Publications and Forms

A sample affidavit for former self-insured group trusts requesting release of security.

 

The application to be completed by an employer applying to individually self-insure.

 

The application to be completed by a group of employers applying to form a self-insured group trust.

 

The safety auditing procedures for those employers applying to individually self-insure.

 

An authorization for release of confidential information that must accompany the Irrevocable Letter of Credit (WC-249).

 

A Surety Bond; one of three options available to meet the self-insurance security requirement.

 

The checklist of required items and information that must accompany the Application for Authority to Self-Insure (WC-81).

 

This report, as required by §287.680 RSMo, briefly describes each of the programs and units and summarizes the transactions and proceedings undertaken for the year 2009.

 

This report, as required by §287.680 RSMo, briefly describes each of the programs and units and summarizes the transactions and proceedings undertaken for the year 2010.

 

This report, as required by §287.680 RSMo, briefly describes each of the programs and units and summarizes the transactions and proceedings undertaken for the year 2011.