The director may issue a certification that an employer is qualified as a self-insurer when such employer meets the following requirements:
(1) He or she has fulfilled the requirements of RCW
51.14.020.
(2) He or she has submitted to the department a payroll report for the preceding consecutive twelve-month period.
(3) He or she has submitted to the department a sworn itemized statement accompanied by an independent audit of the employer's books demonstrating to the director's satisfaction that the employer has sufficient liquid assets to meet his or her estimated liabilities as a self-insurer.
(4) He or she has demonstrated to the department the existence of the safety organization maintained by him or her within his or her establishment that indicates a record of accident prevention.
(5) He or she has submitted to the department a description of the administrative organization to be maintained by him or her to manage industrial insurance matters including:
(a) The reporting of injuries;
(b) The authorization of medical care;
(c) The payment of compensation;
(d) The handling of claims for compensation;
(e) The name and location of each business location of the employer; and
(f) The qualifications of the personnel of the employer to perform this service.
(6) He or she has demonstrated to the department the ability and commitment to submit electronically the claims [data] required by RCW
51.14.110.
Such certification shall remain in effect until withdrawn by the director or surrendered by the employer with the approval of the director. An employer's qualification as a self-insurer shall become effective on the date of certification or any date specified in the certificate after the date of certification.