Maryland Application for Self-Insurance and Instructions

State:
Maryland
Control #:
MD-SKU-1487
Format:
PDF
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Description

Application For Self-Insurance

Maryland Application for Self-Insurance and Instructions is a document issued by the Maryland Insurance Administration (MIA) to assist those who wish to apply for self-insurance in the state of Maryland. It contains various forms and instructions related to self-insurance, such as the Application for Self-Insurers, the Self-Insurer's Financial Statement, the Certification of Self-Insurer, and the Self-Insurer's Surety Bond. The Application for Self-Insurers is used to provide information about the applicant's business, operations, and financial situation. The Self-Insurer's Financial Statement is a financial statement that is used to demonstrate the applicant's ability to self-insure. The Certification of Self-Insurer is used to certify that the applicant is in compliance with all applicable insurance laws and regulations. The Self-Insurer's Surety Bond is a financial assurance that is required for all self-insurers in Maryland.

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FAQ

Every year, the Maryland workers' compensation rates are (supposed to be) adjusted for inflation. For 2021, the rates are as follows: Temporary Total Disability ? 2/3 of the average weekly wage, not to exceed $1,050/week. Permanent Total Disability ? 2/3 of the average weekly wage, not to exceed $1,050/week.

Self-insurance is also called a self-funded plan. This is a type of plan in which an employer takes on most or all of the cost of benefit claims. The insurance company manages the payments, but the employer is the one who pays the claims.

Current regulatory financial requirements for an organization desiring entry into self-insurance are: Three calendar years in business in a legally authorized business form. Three years of certified, independently audited financial statements. Acceptable credit rating for three full calendar years prior to application.

File the online Employer's First Report Of Injury Form. The injured worker can file their claim online- Employee Claim Form (Form C-1) online. Request the WCC Employer's First Report of Injury Form or Employee Claim Form C-1 hardcopy to be mailed via US Postal Service mail.

A business owner who is a sole proprietor, a partner in a business partnership, or an independent contractor does not need to be covered by Maryland workers' compensation insurance. However, they might decide to buy this coverage to protect against the high cost of medical expenses.

60 days: All workers' compensation claims should be filed with the Commission within 60 days of the injury or the discovery of an occupational illness. 2 years: Employees who fail to file accidental injury claims within two years will be barred from receiving compensation forever.

The amount of money awarded depends upon the severity of the employee's injury. Successful claims cover medical expenses, partial payment of lost wages, and, in the case of death, funeral expenses. Additional compensation is also provided for cases of severe and permanent injury.

The Employer's First Report of Injury (FROI) IAIABC 1A-1 (WCC # SF-1) is filed by the employer or their workers' compensation insurance carrier. The injured worker will file the Employee Claim Form C-1. A First Report of Injury (FROI) must be filed by the employer/insurer with the Workers' Compensation Commission.

More info

No authorization for self-insurance will be approved unless a completed application form has been received. Complete the Balance Sheet providing profit and loss to date.A certified copy of a complete specific excess insurance policy, with Maryland endorsements is required. The carrier must be admitted in. Forms are in PDF format. APPLICATION FOR SELF-INSURANCE. Assigned Self-Insurance Certificate Number: If new applicant, please leave blank. Application must be completed in its entirety. SELF-INSURANCE CERTIFICATE APPLICATION. You can complete the Application for Renewal of Authorization to Operate as a Self-Insured Policy (SI-7) here.

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Maryland Application for Self-Insurance and Instructions