South Dakota Statutes

§ 58-20-27 — Application for self

South Dakota·Title 58 INSURANCE·Ch. 58-19 WORKERS' COMPENSATION INSURANCE

An association proposing to self - insure its workers' compensation liability shall apply to the department for the authority to self - insure, using forms available from the department. The application shall include:

(1)The association's name;
(2)The location and mailing address of the association's principal office and where its books and records are kept;
(3)The name and address of each member of the association;
(4)A copy of the bylaws or plan of operation adopted by the association;
(5)Proof of compliance with § 58-20-28 ;
(6)A sample copy of the agreement between the association and the members securing the payment of each member's workers' compensation liability;
(7)A pro forma financial statement, on a form acceptable to the department, showing the finan

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South Dakota § 58-20-27 (Application for self) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Legislative History

SL 1995, ch 282, § 3.

Nearby Sections

15
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