State of Alaska > DOLWD > Workers'
Compensation > Self
Self Insurance - Velma Thomas, Program Coordinator
Every employer who has employees working in Alaska must purchase and keep in effect a workers’ compensation insurance policy, or become approved as a self-insured employer.
In order to qualify as a self-insured employer in Alaska, a company must
- Have been in business within this state for at least five years;
- Have at least 100 employees;
- Have a net worth of at least $10,000,000;
- Have the financial ability to meet current and future obligations under the Act;
- Have a safety/loss program in effect;
- Provide claims services in Alaska either through its own staffed facility, or through independent, licensed, resident adjusters; and
- Agree to post any security deposit required.
An employer who meets these conditions may apply for a Certificate of Self-Insurance by completing and submitting an application Form
07-6129. The application must be accompanied by
- Audited financial statements for the three fiscal or calendar years immediately preceding the filing of the application;
- A copy of the binder or a description of proposed excess insurance including the effective dates, type of coverage, conditions and exclusions, the limits and retentions of each type of coverage, and a guarantee of coverage until the board receives a copy of the policy;
- Statistical information regarding total Alaska payroll, Alaska workers’ compensation losses, and premiums paid for the past three years;
- A copy of or a detailed outline of its safety/loss control program; and
- A security deposit in the amount of $600,000 or 125% of the total accrued workers’ compensation liability, whichever is greater. The security deposit must be in the form of an irrevocable letter of credit from a financial institution authorized to conduct business in Alaska.
In addition to the above, a company which is a majority or wholly owned subsidiary must provide a written guarantee from its parent company. A joint venture must provide a copy of its operating agreement and audited financial statements for the three fiscal or calendar years immediately preceding the filing of the application for each general partner.
A Certificate of Self-Insurance is valid for a period of one year from the date of issue, and may be renewed on application Form
Qualifying as a Self-Insured Employer in Alaska
Application for Certificate of Self-Insurance and Parent Company Guarantee (Form 6129)
Parent Company Guarantee (in PDF)
Renewing Status as a Self-Insured Employer in Alaska
Renewal of Certificate of Self-Insurance (Form 6130)
Self-Insured Employers in Alaska