State of Connecticut Workers' Compensation Commission, John A. Mastropietro, Chairman
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Sec. 31-284-2

Administrative Regulation

Self-Insurance Certification:

Application process: Application Filing; Application Form; Insurance; Certificate of Self-Insurance.

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Sec. 31-284-2. Application process.

(a) Application Filing. An employer who seeks exemption from insuring its risk under the Workers’ Compensation Act shall apply to the Chairman of the commission or his designee for the privilege of becoming an individual self-insurer. An employer who is approved to self-insure agrees to meet by cash payments, all obligations incurred by it under the Act as such become due and payable. An employer who is approved to self-insure is subject to the Commission’s rules and regulations as adopted or amended and subject to the Commission’s full right and authority to prescribe new and additional rules and regulations. The Commission’s authority and its rules and regulations pertaining to self-insurance shall continue to apply to all employers previously self-insured until all liabilities incurred while self-insured have been fully discharged.

(b) Application Form. Application shall be made on the Commission’s prescribed form and signed by an officer of the corporation, partnership, or the proprietor. All questions shall be answered fully and all required documentation shall be attached.

(c) Insurance. Workers’ compensation insurance shall be maintained during the application process and until self-insurance authorization is effective. Applications from employers who do not have insurance as required by the Act pursuant to Section 31-284 of the general statutes shall not be considered.

(d) Certificate of Self-Insurance. Employers approved to self-insure are granted a certificate of self-insurance for a one-year period, or the otherwise stated duration on the certificate. The certificate shall be renewed annually, except for municipal employers issued certificates that are continuous until revoked. The Commission may stagger renewal dates of certificates to facilitate its workload. A certificate of self-insurance applies only to the applicant and its affiliated businesses or subsidiaries included in the application. Other affiliates or subsidiaries may be included under a self-insurer’s certificate in the future upon the approval of the Chairman or his designee.

(Effective October 1, 1996)

NOTE: See also Administrative Regulation Section 31-279-1, Claims Administration

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Workers’ Compensation Commission

Page last revised: July 29, 2014

Page URL: http://wcc.state.ct.us/law/wc-regs/31-284-2.htm

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State of Connecticut Workers' Compensation Commission, John A. Mastropietro, Chairman
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