New York Codes, Rules and Regulations
Title 12 - DEPARTMENT OF LABOR
Chapter V - Workers' Compensation
Subchapter B - Self-insurers
Part 315 - Regulations
Section 315.1 - Application

Universal Citation: 12 NY Comp Codes Rules and Regs ยง 315.1

Current through Register Vol. 46, No. 12, March 20, 2024

(a) Every employer desiring to become a self insurer shall make application in form prescribed by the chairman. This application shall contain:

(1) a payroll report filed by classification code, for the five preceding annual fiscal periods;

(2) a report in a format determined by the chairman indicating compensation and medical losses (payments plus reserves), for a period up to 10 years prior to the date of application;

(3) the most recent, certified, independently audited financial statement of the employer, and copy of form 10K, if any, filed by the employer with the Securities and Exchange Commission. A subsidiary company may submit the consolidated financial statement of the parent company in lieu of its own individual financial statement. In such event, however, the parent company must guarantee the liability of the subsidiary company under the Workers' Compensation Law, by filing with the chairman, an Agreement of Assumption and Guarantee in form approved by the chairman;

(4) a description of the safety organization maintained by the employer for the prevention of accidents; and

(5) a description of the business operations performed or to be performed by the employer.

(b) If, upon examination of the certified, independently audited financial statement and other data submitted, the chairman is satisfied as to the ability of the employer to make current compensation payments and that the employer's tangible assets and profit and loss history make the payment of all obligations that may arise under the Workers' Compensation Law, reasonably certain, the application may be granted subject to the conditions herein provided. The chairman will notify the employer of approval or nonapproval of his or her application within 120 days.

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