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Request for Security Reduction

Every year in the Fall, all active members' security requirements are reviewed based on a review of the current year's Member Information Update Form. However, a member may request a reduction in security prior to this time if they feel a reduction is warranted.

In order for a member to be considered for a reduction in security, the following must be done:

The Fund will request a TPA Certification advising of the number of open claims and reserves. Also, you will be asked to provide a copy of your company's loss run to include all open claims and the last two (2) years of closed claims that occurred during the member's self-insurance period. The loss run must include the following data:

1. Name of Claimant
2. Date of Injury
3. Last 4 Digits of Claimant's Social Security number
4. Description of Injury
5. Medical Paid to Date
6. Indemnity Paid to Date
7. Unpaid Medical Reserves
8. Unpaid Indemnity Reserves

The member's request will then be placed on the next Board of Trustees meeting and the Trustees will make a recommendation that will be submitted to the State Board of Workers' Compensation. If the State Board agrees with the Trustees' recommendation, an order will be issued.

Forms

Self Administered Certification

TPA Certification