Florida Self-Insurers Guaranty Association, Inc.

 

 

*** The following forms can now be completed prior to printing: SI-1, SI-5, SI-17, SI-19 and SI-20 *** 

 

Forms and Documents

FSIGA Plan of Operation

Order Approving Plan of Operation

Rule 69L-5, Florida Administrative Code - Effective March 9, 2010

Form SI-4F - Surety Bond for FSIGA Member 

Form SI-5 - Payroll Report  (includes instructions)                     

Form SI-6 - Letter of Credit       (also in  Word format)

Form SI-10 - Parental Guaranty   (also in Word format)

Form SI-11 - Indemnity Agreement

Form SI-17 - Unit Statistical Report (includes instructions)

Form SI-17 - Electronic Reporting File Format Specifications

Form SI-19 - Certification of Servicing 

Form SI-20 - Report of Outstanding WC Liabilities (includes instructions) 

Compliance Guide for Self-Insurers

Continuing Self-Insurance Reporting Requirements for Terminated Self-Insurers

 

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