Compliance Guide

This guide is intended to provide your company with information on the filing requirements for individual self-insurers for workers’ compensation pursuant to Section 440.38, Florida Statutes.

Continuing Self-Insurance Reporting Requirements

Continuing Self-Insurance Reporting Requirements for Terminated Self-Insurers

Form-SI-4F-Surety-Bond-for-FSIGA-Member (DOC - Acrobat format)

SELF-INSURER'S SURETY BOND FOR FSIGA MEMBER

Form-SI-4F-Surety-Bond-for-FSIGA-Member (DOC - Word Format)

Form SI-5 - Payroll Report (includes instructions)

SELF-INSURER PAYROLL REPORT (includes instructions)

Form SI-6 - Letter of Credit (PDF - Acrobat Format)

SELF-INSURER’S IRREVOCABLE LETTER OF CREDIT

Form SI-6 - Letter of Credit (DOC - Word Format)

SELF-INSURER’S IRREVOCABLE LETTER OF CREDIT. In .DOC format (Microsoft Word compatible).

Form SI-10 - Parental Guaranty (PDF - Acrobat Format)

PARENTAL GUARANTY AND CORPORATE RESOLUTION FOR SELF-INSURED SUBSIDIARY ENTITY.

Form SI-10 - Parental Guaranty (DOC - Word Format)

PARENTAL GUARANTY AND CORPORATE RESOLUTION FOR SELF-INSURED SUBSIDIARY ENTITY. In DOC format (Microsoft Word compatible).

Form SI-11 - Indemnity Agreement

INDEMNITY AGREEMENT

Form SI-19 - Certification of Servicing

CERTIFICATION OF SERVICING FOR SELF-INSURERS

Form SI-20 - Report of Outstanding WC Liabilities (includes instructions)

REPORT OF OUTSTANDING WORKERS’ COMPENSATION LIABILITIES

FSIGA Plan of Operation

The current Plan of Operation of the Florida Self-Insurers Guaranty Association, Inc.

Rule 69L-5

CHAPTER 69L-5: RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT