Section 8.46.020. Application procedures for self-insurance authorization.

	(a)  An employer shall apply for self-insurance authorization on a form prescribed by the department. The completed application must be  
		(1) filed with the division at least 90 days before the desired effective date of self-insurance;  
		(2) signed before a person authorized to take an oath, affirmation, or acknowledgement;  
		(3) accompanied by the employer's audited financial statements for the three fiscal or calendar years immediately preceding the filing of the application form; the employer may submit consolidated financial statements of the employer's parent company if the employer does not have its own audited financial statements and the employer is a majority or wholly-owned subsidiary; a governmental entity must submit audited comprehensive annual financial reports, including detailed schedules, for the three fiscal or calendar years immediately preceding the filing of the application form;  
		(4) accompanied by a description of the proposed excess insurance, including the effective dates, the types of coverage, the conditions and exclusions, the limits and retentions of each type of coverage, and a guarantee of coverage until the division receives a copy of the policies;  
		(5) accompanied by a parent company's guarantee of the subsidiary's obligations under the act, if the employer is a majority or wholly-owned subsidiary; and  
		(6) accompanied by a security deposit as required under 8 AAC 46.045.  
	(b)  The application must be accompanied by a summary of the employer's or the employer's parent company's losses, for three fiscal or calendar years immediately preceding the filing of the application. The summary of losses must be categorized by year by  
		(1) number of medical-only claims;  
		(2) number of indemnity claims;  
		(3) number of fatalities;  
		(4) total incurred loss;  
		(5) total paid loses;  
		(6) total amount of reserves for incurred and unpaid losses;  
		(7) total amount of loss within retention limit;  
		(8) amount of loss subject to reinsurance or excess recovery; and  
		(9) amount of loss subject to subrogation recovery.  
	(c)  An employer shall submit, as part of the supporting documentation with the application, a detailed outline or manual of the employer's safety and loss control programs.  
	(d)  An employer shall report for the most recent three years, its total Alaska payroll, Alaska workers' compensation losses, and premiums paid.  

Authorities

23.30.005;23.30.075;23.30.090;44.62.125

Notes

Reference

8 AAC 46.015

Authority

AS 23.30.005 AS 23.30.075 AS 23.30.090 Editor's note: As of Register 151 (October 1999), the regulations attorney made technical revisions under AS 44.62.125(b)(6) to reflect the name change of the Department of Labor to the Department of Labor and Workforce Development made by ch. 58, SLA 1999 and the corresponding title change of the commissioner of labor.

History

Eff. 11/20/83, Register 88; am 7/20/97, Register 143; am 7/2/98, Register 146; am 6/20/2010, Register 194