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Division Director

Tanner Holloman

Assistant Director

Andrew Sabolic

Workers' Compensation
200 East Gaines Street
Tallahassee, FL 32399-0318
Workers' Compensation Claims
(800) 342-1741
Workers' Compensation Exemption/ Compliance
(850) 413-1609

Mandatory Filing Requirements

Private Self-Insured Employers are required to file important information on an annual basis with the Division of Workers’ Compensation. A self-insurer is responsible for being aware of these obligations and their corresponding due dates. Florida statutes and rules specify the required information that must be filed, the form it must be provided on, and when the form is due. Self-insurers that do not file their information timely are subject to penalties (69L-5.217, F.A.C.). Please use the forms below for reporting required information to the Florida Self-Insurers Guaranty Association, Incorporated.

Mandatory Filing Requirements Checklists

Active Private Self-Insured Employers (Checklist)

Former (Terminated) Private Self-Insured Employers with Open Claims (Checklist)

Mailing Address:

  • Florida Self-Insurers Guaranty Association, Incorporated
    427 East Piedmont Drive, 2nd Floor
    Tallahassee, Florida 32308

Contact FSIGA: