Welcome to the Department of Industrial Relations
Boards, Commissions & Programs

Self Insurance Plans (SIP)

Public Self Insurer's Annual Report

acrobat pdfPDF form requests*  

(The annual report form is NOT available from 12:05 AM to 6:00 AM, Pacific time, Tuesday through Friday, and Sunday.)

To login, please enter User ID,  Password, and select either Employer or TPA/Self Administrator.

User ID:   Password:  
Select user type:   Employer
TPA/Self Administrator

 

acrobat pdf Adobe Acrobat Reader version 6 will work best. Click here to download.
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