Self-Insurance and Tax Office

Click here to view Insurance Carrier and Self-Insurance Tax Forms

Click here to view Self-Insurance Program Forms

Click here to view a PowerPoint presentation on the Self-Insurance Program

WORKERS' COMPENSATION COVERAGE VERIFICATION

ADMINISTRATIVE AND SPECIAL FUND ASSESSMENT RATES FOR CY 2019

At the Commission's public meeting held on October 18, 2018, the Commission established the following Administrative and Special Fund assessment rates for calendar year (CY) 2019:

ADMINISTRATIVE AND SPECIAL FUND ASSESSMENT RATES FOR CY 2018 

At the Commission's public meeting held on October 5, 2017, the Commission established the following Administrative and Special Fund assessment rates for calendar year (CY) 2018:

• 1.75% Administrative Fund tax under A.R.S. § 23-961(G); and
• 0.00% Special Fund assessment: 0.00% under A.R.S. § 23-1065(A) (for general Special Fund liabilities) and 0.00% under A.R.S. § 23-1065(F) (for apportionment liabilities)

As a result of the foregoing action taken by the Commission, the total tax/assessment rate was decreased to 1.75% for CY 2018, which is a 0.5% decrease from the 2.25% rate for CY 2017.
 

ADMINISTRATIVE AND SPECIAL FUND ASSESSMENT RATES FOR CY 2017 

At the Commission's public meeting held on October 20, 2016, the Commission established the following Administrative and Special Fund assessment rates for calendar year (CY) 2017:

• 2.25% Administrative Fund tax under A.R.S. § 23-961(G); and
• 0.00% Special Fund assessment: 0.00% under A.R.S. § 23-1065(A) (for general Special Fund liabilities) and 0.00% under A.R.S. § 23-1065(F) (for apportionment liabilities)

As a result of the foregoing action taken by the Commission, the total tax/assessment rate was increased to 2.25% for CY 2017, which is a 0.75% increase from the 1.50% rate for CY 2016.
 

INFORMATION ON OBTAINING ARIZONA WORKERS' COMPENSATION INSURANCE

Click for a list of Carriers Authorized To Write Workers Compensation In Arizona
Or
Contact the Independent Insurance Agents & Brokers of America at www.iiaba.net. (Go to search for Agent or Broker. When conducting a search, a specific Agent or Broker name is not required. However, please be sure to put the City and State in required fields. This will populate a complete Insurance Agent and Broker list for Arizona.)

Declined by two insurance carriers? You may qualify for the Assigned Risk Pool. For more information about the Assigned Risk Pool, please go to www.ncci.com. The Assigned Risk Pool information can be found under the residual market section of the website. The NCCI Assigned Risk can also be contacted at 505-242-1330 for more information.

SELF-INSURANCE AUTHORITY INFORMATION

Minimum Qualifications for Applying for Self-Insurance Authority

• Annual payroll of at least $2,000,000 (this may include the payroll of included subsidiaries)
• Total assets of $50,000,000 or a cash flow ratio of at least 0.25
• Have conducted business in Arizona for a minimum of 5 years (business can be conducted through a domiciled subsidiary company)

Under the provisions of A.R.S. § 23-961 and § 23-961.01, the Self-Insurance Office processes all initial and renewal applications from individual or group employers requesting authority to act as a self-insured entity for workers' compensation. Application forms may be found here.

Benefits of Being a Self-Insured Employer in Arizona

• Cost Control
• Direct Medical Care
• Pay losses directly and pay self-insured tax assessment amounts, not insurance premiums.

LINKS TO TABLES OF SELF-INSURED EMPLOYERS

Table of Authorized Self-Insured Employers