Revision : 2
Record Description : The SIDN (Self Insured Identification Number) is a number assigned to a new application used by employers applying for new self insured coverage. Then a file is created which includes the application. Then the Self Insured department reviews the file for approval for self insurance coverage. If the file is approved it is assigned a BWC policy number. The information contained in the file are as follows: SI-6 Application, SI-6 page 2, SI-38 Unconditional Contract Guaranty, SI-8 Rehab Opt Out form, SI-41 Handicap Opt Out form, SI-44 Claims Reimbursement Opt Out form, SI-16 Buyout Agreement, Medical Management Questionaire, Financial statements, Secretary of State Certificate and a Safety Manual.