Self insured employer status is available to those employers who excel in occupational health, safety and welfare (OHSW) and in the management and rehabilitation of their injured workers claims. It provides employers with greater flexibility and an opportunity to minimise overall costs. However, a decision to apply for self insured employer status involves considerable thought.

Self insurers remain subject to the Workers Rehabilitation and Compensation Act and must provide full benefits to their employees in accordance with the Act.

Before you apply

Before applying for self insurance you should note some key points, namely:

• An application fee is payable.
• On attaining self insurance an employer becomes directly responsible for all new claims from its workers, and must enter into a contract with WorkCover to manage any existing claims.
• Whilst there is no worker number requirement, WorkCover must consider whether the employer is large enough to be an effective self-insurer.
• The applicant must meet a set of financial criteria to establish its ability to meet claims liabilities. It would be unusual for an employer with net tangible assets of less than $50 million to be considered acceptable.
• The self insurer must provide, at its own cost, annual actuarial reports, financial guarantees, excess of loss insurance and transmit claims data to WorkCover.
• A self insurer must pay a levy as a contribution to the overheads of the WorkCover scheme and this includes a component to cover the liabilities of self insurers in the event of insolvency. This levy is a small percentage of what the employer would pay if it was not self insured.

To apply

The first step of an application is to contact WorkCover's, Self-insured Return to Work Services unit, to arrange a meeting.

Basic WorkCover policies on self insurance are set out in the Code of conduct for self-insured employers under the WorkCover Scheme.

If you have any questions about the information provided contact us on the feedback form.

Self-insurers manage and are liable for their own claims. Employers seeking registration as a self-insurer, or seeking to renew self-insurer registration, are expected to comply with all relevant parts of the code of conduct for self-insured employers under the WorkCover Scheme. Crown agencies must comply with all relevant parts of the South Australian South Australian Public Sector Code of Practice for Crown Self-insured Employers.

The Codes offers a framework of policies and procedures for administering your legal requirements in respect of self-insurer status.

WorkCover performance standards for self-insured provides a framework for employers and workers to get the best results from their occupational health, safety and welfare (OHSW) and rehabilitation and injury and rehabilitation management.

The performance standards relate to the design, implementation and effectiveness of OHSW and injury and rehabilitation systems within a continuous improvement framework.

The WorkCover evaluator will undertake an evaluation of the applicant's conformance with the performance standards. During the evaluation the applicant must aid the WorkCover evaluator in providing access to system documentation, plus human and physical resources.

Evaluations can also be conducted at other times if we think this is warranted.

If you fail or refuse to correct non-compliances we may decide to:

• not grant or renew the self-insurer registration
• reduce the period of registration or
• take other action.

In 2005 a multi-jurisdictional working party of regulatory bodies under the Heads of Workers Compensation Authorities was formed to develop an occupational health and safety audit program and set of guidelines that were agreed at a national level. The National Self-Insurer OHS Audit Tool - User Guide and Workbook is an outcome of that process.

Private national self-insurers may elect to have their OHSW system evaluated against the National Self-Insurer OHS Audit Tool - User Guide and Workbook, however WorkCover will still need to evaluate the self-insurer's injury management system against the WorkCover performance standards and the Natural Consequences Model will still apply.

Self-insurers who elect to be evaluated against the National Self-Insurer OHS Audit Tool - User Guide and Workbook are required to complete a self-audit using the Evaluation Practice Manual.

Further information relating to the Natural Consequences Model and Evaluation Practice Manual are outlined in the Code of conduct for self-insured employers under the WorkCover Scheme.

If you are a private national self-insurer and wish to obtain more information in relation to the National Self-Insurer OHS Audit Tool - User Guide and Workbook call WorkCover on 08 8233 2032.

National Self-Insurer OHS Audit Tool - User Guide and Workbook [1.57Mb]

The Corporation, under the Fourth Schedule to the Workers Rehabilitation & Compensation (Claims & Registration) Regulations, collects claims data from Self Insured Employers to enable the analysis, information exchange, performance evaluation and national comparisons of claims statistics.

Fourth schedule data

Since 1987 the Australian Safety and Compensation Council (ASCC) have collated annual claim statistics from all workers compensation jurisdictions throughout Australia.

As workers compensation benefits and entitlements vary between states and territories, the National Data Set for Compensation-based Statistics (NDS) was developed to allow uniformity and to allow for national comparison of this data.

Data Collection

Self-insured employers are required to transmit their Fourth Schedule Data to WorkCover on a fortnightly basis via our secure site. Some of the data submitted is the basis for the comparisons available in the Exempt Employer Reporting Tool.

Explanation of the required format, in which Self Insured Employers are to provide this information to WorkCover electronically, is documented in Exempt Claim Electronic Transfer System.

For a comprehensive list of data included in the NDS visit the ASCC website

Statistical coding

WorkCover classifies workers compensation injuries and/or diseases for the National Data Set from the information provided by the Self Insured Employer via Fourth Schedule Reporting.

Once a claim has been created at WorkCover, it is then coded using the Type of Occurrence Classification System (version 3), and the Australian Standard of Occupations (version 2). Any claims containing insufficient information for coding purposes are sent back to the Self Insured Employer by the Statistical Coder on a monthly basis with a request for additional information.

The classifications of these claims is the basis for the comparisons available in the Exempt Employer Reporting Tool. For a comprehensive list of data included in the Type Of Occurrence Classification System (version 3) visit the ASCC website.

Format 2 - Legal costs

Self-insured employers are required to provide WorkCover with a list of total legal costs paid in the previous year by 15 September each year.

Details of the aggregate data to be sent to WorkCover are contained in the document Format 2 Self insured employer information at the aggregate level. Note: These costs are for disputed claims only.

Format 2 spreadsheet

To submit your information please insert your data into the Format 2: Legal costs spreadsheet and email to the: Administrator for self-insured employers.

Further assistance

If you require any further assistance on claims data please contact self-insured.

Lump sum

WorkCover records data on Section 42, 43 and 44 payments made. The information you provide is entered onto our database and is used:

• for statistical purposes
• as the basis for historical information (when requests are made for notification of previous lump sum amounts paid to a worker)
• to reconcile payment data reported on individual claims.

Our lump sum calculations information sheet will assist you in correctly advising us of payments made to workers under Sections 42, 43 and 44 of the Workers Rehabilitation and Compensation Act 1986.

Use our Notice of Lump Sum Determination Return (NEW) for determinations made after 1 April 2009 or use our Notice of Lump Sum Determination Return (OLD) for determinations made before 31 March 2009.

WorkCover operates a secure environment to allow the exchange of certain confidential information with self insurers.

The elements Self Insurers may access through this site are:

• A reporting tool that allows a self insurer to obtain comparative industry information relating to incidence and severity of claims and safety performance.
• Delivery of electronic Prescribed Medical Certificates (ePMCs) provided by doctors in respect of the employer's workers.
• Submission of data requirements by the self insurer to WorkCover under the 4th schedule requirements.

Secure access

To access this secure site, you will need to have an official WorkCover identification code and password. To obtain the identification and password you must submit the form properly authorised by the self insured employer.

Please note: the identification and password are unique to the user and must not to be shared. If you leave the employ of the self insured employer, you must notify WorkCover to allow the access codes to be cancelled.

Secure reporting

• Enter employer reporting

If you have any questions about the information provided contact us on the feedback form.

Self Insurers of South Australia (SISA) is active in all aspects of injury prevention and injury management (rehabilitation and claims) and is responsible for the provision of cost-effective management services to its membership.

SISA provides relevant information to members in newsletters and bulletins on legislative matters, WorkCover regulations and business management systems.

It represents the interests of its members and provides a coordinated channel of communication with WorkCover, the State Government and Opposition and individual members of Parliament.

The association regularly liaises with employer and employee organisations.

For more information visit the SISA website.