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Workers Compensation Division Application for Reinsured Employer Group Read all instructions before completing this application. Answer all questions. Return this form to:Oregon Department of Consumer
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An application for self-insured is a form that allows companies to demonstrate financial responsibility to cover potential liabilities without purchasing traditional insurance.
Companies or organizations who want to self-insure their risks are required to file an application for self-insured.
The application for self-insured must be completed with detailed financial information and supporting documentation to show the ability to cover potential liabilities.
The purpose of the application for self-insured is to show that the company has the financial resources to cover potential liabilities without purchasing traditional insurance.
The application for self-insured must include detailed financial statements, risk management plans, and other supporting documentation to demonstrate financial responsibility.
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