The Texas Workers Compensation Self-Insurance Group (SIG) Change in Performance or Fidelity Bond Checklist is used to verify that bond requirements for self-insured employers in Texas are met. The checklist contains two parts: (1) Change in Performance Bond and (2) Fidelity Bond. The Change in Performance Bond is required for all self-insured employers in Texas and must be renewed annually. It is designed to protect the workers’ compensation funds of the State of Texas in the event the employer fails to meet its obligations. It is issued by an authorized surety and must include the name of the employer as the principal and the State of Texas as the obliged. The Fidelity Bond is also required for all self-insured employers in Texas and must be renewed annually. It is designed to protect the workers’ compensation funds of the State of Texas in the event of any fraudulent or dishonest act by the employer or its employees. It is issued by an authorized surety and must include the name of the employer as the principal and the State of Texas as the obliged. The Texas Workers Compensation Self-Insurance Group (SIG) Change in Performance or Fidelity Bond Checklist must be completed and submitted to the Texas Department of Insurance (TDI) prior to the start of the new policy year. The checklist requires the employer to provide the following information: 1. Bond Number 2. Bond Expiration Date 3. Surety Company Name 4. Surety Company Address 5. Bond Amount 6. Bond Premium 7. Policy Number 8. Policy Expiration Date 9. Signature of Authorized Representative The Texas Workers Compensation Self-Insurance Group (SIG) Change in Performance or Fidelity Bond Checklist must also be completed and returned to the Texas Department of Insurance (TDI) within 30 days of any change in the bond information. This includes changes in the bond amount, bond premium, surety company name, or policy expiration date.
Texas Workers Compensation Self-Insurance Group (SIG) Change in Performance or Fidelity Bond Checklist
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How to fill out Texas Workers Compensation Self-Insurance Group (SIG) Change In Performance Or Fidelity Bond Checklist?
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