Senate Bill 189 Changes Applicable to New and Renewal Policies Effective July 1, 2018

Senate Bill 189 changed California Labor Code Sections 3351 and 3352 allowing eligible corporate and cooperative officers and directors, general partners, limited liability company (LLC) members, owners of professional corporations and trustees to waive workers’ compensation coverage for themselves under specific conditions. Scroll to bottom for Waiver of Coverage forms.

Note the following:

  • These changes take effect for new and renewal policies effective on or after July 1, 2018.
  • No action is needed if there is no change from a previously accepted waiver.
  • All Waivers are signed under penalty of perjury.
  • Each eligible person must sign a separate Waiver of Coverage (no group waivers).
  • An eligible person owning multiple entities may list all entities on a single Waiver of Coverage, or
  • An eligible person may sign and submit separate Waivers for each entity for which coverage is waived.
  • Waivers are only effective when accepted by Republic.
  • After July 1, 2018, Republic can only backdate Waivers up to fifteen (15) days from date of receipt.
  • Sole Corporate Shareholders are automatically excluded from coverage, but may elect to be included.
  • Currently covered Sole Corporate Shareholders will continue to be covered, unless they submit a written request to be excluded.
  • No action is needed to exclude a Sole Corporate Shareholder.

Policyholder Instructions on SB 189 describes the specific statutory requirements to waive workers’ compensation coverage for eligible:

  • Officers or Directors of quasi-public and private corporations
  • Managing members of a LLC or general partnership
  • Trustees
  • Officers or Directors of a Cooperative Corporation
  • Owners of a Professional Corporation

Send signed Waivers by email (preferred method) to, or mail original to:

Republic Indemnity
15821 Ventura Blvd., Suite 370
Encino, CA 91436
Attention: Policy Services

For more information, go to California Department of Insurance  or email

Waiver of Coverage Forms
Corporate Officer or Member of Board of Directors Waiver
General Partners and Limited Liability Company Managing Members Waiver
Trustee with the Power to Revoke Waiver
Cooperative Corporation Officer or Board Member Waiver
Owner of Professional Corporation Waiver