HomeMy WebLinkAbout[04d] Workers Comp Coverage 1%itAtike" \Led
C ouncil
CITY or XL atxswIt Agenda Item 4(d) g
MEETING DATE: June 7, 2012
AGENDA ITEM: Workers Comp Deductible — Requested Action: Assign the Workers
Compensation deductible at $2,500 per occurrence.
SUBMITTED BY: Administration/Finance
PREVIOUS COUNCIL ACTION: Annually the City Council must establish the deductible per
occurrence for the Worker's Compensation Policy. Over the past couple of years the City has opted for a
$2,500 deductible per occurrence. The Council has annually adopted to select coverage for elected and
appointed commissioners that serve on the EDA, Planning Commission and Park Board.
BACKGROUND INFORMATION: If the City elects a $2,500 the premium is reduce by 7.0% with
an estimated premium before reduction of $47,719. During the last premium cycle the City did not pay
more than $830 in deductible. The deductible is effective and staff is recommending continuation of the
$2,500 deductible.
BUDGET/FISCAL IMPACT: $3,579 reduction in Work Comp Premium (7 %)
ATTACHMENTS: Request for Council Action •
Coverage Information
REQUESTED COUNCIL ACTION: Authorize staff to notify the insurance carrier of establishing the
Work Comp Deductible at $2,500 per occurrence and to provide coverage for elected and appointed
officials.
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City Employees: Please indicate the estimated payroll for City employees for the coming policy year. The payroll descriptions and
codes provided are the most commonly used. If you need to add additional payroll descriptions, please use the blank spaces and the
codes on the attached list.
Sick, holiday, and vacation pay should be included in the payroll totals. Do not reduce payrolls for sick, holiday, and vacation pay.
Does your City have a flexible benefits plan such as a cafeteria plan, Section 125 plan, or flexible reimbursement account plan?
Yes No
Employee contributions to a flexible benefits plan should be included in the payroll figures you provide. City contributions should
not be included. (This is similar to how these plans are treated under PER A.)
Payroll Description Code Amount Payroll Description Code Amount
Ambulance Services (Not
Volunteer) 7380 $ Sewage Plan 7580 $
Ambulance Services (Volunteer) 7381 $ Off Sale Liquor Store 8017 $
Building Operations 9015 $ Street and Road Construction 5506 $
City Shop and Yard 8227 $ Waterworks 7320 $
Clerical Office 8810 $ Other: $
Blectdc and Steam Power 7539 $ Other: $
Firefighters (Not Volunteer) 7706 $ Other: $
Firefighters (Volunteer) 7708 pop Other: $
Municipal Employees 9410 $ Other: $
Parks 9102 $ Other:
Pollee 7720 $ Other: $
Restaurant and Ban (on sale) 9084 $ Other: $
PRBIIIM OPTIONS •
Please select the premium options below in which the City is most interested. All of the premium options selected will be quoted to
City; however, only one premium option can be ultimately assigned for the coining plan year.
Regular Premium Option: Please indicate if the City would be interested in the regular premium option. Yes No
Deductible Options: Please Indicate. the deductible level and associated premium discount the City would hike to consider.
Deductible Premium Credit Deductible Premium Crediit
$250 1.502 $25,0000 22.002
$500 2.502 $50,000 28.002
$1,000 4.002
$2,500 7.002
$5,000 10.502
$10,000 14.50S
Retrospective Rating: Please indicate if the City would be interested in retrospective rating (if applicable). Yes No
Managed Care Option: Please indicate if the City participates in a state - certified managed care organization (MCO) for workers'
compensation benefits, and if so, the name of that organization. Yes No (please note: there is no longer a premium
credit for enrolling with a MCO)
MCO:
Contact Wormation: Please provide us with a contact for questions about the City's workers' compensation coverage.
,City Contact Person Phone Email
Please fax this completed form to the League of Minnesota Cities Insurance Trust at 651 281 - 129$.
If you have any questions, please contact Barb Meyer, Underwriting Technician, by phone at 651 -215 -4173 or 800-925-1122, or via
email at bmeyerelmc.org.
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