The Official Web Site of the State of South Carolina

ADVISORY NOTICE

At the January 13, 2025 Business Meeting, the Commission approved a change to the 2025 business meeting calendar for the month of July. The full advisory may be accessed here. 

At the Business Meeting on January 13, 2025, the Commission received a summary of proposed changes to the Medical Services Provider Manual. A public hearing has been scheduled for February 10, 2025 to receive public comment on the proposed changes. The full advisory and the summary may be accessed here. 

 

Self-Insurance Forms

The South Carolina Workers’ Compensation Commission offers the following forms applicable to self-insurance procedures. 

If you require assistance, please contact the Self-Insurance Division

Self-Insurance Division
Telephone: 803-737-5412
self-insurance@wcc.sc.gov

 

6

Application to Create a Self-Insurance Fund

PDF

Doc

$250.00

6A

Application for Membership in a Self-Insured Fund

PDF

 

$25.00

7

Application to Individually Self-Insure

PDF

Doc

$250.00 plus $100.00 for each subsidiary

7A

Corporate Guaranty

PDF

Doc

No fee

8

SC Workers’ Compensation Commission Bond Required of
Employer Carrying His Own Risk

PDF

Doc

No fee

8B

Irrevocable Letter of Credit

PDF

Doc

No fee

10

South Carolina Self-Insurance Tax Form

PDF

 

No fee

11

Fund Quarterly Financial Report

PDF

Doc

No fee