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EXCEPTION: A Certificate to Self-Insure that is revoked for three full years is not required to submit this employment and wage information. Forms are in PDF format.Every quarter you must report claim costs and worker hours. The Self-Insured Employer - Annual Hospital Report Instructions provide information on completing the Self-Insured Employer - Annual Hospital Report Form. The application is to be completed in full and accompanied by: (1). Self-insurer's latest audited annual financial report;. Annual Report 2021. Each CSI is a member of the Texas Certified SelfInsurance Guaranty Association (TCSIGA). INDIVIDUAL SELF-INSURERS. QUARTERLY. Workers' compensation claims for any self-insured employer.