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  Main Office
  1212 Court St NE
  Salem, OR 97301
  Phone: 503-763-3800
  Fax: 503-763-3900

  Claims Office
  PO Box 1469
  Lake Oswego, OR 97035
  Phone: 503-763-3875
  Fax: 503-763-3901

CIS is a member service of the League of Oregon Cities and Association of Oregon Counties


  
 
 
Document/Forms required to obtain a quote:
 
Self-Assessment Survey

 Workers’ Compensation Application

Document/Forms required when you become a Member:
 
State of Oregon WCD Endorsement to Self-Insured Group Application

CIS Group Self-insurance Resolution

Sample Volunteer Resolution

Sample Statement of Non-Coverage For Volunteers

Common Forms, Sample Letters and Resolutions
 
Common forms, sample letters and resolutions are available on the Members Only Portal.
 
 
   FILING A CLAIM
Emergency Notification Process

Claims Contact Information

WC 801 Claim Form

WC Incident Report Form

Automobile Crash Report

General Liability Claim Form

Property Claim Form 
   LATEST NEWS
New Oregon Minimum Wage of $8.40/hr effective 1/1/2009

2009 Workers' Compensation Premium Assessment Rate effective January 1st

Workers' Compensation Pure Rates changes on 1/1/2009

STIPENDS paid to volunteer workers can be excluded from subject

Flood & Earthquake Coverage

   UPCOMING EVENTS


Safety Committee Training
Sep 15, 2010 - Sep 15, 2010
Benton County