To become
self-insured for workers’ compensation purposes in Oregon, an employer must submit the
following:
An application in a format prescribed by the director
(Available upon request: Jody Howatt, 503-947-7699.)
Proof of the employer’s
claims processing ability
Annual or audited financial statements for the last three fiscal years, along with the “SEC
Form 10K” (a Securities and Exchange Commission form) if issued
Evidence of an occupational safety and health loss control program
Most recent experience rating modification worksheet
Types and retention levels of excess insurance
Evidence of ability to obtain a surety bond or an irrevocable standby letter of credit
Security
deposits
Security deposits are required to guarantee continued payment of claim liabilities in the case
of default. Adequacy of security deposits is reviewed annually and may be required to be increased
depending upon claim liability, financial condition, and excess insurance coverage.
Insolvent
employers
The Self-Insured Employer Adjustment Reserve and the Self-Insured Employer Group Adjustment
Reserve provide funds to pay claims in the event the self-insured employer, or the self-insured
employer group, fails or is unable to make payments due under ORS Chapter 656.
Self-insured
employer group
Five or more employers may be approved to form a self-insured employer group in accordance
with ORS 656.430.
Number
of self-insured employers
There are approximately 155 current active certified self-insured employer plans in Oregon,
which include approximately 1000 employers. There are currently about 950 employers who are
members of seven self-insured employer groups.
If you have questions about this webpage, please contact Jody Howatt, 503-947-7699.
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An application in a format prescribed by the director
