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A self-insured employer must submit the information below to the Workers’ Compensation Division. The employer may be fined if it does not meet these requirements. If there are concerns with the employer’s certification, the director may require a self-insured employer to provide annual documentation more frequently.
This applies only to self-insured employer groups. Submit documentation that validates the balance of the group’s common claims fund by March 1 (see OAR 436-050-0300):
The employer may request that the common claims fund be combined with the existing security deposit by March 1.
Submit current excess policies according to OAR 436-050-0170:
Submit audited financial report or statement according to OAR 436-050-0175:
Security deposits are updated March through December (see OAR 436-050-0160, 0180, and 0185):
To submit a renewal or new contract, see OAR 436-050-0210:
All self-insured employers and employer groups must submit a report of all claim losses by March 1 of each year.
This information is used to help determine the following:
Employers and employer groups that do not provide the information in accordance with Bulletin 209 may be subject to civil penalties and revocation of self-insurance certification.
Report of losses forms may be submitted using any of the following methods:
The Workers’ Compensation Division may require self-insured employers to complete a claims reserve audit on their annual report of losses. The purpose of the claims reserve audit is to ensure each self-insurer’s claims are valued appropriately for use in deposit, experience rating, and retrospective rating calculations used to secure claim liabilities in the event of a default or insolvency.
The claims reserve audit methodology includes:
Workers’ Compensation Division
Business Identification Number
Employer coverage indexing
Small Business Ombudsman for Workers’ Compensation
Active and Inactive Self-Insured Employers
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