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Complete this form after meeting with the worker. After you and the worker sign, send to the self-insured employer or its representative.Self-Insured Option 2 Vocational Services Summary (F280-064-000). Self Insurance Vocational Reporting Form. Self Insurance Section. Download Fillable Form F280-064-000 In Pdf - The Latest Version Applicable For 2023. This should be in the form of a letter from the insurance carrier(s), showing the loss information for each year, and (4). This manual is a reference and training guide for the employers whom BWC has granted the privilege of self-insurance in the state of. Ohio. Are independent contractors I might hire for various jobs exempt from the Workers' Disability Compensation Act? What is self-insurance?