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Requirements of the Self-Insurance Program
The State and
its political subdivisions may self-insure without further order of the Department if they
do not carry a policy covering all or part of their risks, and if they agree to report
faithfully all compensable injuries and agree to comply with the Act and rules of the
Department.
- Who May Self-Insurer?
(Minimum Requirement)
For all other employers, the minimum
requirements or standards for an exemption from the duty to insure, other than for the
State and its political subdivisions are:
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An
employer desiring an exemption from the duty to insure must file an application on
Department form WKC-7211, which may result in a hearing before the Self-Insurers Council.
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Corporations, limited liability
companies, and limited partnerships shall be registered in the office of the Wisconsin
Department of Financial Institutions.
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If the applicant is a corporation, limited liability company, or a partnership and is a
wholly or majority owned subsidiary, a guaranty of worker's compensation payments must be
submitted on a Department form, executed by the ultimate or top parent company, and be
accompanied by a certified copy of a resolution adopted by the board of directors of the
top parent company, authorizing and directing the execution of the guaranty.
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Applications by corporations must be accompanied by a certified copy of the
resolution adopted by the applicant's board of directors authorizing and directing the
execution of the application and agreement forms. Applications by organizations other than
corporations shall be signed by one or more persons possessing authority to act for the
applicant. Partnerships must submit a consent by all the partners that all individuals
executing the application have the authority to act for the applicant partnership.
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All applicants, when submitting an initial request for self-insurance, shall
submit audited financial statements (which include the opinion of a certified public
accountant) for a minimum of the latest five years. To remain self-insured, unaudited
quarterly and audited annual financial statements must be submitted as soon as they become
available. Companies which submit Form 10Q to the SEC electronically need not send
quarterly reports to this Department, but must send the annual report to shareholders.
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It is recommended that the employer employ persons located in Wisconsin with
knowledge of claims administration under Wisconsin's Act, and occupational safety and
health. The persons may be employees of the applicant, its parent company, a subsidiary
company, or a service company hired by the employer and acceptable to the Department.
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The employer must have
acceptable safety and health performance as measured by worker's compensation statistics
and other occupational injury and illness information, including, but not limited to, the
employer's federal Occupational Safety and Health Administration (OSHA)
compliance and their experience
modification factors for the past few years.
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The employer shall
furnish satisfactory security (guaranty bond and excess worker's compensation insurance),
financial reports and reports on outstanding liabilities before and after self-insurance
is granted, not renewed, terminated or revoked, as the Department requires to assure the
payment of all past, present, existing and potential worker's compensation liability.
- Can an employer insure a portion of its
operations with an insurance carrier and self-insure another, separate
portion?
The Department may grant partial
insurance upon being shown that there will be no confusion between the insured and
self-insured portions of the employer's liability. Unless the separation of employees and
payroll is clear and concise, it has been found that, from the standpoint of the injured
worker, divided or partial coverage is not desirable because it leads to a delay in the
settlement of the claim. In addition, a good deal of expense on the employees part to
recover the worker's compensation to which they are entitled may occur. This is a burden
that the injured employee should not bear. It is also important that proper payroll
records be kept to enable the insurance carrier to determine the appropriate premium
charges.
The self-insurance application contains a section inquiring if all operations are to be
self-insured by special Department order. If an employer intends to insure any of its
worker's compensation risk in Wisconsin with a full coverage policy, the operation should
be clearly identified, and the employer should provide the exact name of the insurance
carrier, the policy number, and the policy ending date.
Under the Act, if a dispute should arise between the full coverage insurance carrier
and the self-insured employer on the question of responsibility for payment, the employer
shall assume full responsibility to immediately make all payments of compensation and
medical expenses to the injured employee, without waiting for the dispute to be
settled. An employer's exemption from the duty to insure is void if the employer carries a full
coverage policy with an insurance carrier and has not applied to the Department and
received permission for partial insurance coverage.
- What about bonds and
excess insurance?
Are all self- insured employers required to carry either
or both?
The Department requires that an employer provide security and excess insurance
coverage as a condition for self-insurance.
* Security:
The minimum amount is $500,000. The amount may be greater based upon the analysis of
each employer's financial capacity, and upon the likelihood and severity of injury or
disease within the employer's occupational classifications.
* Excess insurance:
Excess insurance policies must be procured from a worker's compensation insurance
carrier licensed by the Wisconsin Commissioner of Insurance to write worker's compensation
insurance in Wisconsin, and must be written upon the basis of rates and policy form filed
with and approved by the Wisconsin Compensation Rating Bureau, P.O. Box 3080, Milwaukee,
Wisconsin 53201-3080. (Phone: (262) 796-4540) An actual copy of the excess policy must be
on file with the Bureau. Again, excess insurance retention and upper limit of indemnity
amounts are based upon the individual analysis of each employer's ability to withstand
catastrophe. Any contract between an unauthorized carrier and a self-insurer must be
reported to the Department immediately upon inception of the agreement.
- What is the application
fee?
A non-refundable fee of $1,100 per parent plus $100 for each subsidiary to
be self-insured, shall accompany the initial application(s). An application must be
submitted for each Wisconsin employer in a corporate family. The check or money order
should be made payable to the
Department of Workforce Development.