HomeMy WebLinkAbout[04d] Insurance DeductibleCITY OF S7i J(~kPN
Council Agenda Item `t~
MEETING DATE: July 16, 2009
AGENDA ITEM: Insurance Deductible -Continue $ 2,500 deductible for
Worker's Comp Insurance.
SUBMITTED BY: Administration
BOARD/COMMISSION/COMMITTEE RECOMMENDATION:
PREVIOUS COUNCIL ACTION: Annually the Council is asked to select a deductible for the Worker's
Compensation Policy.
BACKGROUND INFORMATION: The City has had about 3 work comp claims in the past 12 months with
two of the claims larger. Even though we had to large claims, the City modification factor has decreased
from .97 to .89. The City has a safety program in place and the reduction of incidents and lowering of
the modification rate is a result of such. Staff is recommending continuing with the $ 2,500 deductible.
This deductible will result in a savings of premium approximately $ 3,600. At this rate we are still saving
more than we are paying out.
BUDGET/FISCAL IMPACT:
ATTACHMENTS: Insurance Form
REQUESTED COUNCIL ACTION: Accept the staff recommendation and increase the Workers
Compensation deductible to $ 2,500 per occurrence for medical expenses only.
League of Minnesota Cities Insurance Trust
Group Self-Insured Workers' Compensation Plan
145 University Avenue West St. Paul, MN 55103-2044 Phone (651)2]5-4173
Notice of Premium Options for Standard Premiums of $25,000-$50,000
ST JOSEPH, CITY OF Agreement No.: 0200005029
25 1ST AVE. N.W., BOX 668 Agreement Period: From: 8/08/2009
ST. JOSEPH MN 56374-0668 To: 8/08/2010
Enclosed is a quotation for workers' compensation deposit premium.
PAYROLL DESCRIPTION
ESTIMATED DEPOSIT
CODE RATE PAYROLL PREMIUM
SEE ATTACHED SCHEDULE FOR DETAILS
Manual Premium 50864.
Experience Modification .89
Standard Premium 45269.
Deductible Credit 0%
Premium Discount 3826.
Net Deposit Premium 41443.
MANAGED CARE CREDIT
Cities that enroll with astate-certified managed care organization(MCO)receive a 2% premium credit on
their work comp coverage.
Standard Managed Care Net Deposit
Premium Credit Premium
45269. 2% 40538.
OPTIONS
Please indicate below the premium option you wish to select. You may choose only one option and
cannot change options during the agreement period.
1. ~. Regular Premium Option
_ or. with 2% Managed Care Credit:
NET DEPOSIT PREMIUM
41443.
40538.
LM4514 (3/02)
2. ~ Deductlble Premium Optlon
Deductible options are available in return for a premium credit applied to your estimated standard
premium of $ 45269. The deductible will apply per occurrence to paid medical costs only.
There is no aggregate limit.
Deductible Premium Credit NET DEPOSIT PREMIUM
per Occurrence Credit Amount with MCO Credit without
S250 2.00% 905. 39633. 40538.
5500 3.00% 1358. 39180. 40085.
S1.000 5.00% 2263. 38275. 39180.
X 52,500 8.0091 3622. 36916. 37821.
55,000 11.5076 5206. 35332. 36231.
510.000 16.0096 7243. 33295. 34200.
3. l~ Retrospective Rates Premium Option
Retm-Rated Est.Minimum Retro-Rated Esi.Maximum
Minimum Factor Premium Maximum Factor Premium
.694% 31417. 1.15076 52059.
.67191 30375. 1.25076 56586.
.624% 28248. 1.500% 67904.
This quotation is for a deposit premium based on your estimate of payroll and selected options. Your final
actual premium will be computed after an audit of payroll subsequent to the close of your agreement year
and will be subject to revisions in rates, payrolls and experience modification. While you are a member of
the LMCTT workers' Compensation Plan, you will be eligible to participate in dividend distributions from
the Trust based upon claims experience and earnings of the Trust.
U you desire the coverage offered above, please return this signed document for the option you have
selected.
This quotation should be signed by an authorized representative of the city requesting coverage.
Signature
Title Date
I.M4513 (3/02)(Rev.Ol/08)
League of Minnesota Cities Insurance Trust
Group Self-Insured Workers' Compensation Plan
I45 University Avenue West
St. Paul, MN 55103-2044
(651)2.15-4173
The "City"
ST JOSEPH, CITY OF
25 1ST AVE. N.W., BOX 668
ST. JOSEPH MN 56374-
Agreement No.: 0200005029
Agreement Period From: 8/08/2009
To: 8/08/2010
CONTINUATION SCHEDULE FOR QUOTATION PAGE
REMUNERATION RATE CODE DESCRIPTION EST. PREM
137745. 8.35 5506 STREET CONSTRUCTION 11502.
95770. 3.90 7520 WATERWORKS 3735.
83955. 2.65 7580 SEWAGE DISPOSAL PLANT 2225.
POP 8880. 78.84 7718 FIREFIGHTERS(VOL)NON SMOKING 7001.
475355. 3.75 7721 POLICE-NON SMOKING 17626.
1500. 2.85 7722 POLICE RESERVES 43.
397190. .78 8810 CLERICAL OFFICE EMPLOYEES NOC 3098.
3000. 3.27 9016 SKATING RINK OPERATION 98.
119665. 3.54 9102 PARKS 4236.
4000. .46 9410 MUNICIPAL EMPLOYEES ]8.
39394. .19 9411 ELECTED OR APPOINTED OFFICIALS 75.
13240. 3.14 7600 CABLE TV COMPANY 416.
13760. 3.54 9102 DUMPSTER HELPER 487.
54600. .19 9411 BOARDS COMMISSIONS 104.
Manual Premium 50864.
Agent: 203949310
90045: OMANN INSURANCE AGENCY LLC
305 E CEDAR ST
PO BOX 608
ST JOSEPH MN 56374
6/26/2009 LM4680 (8/99)