Member Resources

Golden State Risk Management Authority (GSRMA) provides small to medium sized public entities in California a solution to their insurance and risk management needs.

Larger California public entities like counties, cities and school districts have a dedicated staff of risk managers, legal counsel, claims specialists and loss prevention experts to administrate their insurance and risk management programs.

Smaller entities including rural counties, smaller municipalities, schools and special districts often do not have the budgets to support some or all of these staff positions.

GSRMA provides its member entities with the same level of support, knowledge and sophistication that larger districts enjoy and we do so at a lower cost than members were paying for their insurance coverage alone with their previous carrier.

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Welcome to a Unique Risk Management Option

At GSRMA we:

  • Provide members with the tools, resources and training to help protect their employees and their property from harm.
  • Provide members the best, most comprehensive coverage available for when a loss does occur.
  • Provide all services in the most efficient and cost-effective manner possible to keep rates as low as possible.
  • Embrace the philosophy that GSRMA exists for the benefit of its members.

If you are not satisfied with the quality or cost of your current coverage, let’s talk. We are the answer to over 280 California public entities risk pooling needs. We could be the answer for your entity.

Services Available to GSRMA Member Agencies at No Cost

Medcor is our toll-free nurse triage program used for reporting workplace injuries and illnesses. The nurse triage system provides employees with immediate access to medical professionals and sound medical advice, as well as it provides prompt, consolidated reporting of the incidents. Click here for more information (PDF).

Staff will come to your site and conduct a safety inspection of your facilities. For more information, or to request an inspection, contact our staff at Loss Prevention.

Certified Playground Inspector will come to your site and conduct an inspection of your playground facilities. For more information, or to request an inspection, contact our staff at Loss Prevention.

Staff will come to your site and conduct ergonomic evaluations for requested staff. To request an evaluation please submit your request to Loss Prevention.

An anonymous crime reporting program which offers cash rewards of up to $1,000. For additional details regarding WeTip please click here.

GSRMA is pleased to announce that members now can seek legal advice regarding employment-related issues, at no cost to their district. Members can consult the Eyres Law Group, LLP for answers to questions or to seek guidance on human resources matters. Learn more here.

Members can request this subsidy to offset training expense up to $1,000 annually. To apply for funding fill out the document below, print it out and send it to: GSRMA, Attn: Mark Marshall, P.O. Box 706, Willows, CA 95988, or via fax at (530) 934-8133. Download the LPSF Request Form (pdf)

This program replaces the Loss Prevention Incentive Plan (LPIP) with a best practices emphasis where accreditation is possible. Members may qualify for this award by completing and submitting their RMAP application. The first step is to review the application and note the time requirements. The maximum award is 10% of their annual contribution (maximum$75,000) based upon qualifications. Accreditation is earned when a member achieves the maximum award of 10%.

PLEASE NOTE: this program is intended to function as a “road map” for improving operations at your district, reducing claims and preventing losses.

We are happy to provide further explanation of the program and provide assistance. Please call (530) 934-5633 or email Loss Prevention. RMAP Application Form (pdf)

TargetSolutions is our comprehensive online training service. Please click here to access TargetSolutions. If your district is not currently set up in TargetSolutions, please reach out to Loss Prevention so that we may begin that process.

GSRMA Calendar

DateTimeEventLocation
March 10, 20216PMGSRMA Board MeetingGSRMA Office

Note: All GSRMA Board meetings are held at the GSRMA conference room at 243 W. Sycamore Street, Willows, CA.

Training Calendar

As a GSRMA Member, your training options are many. From inviting our Loss Prevention staff on-site to facilitating on-line training on timely topics, we take great pride in offering an array of options to meet your needs. Examples of class offerings are: Ergonomics, Defensive Driving, Board Etiquette and Backhoe Safety.

Classes such as Fire Extinguisher training, Heat Illness Prevention, Distracted Driving are a phone call (or e-mail) away. If the training you seek is beyond our offerings, we encourage you to apply for our Loss Prevention Subsidy Fund. Each year, up to $1,000 per member is to reimburse training costs and expenses.

DateTimeEventLocationREGISTER
March 09, 20211:00PMCal/OSHA Emergency Regulations w/ Q&AZoom WebinarClick here
March 18, 202110:00AMInspecting the WorkplaceZoom WebinarClick here
March 25, 202110:00AMHiring the Right District ManagerZoom WebinarClick here
April 01, 202110:00AMCustomer Service for Public EntitiesZoom WebinarClick here
April 15, 202110:00AMSafe Driving PracticesZoom WebinarClick here
May 06, 202110:00AMHeat Illness PreventionZoom WebinarClick here
May 27, 202110:00AMClaims Trends for Public EntitiesZoom WebinarClick here

Contact our Events Team for more information regarding events and training opportunities.

Claim Forms

ClaimsDownload
Form Completion InstructionsDownload Form Instructions
Claim for DamagesDownload Claim Damages Form
Accident Incident – Schools OnlyDownload Accident Incident Form
Auto Loss NoticeDownload Auto Loss Notice Form
Incident ReportDownload Incident Report Form
Property Loss NoticeDownload Property Loss Notice Form
WC Mileage Form 2021Download WC Mileage Form 2021
Rejection of Timely ClaimDownload Rejection of Timely Claim Form
Rejection of Timely Claim with ProofDownload Rejection of Timely Claim with Proof Form
OSHA Form 300Download OSHA Form 300
OSHA Form 300A, 301Download OSHA Form 300A, 301
Time of Hire PamphletDownload Time of Hire Pamphlet
DWC FormDownload DWC Form
Form 5020Download Form 5020

Employee Benefits Forms

Employee BenefitsDownload
2020 GSRMA Health, Dental, Vision, & EAP Enrollment FormDownload
20-21 GSRMA Employee Benefits BrochureDownload

Loss Prevention Forms

Loss PreventionDownload
School District Employee Training MatrixDownload School District Employee Training Matrix
Risk Management Accreditation Program (RMAP)Download Risk Management Accreditation Program (RMAP) Form
Loss Prevention Subsidy Fund (LPSF) requestDownload Loss Prevention Subsidy Fund (LPSF) request

Member Services Forms

Member ServicesDownload
Volunteer Workers’ Compensation Coverage – Information PageDownload Volunteer Workers’ Compensation Coverage – Information Page
Workers’ Compensation Coverage for Unpaid Volunteers – DeclinationDownload Workers’ Compensation Coverage for Unpaid Volunteers – Declination
Workers’ Compensation Resolution – Board Only – SampleDownload Workers’ Compensation Resolution – Board Only – Sample
Workers’ Compensation Resolution – Board OnlyDownload Workers’ Compensation Resolution – Board Only
Workers’ Compensation Resolution – Board and Volunteers – SampleDownload Workers’ Compensation Resolution – Board and Volunteers – Sample
Workers’ Compensation Resolution – Board and VolunteersDownload Workers’ Compensation Resolution – Board and Volunteers
Workers’ Compensation Resolution – Volunteers Only – SampleDownload Workers’ Compensation Resolution – Volunteers Only – Sample
Workers’ Compensation Resolution – Volunteers OnlyDownload Workers’ Compensation Resolution – Volunteers Only

Miscellaneous Forms

Loss PreventionDownload
Certificate RequestDownload Certificate Request
Ergo Evaluation Request FormDownload Ergo Evaluation Request Form (Word) (PDF)
Member Expense Form 2020Download Member Expense Form 2020
Member Expense Form 2021Download Member Expense Form 2021

Miscellaneous Resources

Loss PreventionDownload
Insurance Requirements in Contracts(IRIC)Download IRIC