-links .sm-icons a:hover span[class^="ca-gov-icon-"] { color:#fdeabf !important; } </style> <header role="banner" id="header" class="global-header">  <div id="skip-to-content"> <a href="#main-content">Skip to Main Content</a> </div> <div class="utility-header"> <div class="container"> <div class="flex-row"> <div class="social-media-links"> <div class="header-cagov-logo"><a href="https://ca.gov"><span class="sr-only">CA.gov</span> <img src="/images/Ca-Gov-Logo-Gold.svg" class="pos-rel" alt="" aria-hidden="true" /></a> </div> <ul class="sm-icons"> <li><a href="https://www.linkedin.com/company/californiadir"><span class="ca-gov-icon-share-linkedin" aria-hidden="true" title="LinkedIn"></span><span class="sr-only">LinkedIn</span></a></li> <li><a href="https://www.facebook.com/CaliforniaDIR"><span class="ca-gov-icon-share-facebook" aria-hidden="true" title="Facebook"></span><span class="sr-only">Flickr</span></a></li> <li><a href="https://twitter.com/#!/CA_DIR"><img class="x-icon dark-bkg" style="margin-top:-3px;padding-bottom:4px;" src="/images/icons/x-logo-white.png" title="X (Twitter)" /><span class="sr-only">Twitter</span></a></li> <li><a href="http://www.youtube.com/CaliforniaDIR"><span class="ca-gov-icon-youtube" aria-hidden="true" title="YouTube"></span><span class="sr-only">YouTube</span></a></li> <li><a href="https://www.instagram.com/ca_dir/"><span class="ca-gov-icon-instagram" aria-hidden="true" title="Instagram"></span><span class="sr-only">Instagram</span></a></li> </ul>  </div> <div class="settings-links"> <a class="nowrap" class="crowded-link" href="/mediaroom.html" style="padding-top:3px;">Press room</a> <span class="careers"><a class="nowrap" href="/dirjobs/dirjobs.htm">Careers at DIR</a></span> <a class="nowrap" href="/Multilingual/Spanish/index.html">Índice en español</a> <button class="btn btn-sm" style="box-shadow:none;" data-bs-toggle="collapse" data-bs-target="#siteSettings" aria-expanded="false" aria-controls="siteSettings"><span class="ca-gov-icon-gear" aria-hidden="true"></span>Settings</button> <a class="nowrap" style="margin-left:35px;" href="#" data-bs-toggle="modal" data-bs-target="#gt-translate-modal"><span class="ca-gov-icon-globe white"></span> Translate</a> </div> </div> </div> </div>   <div class="site-settings section collapse collapsed" id="siteSettings"> <div class="container p-y"> <div class="settings-bar-buttons"> <div class="btn-group" aria-label="contrastMode"> <button type="button" class="btn btn-default btn-lg bg-transparent bg-s1-hover disableHighContrastMode">Reset</button> </div> <div class="btn-group"><button type="button" class="btn btn-s1 btn-lg brd-s1 enableHighContrastMode">High contrast</button> </div> <div class="btn-group"> <button type="button" class="btn btn-s1 btn-lg brd-s1 increaseTextSize"> <span class="hidden-xs">Increase font size</span> <span class="visible-xs">Font <span class="sr-only">increase</span> <span class="ca-gov-icon-plus-line small" aria-hidden="true"></span> </span> </button> </div> <div class="btn-group"> <button type="button" class="btn btn-s1 btn-lg brd-s1 decreaseTextSize"> <span class="hidden-xs">Decrease font size</span> <span class="visible-xs">Font <span class="sr-only">decrease</span> <span class="ca-gov-icon-minus-line small" aria-hidden="true"></span> </span> </button> </div> <div class="btn-group"> <button type="button" class="btn btn-s1 btn-lg brd-s1 dyslexicFont">Dyslexic font</button> </div> <button type="button" class="close ms-auto" data-bs-toggle="collapse" data-bs-target="#siteSettings" aria-label="Close"> <span aria-hidden="true" class=" ca-gov-icon-close-mark"></span> </button> </div> </div> </div>    <div class="section-default"> <div class="branding"> <div class="header-organization-banner" style="position:relative;"> <div class="test-site-marker"></div> <a href="/" style="border:none;"> <div class="logo-assets"> <img src="/images/template-logo.png" class="logo-img" alt="Calfornia Department of Industrial Relations" /> <div class="logo-text"> <span class="logo-state"></span> <span class="logo-dept"></span> </div> </div> </a> </div> </div> </div>   <div class="mobile-controls"> <span class="mobile-control-group mobile-header-icons">  </span> <div class="mobile-control-group main-nav-icons"> <button class="mobile-control toggle-search"> <span class="ca-gov-icon-search hidden-print" aria-hidden="true"></span><span class="sr-only">Search</span> </button> <button id="nav-icon3" class="mobile-control toggle-menu" aria-expanded="false" aria-controls="navigation" data-bs-toggle="collapse" data-bs-target="#navigation"> <span></span> <span></span> <span></span> <span></span> <span class="sr-only">Menu</span> </button> </div> </div>  <div class="navigation-search full-width-nav container">       <div id="head-search" class="search-container featured-search"> <div class="container"> <form id="Search" class="pos-rel" action="/serp.html"> <span class="sr-only" id="SearchInput">Custom Google Search</span> <input type="text" name="q" aria-labelledby="SearchInput" placeholder="Search" class="search-textfield" /> <button type="submit" class="gsc-search-button"><span class="ca-gov-icon-search" aria-hidden="true"></span><span class="sr-only">Submit</span></button> <div class="close-search-btn"><button class="close-search gsc-clear-button border-0 bg-transparent pos-rel" type="reset"><span class="sr-only">Close</span></button></div> </form> </div> </div>       <nav id="navigation" class="main-navigation dropdown" lang="en"> <ul id="nav_list" class="top-level-nav"> <li class="nav-item"> <a href="/dlse/" class="first-level-link"><br class="show-large-up" />Labor <br class="hide-1280-up hide-small-and-medium" />Law</a> <div class="sub-nav"> <ul class="second-level-nav"> <li class="unit1"> <a href="/dlse/" class="second-level-link">Labor Commissioner's Office</a> </li> <li class="unit1"> <a href="/dlse/Judgment-Enforcement-Unit.html" class="second-level-link">Judgment Enforcement Unit</a> </li> <li class="unit1"> <a href="/dlse/dlseWagesAndHours.html" class="second-level-link">Wages</a> </li> <li class="unit1"> <a href="/dlse/DistrictOffices.htm" class="second-level-link" aria-label="District Offices for DLSE">Offices</a> </li> <li class="unit1"> <a href="/dlse/dlse-bofe.html" class="second-level-link">BOFE</a> </li> <li class="unit1"> <a href="/dlse/DLSE-CL.htm" class="second-level-link">Minors</a> </li> <li class="unit1"> <a href="/dlse/outreach.html" class="second-level-link">Outreach</a> </li> <li class="unit1"> <a href="/dlse/Manual-Instructions.htm" class="second-level-link">Policy</a> </li> <li class="unit1"> <a href="/dlse/DLSE-Databases.htm" class="second-level-link" aria-label="Labor Law Databases">Databases</a> </li> <li class="unit1"> <a href="/dlse/DLSE_OpinionLetters.htm" class="second-level-link">Opinions</a> </li> <li class="unit1"> <a href="/dlse/dlseRetaliation.html" class="second-level-link">Retaliation</a> </li> <li class="unit1"> <a href="/dlse/Training.htm" class="second-level-link" aria-label="DLSE Training">Training</a> </li> <li class="unit1"> <a href="/wpnodb.html" class="second-level-link">Postings</a> </li> <li class="unit1"> <a href="/dlse/Registration_Services.html" class="second-level-link">Registration Services</a> </li> <li class="unit1"> <a href="/Public-Works/PublicWorks.html" class="second-level-link" aria-label="Public Works home page">Public Works</a> </li> <li class="unit1"> <a href="/dlse/ECU/ElectricalTrade.html" class="second-level-link">Electrician Certification</a> </li> </ul> </div> </li> <li class="nav-item"> <a href="/dosh/" class="first-level-link">Cal/OSHA - <br class="hide-small-and-medium" />Safety & Health</a> <div class="sub-nav"> <ul class="second-level-nav"> <li class="unit1"> <a href="/dosh/" class="second-level-link">Cal/OSHA Home</a> </li> <li class="unit1"> <a href="/dosh/consultation.html" class="second-level-link">Consultation</a> </li> <li class="unit1"> <a href="/dosh/Enforcementpage.htm" class="second-level-link">Enforcement</a> </li> <li class="unit1"> <a href="/dosh/HeatIllnessInfo.html" class="second-level-link">Heat Illness Prevention</a> </li> <li class="unit1 linex2"> <a href="/dosh/puborder.asp#IIPP" class="second-level-link">Injury & Illness Prevention Program</a> </li> <li class="unit1"> <a href="/dosh/cal_vpp/vpp_index.html" class="second-level-link">Partnership Programs</a> </li> <li class="unit1"> <a href="/dosh/Payment_options.html" class="second-level-link">Payment Options</a> </li> <li class="unit1 linex2"> <a href="/permits-licenses-certifications.html" class="second-level-link">Permits, Registrations, Certifications, & Licenses</a> </li> <li class="unit1"> <a href="/dosh/PublicSafety.html" class="second-level-link">Public Safety</a> </li> <li class="unit1"> <a href="/dosh/Required-Notifications.html" class="second-level-link">Required Notifications</a> </li> <li class="unit1 linex2"> <a href="/dosh/Worker-Health-and-Safety-in-Wildfire-Regions.html" class="second-level-link">Worker Safety & Health in Wildfire Regions</a> </li> <li class="unit1"> <a href="/wpnodb.html" class="second-level-link">Workplace Postings</a> </li> </ul> </div> </li> <li class="nav-item"> <a href="/dwc/" class="first-level-link"><br class="show-large-up" />Workers' <br class="hide-1280-up hide-small-and-medium" />Comp</a> <div class="sub-nav"> <ul class="second-level-nav"> <li class="unit1"> <a href="/dwc/" class="second-level-link">Workers' Comp Home</a> </li> <li class="unit1"> <a href="/dwc/a_z_index.htm" class="second-level-link">A - Z Index</a> </li> <li class="unit1"> <a href="https://www.dir.ca.gov/DWC/CourtCalendar/CourtCal.asp" class="second-level-link">Court calendar</a> </li> <li class="unit1"> <a href="/dwc/DEU.html" class="second-level-link">Disability Evaluation Unit</a> </li> <li class="unit1"> <a href="/dwc/dir2.htm" class="second-level-link" aria-label="District Offices for Division of Workers' Compensation">District Offices</a> </li> <li class="unit1 linex2"> <a href="/dwc/eams/eams.htm" class="second-level-link">Electronic Adjudication Management System</a> </li> <li class="unit1"> <a href="/dwc/employer.htm" class="second-level-link">Employer Information</a> </li> <li class="unit1"> <a href="/dwc/IMR.htm" class="second-level-link">Independent Medical Review</a> </li> <li class="unit1 linex2"> <a href="/dwc/IandA.html" class="second-level-link">Information and Assistance Unit</a> </li> <li class="unit1"> <a href="/dwc/injuredworker.htm" class="second-level-link">Injured Worker</a> </li> <li class="unit1"> <a href="/dwc/MedicalUnit/imchp.html" class="second-level-link">Medical Unit</a> </li> <li class="unit1 linex2"> <a href="/RTWSP/RTWSP.html" class="second-level-link">The Return-to-Work Supplement Program</a> </li> <li class="unit1"> <a href="/dwc/claims.html" class="second-level-link">UEBTF & SIBTF</a> </li> </ul> </div> </li> <li class="nav-item"> <a href="/osip/" class="first-level-link"><br class="show-large-up" />Self <br class="hide-1280-up hide-small-and-medium" />Insurance</a> <div class="sub-nav"> <ul class="second-level-nav"> <li class="unit1"> <a href="/osip/" class="second-level-link" aria-label="About Self Insurance">Self Insurance Home</a> </li> <li class="unit1"> <a href="/osip/AppRequirements.htm" class="second-level-link" aria-label="About Self Insurance">About</a> </li> <li class="unit1"> <a href="/osip/SelfInsuredEmployers.htm" class="second-level-link" aria-label="Self-insurance information for Employers.">Employers</a> </li> <li class="unit1"> <a href="/osip/SI-groups/index.html" class="second-level-link">Groups</a> </li> <li class="unit1"> <a href="/osip/examination.htm" class="second-level-link">Third Party Administrators</a> </li> <li class="unit1"> <a href="/osip/PublicEntitiesAndJPA.htm" class="second-level-link">Joint Power Authorities</a> </li> <li class="unit1"> <a href="/osip/OSIP-AuditUnit.html" class="second-level-link" aria-label="Self Insurance Audit Unit">Audits</a> </li> <li class="unit1"><a href="/osip/pubandforms.htm" class="second-level-link" aria-label="Forms related to Self-Insurance">Forms</a> </li> <li class="unit1"> <a href="/osip/lawsandregs.htm" class="second-level-link" aria-label="Regulations related to OSIP">Regulations</a></li> <li class="unit1"> <a href="/osip/generalinfo.htm" class="second-level-link" aria-label="Contact Office of Self Insurance">Contact</a> </li> </ul> </div> </li> <li class="nav-item"> <a href="/das/" class="first-level-link"><br class="hide-small-and-medium" />Apprenticeship</a> <div class="sub-nav"> <ul class="second-level-nav"> <li class="unit1"> <a href="/das/" class="second-level-link">Apprenticeship Home</a> </li> <li class="unit1"> <a href="/databases/das/aigstart.asp" class="second-level-link">Apprenticeship Search</a> </li> <li class="unit1"> <a href="/das/publicworks.html" class="second-level-link" aria-label="Public Works apprenticeship requirements">Public Works</a> </li> <li class="unit1"> <a href="/das/ProgramSponsor.htm" class="second-level-link">Sponsors</a> </li> <li class="unit1"> <a href="/databases/das/descOfAppr.html" class="second-level-link">Overview</a> </li> <li class="unit1"> <a href="/das/educators.htm" class="second-level-link">Educators</a> </li> <li class="unit1"> <a href="/das/employers.htm" class="second-level-link" aria-label="Apprenticeship information for employers">Employers</a> </li> <li class="unit1"> <a href="/das/veterans.html" class="second-level-link">Veterans</a> </li> </ul> </div> </li> <li class="nav-item"> <a href="/directors_office.html" class="first-level-link"><br class="show-large-up" />Director's <br class="hide-1280-up hide-small-and-medium" />Office</a> <div class="sub-nav"> <ul class="second-level-nav"> <li class="unit1"> <a href="/directors_office.html" class="second-level-link">Director's Office Home</a> </li> <li class="unit1 linex2"> <a href="/OLA/default.html" class="second-level-link">Office of Legislative and Regulatory Affairs</a> </li> <li class="unit1 linex2"> <a href="/OPRL/Statistics_Research.html" class="second-level-link">Office of the Director - Research</a> </li> <li class="unit1 linex2"> <a href="/Division/Decisions-and-Determinations.html" class="second-level-link">Office of the Director - Decisions and Determinations</a> </li> <li class="unit1"> <a href="/mediaroom.html" class="second-level-link">Press Room</a> </li> <li class="unit1"> <a href="/Public-Works/PublicWorks.html" class="second-level-link" aria-label="Public Works home page">Public Works</a> </li> <li class="unit1"> <a href="/osip/sip.html" class="second-level-link">Self Insurance Plans</a> </li> <li class="unit1"> <a href="/LETF/LETF.html" class="second-level-link">Labor Enforcement</a> </li> <li class="unit1"> <a href="/aboutdir.html" class="second-level-link">About DIR</a> </li> </ul> </div> </li> <li class="nav-item"> <a href="/BoardsAndCommissions.html" class="first-level-link"><br class="hide-small-and-medium" />Boards</a> <div class="sub-nav"> <ul class="second-level-nav"> <li class="unit1 linex2"> <a href="/BoardsAndCommissions.html" class="second-level-link">Boards and Commissions Home</a> </li> <li class="unit1 linex3"> <a href="/chswc/chswc.html" class="second-level-link">Commission on Health and Safety and Workers' Compensation (CHSWC)</a> </li> <li class="unit1 linex2"> <a href="/oshsb/oshsb.html" class="second-level-link"><span style="font-weight:normal">Occupational Safety & Health </span><span style="font-weight:bold; opacity:.85;">Standards Board</span> (OSHSB)</a> </li> <li class="unit1 linex2"> <a href="/oshab/oshab.html" class="second-level-link">Occupational Safety & Health <span style="font-weight:bold;opacity:.85;">Appeals Board</span> (OSHAB)</a> </li> <li class="unit1 linex2"> <a href="/wcab/wcab.htm" class="second-level-link">Workers' Compensation <span style="font-weight:bold;opacity:.85;">Appeals Board (WCAB)</span></a> </li> <li class="unit1"> <a href="/AB1228/AB1228.html" class="second-level-link">Fast Food Council</a> </li> <li class="unit1 linex2"> <a href="/iwc/iwc.html" class="second-level-link">Industrial Welfare Commission (IWC)</a> </li> </ul> </div> </li> </ul> </nav>   </div> </header>   <div id="main-content" class="main-content"> <div class="container p-t-md"> <main class="main-primary" id="main">   <ol class="breadcrumb"> <li><a href="/osip/">Office of Self-Insurance Plans (OSIP)</a></li> </ol>    <h1>Self-Insurance Groups</h1> <br /> <div class="displaybox box-3 floatrighttop" style="width:20em;max-width:20em;box-sizing:content-box;margin-right:8px; position:relative;"> <h2 style="text-align: center">SIG Self-Insurance by the Numbers - 2023</h2> <p ><strong>$7.7 Billion</strong> total self-insured payroll <br> <strong>224,991 </strong> CA Workers covered by self-insurance <br> <strong>25</strong> CA Groups are active self-insurers <br> <strong>1,863</strong> CA Group members are active self-insurers <br> <strong>$236</strong> <strong>Million</strong> Estimated Claims Reserves (EFL) <br> <strong>$108</strong> <strong>Million</strong> Medical and Indemnity payments <br> <strong>5,020 </strong>Open Workers’ Compensation cases </p> <div class="clear_right"></div> </div> <p>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.</p> <div class="displaybox box-92" > <ul> <li><a href="SIG-Requirements.pdf" class="pdf_link">SIG Requirements</a></li> <li><a href="Definitions.pdf" class="pdf_link">SIG Definitions</a>  </li> </ul> </div>    <div class="displaybox box-4"> <ul> <li><a href="SIGBoardMemberResponsibilities.pdf" class="pdf_link">SIG Board of Trustee Duties and Responsibilities </a> </li> <li><a href="SIGAffiliateMemberResponsibilities.pdf" class="pdf_link">SIG Member Responsibilities </a> </li> <li><a href="SIGAuditorGuidanceLetter.pdf" class="pdf_link">SIG Auditor Responsibilities and Reports</a></li> </ul> </div> <h3>Roster of self-insured groups and their affiliate members </h3> <ul> <li><a class="pdf_link" href="/OSIP/Rosters/GroupRoster/siGroupRosterMaster.pdf">Group self-insurers roster</a><a aria-label="Group Self-insurers roster" class="excel_link" href="/OSIP/Rosters/GroupRoster/siGroupRosterMaster.xlsx"> Excel version</a> </li> </ul> <h3>OSIP SIG Aggregate Statistics</a></h3> <ul> <li><a href="Annual-Aggregate-Group-Totals-2023-AR.pdf">Annual Aggregate Group Totals 2023</a></li> <li><a href="Annual-Aggregate-Group-Totals-2022-AR.pdf">Annual Aggregate Group Totals 2022</a></li> <li><a href="Annual-Aggregate-Group-Totals-2021-AR.pdf">Annual Aggregate Group Totals 2021</a></li> <li><a href="Annual-Aggregate-Group-Totals-2020-AR.pdf">Annual Aggregate Group Totals 2020</a></li> <li><a href="Annual-Aggregate-Group-Totals-2019-AR.pdf">Annual Aggregate Group Totals 2019</a></li> <li><a href="Annual Aggregate Group Totals 2018 AR.pdf">Annual Aggregate Group Totals 2018</a></li> <li><a href="Annual Aggregate Group Totals 2017 AR.pdf">Annual Aggregate Group Totals 2017</a></li> <li><a href="Annual Aggregate Group Totals 2016 AR.pdf">Annual Aggregate Group Totals 2016</a></li> <li><a href="Annual Aggregate Group Totals 2015 AR.pdf">Annual Aggregate Group Totals 2015</a></li> <li><a href="Annual Aggregate Group Totals 2014 AR.pdf">Annual Aggregate Group Totals 2014</a></li> <li><a href="Annual Aggregate Group Totals 2012.pdf">Annual Aggregate Group Totals 2012</a></li> <li><a href="Annual Aggregate Group Totals 2011.pdf">Annual Aggregate Group Totals 2011</a></li> <li><a href="Annual Aggregate Group Totals 2010.pdf">Annual Aggregate Group Totals 2010</a></li> </ul> <hr /> <div class="displaybox box-12" > <p><strong>GROUP FORMS</strong> - Below are forms for use that are specific to groups.</p> <ul> <li><a href="/OSIP/FormS-1.pdf" class="pdf_link">Form S-1</a> (1-2016) <br /> Group master application for certificate of consent to self-insure</li> <li><a href="/OSIP/FormS-2A.pdf" class="pdf_link">Form S-2A</a> (1-2016) <br /> Group affiliate member interim application </li> <li><a href="/OSIP/FormS-2B.pdf" class="pdf_link">Form S-2B</a> (1-2016) <br /> Application for affiliate certificate of consent to self-insure as a member of a group self-insurer </a></li> </li> <li><a href="/OSIP/FormS-3.pdf" class="pdf_link">Form S-3</a> (1-2016)<br /> Corporate resolution </li> <li><a href="/OSIP/FormS-4.pdf" class="pdf_link">Form S-4</a> (1-2016)<br /> Indemnity agreement and power of attorney</li> <li><a href="/OSIP/FormS-5.pdf" class="pdf_link">Form S-5</a> (1-2015)<br /> Agreement of assumption and guarantee of workers’ compensation liabilities for group and affiliate members</li> <li><a href="/OSIP/FormS-6.pdf" class="pdf_link">Form S-6</a> (1-2016)<br /> Agreement and undertaking for security deposit</li> </ul> </div>  <p class="page-date">June 2024 </p> </main>  <div class="main-secondary" role="navigation" aria-label="Common links for self insurance.">    <div class="panel-heading sidebar-title"> <h2>Office of Self-Insurance Plans (OSIP)</h2> </div> <div class="panel panel-default"> <div class="panel-heading"> <h3>Quick Links</h3> </div> <div class="panel-body"> <ul> <li><a href="https://efiling.dir.ca.gov/OSIPO/">OSIP Online Services</a></li> <li><a href="/osip/payments-invoices.htm">Make a Payment</a></li> <li><a href="/osip/AppRequirements.htm">Get information about self-insurance and the requirements to self-insure</a></li> <li><a href="/osip/examination.htm">Third Party Administrator and Qualified Administrator Information</a></li> <li><a href="/osip/databases/sisr/default.aspx">Determine if an employer is self-insured</a></li> <li><a href="/osip/databases/adminpass/Default.aspx">Determine if a person holds a Qualified Administrator's certificate </a></li> <li><a href="/osip/OSIP-FAQ.htm">Frequently Asked Questions (FAQs)</a></li> </ul> </div> <div class="panel-heading"> <h3>Related Links</h3> </div> <div class="panel-body"> <ul> <li><a href="https://www.securityfund.org/government">Self-Insurers' Security Fund<span class="ca-gov-icon-external-link"></span></a></li> <li><a href="http://www.caself-insurers.com/">California Self-insurers' Association<span class="ca-gov-icon-external-link"></span></a></li> <li><a href="http://www.siia.org/i4a/pages/index.cfm?pageid=6305">Self-insurance Institute of America</a></li> <li><a href="http://www.ca-sig.org/">CA-SIG<span class="ca-gov-icon-external-link"></span></a></li> </ul> </div> <div class="panel-heading"> <h3>About OSIP</h3> </div> <div class="panel-body"> <ul> <li><a href="/osip/AppRequirements.htm">About Us</a></li> <li><a href="/osip/generalinfo.htm">Contact</a></li> <li><a href="/osip/sitemap.htm">OSIP site map</a></li> <li class="home_link"><a href="/osip/sip.html">OSIP Home</a></li> </ul> </div> </div>  </div>  </div> </div>   <footer id="footer" class="global-footer" lang="en"> <button class="return-top"><span class="sr-only">Back to top</span></button>  <div class="section" style="background-color:#444;"> <div class="container"> <div class="upper_footer"> <div class="row"> <div class="col-md-4 footer_links"> <h2>About DIR</h2> <ul> <li><a href="/aboutdir.html">Who we are</a></li> <li><a href="/divisions_and_programs.html">DIR Divisions, Boards & Commissions</a></li> <li><a href="/Tribal-Consultation.html">Tribal Consultation</a> <li><a href="/Contactus.html">Contact DIR</a></li> </ul> </div> <div class="col-md-4 footer_links"> <h2>Work with Us</h2> <ul> <li><a href="/dirjobs/dirjobs.htm">Career Opportunities</a></li> <li><a href="/permits-licenses-certifications.html">Licensing, registrations, certifications & permits</a></li> <li><a href="/dosh/Required-Notifications.html">Required Notifications</a></li> <li><a href="/pra_request.html">Public Records Requests</a></li> </ul> </div> <div class="col-md-4 footer_links"> <h2>Learn More</h2> <ul> <li><a href="/Bilingual-Services-Act/default.html">Acceso al idioma</a></li> <li><a href="/faqslist.html" aria-label="Index of frequently asked questions at DIR">Frequently Asked Questions</a></li> <li><a href="/federal-funding-disclosure.html">Federal Funding Disclosure</a></li> <li><a href="/sitemap/sitemap.html" aria-label="Site map for the DIR website">Site Map</a></li> </ul> </div> <div class="clear_left"></div> </div> </div> </div> <div class="container lower_footer" style="max-width:100%;font-size:93%;padding-top:15px;padding-bottom:15px;background:#292929;"> <a href="/RaI/ReportAnIssue.aspx" class="btn btn-app footer-issue-button">Report a website issue</a> <div class="row"> <div class="three-quarters center" style="padding-top:4px;width:80%;margin-left:10%;"> <ul class="footer-links"> <li><a href="#skip-to-content">Back to Top</a></li> <li><a href="/od_pub/conditions.html">Conditions of Use</a></li> <li><a href="/od_pub/disclaimer.html" aria-label="Disclaimer for DIR website.">Disclaimer</a></li> <li><a href="/od_pub/privacy.html">Privacy Policy</a></li> <li><a href="/Nondiscrimination-Notice.html">Nondiscrimination Notice</a></li> <li><a href="/accessibility.html">Accessibility</a></li> <li><a href="/od_pub/help.html">Site Help</a></li> <li><a href="/ContactUs.html">Contact DIR</a></li> </ul> </div> <div class="quarter text-right" style="width:10%;"> <ul class="socialsharer-container" style="padding-top:6px;"> <li><a href="https://www.facebook.com/CaliforniaDIR"><span class="ca-gov-icon-share-facebook dark-bkg" aria-hidden="true" title="Facebook"></span><span class="sr-only">Flickr</span></a></li> <li><a href="https://twitter.com/#!/CA_DIR"><img class="x-icon" style="margin-top:3px;vertical-align:top;" src="/images/icons/x-logo-white.png" title="X (Twitter)" /></span><span class="sr-only">Twitter</span></a></li> <li><a href="http://www.youtube.com/CaliforniaDIR"><span class="ca-gov-icon-youtube" aria-hidden="true" title="YouTube"></span><span class="sr-only">YouTube</span></a></li> </ul> </div> </div> </div>  <div class="copyright"> <div class="container text-right"> Copyright © <span id="thisyear"> <script>document.getElementById('thisyear').appendChild(document.createTextNode(new Date().getFullYear()))</script> </span> State of California </div> </div> </footer>  <div class="decoration-last"> </div>  <div class="modal fade" id="gt-translate-modal" role="dialog" tabindex="-1"> <div class="modal-dialog modal-lg"> <div class="modal-content"> <div class="modal-header"> <h1 class="modal-title"><img src="/images/icons/icon_globe_large.png" style="vertical-align:bottom;" alt="" /> Language Services at DIR</h1> <button type="button" class="close btn btn-secondary" data-bs-dismiss="modal"><span class="sr-only">Close modal</span><span class="ca-gov-icon-close-mark" aria-hidden="true"></span></button> </div> <div class="modal-body">  <p>The Department of Industrial Relations (DIR) recognizes the importance of communicating effectively with individuals, including those with limited English proficiency. DIR is making an effort to provide meaningful services for individuals that speak languages other than English.</p> <h2 class="like-h3">If you need to access information in a language other than English:</h2> <ul class="spaced large"> <li style="margin-bottom:30px;"><h3 class="like-h4">Use the Google Translate function below:</h3> <div class="displaybox box-8" style="max-width:600px; padding-top:15px;background:#f0f0f0;"> <div id="google_translate_element"></div> <p style="margin-top:20px; padding-left:48px;text-indent:-45px;font-size:96%;"><strong>Note:</strong> This is a service provided by Google. Google Translate cannot translate all types of documents, and may not provide an exact translation.</p> </div> </li> <li><h3 class="like-h4">Contact DIR to request an interpreter over the phone:</h3> <table class="table offices vertical_lines"> <tr> <th>Office Name</th> <th>Topic</th> <th>Phone Numbers</th> </tr> <tr> <td>Cal/OSHA</td> <td>Workplace Safety and Health</td> <td>833-579-0927</td> </tr> <tr> <td>Labor Commissioner's Office</td> <td>Wages, breaks, retaliation and labor laws</td> <td>833-526-4636</td> </tr> <tr> <td>Division of Workers' Compensation</td> <td>Benefits for work-related injuries and illnesses</td> <td>1-800-736-7401</td> </tr> <tr> <td>Office of the Director</td> <td>Any other topic related to the Department of Industrial Relations</td> <td>844-522-6734</td> </tr> </table> </li> </ul>  </div> <div class="modal-footer"> <button type="button" class="btn btn-default" data-bs-dismiss="modal">Close</button> </div> </div> </div> </div>   <script src="https://california.azureedge.net/cdt/statetemplate/6.1.0/js/cagov.core.min.js"></script>  <script type="text/javascript"> function googleTranslateElementInit() { new google.translate.TranslateElement( // {pageLanguage: 'en', layout: google.translate.TranslateElement.InlineLayout.SIMPLE}, {pageLanguage: 'en'}, 'google_translate_element' ); } </script> <script type="text/javascript" src="https://translate.google.com/translate_a/element.js?cb=googleTranslateElementInit"></script>  <script src="/js/libs/jquery.js"></script> <script type="text/javascript" src="/js/libs/jquery.js"></script> <script type="text/javascript" src="/javascript/custom_scripts.js"></script>   </body> </html>

CINXE.COM

Self-Insurance Groups