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What must an employer do to maintain the self-insurance privilege? Make payable to: Department of Labor Workers' Compensation Administrative Trust Fund. 22.Name of excess insurance carrier (if any). The self-insuring employer must post a copy of the Certificate of Employer's Right to Pay Compensation. (8) Payment of any required application filing fee. PROVIDED IN THE MISSISSIPPI WORKERS' COMPENSATION ACT AS A SELF-INSURER. Application for self-insurance under Sections 65. APPLICATION TO SELF-INSURE. The undersigned, an employer subject to the current and future provisions of the North Carolina. Please list all Utah self-insured claims not paid in full.