What should I do if I wish to terminate my self-insurance authority?

In order to terminate your self-insurance authority, please submit the following to the Division:
  • A formal notification from the self-insured employer who wishes to voluntarily terminate its self-insurance authority;
  • Detailed loss runs from the first date of self-insurance authority through the termination request date;
  • Self-Insurer′s past two years of audited financials; and
  • Copy of certificate of insurance for the replacement coverage.
  • The Division may require additional information.

Feedback and Knowledge Base