Regulating self-insured

ReturnToWorkSA is responsible for the regulation of self-insurers.

The maximum period of registration as a private self-insurer is five years. Self-insurer performance is reviewed throughout the period of registration to determine on-going compliance and whether registration should be renewed, and the length of the period of renewal.

Registration - terms and conditions

In accordance with terms and conditions of registration, a self-insured employer is required to provide ReturnToWorkSA with current information on its operations, liabilities and financial performance.  Mandatory requirements include:

Financial Statements
  • Audited copies of a self-insured employer’s financial statements must be provided each year, within 5 months after the end of the employer’s financial year.
Actuarial Reports and Financial Guarantee
  • An actuary report must be provided each year within 3 months after the end of the employer’s financial year. The actuary report is used to calculate the value of the financial guarantee.
  • On receiving an actuary report, ReturnToWorkSA will calculate the value of the required financial guarantee and notify the self-insured employer if a new financial guarantee is required.  Actuarial reports and financial guarantees must comply with the guideline for actuary reports and financial guarantees (DOCX, 502 KB).
  • The minimum guarantee amount for the 2020 calendar year is $900,000.
Excess of Loss
  • A self-Insured employer must maintain an excess of loss insurance policy. The requirements of the policy are contained within the code of conduct for self-insured employers (PDF, 7971 KB).
  • Excess of loss insurance policies should be submitted to ReturnToWorkSA on, or prior to the expiry of the current policy.

Financial statements, excess of loss insurance policies and actuary reports should be submitted to SelfInsured@rtwsa.com.

Claims Data
Lump sum payments
  • We record data on lump sum payments made to injured workers by self-insured employers. The information you provide is entered into 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.
  • Self-insured employers are required to notify us of any lump sum payment via their EDI data transmission.

Evaluation of private self-insured employers

We will undertake an evaluation of all private self-insured employers prior to the end of each registration period.

Evaluation involves desktop and site based activity to confirm whether the self-insured employer continues to meet the conditions of registration.

Evaluations are undertaken in line with the code of conduct for self-insured employers (PDF, 7971 KB) and the self-insured registration and evaluation practice guideline (DOCX, 626 KB).

Evaluations will test the employer’s compliance to the requirements of registration as a self-insured employer, including conformance to the injury management standards (DOCX, 481 KB) and work health and safety standards (DOCX, 520 KB).

A guide to the injury management standards (DOCX, 506 KB) and guide to the work health and safety standards   (DOCX, 846 KB) has been developed to assist employers in demonstrating compliance.

In addition to evaluations, ReturnToWorkSA may undertake periodic reviews of an employer’s compliance to the requirements of registration. These reviews are normally associated with a specific term and condition applied to an individual self-insured employer’s registration.

Registration - compliance

Registration as a self-insured employer carries with it certain responsibilities and obligations. A self-insured employer must ensure the delegated powers and discretions are administered in accordance with the objects and requirements of the Return to Work Act 2014, and compliance with the terms and conditions of registration is maintained.

ReturnToWorkSA views circumstances where an employer is unable or unwilling to comply with the requirements of registration to be a serious matter. Examples of matters considered serious include, but are not limited to:

  • material non-compliance with the terms and conditions of registration
  • material non-compliance to the requirements of the Act, or Code of conduct for self-insured employers
  • material non-compliance to the requirements of the injury management standards or the work health and safety standards
  • non-provision of suitable employment, where the self-insured employer has not demonstrated it is not reasonably practicable to do so
  • unreasonable exercise of delegated powers and discretions
  • non-provision of life time care and support of seriously injured workers
  • failure to implement an order of the South Australian Employment Tribunal
  • administration of a delegation with a bias toward the interest of the self-insured employer.

Where a self-insured employer is unable or unwilling to comply with the requirements of registration, ReturnToWorkSA may impose a sanction. Sanctions may include:

  • applying a term or condition on the self-insured employer’s registration
  • reducing or revoking a period of registration
  • non-renewal of registration
  • removal of the self-insured employer’s delegations.