Member Information Update Form

Each year the Member Information Update Form is available online for access by the person designated by the self-insured company as the contact person. The form is not available for access by the Third Party Administrator unless the login information is provided to them by the contact person. This form must be submitted online to the Georgia Self-Insurers Guaranty Trust Fund by the due date or earlier in order to avoid being penalized.

Active Member Update Form

Please see the Login – Member Information Update Form tab located in the upper right hand corner of this website

Cancelled Member Update Form

Please see the Login – Member Information Update Form tab located in the upper right hand corner of this website

TPA Notice of Exemption Form

TPA Notice Of Exemption