Board Members

Membership Qualifications

The Minnesota Self-Insurers' Association is a non-profit organization dedicated to represent member companies and associations in all matters relating to the Minnesota Workers' Compensation Act and state requirements for self-insurance status.

Membership Qualifications

1. Applicant must fully self insure or retain at least $250,000.00 in workers compensation liability, and abide by the rules and regulations of all State agencies that govern self-insurance.

OR

2. Applicant (associate) must be a business with a significant interest in workers' compensation issues.

3. Approved member's business must agree to abide with the By-Laws and the Articles of Incorporation of the MSIA and name a representative/s who are employees of that Company/Association.

 

Membership Application

Business Name:     Contact Information Name:   Business Address:   Address (Cont):   City:    State:      Zip:        Phone:   Fax:   Email:         Business Function:     -- SELECT-- Attorney Construction Government Services Manufacturing Medical Services Rehabilitation/Vocational Services Other       Business Affiliation with MSIA     --- SELECT --- Administration Employer Medical Rehabilitation Vocational Other       Number of MN Employees:         Self Insured:   Yes      No