Workers' Compensation Depository

Instructions for Applying to Become a Workers' Compensation Depository

A. Requirements

A Workers' Compensation Depository pursuant to California Insurance Code (CIC) §11691 must meet the following requirements:

1. The financial institution must be one of the following:
   1. Bank authorized to do trust business
   2. Savings and Loan Association authorized to do trust business
   3. Trust Company.
2. The institution must be located in California.
   1. State institutions must be incorporated in California.
   2. National Institutions must have its official main office (designated in the charter) in California.
3. The institution must have both:
   1. Minimum deposits of $750 million, and
   2. Minimum net worth of $100 million, or can demonstrate to the satisfaction of the commissioner that the institution is financially secure.

B. Procedure

Send a letter with the filing fee for applying to be a qualified custodian pursuant to CIC §1104.9(a)(5) (which also applies to depositories) designated in the current Schedule of Fees, to the California Department of Insurance, Corporate Affairs Bureau,1901 Harrison Street, 6th Floor, Oakland, CA  94612. (Fees are nonrefundable.) Explain how the institution meets the three requirements. Attach documents which verify compliance (copies of state or federal license, charter, and annual report or other document showing deposits and net worth.) Please provide a contact person for further correspondence. If the financial institution has any questions, please contact the Department at (415) 538-4035, or CAB-SF-Intake@insurance.ca.gov.

Instructions for Filing a Workers’ Compensation Depository Agreement

A. Requirements

Once the financial institution has been approved as a workers compensation depository, in order to act as such for an insurer, the financial institution must file a workers’ compensation trust agreement with the Insurance Commissioner. This is a three-party agreement between the financial institution, the workers’ compensation insurer and the Commissioner.

Use the Workers' Compensation Deposit Trust and Security Agreement (PDF)

1. Execute the form in quadruplicate, with all original signatures.
    
2. Attach to the back of the trust agreement form three schedules designated as A., B., and C.
   1. Schedule A should list the sum of all securities.
   2. Schedule B should list all securities where ownership is evidenced by credit on the books of account and records in the Federal Reserve Bank.
   3. Schedule C should list securities where ownership is evidenced by credit on the books of account and records of a qualified depository.

B. Procedure

File the depository agreement with the California Department of Insurance, Corporate Affairs Bureau, 1901 Harrison Street, 6th Floor, Oakland, CA  94612. Attach the filing fee for filing the trust agreement designated in the current Schedule of Fees (fees are non-refundable) and provide a contact person for further correspondence. If the financial institution has any questions, please contact the Department at (415) 538-4035, or CAB-SF-Intake@insurance.ca.gov.

Deposits must be held in accordance with CIC §11691 and the Workers' Compensation Deposit Regulations, Title 10 of the California Administrative Code, §§2509.1 to 2509.20. Please note that a financial institution that qualifies to be workers’ compensation depository also qualifies to be a Qualified Custodian under §1104.