California Code of Regulations
Title 8 - Industrial Relations
Division 1 - Department of Industrial Relations
Chapter 8 - Office of the Director
Subchapter 2 - Administration of Self-Insurance Plans
Article 13 - Group Self-Insurance
Section 15483 - Agreement of Assumption and Guarantee of Group Member's Liabilities

(a) Each group self-insurer shall provide an Agreement of Assumption and Guarantee of Liabilities of Workers' Compensation Liabilities For Group Members for each group member, executed by the group self-insurer or Group Administrator on its behalf if authorized in the group self-insurer's bylaws. If the group self-insurer does not execute an Agreement of Assumption and Guarantee of Liabilities of Workers' Compensation Liabilities For Group Members for any proposed group member, the Director shall deny the application to self-insure of the proposed group member, or, if an Interim Certificate of Consent to Self-Insure has been issued to a group member and the group self-insurer declines to execute an Agreement of Assumption and Guarantee of Liabilities of Workers' Compensation Liabilities For Group Members for that group member, it shall be cause for revocation of the Affiliate Certificate of Consent to Self-Insure of the group member.

(b) In addition, each group member that is a subsidiary or affiliate or is otherwise controlled or owned by another entity shall provide an Agreement of Assumption and Guarantee of Liabilities executed by the holding company, ultimate parent company, controlling general partners, owner, or owners having controlling ownership as required for subsidiaries and affiliates of individual private self insurers by Section 15211.2 of these regulations. If the holding company, ultimate parent company, controlling general partnership, or owner having controlling ownership of the group member declines to execute an Agreement of Assumption and Guarantee of Liabilities, the Director may deny the application of the proposed group member. If a group member is acquired by another entity while the group member is self-insured and that new holding company, ultimate parent company, controlling general partnership, or owner having controlling ownership declines to execute an Indemnity Agreement and Power of Attorney (Form S-4 (1-2016)), it shall be deemed cause for revocation of the group member's Affiliate Certificate of Consent to Self-Insure.

(c) The Agreement of Assumption and Guarantee of Liabilities For Group and Affiliate Members shall be written upon a form provided by the Chief (Form S-5 (1-2015)). The form is available on the website of the Office of Self-Insurance Plans at http://www.dir.ca.gov/osip.