Schools Insurance Program for Employees

WORKERS' COMPENSATION SERVICES

The public school districts and Cuesta College Community College in San Luis Obispo County are self-insured for workers' compensation benefits through SIPE. SIPE uses a third-party administrator (TPA), York Insurance Services for claims administration. This partnership has created a cost effective program, assures quality care to the injured employee, and provides proficient managed care, so the employee returns to work as soon as possible. 

SIPE provides workers' compensation coverage for its Members a self-insured retention (SIR) level of up to $250,000 per occurrence. Claims exceeding the SIR are covered by excess insurance provided by Liberty Mutual and Republic Indemnity.

Under the authority of the Department of Industrial Relations, Self-Insured Division, SIPE self-insures all work related injuries by levying a premium to Member districts using a base rate and assigning an experience modification factor to each member to arrive at a net rate. Premiums are used to pay claims, third-party claims administration, and SIPE administrative costs.

Information for Employees

Each employee is required to immediately report injuries to their supervisor regardless of the severity of the injury or illness. 

What to do if you get injured at work?

• If the injury or illness is an emergency and requires urgent medical care, have someone call 911.
• Immediately report the incident to your supervisor or designated person.

What to expect after reporting a work related injury or illness?

• Prompt medical care if requested or necessary.
• Your employer will give you a Medical Release Form and DWC-1, Workers’ Compensation Claim Form. Complete and return this form immediately if you wish to open a claim or seek medical attention. State law requires that this form be provided to you or a dependent within one (1) working day of receiving notice or knowledge of any injury being work related.
• With your input, a supervisor or designated person will complete a SIPE Accident Investigation Report Form to evaluate any potential safety conditions or hazards for prevention purposes and to determine if any addition safety training is necessary.
• If injury or illness requires medical care, you will be referred you to your district’s designated medical facility, unless you have pre-designated your personal physician prior to the injury.
• Return copies of provided forms to designated person including, Physicians Authorization to Render Medical Care and Return to Work Evaluation.   
• Depending on physician’s return to work evaluation, you may be released to full duty, released with work restrictions or limitations, or remain off work.
• Within a few days, you will be contacted by telephone and/or U.S. mail from a representative from York Insurance Services, SIPE’s claim administrators. In some cases, you may also be contacted by an investigator wishing to interview you about your claim.
• Return all requested documentation in a timely manner to avoid a delay in your claim.

Information and Forms for Districts - Click here to go to the member’s area.