Information for Canceled Members

CANCELLATION OF SELF-INSURANCE

If you are a member company that wants to cancel self-insurance in Georgia, please submit a formal letter to notify us of your cancellation date, along with proof of workers’ compensation coverage going forward. The formal letter and supporting documents should be e-mailed to gafund@deflaw.com.

Although you have canceled your self-insurance, you will continue to be responsible for the claims that occurred while you were self-insured. Therefore, the Georgia Self-Insurers Guaranty Trust Fund and the State Board of Workers’ Compensation will maintain the security presently on file. Please see the requirements of canceled members below.

SECURITY
Your letter of credit or surety bond will be maintained in our files until you have satisfied the requirements of, requested, and been granted an elimination of security. Please see the “Security” section of this website for information related to eliminations of security.

MEMBER INFORMATION UPDATE FORMS
You must continue to complete and submit the Member Information Update Form annually until your security has been returned and your file closed.

FINANCIAL STATEMENTS
A complete copy of audited financial statements for each fiscal year is required of all self-insured employers. You must continue to forward a copy of the audited financial statements to us until you’ve been canceled for five (5) years.

ASSESSMENTS/PENALTIES
As long as the Member Information Update Form is required, the annual assessment fee is required. The annual assessment fee is calculated as 1.5% of medical/indemnity paid, as reported on the MIUF; however, the minimum assessment fee is $2,000 and the maximum assessment fee is $8,000.

CLAIMS AUDITS
You may be required to submit to a claims audit of open and closed Georgia self-insured workers’ compensation claims.

LOSS PORTFOLIO TRANSFER

If your company cancels self-insurance and does not want to continue annual reporting to the Georgia Self-Insurers Guaranty Trust Fund, maintain security on file, submit financial statements, and pay assessment fees and penalties, you can complete a Loss Portfolio Transfer.

  • The Loss Portfolio Transfer company must have an A.M. Best Rating of “A” or better.
  • Deviations from the approved language are not permitted.
  • Both the Loss Portfolio Transfer and Assumption Agreement and the Addendum must be completed.
  • The “Effective Date” of the Loss Portfolio Transfer and Assumption Agreement andAddendum must be on or after the date your company cancels self-insurance.
  • The first blank on page 2 of the Loss Portfolio Transfer and Assumption Agreement should be the date your company was approved for self-insurance in the state of Georgia. If you are unsure of this date, please contact the Georgia Self-Insurers Guaranty Trust Fund.
  • Once all five originals have been signed by the Administrator of the Georgia Self-Insurers Guaranty Trust Fund and the State Board of Workers’ Compensation, security will be returned and your company’s file will be closed.

You must submit five executed originals to the Georgia Self-Insurers Guaranty Trust Fund.

 

  1. For you
  2. For the Loss Portfolio Transfer Company
  3. For the State Board of Workers’ Compensation
  4. For the Georgia Self-Insurers Guaranty Trust Fund
  5. For the bank or bonding company that issued the current security

LOSS PORTFOLIO TRANSFER FORMS

The decision of which of the two forms will be used in any given case (Loss Portfolio Transfer and Assumption Agreement – Employer no longer exists or Loss Portfolio Transfer and Assumption Agreement – Employer still exists) will be based upon the factual circumstances of that case. Additionally, the forms are subject to final approval by the Georgia Self-Insurers Guaranty Trust Fund and the State Board of Workers’ Compensation.