HomeMy WebLinkAboutG- 5 Staff Report Independent Cities Risk Management Authority (ICRMA) InsuredCONSENT CALENDAR
TO: THE HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL
FROM: VICTORIA CROSS, DIRECTOR OF HUMAN RESOURCES
VIA: RICK COLE, CITY MANAGER .ar-l°
DATE: MAY 19, 2003
SUBJECT: INDEPENDENT CITIES RISK MANAGEMENT AUTHORITY (ICRMA) SELF INSURED WORKERS'
COMPENSATION PROGRAM
RECOMMENDATION
It is recommended that City Council approve and adopt the attached Resolution authorizing participation
in the Independent Cities Risk Management Authority (ICRMA) Workers' Compensation Program (WCP)
effective July 1, 2003.
BACKGROUND
ICRMA is a joint powers agency with 28 member cities throughout Southern California. Historically, the
City has procured Excess Workers' Compensation Coverage on a group purchase basis through ICRMA
until this year. In June 2002, member cities of ICRMA were hit with the realities of the insurance crisis
upon receipt of their Workers' Compensation renewal quotes for the policy year beginning July 1, 2002.
The quotations for all ICRMA member cities were dramatically higher than the previous year and Azusa's
insurance premium rose from $34,000 in FY 2001-2002 to $101,330 in FY 2002-2003. ICRMA members
were faced with few options, as little time was available to renew coverage, there were very few
commercial insurance markets willing to underwrite municipal risks.
Because of the negative budgetary consequences of these increases the ICRMA Board approved the
exploration of a self-funded excess Workers' Compensation Program (WCP) and an ad hoc committee was
formed. The Program Development Committee consisted of members from all of the ICRMA standing
committees and also included the President and Vice President of ICRMA. This committee met frequently
and developed the following WCP for the ICRMA Board's consideration. The ICRMA Board met on
November 19, 2002 and approved the establishment of the WCP. The new WCP has two enrollment
periods:
➢ January 1 through March 1, 2003
➢ July 1, 2003
The program provisions, terms of coverage and financial implications of the WCP are beneficial to Azusa.
Staff recommends participation in this program at the $500,000 Self Insurance Retention (SIR) level which
is the current level of coverage maintained by the City.
The WCP would help to protect the City from further rate increases and ever worsening condition of the
insurance market and new legislation increasing workers' compensation benefits. Additionally,
participation in the WCP would enhance the ability to provide loss control measures and increased
oversight of the claims administrator.
Participation in the WCP requires three (3) full program years and would decrease the City's Workers'
Compensation Insurance premium from the estimated $160,000 proposed in the Human Resources Fiscal
Year 2003-2004 operating budget to $95,000 for the upcoming Fiscal Year 2003-2004. This also reflects
a slight savings from last year's premium of $101, 330.
FISCAL IMPACT
There is no fiscal impact as the insurance premium has been absorbed into the proposed Fiscal Year 2003-
2004 Human Resources budget.
Attachments: Resolution — Authorizing Participation in the Workers' Compensation Program
ICRMA Memorandum of Workers' Compensation Program Coverage (Draft)
ICRMA Bylaws for the Workers' Compensation Program
RESOLUTION NO.
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF AZUSA AUTHORIZING
PARTICIPATION IN THE WORKERS' COMPENSATION PROGRAM OF THE
INDEPENDENT CITIES RISK MANAGEMENT AUTHORITY (ICRMA)
WHEREAS, the City of Azusa ("City"), is a member In good standing of the Independent Cities Risk
Management Authority ("Authority"); and
WHEREAS, the Authority Is establishing a Workers' Compensation Program ("Program"), through
which member cities, Including this City, may secure workers' compensation coverage; and
WHEREAS, the Authority offers various self-insurance rementions (SIRS) and coverage limits as
determined by its Governing Board; and
WHEREAS, the City has received and reviewed a copy of the Program Bylaws, Memorandum of
Coverage, and other related documents; and
WHEREAS, It is expressly understood that a commitment by a participant in the Program must be
for a period of no less than three (3) full program years; and
WIffREAS, It appears to be in the best Interest of the City ttlat it participate in said Program.
NOW, THEREFORE, BE 1T RESOLVED, that the City Council of the City of Azusa does hereby find
determine, and declare as follows:
1) a City hereby elects to join and remain a member of'the Program for a period of not less than
rhree (3) full program years provided the minimum participation requirements in the Program
re met.
R
2) The City hereby requests that, commencing on July 1, 2,003 of the program period, the City's
Industrial Injury or Illness claims be covered by the Program.
3) The City approves the Program Bylaws and Memorandum of Coverage and other related
documents.
4) The City's designee is hereby authorized and directed to execute such documents and may be
required to bind the City to the terms and covenants of the Program.
S) The City shall maintain a Certificate of Consent to Self -Insure for Workers' Compensation
liabilities from the Director of Industrial Relations, State of California, and shall Immediately
advise the Authority If there is any revocation of change in said Certificate.
6) The City Clerk of the City of Azusa is hereby directed to certify a coy of the resolution and
forward same promptly, by mall, to the Authority at the following address:
ICRMA
5777 West Century Boulevard, Suite 665
Los Angeles, California 90045
PASSED AND ADOPTED by the City Council of the City of Azusa at a regular meeting held on the
19'" day of May 2003.
MAYOR OF THE CITY OF AZUSA
ATTEST:
CITY CLERK OF THE CITY OF AZUSA
STATE OF CALIFORNIA)
SS
COUNTY OF LOS ANGELES)
I HEREBY CERTIFY that the foregoing Resolution was duly alcjopted at a regular meeting of said City
Council onthe 19'" day of May 2003, by the following roll call votel
AYES: COUNCIL MEMBERS: y
NOES: COUNCIL MEMBERS: §3
ABIENT: COUNCIL MEMBERS:
I'
CITY CLERK OF THE CITY OF AZUSA
INDEPENDENT CITIES RISK MANAGEMENT AUTHORITY
(ICRMA)
MEMORANDUM OF WORKERS' COMPENSATION PROGRAM COVERAGE
January 1, 2003 to June 30, 2004 PROGRAM YEAR
II'
TO BE EFFECTIVE JANUARY 1, 2003
a
INDEPENDENT CITIES
RISK MANAGEMENT AUTHORITY
MEMORANDUM OF COVERAGE
FOR SELF-INSURANCE OF
WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY
TABLE OF CONTENTS
PART ONE — WORKERS' COMPENSATION COVERAGE....................................................2
PART TWO — EMPLOYERS' LIABILITY COVERAGE...........................................................3
PART THREE- THE PARTICIPANT'S RETENTION AND AUTHORITY'S LIMIT OF LIABILITY 3
PARTFOUR - CLAIMS...............................................................................................................4
A. The Participant's Claims Reporting Duties........................................................................4
B. Settlement..........................................................................................................................5
PARTFIVE - PREMIUM..............................................................................................................5
A. Deposit Premium...............................................................................................................5
PARTSDC - CONDITIONS..........................................................................................................6
A. Acceptance.........................................................................................................................6
B. Cancellation.......................................................................................................................7
C. Inspection...........................................................................................................................7
D. Records..............................................................................................................................7
E. Transfer of the Participant's Rights and Duties.................................................................7
F. Financial Audit..................................................................................................................7
INDEPENDENT CITIES RISK MANAGEMENT AUTHORITY
MEMORANDUM OF COVERAGE
FOR SELF-INSURANCE OF
WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY
The Independent Cities Risk Management Authority (hereinafter the "Authority") in consideration
for the payment of the contribution and subject to all terms of this Memorandum, does hereby agree
to provide coverage to the Participants (ICRMA member cities electing to participate in the workers'
compensation program) named in Item 1 of the Declaration Page subject to the terms and conditions
set forth in the Memorandum:
GENERAL SECTION
A. The Memorandum
This Memorandum includes at its effective date the Declaration Page and all endorsements
listed on the Declaration Page. This Memorandum is the coverage document between the
Participant and the Authority. The terms of this Memorandum may not be changed or
waived except by endorsement issued by the Authority to be part of this Memorandum.
B. Who Is Covered
The Participant is named in Item I of the Declaration Page and is a Participant as defined in
the Authority's Agreement. If an entity named in Item 1 of the Declaration Page loses its
status as an active Participant of the Authority, the coverage under this Memorandum of
Coverage shall terminate immediately upon such change in status.
C. Workers' Compensation Law
Workers' Compensation law means the workers' or workmen's compensation law and
occupational disease law of the State of California and such other state laws as may be
applicable. It includes any amendments to that law which are in effect during the term of this
Memorandum. It does not include any federal workers' or workmen's compensation law,
any federal occupational disease law, -or the provisions of any law that provide non-
occupational disability benefits.
D. State
State means any state of the United States of America and the District of Columbia.
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E. Qualified Self -Insurer
The Participant provides evidence that it is a duly qualified self-insured under the Workers'
Compensation Law of the State of California and will continue to maintain such
qualifications during the term this Memorandum is in effect. If the Participant should fail to
qualify or fail to maintain such qualifications, the coverage provided under this
Memorandum shall automatically terminate the first date of such failure.
PART ONE — WORKERS' COMPENSATION COVERAGE
The Authority will provide coverage for workers' compensation losses in the same manner as the
excess insurance carrier, except for Item 3 below, up to the Authority's Limit of Liability stated in
Item 3.b. of the Declaration Page.
This coverage applies to bodily injury by accident or bodily injury by disease. Bodily injury includes
resulting death.
1. Bodily injury by accident must occur during the coverage period.
2. Bodily injury by disease must be caused or aggravated by the conditions of employment by
the Covered Party. The employee's employment period and exposure to the conditions
causing or aggravating such bodily injury by disease must occur during the coverage period.
3. Salary benefits listed in Labor Code Section 4850.
A. PAYMENTS THE COVERED MEMBER MUST MAKE
The Authority is not responsible for any payments in excess of benefits regularly
provided by the Workers' Compensation Law, including those required because:
1. Of the Covered Member's serious and willful misconduct;
2. The Covered Member knowingly employs an employee in violation of law;
3. The Covered Member knowingly fails to comply with a health or safety law or
regulation;
4. The Covered Member discharges, coerces, or otherwise discriminates against any
employee in violation of the Workers' Compensation Law; or
The Covered Member violates or fails to comply with any Workers'
Compensation Law.
6. Salary benefits listed in Labor Code Section 4850 for any claim that exceeds the
Limit of Liability stated in Item 3.b. of the Declaration Page.
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If the Authority makes any payments in excess of the benefits regularly provided by the
Workers' Compensation Law on the Covered Member's behalf, the Covered Member
will reimburse the Authority promptly.
PART TWO — EMPLOYERS' LIABILITY COVERAGE
The Authority will provide coverage for employer's liability losses in the same manner as the excess
insurance carrier, except as noted in Part One, Item 3, up to the Authority's Limit of Liability stated
in Item 3b of the Declaration Page.
This coverage applies to bodily injury by accident or bodily injury by disease. Bodily injury includes
resulting death. This coverage will apply to damages awarded against the Covered Party, over the
amount of the Covered Party's retained limit and subject to the Limit of Liability set forth herein,
provided that those damages are the direct consequences of bodily injury that arises out of and in the
course of the injured employee's employment by the Covered Party, and are claimed against the
Covered Party in a capacity other than as employer.
A. The bodily injury must arise out of and in the course of the injured employee's employment
by the Covered Party.
Bodily injury by accident must occur during the coverage period.
Bodily injury by disease must be caused or aggravated by the conditions of employment by the
Covered Party. The employee's employment period and exposure to the conditions causing or
aggravating such bodily injury by disease must occur during the coverage period.
PART THREE - THE PARTICIPANT'S RETENTION AND AUTHORITY'S LIMIT OF LIABR=
A. The Participant's Retained Limit
The Participant shall pay from its own account any loss up to the amount stated in Item 3.a.
of the Declaration Page as the Participant's Retained Limit.
B. Authority's Limit of Liability
The Authority will indemnify the Covered Member for loss under Workers' Compensation
Laws, but will not exceed the Limits of Liability stated in Item 3.b. of the Declaration Page
on any one loss. Coverage will include all benefits required under Workers' Compensation
Laws, including full salary benefits listed in Labor Code Section 4850. The authority will
pay on behalf of the Covered Member for Employer's Liability losses but will not exceed the
Limits of Liability stated in Item 3 of the Declaration Page on any one loss.
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C. Attachment of Coverage by Authority
The coverage provided by this Memorandum shall not apply to any claim until the amount
paid by or on behalf of the Participant shall have equaled or exceeded the per occurrence
Retained Limit of the Participant. The Authority shall then only be liable for the amount
actually incurred that is in excess of the Participant's per occurrence retained limit, regardless
of whether the Participant has other insurance, has other pooled coverage, or pays the per
occurrence retained limit itself. Amounts to be paid on a claim otherwise covered under this
Memorandum shall not be paid until such time that the underlying per occurrence retained
limit has been paid.
Nothing contained herein shall operate to increase the Authority's Limit of Coverage under
this Memorandum.
D. Labor Code Section 4850
This coverage applies to the cost of salary benefits listed in Labor Code Section 4850;
however, for any claim that exceeds the Limit of Liability stated in Item 3.b. of the
Declaration Page, any costs not covered by any excess coverage obtained by the Authority
shall be paid exclusively by the Covered Member. In no event will the Authority pay any
amount in excess of the Limit of Liability stated in Item 3.b of the Declaration Page.
PART FOUR - CLAIMS
A. The Participant's Claims Reporting Duties
The participant must immediately notify the Authority in writing of any claim, either paid or
reserved, for 50% or more of the Participant's Retained Limit stated in Item 3.a. of the
Declaration Page due to any of the following events: claim, award, verdict, action, suit,
proceeding, or judgment.
The Participant must also give the Authority immediate written notice of any injury involving
the following types of accidents:
1. a fatality;
2. an amputation of a major extremity;
3. any serious head injury (including skull fracture or loss of sight of either or both eyes);
4. any injury to the spinal cord;
5. any second or third degree burn of 25% or more of the body;
6. any accident which causes serious injury to two or more employees; or
7. any disability of more than one year or when it appears reasonably likely that there will
be a disability of more than one year.
Notice of accident given to the Authority shall contain complete details of the injury, disease,
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or death. If a suit, claim, or other proceeding is commenced because of an injury listed in
above Section 2 or of any injury that appears to involve coverage by the Authority, the
Participant shall give the Authority:
1. all notices and legal papers related to the claim, proceeding or suit, or copies of these
notices and legal papers; and
2. copies of reports on investigations made by the Participant on such claims, proceedings,
or suits.
Settlement
Claims in excess of the Participant's retention shall not be settled without the written consent
of the Authority. The Authority has the right to participate with the Participant in the
settlement, defense, or appeal of any claim, suit, or proceeding that might involve a loss to
the Authority. Settlement authority above the Participant's Retained Limit will be as
described in the Bylaws.
PART FIVE - PREMIUM
A. Deposit Premium
At the beginning of each Program Year, the Participant must pay the Authority the
Deposit Premium subject to the provisions in the Bylaws and:
2. The Deposit Premium will be based on the payroll as defined in the Bylaws, and all
other remuneration payable during the Program Year for the services of -
a. all the Participant's officers and employees engaged in work covered by this
Memorandum;
b. all volunteers declared or otherwise required to be covered. The value of the
volunteers' service shall be based upon a flat rate per volunteer; and
C. all other persons engaged in work that could make the Authority liable under
Part One (workers' compensation insurance) of this Memorandum. If the
Participant does not have payroll records for these persons, the contract price
remuneration for their services and materials may be used as the premium
basis. This paragraph will not apply if the Participant gives the Authority
proof that the employers of these persons lawfully secured their workers'
compensation obligations.
If the Authority cancels this Memorandum, final premium will be calculated pro rata based
on the time this Memorandum was in force.
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PART SIX - CONDITIONS
A. Acceptance
By acceptance of this Memorandum, the Participant agrees that the statements made on the
Declaration Page are the Participant's agreements and representations, that this
Memorandum is issued in reliance upon the truth of such representations, and that this
Memorandum embodies all agreements existing between the Participant and the Authority or
any of the Authority's agents relating to this coverage.
B. Notice of Accident
1. The Covered Member shall give prompt written notice to the Authority if a claim
for an injury or disease occurs which appears to involve coverage by the
Authority.
2. Notice of accident given to the Authority shall contain complete details on the
injury, disease, or death. If a suit, claim, or other proceeding is commenced
which appears to involve coverage by the Authority, the Covered Member shall
give the Authority:
(a) All notices and legal papers related to the claim, proceeding, or suit, or
copies of these notices and legal papers; and
(b) Copies of reports on investigations made by the Covered Member on
such claims, proceedings, or suits.
3. If written notice is not provided by the Covered Member to the Authority within
thirty (30) days of knowledge of such claim, coverage will not be provided under
this Memorandum of Coverage. This requirement is a condition precedent to
coverage under this Memorandum of Coverage.
C. Subrogation — Recovery from Others
The Authority has the Covered Member's rights, and the rights of persons entitled to
compensation benefits from the Covered Member, to recover the Authority's loss from any
third party liable for the injury. The Covered Member will do everything necessary to protect
those rights for the Authority and to assist in enforcing them. Any recovery, after deducting
the Authority's recovery expenses, will first be used to reduce the Authority's loss. The
balance, if any, will be returned to the Covered Member.
D. Memorandum Conforms to Law
If terms of this Memorandum are in conflict with any laws applicable to this Memorandum,
the Authority's Agreement, the Authority's Bylaws, or the Authority's Pooled Workers'
Compensation Program Master Plan Document, this statement amends this Memorandum to
confirm to such law or document.
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E. Cancellation
The Participant may not withdraw from this Memorandum during the Program Year.
F. Inspection
The Authority has the right, but is not obligated, to inspect the Participant's workplaces at
any time. The Authority's inspections are not safety inspections. They relate only to the
insurability of the workplaces and premiums to be charged. The Authority may give the
Participant reports on the conditions the Authority finds. The Authority may recommend
changes. While they may help reduce losses, the Authority does not undertake to perform the
duty of any person to provide for the health or safety of the Participant's employees or the
public. The Authority does not warrant that the Participant's workplaces are safe or healthful
or thht they comply with law, regulations, codes, or standards.
G. Records
The Participant will keep records of information needed to compute premium. The
Participant will provide the Authority with copies of those records upon the Authority's
request.
H. Transfer of the Participant's Rights and Duties
The Participant's rights and duties under this Memorandum may not be transferred without
the Authority's written consent.
Financial Audit
The Participant will allow the Authority to examine and audit all of the Participant's records
that relate to this Memorandum. These records include ledgers, journals, registers, vouchers,
contracts, tax reports, payroll and disbursement records, and computer programs for storing
and retrieving data. The Authority may conduct the audits during regular business hours
during the Program Year and within three years after the Program Year ends. Information
developed by audit will be used to determine final premium.
If any terms of this Memorandum are in conflict with any laws applicable to this Memorandum, the
Authority's Agreement, the Authority's Bylaws, or the Authority's Pooled Workers' Compensation
Program Master Plan Document, this statement amends this Memorandum to conform to such law or
document.
INDEPENDENT CITIES RISK MANAGEMENT AUTHORITY
LE
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INDEPENDENT CITIES
RISK MANAGEMENT AUTHORITY
BYLAWS
FOR THE
WORKERS' COMPENSATION PROGRAM
INDEPENDENT CITIES
RISK MANAGEMENT AUTHORITY
BYLAWS
FOR THE
WORKERS' COMPENSATION PROGRAM
TABLE OF CONTENTS
ARTICLE I: GENERAL .........................................
A. AUTHORITY .................................................
B. PURPOSE.......................................................
C. PARTICIPATION ...........................................
D. GOVERNANCE .............................................
E. GOALS AND OBJECTIVES .........................
ARTICLE II: PROGRAM ELEMENTS........................................................................................
3
A.
PROGRAM YEARS................................................................................................................3
B.
RETAINED L MITS................................................................................................................3
C.
DEPOSIT PREMIUMS...........................................................................................................3
D.
DIVIDEND AND ASSESSMENTS........................................................................................5
E.
EXCESS COVERAGE................:...........................................................................................6
ARTICLE III: ADMINISTRATION............................................................................................... 7
A. GOVERNING BOARD...........................................................................................................7
B. COMMITTEES........................................................................................................................7
C. GENERAL MANAGER..........................................................................................................7
D. WORKERS' COMPENSATION PROGRAM MANAGER'S DUTIES.................................8
ARTICLE IV: CLAIMS ADMINISTRATION............................................................................ 10
A. CLAIMS PROCEDURES MANUAL...................................................................................10
B. CLAIMS AUDIT...................................................................................................................10
C. CLAIM SETTLEMENT AUTHORITY................................................................................10
D. DISPUTES BETWEEN PARTICIPANTS AND GENERAL MANAGER OR WORKERS'
COMPENSATION PROGRAM MANAGER, OR COMMITTEE..............................................11
ARTICLE V: PARTICIPATION.................................................................................................. 12
A. ELIGIBILITY AND APPLICATION....................................................................................12
B. PARTICIPANTS' DUTIES....................................................................................................12
C. TERMINATION....................................................................................................................13
ARTICLE VI: TERMINATION AND DISSOLUTION............................................................. 15
ARTICLE VII: AMENDMENTS................................................................................................ 16
INDEPENDENT CITIES RISK MANAGEMENT AUTHORITY
BYLAWS
FOR THE
WORKERS' COMPENSATION PROGRAM (WCP)
ARTICLE I: GENERAL
A. AUTHORITY
The Workers' Compensation Program (WCP) Bylaws of the Independent Cities Risk
Management Authority (Authority), shall be treated as one of the Authority's
governing documents. However, any conflict between the WCP Bylaws, the
Authority's Joint Exercise of Powers Agreement (Agreement), or the WCP
Memorandum of Coverage (MOC) shall be determined in favor of the Agreement or
the MOC.
2. The WCP Bylaws are intended to be the primary source of information, contain the
rules and regulations, and serve as the operational guide for the conduct of the WCP.
The WCP has been organized under authority granted by, and shall be conducted in
accordance with, the laws of the State of California; regulations prescribed by the
Department of Industrial Relations (DIR) and the State of California Audit Unit; and
the accreditation standards set forth by the California Association of Joint Powers
Authorities (CAJPA).
B. PURPOSE
The Authority, as a part of its overall objectives, has designed the WCP to provide for the
varied needs of its member cities in the area of workers' compensation liability.
C. PARTICIPATION
All member cities of the Authority may become a participant (Participant) in the
WCP, and are encouraged to do so. However, the terms and conditions which may be
imposed on a member city which desires to join the WCP may be different,
depending upon payroll; number of employees, the size of the city, its loss record,
and other pertinent information.
2. The Authority, as determined by the actuary and approved by the Authority's
Governing Board (Board), may determine a minimum participation level which must
be met prior to its effective date.
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D. GOVERNANCE
Each member city's appointed primary representative, one alternate, and one substitute
alternate representative to the governance of ICRMA, shall be the representative for the
WCP. The member city will be entitled to one vote on all issues or decisions that involve the
WCP. It is expected, but not mandatory, that the primary representative from each member
city will be the individual designated as the member city's appointee to the Board and that
the alternate representative(s) will be the individual(s) designated as the member city's
alternate representative on the Board.
E. GOALS AND OBJECTIVES
The Authority offers its member Cities this WCP designed to provide coverage for
the liabilities imposed by the workers' compensation laws of California as well as
those imposed by common law upon employers.
2. The WCP shall provide workers' compensation coverage for the Participants utilizing
an optimum mix of risk retention and risk transfer. The WCP shall provide various
levels of retentions for the Participants, provide a risk sharing pool for losses above
individual retention levels up to the Authority's Self -Insured Retention (SIR), and
obtain excess coverage for the amount of the loss which exceeds the Authority's SIR.
Additionally, the WCP shall provide for the sharing of operating costs and payment
of the excess coverage by charging all Participants their share of such costs.
Although the WCP is provided to the Participants under those terms and conditions
which prevail at the time of the Participant's joining the WCP, the Board shall have
the right to alter, from time to time, the terms and conditions of the excess coverage
and the pooled underlying coverage in response to the needs and abilities of the WCP
and the participating cities, as well as in response to availability of coverage from
outside sources.
4. The Authority offers participation in a risk sharing pool covering losses of
Participants in accordance with the Agreement adopted by the member Cities. The
assets of the pooled program shall be maintained at all times as the assets of the
Participants collectively. The assets may be disbursed only pursuant to the provisions
of these Bylaws, and no Participant shall have an individual right to exercise control
over said assets except as provided in the Agreement.
5. The WCP will provide coverage for injuries and illnesses to the Participants'
employees under the terms and conditions set forth in the MOC. In addition to the
coverage provided by the MOC, the Authority may purchase excess insurance or
reinsurance. The amount of coverage to be pooled and/or purchased is at the
discretion of the Board.
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ARTICLE II: PROGRAM ELEMENTS
A. PROGRAM YEARS
1. A program year is defined by the term of the coverage period, generally a period of
12 months. Except for the originating program year which will run from program
inception through June 30, 2004, the WCP will have program years which begin at
12:01 a.m. on July 1 and end at midnight on the following June 30.
2. Each program year shall be accounted for separately. The income and expenses of
each program year shall be accounted for separately from any other program years'
income or expenses.
3. A program year shall not be closed until such time that the Board authorizes closure,
being convinced that known claims for the year are all closed and the probability of
further claims being discovered is minimal. Any closed years, however, may be
reopened if deemed necessary and approved by the Board.
B. RETAINED LIMITS
The WCP shall annually establish the limit of coverage for the pool. The underlying coverage
of the WCP shall provide Participant's retained limits of $350,000, $500,000, $750,000, and
$1,000,000 per occurrence, or other limits which may be modified by resolution. The
Participants may annually select their retained limit as approved. The amount of each loss,
including expenses, which is less than the retained limit chosen by the applicable Participant,
shall be paid by the Participant.
C. DEPOSIT PREMIUMS
1. Annually, each Participant shall pay a deposit premium to the Authority for each
program year. Such Deposit Premiums shall consist of the amount needed to cover
excess insurance or reinsurance premiums (if any), administrative expenses and
actuarially -determined losses, plus a margin for added confidence as determined by
the Board.
2. The deposit premium shall be initially calculated for each Participant by taking the
Participant's expected annual payroll, as determined by the Federal W-3 form
provided by each Participant, multiplied by the Board adopted rate per $100 of
payroll. After the end of the program year, adjustments from expected to actual
payroll shall be made. Debit adjustments shall be billed to the Participant, and credit
adjustments will apply to next year's billings. An annual audit of a Participant's
payroll may be conducted by the Authority.
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ICRMA Bylaws for the Workers' Compensation Program (WCP) DRAFT
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3. The deposit premium shall also include:
(a). All volunteers declared or otherwise required to be covered. The value of the
volunteers' service shall be based upon a flat rate per volunteer; and
(b). all other persons engaged in work that could make the Authority liable under
Part One (workers' compensation insurance) of the MOC. If the Participant
does not have payroll records for these persons, the contract price
remuneration for their services and materials may be used as the premium
basis. This paragraph will not apply if the Participant gives the Authority
proof that the employers of these persons lawfully secured their workers'
compensation obligations.
4. EXPERIENCE MODIFICATION
Each Participant shall be evaluated each year for an experience modification
adjustment that shall be applied to the deposit premium, in accordance with the
following calculations. Such modification adjustment may be adjusted periodically:
(a). The exposure base is a measurement of the relative size of each member city.
The most readily available information to use as an exposure base is payroll;
(b). A component (applied as a % weighted factor, determined annually) of the
experience modification adjustment shall include the actual loss experience
of the individual Participant as it relates to the average loss experience of the
group as a whole. The criteria which shall be used is the relationship of actual
average loss experience over the period being rated as it relates to the average
payroll for the same period. Such loss experience shall consider seven years
of loss experience with a one year lag from the current program year. The
experience modification calculation will be done only once at the initial
deposit premium stage and the same experience modification calculation will
be used when determining the final premium; and
(c). To mitigate the impact of catastrophic exposures that could skew the
experience modification calculation, the loss experience calculation shall
only use losses in the total incurred range of $50,000 to $350,000. Any
losses greater than $350,000 in total incurred costs will be reduced to
$350,000 unless otherwise modified by resolution by the Governing Board.
An additional component of the experience modification calculation shall be the
relative risk factors of payroll classifications (safety, public works, other) with a %
weighted factor.
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ICRMA Bylaws for the Workers' Compensation Program (WCP) DRAFT
Last updated 11.21.02
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D. DIVIDEND AND ASSESSMENTS
DIVIDENDS
(a). Five years after the end of the program year, the first dividend calculation
shall be performed. Each year thereafter there shall be an additional dividend
calculation made until such time as the program year is closed. Any dividends
available to be declared and returned to the Participants will be at the
discretion of the Board.
(b). Calculation
Dividends are available to be declared only at such time as the WCP
has equity, with liabilities actuarially stated undiscounted at a 80%
confidence level. The calculated amount shall represent the maximum
dividend available to be declared.
ii. This amount shall be reduced if the two succeeding years (after the
fifth program year reaches eligibility) have negative equity, with
liabilities actuarially stated at an expected confidence level.
Each Participant's share of any refunds shall be allocated based upon
the method in which they were collected, beginning with the oldest
program year. However, until the last claim of a program year has
been paid and the program year has been closed, the program year
must maintain sufficient funds to satisfy the 80% confidence level
undiscounted requirement.
2. ASSESSMENTS
(1) Assessments may be levied for the risk sharing layer of any program year(s),
as recommended by the Finance Committee and approved by the Board, on
the Participant at such time that an actuary finds that the assets of the WCP,
as a whole, do not meet the expected undiscounted losses of the WCP. Each
Participant's share of the assessment shall be allocated based upon the
deposit premiums collected for the risk sharing layer of each respective
program year being assessed. If such assessment is not sufficient to relieve
the pool of its actuarial determined deficit in the year of the assessment, such
assessment shall be levied each subsequent year until the actuarial deficit is
relieved. The timing of payment shall be determined by the Board at time of
assessment.
(2) Equity, from the risk sharing layer, may be exchanged between eligible
program years if sufficient funds are available. The transfer of equity will be
performed such that the individual Participant's share of equity is separately
ICRMA Bylaws for the Workers' Compensation Program (WCP) DRAFT
Inst updated 11.21.02
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applied so as to maintain the integrity of each Participant's balance.
E. EXCESS COVERAGE
1. The Board shall ensure that each program year is provided with excess workers'
compensation coverage for the Participants. It is the intent and purpose of the
Authority to continue to provide such coverage to the Participants, provided that such
coverage can be obtained, and the coverage is not unreasonably priced. This coverage
may be obtained from an insurance company, by participating in another pool
established under the Government Code as a joint powers authority, or offered
through another WCP pooling procedure. If the coverage is purchased from an
insurance company, such insurance company shall have an A.M. Best Rating
Classification of A- or better and an A.M. Best Financial Rating of VII or better or
their equivalents.
2. The Authority, through the WCP, shall provide, where economically practical, at
least $10,000,000 of total combined limits. Total combined limits is the maximum
this WCP will pay for each injury or illness, regardless of whether the liability arises
from Workers' Compensation Laws, Employer's Liability, or a combination of these.
3. Premiums for such coverages shall be paid by the WCP from the proceeds received
as deposit premiums from the Participants.
4. The Board may, from time to time, alter excess coverage based on insurance market
conditions, available alternatives, costs, and other factors. The Board shall place
excess coverage with the two competing objectives of security and minimizing costs
to the WCP as a whole.
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ICRMA Bylaws for the Workers' Compensation Program (WCP) DRAFr
Last updated 11.21.02
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ARTICLE III: ADMINISTRATION
GOVERNING BOARD
Discussion of developments and performance of the WCP may occur as part of any
scheduled Board meeting.
2. The Board retains unto itself the authority as consistent with the Agreement.
3. The Board shall have the responsibility and authority to carry out and perform all
other functions, and make all decisicns affecting the WCP, provided that such
functions and decisions are consistent with the powers of the Authority and are not in
conflict with the Agreement, the Bylaws, or the MOC.
COMMITTEES
The Board may establish a committee to oversee certain responsibilities delegated to the
Board. The committee may be a newly -created committee or the responsibilities may be
assigned to an existing committee.
GENERAL MANAGER
The General Manager shall be responsible for
1. The overall operation of the WCP;
2. Monitoring the status of the WCP and its operations, the development of losses, the
program's administrative and operational costs, service companies' performance, and
brokers' performance;
Assisting the Board in selecting brokers, actuaries, auditors, and other service
companies;
4. Promoting the programs to prospective new Participants;
Preparing, distributing, and maintaining all records of the WCP, including its Bylaws
and MOC as these may be amended from time to time; and
6. Preparing Certificates of Coverage and Waivers of Subrogation as may be required
by the Participants in the WCP.
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ICRMA Bylaws for the Workers' Compensation Program (WCP)
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WORKERS' COMPENSATION PROGRAM MANAGER'S DUTIES
The Workers' Compensation Program Manager (WCPM), unless otherwise modified by
resolution, shall:
Generally, oversee all workers' compensation claims administration and management
and report to the General Manager;
2. Develop for Board approval of performance standards third party administrators;
Maintain files on all claims reported to the Authority;
4. Recommend to the Board the setting of reserves for those cases that are likely to
penetrate to pooled funds;
5. Upon the reporting of each claim that has an expectation of exceeding the minimum
incurred loss threshold set by the Board, review said claim for the Authority and
report said claims to the Board at the next scheduled meeting;
6. Review the progress of all reported claims for the Authority and, if directed by the
Board, propose reserve changes, and/or take control and assume settlement authority
for the claim;
Recommend claim settlements to the Board for approval;
8. Annually, prepare a detailed report on the WCP, showing the activity by program
year and the cumulative activity of all years, including number of claims, losses
which have been incurred by each Participant, and the losses which have been shared
through pooling;
9. Assist the Participants in training theirpersonnel in the correct procedures for timely
and accurately reporting claims;
10. As required, provide advice and assistance to Participants;
11. Periodically review third party claims administrator's claims files. The review
should include the new indemnity claims reported, claims currently open and
reported twelve months prior, and those claims for which a Participant has requested
a specific review;
(a). Provide guidance to the claims adjuster on the management of problem or
complex claims;
(b). Advise, where needed, on the selection of legal representation in anticipation
of litigation;
ICRMA Bylaws for the Workers' Compensation Program (WCP)
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(c). Monitor and evaluate the effectiveness of the defense firms and the
management of the litigation;
(d). Monitor and evaluate the effectiveness of medical treatment as respects
claims costs, especially those involving complex medical issues;
(e). Evaluate, where needed, recommendations for settlement of claims;
(f). Mediate differences, if any, between the claims adjuster and a Participant;
and
(g). Review the performance of the claims adjusters' personnel assigned to the
Authority's account with special emphasis in the handling of "open claims."
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ICRMA Bylaws for the Workers' Compensation Program (WCP) DRAFT
Last updated 11.21.02
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ARTICLE IV: CLAIMS ADMINISTRATION
A. CLAIMS PROCEDURES MANUAL
A Workers' Compensation Claims Procedures Manual (Manual) including reporting
procedures, forms, and other vital information shall be adopted by the Board and
provided to all Participants.
2. All Participants shall be held accountable for understanding and abiding by the
procedures stated in the manual, as well as any changes thereto.
B. CLAIMS AUDIT
--- 1.- At-leastonce every two years, the adequacy of claitln&Mj ng f2Lboth the_Authoritx',.m.—
and the Participants shall be examined by an independent auditor who specializes in
claims auditing.
2. The Board shall approve the claims auditor. The costs of such claims audit shall be
paid by the Authority.
The claims audit report shall address the issues of both adequacy of claims
procedures and accuracy of claims data. The report shall be filed with the Authority
and sent to each Participant.
C. CLAIM SETTLEMENT AUTHORITY
Participants - Each Participant shall have settlement authority for all claims,
including attorney fees and other costs, which do not exceed 100% of the member
city's Retained Limit. The WCPM will review these claims from time to time and
'-may offer his/her recommendation to the Participants'- Third Party Administrator
(TPA) and the Participant regarding settlement.
2. The WCPM shall have settlement authority for all claims which exceed 100% of the
Participant's retained limit, but only up to $50,000. The WCP (or other identified)
Committee shall have settlement authority above $50,000 and up to $250,000 above
each Participants' Retained Limit. The Board shall have settlement authority above
$250,000 up to the Self -Insured Retention of the Authority. The General Manager
and the WCPM will ensure that the Participant is kept informed regarding these
claims, and will take into consideration the Participant's desires in any settlement
process; however, the General Manager and the WCPM shall keep the best interests
of the Participants paramount in any decision. Any claims settlement decision made
by the General Manager or WCPM may be appealed to the Board within 30 days
after notice of the decision to the Participant. The decision of the Board shall be final.
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ICRMA Bylaws for the Workers' Compensation Program (WCP) DRAFT
Inst updated 11.21.02
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D. DISPUTES BETWEEN PARTICIPANTS AND GENERAL MANAGER OR
WORKERS' COMPENSATION PROGRAM MANAGER, OR COMMITTEE
1. Any matter in dispute between a participating Participant and the General Manager or
WCPM shall be heard by the appropriate Committee whose decision may be
appealed to the Board within thirty (30) days of the Committee's decision. The
decision of the Board shall be final.
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ICRMA Bylaws for the Workers' Compensation Program (WCP) DRAFT
Last updated 11.21.02
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ARTICLE V: PARTICIPATION
ELIGIBILITY AND APPLICATION
1. ELIGIBILITY
(a). The applicant city must commit to at least three full program years of
participation in this WCP.
(b). Any member of the Authority may apply to participate in the WCP by
providing an- z:dopted resolution of its city council and such other
information/materials as may be required. The city's resolution shall commit
the applicant city to three full years of participation in the WCP, if accepted,
—and consent to be g--«--Med--,for-workers'-compensation matters in accordance
with these Bylaws, the approved MOC and other documents and policies
adopted by the Board. The resolution may also state the retained limit desired
by the applicant city.
(c). It is recommended that a city only enter the WCP at the commencement of a
new program year. If a city chooses to enter the WCP at any other time, the
deposit premium for the remainder of the program year will be pro rated. The
new member city will begin coverage on the date that is mutually acceptable
to the city and the Board; however, the new Participant will be required to
share losses with the other members of the WCP for the entire program year.
The application for participation shall be submitted at least 60 days prior to
the date the city wishes coverage to begin to ensure that the State Certificate
of Consent to Self -Insure is received prior to the inception date, and that the
Board may have adequate time to review and evaluate the acceptability of the
applicant.
2. APPROVAL OF APPLICATION
(a). The Board shall, after reviewing the resolution and other underwriting
criteria, determine the acceptability of the exposures presented by the
applicant city.
(b). The Board shall, after a review of the resolution and other underwriting
criteria, advise in writing, the applicant city of its decision to accept or reject
the request within 10 days after the decision has been made.
PARTICIPANTS' DUTIES
1. The Participants shall provide payroll, using the Federal W-3 form and all other
requested information in conformance with the policies adopted by the Board.
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ICRMA Bylaws for the Workers' Compensation Program (WCP)
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2. The Participants shall disclose activities not usual and customary in their operation.
3. The Participants shall at all times cooperate with the Authority's General Manager,
WCPM, claims adjusting company, and loss control personnel, in regards to
underwriting activities of the Authority.
4. Each year the Authority shall bill Participants for a workers' compensation deposit
premium for the next program year. The billings shall be due and payable in
accordance with the Bylaws.
5. Billings may be made to Participants for a program year found to be actuarially-- — -- _
unsound. All billings for payments to bring a program year into an actuarially sound
condition are due and payable upon receipt.
6. Participants that have formerly participated in the WCP, but have withdrawn as a
Participant, shall be required to pay all applicable billings for the program years in
which they participated. Delinquent billings, together with penalties and interest,
shall be charged and collected from the Participant in accordance with the policies
adopted by the Board. Any Participant which voluntarily withdraws from the WCP
shall not be permitted to apply for participation in the WCP until the expiration of
three years from the date of the Participant's withdrawal.
Penalties and interest shall be charged against any amounts delinquent in accordance
with the policies adopted by the Board.
C. TERMINATION
VOLUNTARY TERMINATION
(a). A Participant which has maintained its participation in the WCP for three full .
program years, may terminate its participation if, at keast six. months before
the next program year, a written request to terminate participation is received
from the Participant, or
(b). A Participant that has not maintained its participation in the WCP for three
full program years shall not be permitted to withdraw from the WCP prior to
the end of its commitment period and shall be obligated for payment of
premiums for these three years.
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ICRMA Bylaws for the Workers' Compensation Program (WCP) DRAFT
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2. INVOLUNTARY TERMINATION
(a) The Board may initiate termination of future participation for the following
reasons:
(i) Termination as a member of the Authority;
(ii) Declination to cover the city by the entity providing excess coverage;
(iii) Nonpayment of premiums, assessments, or other charges;
(iv) Frequent late payment of premiums, assessments, and/or other
charges: subject to interest and penalty charges;
�. (v) __._Failure to timely provide requested underwriting informations-_ --.—
(vi) Consistent poor loss history relative to the pool;
(vii) Substantial change in exposures which are not acceptable in this
WCP;
(viii) Financial impairment that is likely to jeopardize this WCP's ability to
collect amounts due in the future; and/or
(ix) Revocation of Certificate to Self -insure.
(b) The Board shall have the authority, upon a two-thirds approval, to authorize a
termination notice be sent to a Participant. Such notice shall be sent at least
60 days prior to termination.
3. Termination of participation, whether voluntary or involuntary, in future program
years does not relieve the terminated city of any benefits or obligations of those
program years in which the city participated. These obligations include :payment of
assessments, retrospective adjustments, or any other amounts due and payable. Any
Participant which voluntarily withdraws as a Participant from the WCP shall not be
permitted to renew participation in the program until the expiration of three years
from the date of the Participant's withdrawal.
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ICRMA Bylaws for the Workers' Compensation Program (WCP) DRAFT'
Last updated 11.21.02
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ARTICLE VI: TERMINATION AND DISSOLUTION
The WCP may be terminated and dissolved any time during the first three years by the written
consent of all Participants, and thereafter by the written consent of two-thirds of the Participants.
However, this WCP shall continue to exist for the purpose of disposing of all claims, distributing
assets, and all other functions necessary to conclude the affairs of the WCP.
Upon termination of the WCP, all assets of the Authority shall be distributed only among the
Participants, including any of those parties which previously withdrew pursuant to Article V, in
accordance with and proportionate to their deposit premiums and assessments paid during the term
of participation. The Board shall determine such distribution within six months after the last pending
claim or loss, covered by the WCP, has been finally resolved and there is a reasonable expectation
that no new claims will be filed.
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ICRMA Bylaws for the Workers' Compensation Program (WCP) DRAFT
Last updated 11. 21.02
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ARTICLE VII AMENDMENTS
These WCP Bylaws may be amended or repealed by a two-thirds (2/3rds) vote of the representatives
of the Board present and voting at the meeting provided prior written notice, as provided within the
Agreement, has been given to the Board.
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ICRMA Bylaws for the Workers' Compensation Program (WCP)
DRAFT
Last updated 11.21.02
Nefi amended november 21 2W2 - S,h v .rs nZ.