Completed applications are to be sent in duplicate to the State Board of Workers' Compensation along with three years of audited financial statements and the application fee of $500. The check for the application fee must be made payable to the Georgia Self-Insurers Guaranty Trust Fund. After the application is reviewed by the State Board, one copy of the application, the financial statements, and the application fee are sent to the Georgia Self-Insurers Guaranty Trust Fund. The Trustees of the Georgia Self-Insurers Guaranty Trust Fund review the application and financial statements, and make a recommendation to the State Board regarding the acceptance of the applicant for self-insurance. The State Board has final authority regarding the acceptance of any applicant, and will issue an Order accepting or rejecting the applicant. The State Board's Order will state the provisions under which the applicant has been accepted, including the amount of security to be filed with the Georgia Self-Insurers Guaranty Trust Fund, the requirements for specific excess workers' compensation insurance, and payment of the initial assessment of $8,000.
Upon completion and approval of your company's application, your company is required to submit annually the audited Financial Statements, the Member Information Update Form, assessment fees and the specific excess workers' compensation insurance. Also, your company will be required to submit the following form with regard to your company's contact person and Georgia TPA/claims contact person information, click here.