Membership
Dear Indiana Self-insurer and Self-insurance professional:
It is time to renew your ISIA membership for 2019. ISIA is the only organization in Indiana dedicated to serving Indiana employers and claims professionals who self-insure and administer worker’s compensation self-insurance obligations. ISIA works for its members and with other employer groups and the Indiana Worker’s Compensation Board to make sure that the Indiana Worker’s Compensation Act remains responsive and effective.
Please review our HOME page at www.indianaselfinsurers.org for a description of ISIA and its goals and please renew your ISIA membership today.
Sincerely,
INDIANA SELF-INSURERS ASSOCIATION, INC.
Robert Fanning, Executive Director
2019 NEW MEMBER AND RENEWAL APPLICATION
The Indiana Self-Insurers Association, Inc. is a nonprofit association of Indiana employers which self-insure their worker’s compensation obligation (Corporate Membership) and of companies which provide services to self- insured employers (Associate Member).
ANNUAL DUES FOR CORPORATE MEMBERS are based on the number of Indiana employees:
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Fewer than 500
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$350.00
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500 but fewer than 2,000
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$425.00
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2,000 but fewer than 5,000
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$475.00
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5,000 but fewer than 10,000
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$525.00
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10,000 or more
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$700.00
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ANNUAL DUES FOR ASSOCIATE MEMBERS are: $350.00
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Click Here To Download the Form Fillable PDF of the Application.
2019 New Member and Renewal Online Application
Please make check payable to:
“Indiana Self-Insurers Association, Inc.” (IRS #35-1420875)
Mail Check & Application to:
Robert Fanning, Executive Director
P.O. Box 160
Syracuse, IN 46567
Remember you can just Download the Form Fillable PDF of the Membership Form and mail it in.