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052714ssa Agenda Package
9:00am 10:30 am 11:15am 11:30 am 12:00 pm 12:15 pm 1:15pm 1:30pm Harnett County Board of Commissioners Special Session **Voting Meeting** Tuesday, May 27, 2014 9:00am Joint Meeting with the Harnett County Board of Education Property and Casualty Broker Presentations: 1) Snipes Insurance 2) Surry Insurance 3) NCACC **Approval of Property and Casualty Broker and Proposed 2014/2015 Plan **Approval of Health Insurance Broker and Proposed 2014/2015 Health Plan Working Lunch Budget Discussion: 1) Board of Education request 2) Overall budget review County Manager's Report: -Regular Meeting Agenda Review Closed Session .... ..... - - - - HARNETT COUNTY Insurance Package WORKERS COMPENSATION PROGRAM 07/01/14-07/01/15 Snipes Insurance Service, Inc. P.O. Box 1165-Dunn, North Carolina 28335 Ph: (910) 892-2121 Fax: (910) 892-5228 www .snipesinsurance.com Producer: J. Dal Snipes, CIC dal@snipesins.com Account Manager: Amy G. Hartley, CIC, CPSR amy@snipesins.com Your Service Team Safety National is committed to providing industry leading services to our policyholdcn. The Service Team is the keystone to that promise. This highly ex:perienced team is identified now and established early in the policy term so there is a seamless transition and efficient delivery of service for your client's needs. The Service Team consists of a one point contact in underwriting. claima, risk control, policy ler\'ices, audit, legal, and finance . We welcome the opportunity for you to experience our commitment to yoor success by contacting any member of our team with your questions or requests. Vanessa Annunziata (314)692-1378 vanessa.annun.ziata@safetynational .com Senior Underwriter -Excess WC Ryan Johnson (314) 810-5476 ryan.johnson@safetynational .com Underwriting Operations Technician Jennifer McKee (678) 488-4977 jennifer.mckee@safetynationaJ .com Regional Business Devdopment Manager David Snodgrass (314)692-1331 david.snodgrass@safetynational.com Risk Control Karen Casserly (314) 810-5438 karen.casserly@safetynational .com MAP Client Services Mitch Neuhaus (314) 692-9517 mitch.neuhaus@safetynational .com VPCiaims Tom Redoutey (314)812-4131 tom. redoutey@safetynational .com Premium Audit Manager - - - - Safety National at a Glance Company History and Bac:kground • Spedallsts ln Workers' Compensation since 1942 • Ucensed and admitted in all so states, the District of Columbia, Guam, Puerto Rico, Canada, and the U.S. vtrpn Islands • Bxdusi~ distribution thf'OUih brokers and ~~Mts • Longest continual provider of Excess Workers' Compensation in the United States • Leadlq provider of Excess Workers' Compensadou with a?" domestic market ahare • High level of dedication, knowledp, experience and quality service distinguish us ln the martetplace • Named one of' the •Best PJaces to Wo~ by Business Insurance mqazine Financial Strength and Stability+ • Pollcyholden'IUI'J)hu-$L2 billion (20.1" lncre&H over 12/12) and t4.2 billion ln assets • A.M. Best Rating • A+ • (SUperior) Financial Size Catesory XU • Standard&: Poor's •A+• (Strona} • A member of the Tokio Marine Group, wtth over $18o blDion in total assets. The Group's main opentln& subsidiary, Tokio Marine and Nichido Plre (TMNF), eJVoyl an A.M. Best Rating A++ (Superior), Plnandal Size Catelory XV. Products and Services • Excess Workers' Compen11don o Spedftc and Agrepte Excess~ .. for individual or IJ'OUP self-Insureds o Monollne Agrepte Cove,.e • Self-Inaurance Bonds • Loa Portfolio Tran*rs (I.Pf) • TEXceu®-Texu Non Subscriber Program • 1'1uty Reinsurance • Public Entity Multi-Une Coverap Safety National Jl)l Schuetz Road Sc.l.ouil, Miuourt 6)146 • La1Je Cuullty Propam o l.afle Deductible Worken' CompeDAtlon 0 Auto and General Uablltty • Alternatlw Risk Pro&rams • MAP Client Services 0 Risk Control Servloea o Best Doctors partnel"'hip ~ la.99S ·SJOO (IIIIJ-fiw) )14·99~·SJOO E-fNII ~pfctyDarioml.cocn ~b www ... ~oom - - - CRISIS. PROTEC'T .ION Safety Nftlonal Crisis Protection Is a crlsls rnanaeement and extraction benefit prcMded ucluslwty for 5at.ty National'\ ElCCt'U and lMp o.ductJb(e Woficers' CompensMion customers. If your business underps a qu~"' •DomatJc: Crisis £wnt• tMt dlf'Ktly Involves your business and lnvolws the dNtft of two or more ol your employets. Saftty NatioN~ will either pay one of our appnMd vendors to assist with crisis mana11ment or rwimburH you directly for the IPPf'OIMd costs Incurred with a 'fenCior ol your dloica. If you experience a quallfylna •1m.m.ttona1 Extraction Crlsb Ewnt" ttt.t requires 1ntem1t1ona1 emp&oyM fttniC.tlon, wt will reimburw )IOU directly for the approwd costs. How Does It Work? II a (IUI(Ifyin& •Domestic Crisis Event" or •~ntemat~ona~ Extraction Crisis Event" occurs, Sllfty N.uon.l Crisis Protection wfU http you rnlniflom post-crtsls rf:sll to Cht orpniDtlon,lts Ukeho&den and ~ dln!c:tty IIW'Otwd In the eyent (lndudlntlmrntdlate famlty of the lrwolwd employM). The annual, agrepte Umlt for these compfirnerary benefits, or any combination of the two, Is $50,000. These benefits are acctSSible when you rtHd them and •~ pnMdtd ~ Slllty Nltlonll frM of charet· "Domestic Crisis Events" Include: MultiiM ... ,..,.. dutllt (two or IliON) nsultlni ..... the .................. evenb: ... Explosion • Arson • Bombing ... Wortcplac. Violence • Structural Fire • ~lcullr Accident .............. ,.. ................ , .......... tro.t:Mr.ao ............. 4111uten: • Tornado ... Explosion • Wildfire ... Structural Fire • Eal"thquW and any Resultlna Tsunami • Hurricane ... Flood "International Extraction Crisis Events" Include: f fllyee utnctlon liMit .... .., .... ··---= Man-Made Events: ... Elcploslon • BomblnJ • Riot • G<Mmment Colllptt&r Polltlall Unrest Benefits: ... Provided It no cost to policyholders. wktl I $50,000 In- null. ...... t. benefit limit for a quallfytnt .Domestic Crisis Ewnt.• a qualfyfn1·~ Extraction Crisis Event• or any combination ol the two. • A 24-hour crisis hotllne to~ and IPPfawd ·~ IMStk Crtsls £wnt• wndors. • 8eMflt emnds to lmmedl* fMnlly tlan ~that Is clrectly lnvolwd In the •OomestJc: Cttsk Event."' Natural Dlusten: ... Tornado • Explosion • Wlldflre • Earthquake and any ResultlnJ Tsunami • Cydonefl'Yphoon/HIIlriane •Flood • Ttw benlftt can be used for qualified •Domtstic Otsls Ewnts" to help )IOU with: • CrlslsMa~t • Crtlllllnponse • Public Relations • EIMf'll'q PsyctdopCII Tr8tment • Includes crltK communication and media manaprnent. • Short~ counM~~n~ and refenal for dlrwctly Involved employees and their lmrneciiMe famRy • • For more Information about Safety National Crisis Protection, please visit www.safatynatlonal.cornlcrlsls_protectlon. If you have additional questions about this free benefit, please contact us at crlslsprotectlonOsafetynatlonal.com. - - .... - - - - - - - - - - - MANAGEMENT Resources that offer a wealth of information to Improve workplace safety. Safety Essentials Online This online service provides resources to help Improve safety and health compliance, best practices, policies and written programs. It Includes: • Customizable and downloadable training tools .. ==-~--. ~..::::-- ~ --.. --·-··--~-·-------- -. ---· --·~---------~- ............ -tal • Explanations of applicabJe laws and regulations --llllllli~ .... ~..- • Dally regulatory updates • Best practices case studies and whitepapers • Daily safety news articles • Ask the Experts O&A database • An online database of over 4 million SDSs • Customizable newsletter templates • A safety Plan Builder library ANALYSIS -·~ -.... -----I (,e ... ·--- ~·--- ·------M•Mflee= .. _,_ Methods to measum and analyze the effectiveness of your worlan' compensation cost contsinment program. . .. ....,.. ___ _ WEK. Workers' Comp Kit® This online self evaluation will help identify success of program components, provide cost comparisons and program Improvement solutions through three mafor steps: • Program Evaluation -to help determine how well your workers' compensation program aligns with Industry best practices In terms of managing and controlling claims costs. • Cost Reduction -with access to over 60 tools such as letters, presentations, forms and worksheets to assist in reducing the cost of claims after they've occurred. • Benchmartc.lng -the ability to compare your losses to your peers on a national level within one of 141ndustry averages or on a state level . .... _ ·- :::"'-- • VIsit www.SafetyNatlonal.com/map for more details or cal1888-995-5300. ---- .... - - - - - - - - - - - - - - PREVENTION Tools to help pt'fN81Jt Injuries before they occur. save lives and reduce organizational costs. Safety Training Source This self-paced, onHne employee learning management system provides courses that can be assigned to employees or entire departments, enabling you to track their progress and overall scores. Over 150 courses are included with select items available in Spanish. S:ERVE Safety: Emergency Responder Vehicle Education (S:ERVE) is an online driver simulation and curriculum created to educate law enforcement, firefighters, and EMS pensonnel to drive at their safest In emergency response scenarios in an effort to reduce collision rates . Remedy Interactive oJ This online tool promotes workplace 'T~:~lct ve wellness by helping employees work ......... •• .......... more comfortably at their computers and workstations with self-help ergonomic tools. It Is designed to tlelp decrease Injury-related costs, drive down absenteeism and better address OSHA compliance. Also Available Through MAP Client Services: • Risk control services that include access to a network of safety experts and consultants. • Vendor discounts available for a variety of safety management and training materials. VIsit www.SafetyNational.oom/map for more details or call888-995-5300. S:ERVE is an online driYer aimulation aad curriculum created to educate law S ~·.-E RVE cnfon:ement, &rdipten, EMS and other emergency rapoadcn to drive at their safat in an eff'on to ~«' collwon rates in emetJeDcy response scenariO&. The program guicla u.scn throop a aeries of situations in which deciaion making is key. Usen prioritize their Slltty Emergt'l'lty ~ ~ E~ vehicle handling and emagency tuk acdvida while aperiendJll situations related to typic:al emergency response or pursuit operations. S:ERVE meets the staoda.rda established by the International Association ofDiruton ofLaw Enforcement Scanda.rds aad Traiftiag (IADLES'I) and the Federal Law Enforcement Tnin.ing Aaredicadon (FLETA). ScERVE loduda 6ft c:.ore lcuon plaDit lnteneaion Approecb-Select appropriate methods for maximizing vehicle oontrol when appmach.ing intmeerions and recognizing rhc risks associated with improper intmection negodarlon. lntenection Aaeument -l...carn to I'COOgllize. ca~rize and prioritiu: all potential hazards. <learing the lnteneaion Buies -Decipher appropriate techniques and rc:cogn.iu me dangers associated with improper intersection douing. Clarlns the lntenedion Advanced -Review and reinforce awareness of risk faaors when dearing intersections and how to avoid common mistakes when doing so. lntenection Deputare & Coune Summary -l...t:arn me steps for safely dcp:ming an intersection, then oomplcte a mmprehc:RSM= course recap of aU key oonccpts. lmpnmrd Comprebeulon S:ERVE offers an interactive functionality to support a higher learning retention rate than traditional classroom environments. Users are tested throughout c.ach lesson to ensure oompltte un<krstanding of the nuterial and receive immediate feedback on performance. To re.sene access to S:ERVE for )'OW' orpnfudon, contact: Arid jenkins, CSP, MBA, ARM 314-692-1385 Riskeonrrol@lsaktynational.com Lam more about MAP Oient Senica S:ERVE will be offered through Safety National's MAP Client Services-a program [hat offers various resources to help policyholders improve their workers' oompensation management, analysis and prevention effora. V'ISit www.aaktynational.com to view the full suite of products and resources ofkrro to policyholders rhrough MAP Client Services. INSURED: Harnett County, NC POLICY DATE: 07/0111+07/01/15 SAFETY NATIONAL INSURANCE 2013-14 2014-15 I POLICY I ADDITIONAL INFO. OPTION! ADDITIONAL INFO. DIFFERENCE %CHANGE I I 1\VORKCOMP $126,945.00 $181,.327.00 $54,.382.00 42.84°/t I I I INFO $34,179,445.00 PAYROLL EXPIRING $29,725,733.00 PAYROLL RENEWAL -15,053,712.00 -14.53•1. $1,018,.397 .00 MANUAL PREMIUM $999,276.00 MANUAL PREM I UM -$19,121.00 -1.88°/t EXPIRING RENEWAL 325°/t LOSS FUND -Je 400-/o 23.084'/o $3,.309, 790.00 ESTIMATED LOSS FUND $3,997,104.00 ESTIMATED LOSS FUND $687.314 .00 20.-nol. EXPIRING RENEW $1,000,000.00 AGGREGATE EXCESS LIMIT $1,000,000.00 AGGREGATE EXCESS LIMIT $0.00 0.1)0°/o $750,000.00 SIR/LOSS LIMITATION $1,000,000.00 SIR/LOSS LIMITATION $250,000.00 33.33°/t -- .. PHONE# (314) 995-5300 Safety NsUonsl Cssushy Corpon1Uon 1832 Schuetz Road StLouis, MO 63146 TO: SNIPES INSURANCE SERVICE, INC. ATTN: Ms. Amy Hartley PHONE: {910) 892-2121 FAX: (910) 892-5228 FROM: Vanessa Annunziata DATE: 05/0912014 FAX# (314) 995-3843 EXCESS WORKERS' COMPENSATION INSURANCE QUOTATION Name of Risk: COUNTY OF HARNEn Account: 6018214 Previous Policy Number: AGC4049190 I Specific & Aggregate Excess 2 of4 INSURED: Harnett County, NC POLICY DATE: 07/01/1+07/01/15 SAFETY NATIONAL INSURANCE I 2013-14 I 2014-15 I POLICY ADDITIONAL INFO. OPTION2 ADDITIONAL INFO. DIFFERENCE I %CHANGE 'WORKCOMP $126,945.00 $166,464.00 $39,519.00 Jt.u•t. INFO $34,779,445.00 PAYROLL EXPIRING $29,725,733.00 PAYROLL RENEWAL -$5,053,712.00 -1t.SJ•t. S1,018,397 .00 MANUAL PREMIUM $999,276.00 MANUAL PREMIUM -$19,121.00 -1 .880/o EXPIRJNG RENEWAl 325°/e LOSS FUND •t. 410"/o 26.15% $3,309,790.00 ESTlMATED LOSS FUND $4,097,032.00 ESTIMATED LOSS FUND $787,242.00 23.798/o EXPIRING RENEW $1,000,000.00 AGGREGATE EXCESS LIMIT $1,000,000.00 AGGREGATE EXCESS LIMIT $0.00 0.00% $7.50,000.00 SIR/LOSS LIMITATION $1,100,000.00 SIR/LOSS LIMITATlON $350,000.00 46.67% I I I f I INSURED: Harnett County. NC POUCY DATE: 07/0111+07/01/15 SAFETY NATIONAL INSURANCE 2013-14 2014-15 I - POUCY I ADDITIONAL INFO. OPTION 3 ADDITIONAL INFO. DIFFERENCE 0/eCHANGE WORKCOMP $126,945.00 $145,656.00 $18,711.00 14.74•1. ---- INFO $34, n9,44S.OO PAYROLL EXPIRING $29,725,733.00 PAYROLL RENEWAL -$5,053,712.00 -14.53"1. -- $1,018,397.00 MANUAL PREMIUM $999,276.00 MANUAL PREMIUM -$19,121.00 -1.880/e EXPIRING R Nl".WAl 325•;. LOSS FUND "1. 425•;. 30.TI-/e I SJ,J09, 790.00 ESTIMATED LOSS FUND $4,246,923.00 ESTIMATED LOSS FUND $937,Ul.OO :zs ... n•;. EXPIRING R~Nt:.W $1,000,000.00 AGGREGATE EXCESS LIMIT $1,000,000.00 AGGREGATE EXCESS LIMIT so.oo 0.00% $750,000.00 SIR/LOSS LIMITATION s~.ooo.oo SIR/LOSS LIMITATION $500,000.00 66.6,.1. I I I I - - - - - PHONE# (314) 995-5300 Safety NsUonsl Cssushy Corpo111tion 1832 Schuetz Road St. Louis, MO 63146 TO: SNIPES INSURANCE SERVICE, INC . ATTN : Ms. Am'j_ Hartle_y PHONE: (91 0) 892-2121 FAX : (91 0) 892-5228 FROM: Vanessa Annunziata DATE: 05/0912014 FAX# 1314) 995-3843 EXCESS WORKERS' COMPENSATION INSURANCE QUOTATION Name of Risk: COUNTY OF HARNETT Account: 6018214 Previous Policy Number: AGC4049190 I S~cific & A~ate Excess 1 of4 - - S.l'flly NlltioMI C.su11hy CDipD,.tlon 1832 Schuetz Road St Louts, MO 63146 PHONE t {314} 995-5300 FAX# (314) 995-3843 TO : SNIPES INSURANCE SERVICE, INC . ATTN : Ms. Amy Hartley PHONE: ce1o) 892-2121 FAX: (91 0) 892-5228 'FROM: Vanessa Annunziata DATE: 051'0912014 EXCESS WORKERS' COMPENSATION INSURANCE QUOTATION EndQJHmtptl: NORTH CAROLINA MANDATORY ENDORSEMENT($), IF APPLICABLE 1061 10 1207 QMC) POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE ContioMDCill: The qUOit II subject to the following: 1. Subject to receipt, reWJw and .cceptance of Information contained in SNCC's Ef11Jioyee Concentration Supplemental Information (08.'04) form prtor to binding. ~ 2. This Agreement willlndude coverage for Wrters' Compenution loss caused by acts of terrorism as defined In the Agreement. Coverage for such losses wll still be subject to all tenns, delnitions, exclus6ons, and conditions In the Agreement, & any applicable federal and/or state laws, rules , or regulallons. Be advised that, under the Terrorism Risk Insurance Act of 2002 as amended, terrorism losses would be partially reimbursed by the U.S. Government under a formula established by the Ad. Under this formula, the U.S. Government would generally reimburse 85% of cowred tenorism losses exceeding a deduc:1ible paid by us. The Ad contains $100 bllion cap that limits the reimbursement from the U.S. Government as wei as from all insurers. If aggregate Insured losses for all Insurers exceed $100 blllon, your cow rage may be reduced. The portion of the EMPLOYER's annual premium attributable to cowrage for losses caused by a certified ad of terronsm Is : 0 .5% Cgnvnentl: 1. Endof'Sements mandated by the coverage state(s) will automatlcaly be added to your policy regardless of whether they are shown In the above schedule. In addllon, a change In an endorsement fonn number may OCQ.Ir as a result of state tiling requirements/updates arising subsequent to this quote. 2. Included in our quote are the MAP Client SeMo&s. These resources consist of both risk control and claim services including: Safety Essentials On-line; 'M>tkers' Cof11) Kil; Safety Training Sourot; and Best Doctors Catcare and Ask Best Doctors programs -which provide In-depth case re>Mw by wor1d renowned doctors. 3. INCLUDED IN OUR QUOTE ARE THE RESOURCES OF THE BEST DOCTORS CATCARE PROGRAM, ~ICH PROVIDES IN-DEPTH CASE REVIEW BY 'M:>RLD-R~ED DOCTORS. 4. This Agreement wtll k'ldude coverage for Wbrkers' CompenMtlon loss caused by acts of tenonsm as defined In the Agreement. Cowrage for suctllosses will still be subjac:l to all tenns, definitions, uduslons, and conditions in the Agreement, & any applicable federal and/or state laws, rules, or regulations. Be advised that, under the Terrolism Risk Insurance Ad of 2002 as amended, terrorism losses would be partlaly reimbursed by the U.S. Government under a formula established by the Ad. Under this formula, the U.S. Gowmment woukt generally reimburse 85% of cow red terrorism losses exceeding a deductible paid by us. The Ad contains $100 billion c.p that limits the relrrtM.~rwment from the U.S. Government as wei as from all Insurers. If aggregate Insured losses for al Insurers exceed $100 blllon, your cowrage may be reduced. The portion of the EMPLOYER's annual premum attributable to cow rage for losses caused by a certified act of terrorism Is: 0.5., WORKERS COioiPEHSATION Service Highlights • Designated account manager • Designated lost time adjuster located in North Carolina • Unlimited on-line access to claims information, via MasterKey Connects® • First Report of Injury via the internet Renewal Proposal for County of Harnett July 1, 2014-June 30, 2015 • Banking arrangements {coordination with Association Accountant) • Provide information to the Excess Carrier • Indexing • Check stock, issuance, postage • Scheduled claim reviews • Key Risk will act as Account Manager for Mandatory Insurer Reporting to CMS • A~cess to Essentials Essentials- Risk Management free video lending library and other resources County of Harnett Self Insured Workers Contpensation Program Renewal Term 7/1/14-6/30/15 Service Claims Administration Annual administrative fee Medical Bill Adjudication and Network Access Risk Management Resources Subrogation Recoveries Claim Type Definitions: Fee Summary $28,000 Mm1mum Annual Fee Per claim fees applied only if the minimum is exceeded- Indemnity: Medical only: $1,000 $600 per new claim $120 per new claim Medical Bill Repricing: $8.75 per bill Enhanced Savings: 30% of savings beyond fee schedule Included at no additional fee: Unlimited onhne access To Master Key Connects Risk Management Essentrals Resources 10% of subrogation recoveries Medical Only defined as cla•ms that have no paid indemnity. This Includes medical only claims that are lnvest.Jgated, denied, or Involve subrogation. lndemnrty • defined as claims with more than $2,000 In medical Dills; seven days or more of lost ttme; payment of PPD or dlsftgurement; litigation or med•at•on process; and an employee who returns to work on transitional duty (alternate or "light" duty), but requ1res follow-up by the da•m adjuster to facilitate a full, unrestncted return to work. Allocated Expense Definition Claim expenses Include allocated loss adjustment expenses Including, but not hmlted to: leQal services and defense costs, Independent medical evaluations, photocopy and medtcal reportS, pollee reports, surveillance, court reporter fees, transcnpt fees, cop•es of depositions, expert witness fee<i, rehabihtat•on services, med•cal b•ll re-pr1c1119, negotiation services, access to preferred provider networkS, and utilization review services. Program expeno;es Include, but are not hm1ted to, assessments, taxes, and aud•t and actuary fees. Working Together. Delivering Better Outcomes. WOIIfiS CO .. PfiiSAliON .. Managed Care Service Fees (Fcc Stnu.:turc for Kc) Risk Managcd Carc Scr. ices allnt:atcd hl the daim tile) Utilization Review - .. Medicare Set Aside - - - KEY RISK LOSS CONROL SERVICES Access to Essentials Risk Management Free video lending library and other resources. Loss control services are available from Key Risk on a per project or as needed basis at a rate of $140.00 per hour. Key Risk will provide a free initial consultation to review the County's needs and concerns. Key Risk can assist with frequency analysis, safety programs, training, on-site evaluation of particular problems that have been identified. ManageAR V wEWCAKMIK2dBQK3y/ Page 1 of2 1 VwEPDwULL TE40Tc30C Workers Compensation Assigned Risk Premium Calculator Requestl!d Effective Date: 7/1/2014 Agent AMY WORTON ~10: 13259~149 Applicant: COUNTY OF HARNETT Premium Calculation k;Jency: SNIPES INSURANCE SERVICE INC k;Jency Address: PO BOX 1165 DUNN, NC 28334 The premium calculated IS based upon the Information that you ~ provided and Is subject to ...erificabon by ltle NCRB. For definitiOnS d the line items below, see the Frequently Asked Questions section on the ~ page. a ... Total# Code Payroll Empfoyees Rate Premium Messqe 6217 $385,726 15.81 $60,983 7380 $554,878 11.31 $62,757 7520 $2,576,156 8.29 $213,563 7580 $815,949 7.47 $60,951 7705 $2,624,252 18.78 $-492,835 7710 $129,892 11.42 $14,834 7720 $6,854,397 5.72 $392,072 8380 $85,571 6.11 $5,228 8810 $6,264,373 0.39 $24,431 8820 $329,406 0.)4 $1,120 8831 $205,291 3.07 $6,302 8832 $1,871,944 0.86 $16,099 8835 $525,438 5.75 $30,213 9015 $459,464 8 .04 $36,941 9102 $82,532 6.31 $5,208 9403 $27,876 18.87 $5,260 9410 $5,932,588 6.77 $401,636 Total Manu.l Premium: $1,830,433 Increased Um1ts r# Employer liability Factor(0.011): $20,135 Balance to Inaeased Umits r# Employer l...lablllty: $0 Total Subject Premium: $1,850,568 Experience Modification (1.00): $0 Total Modified Premium: $1,150,568 AAAP Surchar\)e (0): $0 0\arge for Non-ratable Element: $0 &tlance to Minimum Premium at Standard Umlts: $0 https://www.ncrb.org/ManageARJDefault.aspx?pcd=premium&appid=41 b4c3 fb-b72a-41 c... 5/21/2014 Mana geAR Page 2 of2 ToDI Standard Premium: $1,850,568 Expense Constant: $250 Terrorism Charc~: $5,945 Catastrophe (Other Than Certified Acts of Terrorism) Charge: $2,973 Estimated Annual Premium: $1,859,736 Required Deposit Premium: $929,868 Loss Sensitive Rating Plan Deposit Premium: $370,114 ToDI Required Deposit Premium: $1,299,982 https://www .ncrb.org!ManageAR!Default.aspx?pcd=prerniurn&appid=41 b4c3fb-b72a-41 c... 5/21/2014 Loss Sensitive Rating Plan The brochure that follows this cover sheet is designed to assist you with questions regarding the Assigned Risk Loss Sensitive Rating Plan (LSRP). For more detailed information on the LSRP you may refer to the NCCI Basic Manual Rule 4-C. Rule 4-C provides information on North Carolina State Rule Exceptions as they pertain to the LSRP. The State Rule Exceptions for North Carolina refer you to the ACORD 135 NC Application. The ACORD 135 NC Application is the approved form for use when applying for assigned risk coverage in North Carolina. The ACORD 135 NC Application shows payment methods allowed in North Carolina and includes notification to the employer and their representative of the eligibility requirements for LSRP. For assistance with a North Carolina assigned risk application or questions about the application of LSRP on North Carolina assigned risk policies. contact the North Carolina Rate Bureau at 919-582-1056 or www.ncrb.org 1/23/12 NCCI National Council on Compensation Insurance. Inc. Loss Sensitive Rating Plan (LSRP) A guide to the mandatory assigned risk retrospective rating program C> Copyri&ht 2011 National Council on Compensation Insurance, Inc. All Rights Resrrved. NCCI's Assigned Risk Loss Sensitive Rating Plan (LSRP) This brochure is designed to help you understand NCCI's assigned risk Loss Sensitive Rating Plan (LSRP) and how ~ affects the cost of workers compensation insurance in the residual market. This brochure is an overview of the filed and approved plan. Refer to the glossary to facilitate quick reference for terms used frequently throughout this brochure. Refer to Rule 4-C of NCCI's Basic Manual for Worlcei'S Compensation and Employei'S Liability Insurance (Basic Manual) for details and state- specific requirements of LSRP. Introduction LSRP is a mandatory assigned risk retrospective rating plan for those employers whose LSRP standard premium meets a minimum threshold of $250,000. Unlike experience rating, which adjusts the premium of an employer's policy based on the employer's past experience, LSRP adjusts the premium of an employer's policy on the basis of losses incurred during the same policy period. LSRP does not change the coverage provided by the policy. As with any retrospective rating plan, LSRP is a type of pricing plan that is applied to a policy. Premium for a retrospectively rated policy is determined after the expiration of the policy and continues to be adjusted for several years after the expiration of the policy, based on the development of the employer's losses incurred during the policy term. LSRP is constructed to be uniformly applied to all eligible residual market employers. The plan parameters that form the basis of the LSRP are not negotiable because residual market assignment is random; fixed parameters are necessary to ensure consistent application of the LSRP rules. Purpose LSRP is designed to: • Encourage safety and loss prevention • Provide incentives for employers with favorable loss experience through lower premiums • Provide a disincentive for employers with unfavorable loss experience through higher premiums • Depopulate the residual market LSRP provides large employers with a financial incentive to promote workplace safety and reduce losses by requiring employers to accept greater financial responsibility for the losses they incur. Also, LSRP removes the potential financial advantage that guaranteed cost residual market coverage might otherwise provide for large employers with unfavorable loss experience. The intent of LSRP is for premium on a policy to closely reflect the actual loss experience of the employer on that policy. The ultimate impact of LSRP on any given policy depends on the development of an employer's incurred losses on that policy over time. LSRP Valuations LSRP policies are subject to four valuations after policy expiration when incurred losses are valued in accordance with the applicable statistical plan. The first valuation occurs 1 B months after the month in which the policy became effective. The subsequent valuations occur annually thereafter at 30, 42, and 54 months after the month in which the policy became effective. The valuations adjust LSRP standard premium to reflect the actual experience of the employer by using the following formula: © Copynght 2011 National Council on Compensation Insurance. Inc. All Rlghts Reserved. 2 LSRP (AdditionaVRetum) Premium = {[(SP x BPF) + (ICL x lCF) + (SP x lDF x LCF)] x TM}-SP Where .•. Equals ... SP lSRP Standard Premium BPF Basic Premium Factor ICl Incurred losses LCF loss Conversion Factor LDF loss Development Factor TM Tax Multiplier The result of the actual experience may be additional premium, return premium. or no change to the estimated premium. Nonpayment of any additional premium to the assigned carrier may result in cancellation of any in-force WOJkers Compensation Insurance Plan (WCIP) policy by any assigned carrier, and the employer, as defined under the WCIP, may no longer be in good faith eligible for coverage under the WCIP. Eligibility lSRP is a mandatory plan for all qualifying policies in the residual market. Generally, to qualify for lSRP, the combined LSRP standard premium of alllSRP-approved states on the policy (or policies to the extent that an employer has multiple policies that are combinable for experience rating as defined in NCCI's Experience Rating Plan Manual) must meet or exceed $250,000. Employers that generate premium of at least that size ($250,000) are expected to have a sufficient number of claims to allow loss prevention services to be effective. Refer to Basic Manual Rule 4-C for more information about LSRP eligibility. Generally, lSRP applies to an employer with multistate operations when the total lSRP standard premium of all states that have approved lSRP meets the lSRP standard premium eligibility requirement. If some states don't have lSRP. multiple policies may be required. Further. an assigned risk employer that qualifies for lSRP in Indiana must be written on a separate policy. Refer to Basic Manual Rule 4-C for information regarding the issuance of separate WCIP policies for multistate operations. Prior to policy issuance, each application and/or policy renewal is reviewed by the carrier to estimate the size of the policy's premium. If the policy meets the lSRP premium eligibility threshold, the policy is issued with an endorsement indicating that it qualifies for lSRP. LSRP Contingency Deposit If an employer qualifies for lSRP, an lSRP contingency deposit of 20% of the lSRP standard premium is required for new and renewal policies. This lSRP contingency deposit is in addition to the deposit required of all assigned risk employers. The lSRP contingency deposit serves as collateral for premium that may be due to the assigned carrier as a result of losses incurred during the policy term. The lSRP contingency deposit is calculated by multiplying the LSRP standard premium by 20%. When assigned risk policies are combined for lSRP purposes, the lSRP contingency deposit is calculated by multiplying the combined LSRP standard premium for all policies by 20%. A new lSRP contingency deposit is required for each renewal policy. The lSRP contingency deposit must be paid using any of the following payment methods: • Automated Clearing House/Electronic Funds Transfer (ACHIEFT) • Credit Card • Personal or Business Check Another option is an irrevocable letter of credit (llOC). The llOC may be provided for each policy term as collateral for the LSRP contingency deposit. The llOC must be for an amount at least equal to the lSRP 3 IC Copyright 2011 National Council on Compensatlon Insurance, Inc. All Rights Reserved. contingency deposit of 20% and must meet certain conditions as defined in Rule 4-C of NCCI's Basic Manual. The ILOC can only be used for the LSRP contingency deposit. Failure by the employer to submit an acceptable ILOC within 30 days of the issue date of the binder will require the employer to tender a check made payable to the assigned carrier within 10 days of the employer infonning the assigned carrier that an ILOC could not be obtained. If the ILOC or LSRP contingency deposit is not provided within the required time frame, the policy will be cancelled for nonpayment of premium. Typically, the LSRP contingency deposit is retained by the assigned carrier until all four valuations are completed. However, the assigned carrier may use sound underwriting judgment to detennine whether to return the LSRP contingency deposit at an earlier valuation. Note: The assigned carrier must hold the LSRP contingency deposit for all professional employer organizations (PEO) and temporary arrangements policies until the fourth or final valuation is completed. LSRP Eligibility Adjustment Period During the first 120 days of the policy term (except for those policies issued to PEOs and temporary arrangements), the carrier reevaluates the LSRP eligibility of the policy if the policy premium changes or the employer obtains coverage in the voluntary market or cancels the policy for reasons other than retiring from business. The purpose of this adjustment period is to account for premium increases and decreases within the first 120 days of the policy period. Depopulation of the residual market is a major goal of LSRP. If an employer with an LSRP policy is able to obtain coverage in the voluntary market within 120 days of policy inception. the premium for the LSRP policy is calculated on a guaranteed cost basis. The following tables summarize how the LSRP adjustment period can affect a residual market policy: Table 1 Increase/Decrease In LSRP Standard Premium If during the first 120 days of the ~llcy tenn ••• Then ••• The LSRP standard premium decreases and falls • The policy is converted to a guaranteed cost below the LSRP eligibility threshold policy, retroactive to policy inception • LSRP contingency deposit is returned The LSRP standard premium Increases and meets • LSRP is applied retroactively to policy inception the LSRP eligibility threshold • An LSRP contingency deposit will be required within 30 days of the assigned carrier issuing notice of the application of LSRP If after the first 120 days of the policy tenn ... Then •.• The LSRP standard premium decreases and falls LSRP continues to be applied to the policy(ies) below the LSRP eligibility threshold The LSRP standard premium Increases and meets • The policy(ies) will remain a guaranteed cost the LSRP eligibility threshold policy(ies) • LSRP is applied at renewal, subject to meeting the eligibility requirements on the renewal policy(ies) 4 Q Copyright ZOll National Council on Compensation Insurance, Inc. All Rights Reserved. Table2 Obtaining Voluntary Coverage If an employer with an LSRP policy(ies) obtains Then .•• coverage In the voluntary market ... During the first 120 days of the policy tenn • The policy is converted to a guaranteed cost policy, retroactively to policy inception • The policy is cancelled pro rata • The LSRP contingency deposit and any unearned premium is returned, subject to final audit After the first 120 days • LSRP continues to apply to the policy • The policy is cancelled pro rata • Valuations are calculated in accordance with Basic Manual Rule 4-C • The assigned canier must hold the LSRP contingency deposit in accordance with Basic Manual Rule 4-C Application of LSRP to Professional Employer Organization (PEO) and Temporary Arrangements There are additional rules for the application of LSRP to policies covering PEO and temporary arrangements. Due to the fluctuations in exposure for these types of operations. LSRP is applied to policies covering PEO and temporary arrangements if, at any time during the policy period, the premium for that coverage reaches the minimum threshold required for LSRP eligibility. Conversely, if the premium falls below the threshold during the policy period, the policy continues to be subject to LSRP. This is due to the wide variances in payroll for these types of operations. Table 3 Application of LSRP to PEO and Temporary Arrangements If the arrangement is covered under a ... Then eligibility for LSRP will be ... PEO master policy Based on LSRP standard premium for the entire master policy (PEO and clients) PEO multiple coordinated Policy (MCP) • For individual clients of PEOs-Detennined separately by each individual client PEO policy written in accordance with NCCI's Sas/c Manual • For PEOs (excluding clients}-Based on LSRP standard premium of any PEO policy written in accordance with NCCI's Basic Manual Temporary Arrangement Based on LSRP standard premium for the entire temporary arrangement policy PEO and temporary arrangement policies are subject to NCCI's Basic Manual Rule 4-C. If the LSRP eligibility threshold is met at any time then : • LSRP is applied retroactive to policy inception • An LSRP contingency deposit is required to be paid within 30 days of the assigned carrier issuing notice of the application of LSRP PEO and temporary arrangement LSRP policies are subject to a first valuation with three subsequent valuations for a maximum of four valuations . The assigned carrier must hold the LSRP contingency deposit for all professional employer organizations (PEO) and temporary arrangements policies until the fourth or final valuation is completed . . ()Copyright 2011 National Council on Compensation Insurance, Inc. All Rights Reserved. 5 Examples of the Calculation of LSRP The following examples will help you undenstand how the valuations will impact your workers compensation premium. In these examples, the assigned carrier is holding the LSRP contingency deposit until the fourth valuation. The values and factons used in the valuations are for illustration purposes only. Please refer to NCCI's Basic Manual-Rates/Loss Costs Index -Assigned Risk Miscellaneous Values pages for applicable factors in your state. The formula below applies for all examples: LSRP (Additional/Return) Premium = {[(SP x BPF) + (ICL x LCF) + (SP x LDF x LCF)] x TM}-SP Where ••• Equals ••• SP LSRP Standard Premium BPF Basic Premium Factor ICL Incurred Losses LCF Loss Convension Factor LDF Loss Development Factor TM Tax Multiplier Example 1 Consider Policy A, with valuations between the LSRP minimum and maximum premium amounts. LSRP Standard Premium (SP) $339,000 LSRP Contingency Deposit Percentage 20% LSRP Contingency Deposit $67,800 LSRP Factors Basic Premium Factor (BPF) 0 .40 Minimum Premium Factor (MinPF) 0.75 Maximum Premium Factor (MaxPF) 1.75 Loss Conversion Factor (LCF) 1.125 Tax Multiplier (TM) 1.126 Valuation Incurred Losses (ICL) Loss Development Factors (LOF) 1st $184,000 0 .31 2nd $271 ,200 0.21 I 3rd $280,000 0.15 4th $289,650 0.10 6 C> Copyr!Jht 2011 National Council on Compensation Insurance, Inc. All Rights Reserved. LSRP (Additional/Return) Premium Calculations Factors/Formulas 1st Valuation 2nd Valuation 3rd Valuation 4th Valuation 1. LSRP Standard Premium (SP) $339,000 $339,000 $339,000 $339,000 2. Basic Premium Factor (BPF) 0.40 0.40 0.40 0.40 3. Basic Premtum (1) x (2) $135,600 $135,600 $135,600 $135,600 4. Incurred Losses (ICL) $184,000 $271,200 $280,000 $289,650 5. Loss Conversion Factor (LCF) 1.125 1.125 1.125 1.125 6. Converted Losses (4) x (5) $207,000 $305,100 $315.000 $325.856 7. Loss Development Factor 0.31 0.21 0.15 0.10 (LDF) 8. Loss Development Premium $118,226 $80,089 $57,206 $38,138 (1) X (7) X (5) 9. Subtotal (3) + (6) + (8) $460,826 $520,789 $507,806 $499,594 10. Tax Multiplier (TM} 1.126 1.126 1.126 1.126 11. Valued LSRP Premium (9} x $518,890 $586,408 $571,790 $562,543 (10) 12. Minimum Premium Factor 0.75 0.75 0.75 0.75 (MinPF} 13. LSRP Mtnimum Premium (1} x $254,250 $254,250 $254,250 $254,250 (12) 14. Maximum Premium Factor 1.75 1.75 1.75 1.75 (MaxPF) 15. LSRP Maximum Premium (1)x $593,250 $593,250 $593,250 $593,250 ( 14) 16. LSRP Premium (adjusted for $518,890 $586,408 $571,790 $562,543 minimum/maximum if necessary) 17. Premium billed through prior $339,000 $518.890 $586,408 $571,790 valuation 18. LSRP (Additional/Return) $179,890 $67,518 $14,618 $9,247 Premium (16)-(17) (additional) (additional) (return) (return) Example 1 Summary Based on the incurred losses, the LSRP premium as of the 4th valuation is $562,543. The valued LSRP premium is between the minimum and the maximum premium under the LSRP. So, no further premium adjustment is needed. At the 4th valuation, the amount due to the employer is $77,047. which is the sum of the return premium of $9,247 and the LSRP contingency deposit of $67,800. Example 2 Consider Policy B. with the 4th valuation below the LSRP minimum premium amount. LSRP Standard Premium (SP) $270,000 LSRP Contingency Deposit Percentage 20% LSRP Contingency Deposit $54,000 LSRP Factors Basic Premium Factor (BPF) 0.40 Minimum Premium Factor (MinPF} 0.75 Maximum Premium Factor (MaxPF) 1.75 Loss Conversion Factor (LCF) 1.171 Tax Multiplier (TM) 1.168 © Copynght 2011 National Council on Compensation Insurance, Inc. All Rights Reserved. 7 - - Valuation IRcurred Losses (ICL) Loss Development Factors (LDF) ~ ~ 1st $78,000 0.31 I 2nd $90,300 0.20 ~ I 3rd $60,000 0.16 4th $53,100 0.01 LSRP (Additional/Return} Premium Calculations Factors/Formulas 1st Valuation 2nd Valuation 3rd Valuation 4th Valuation 1. LSRP Standard Premium (SP) $270,000 $270,000 $270,000 $270,000 2. Basic Premium Factor (BPF) 0.40 0.40 0.40 0.40 3. Basic Premium (1) x (2) $108,000 $108.000 $108,000 $108,000 4. In curred Losses (ICL) $78,000 $90,300 $60,000 $53,100 5. Loss Conversion Factor (LCF) 1.171 1.171 1.171 1.171 6. Converted Losses (4) x (5) $91 ,338 105 741 $70,260 $62,180 7. Loss Development Factor 0.31 0.20 0.16 0.01 (LOF) 8 . Loss Development Premium $98,013 $63,234 $50,587 $3,162 (1) X (7) X (5) 9 . Subtotal (3) + (6) + (8) $297,351 $276.975 $228,847 $173,342 10. Tax Multiplier (TM) 1.168 1.168 1.168 1.168 11 . Valued LSRP Prem ium (9) x $347,306 $323,507 $267,293 $202,463 {10)_ 12. Minimum Premium Factor 0.75 0.75 0.75 0 .75 (MinPF) 13. LSRP M1mmum Prem•um (1) x $202,500 $202,500 $202,500 $202,500 (12) 14. Maximum Premium Factor 1.75 1.75 1.75 1.75 (MaxPF) 15. LSRP Maximum Premium (1) x $472,500 $472,500 $472,500 $472,500 (14) 16. LSRP Premium (adjusted for minimum/maximum if $347,306 $323.507 $267,293 $202,500 necessary) 17. Premium billed through prior $270,000 $347,306 $323,507 $267,293 valuatio n 18. LSRP (Additional/Return) $77,306 $23,799 $56,214 $64,793 Premium (16)-(17) (additional) (return) (return) (retum) Example 2 Summary Based on the incurred losses, the valued LSRP premium as of the 4th valuation is $202,463. Since the valued LSRP premium of $202,463 is below the LSRP minimum premium of $202,500, the LSRP minimum premium of $202,500 becomes the LSRP premium. At the 4th valuation, the LSRP premium of $202,500 is subtracted from the amount paid through the 3rd valuation, $267,293. The 4th valuation is adjusted to a return premium of $64,793. The amount due to the employer is $118,793, which is the sum of the return premium of $64,793 and the LSRP contingency deposit of $54,000. Example 3 Consider Polley C, with 3rd and 4th valuations above the LSRP maximum premium amount. L SRP Standard Premium (SP) $420.000 LSRP Contingency Deposit Percentage 20% LSRP Contingency Deposit $84,000 8 () Copyrt1ht 2011 National Council on Compens.1tlon lnsunnce, Inc. All Rl1hts Ruervt!d. -I LSRP Factors Baste Premium Factor (BPF) 0.40 Mtnimum Premium Factor (MinPF) 0.75 Maximum Premium Factor (MaxPF) 1.75 Loss Conversion Factor (LCF) 1.185 Tax Multiplier (TM) 1.151 Valuation Incurred Losses (ICL) Loss Development Factors (LDF) 1st $240.000 0.20 2nd $300,000 0.14 3rd $400,000 0.10 4th $560,000 0.05 LSRP (Additional/Return) Premium Calculations Factors/Formulas 1st Valuation 2nd Valuation 3rd Valuation 4th Valuation 1. LSRP Standard Premtum (SP) $420,000 $420,000 $420,000 $420,000 2 . Basic Premtum Factor (BPF) 0.40 0.40 0.40 0.40 3. Basic Premtum ( 1) x (2) $168,000 $168,000 $168,000 $168,000 4. Incurred Losses (ICL) $240,000 $300,000 $400,000 $560,000 5 . Loss Conversion Factor (LCF) 1.185 1.185 1.185 1.185 6 . Converted Losses (4) x (5) $284 400 $355 500 $474,000 $663,600 7. Loss Development Factor 0.20 0.14 0.10 0.05 (LDF) 8. Loss Development Premium $99.540 $69,678 $49,770 $24.885 (1) X (7) X (5) 9. Subtotal (3) + (6) + (8) $551,940 $593,178 $691,770 $856,485 10. Tax Multiplier (TM) 1.151 1.151 1.151 1.151 11 . Valued LSRP Premium (9) x $635,283 $682,748 $796,227 $985,814 (10) 12. Minimum Premium Factor 0 .75 0.75 0 .75 0.75 (MinPF) 13. LSRP Mtnimum Premium (1) x $315,000 $315,000 $315.000 $315,000 (12) 14. Maximum Premium Factor 1 75 1.75 1.75 1.75 (MaxPFl 15. LSRP MaXImum Premium (1) x 5735,000 $735,000 $735,000 $735,000 (14) 16. LSRP Premium (adjusted for minimum/maximum if $635.283 $682,748 $735,000 $735,000 necessary) 17. Premium billed through prior $420,000 $635,283 $682,748 $735,000 valuation 18. LSRP (Additional/Return) $215,283 $47,465 $52,252 Premium $0 {16)-{17) (additional) (additional) (additional) Exampfe 3 Summary Based on the incurred losses. the valued LSRP premium as of the 3rd valuation is $796,227. When the maximum premium factor is applied, the LSRP maximum premium equals $735,000 ($420.000 x 1. 75). Therefore, the adjusted policy premium at the 3rd valuation is $735,000. The valued LSRP premium as of the 4th valuation is $985,814. Since this also exceeds the LSRP maximum premium of $735,000, the LSRP maximum premium still applies at the 4th valuation. ()Copyright 2011 Nalional Council on Compensation Insurance, Inc. All Rights Reserved. 9 Because the maximum premium of $735,000 still applies and has been paid in full as of the 3rd valuation, no LSRP additional/retum premium is due. Therefore, the only amount due to the employer is the LSRP contingency deposit of $84,000. LSRP Frequently Asked Questions 1. Is there one LSRP contingency deposit for the entire time an employer qualifies for LSRP? No, LSRP eligibility is determined on a per·policy period basis. Each policy is a separate contract and, therefore, requires a separate contingency deposit for each policy. 2. If I have operations In more than one state, how will LSRP apply? LSRP is designed to accommodate the large assigned risk employer that has operations in several states. The plan provides for a muHistate policy when the estimated aggregate (total of all states having approved LSRP) annual LSRP standard premium meets the LSRP standard premium eligibility requirement. If some states don't have LSRP, muHiple policies may be required. Further. an assigned risk employer that qualifies for LSRP in Indiana must be written on a separate policy. Refer to the Basic Manual for the rules that require the issuance of separate WCIP policies. 3. What factors are applied to LSRP valuations? The factors for LSRP can be found in the individual state Assigned Risk Miscellaneous Values pages in NCCI's Basic Manual-Rates/Loss Costs Index. In most states, the factors are applied on an anniversary rating date basis. Refer to the Basic Manual for details regarding stale--specific rules. 4. If there is a deductible on LSRP, how are the losses Included In LSRP valuations? For those states that have deductible programs applicable to residual market policies, the deductible program is optional to the policyholder, but if selected, applies to the LSRP policy. The credit is applied as outlined in the state's assigned risk workers compensation premium algorithm. The rules for LSRP require carriers to use the same loss information as reported under NCCI's Statistical Plan. 5. How will I know if I am written under an LSRP policy? You will be notified that your policy is eligible for LSRP as follows: a. ACOR0~133Appllcatlon Notification about LSRP is provided to the employer and its representative when submitting the ACORD«~ 133 application for coverage in the residual market. By signing the applicant statement on the ACORD«~ 133, the applicant understands and agrees that they are acknowledging that the LSRP has been explained by the producer, and agrees to the terms of LSRP if the employer meets the eligibility requirements. If the eligibility requirements are met, the applicant also agrees to submit an additional LSRP contingency deposit equal to 20% of LSRP standard premium. b. NCCI Binder In states that have approved LSRP, notification about the application of LSRP to an employer's assigned risk policy is provided to the employer and its representative on the binder notification pages. c. Endorsements Each application and/or policy renewal is reviewed by the assigned carrier to determine the size of the premium owed under the policy. If the policy meets the LSRP minimum premium eligibility threshold of $250,000 at the time the policy is reviewed, the policy is issued with the Assigned Risk Loss Sensitive Rating Plan Endorsement indicating that it qualifies for LSRP. Conversely, if 10 ()Copyright 2011 National Council on Compensation Insurance, Inc. All Rights Reserved. - the policy does not meet the LSRP eligibility requirements at the time it is reviewed, it is issued with the Assigned Risk Loss Sensitive Rating Plan Notification Endorsement. LSRP Endorsements Table Endorsement Instructions and Purpose WC 00 04 17 B-Assigned Risk loss Sensitive • Assigned carriers must attach this Rating Plan Notification Endorsement endorsement to all new and renewal assigned risk policies regardless of premium size • This endorsement ensures that all assigned risk employers, regardless of premium size, are notified of the intent and details of LSRP as well as possible application of LSRP if the employer meets the eligibility requirements WC 00 04 18 F-Assigned Risk loss Sensitive • All assigned carriers must attach this Rating Plan Endorsement endorsement to all new and renewal assigned risk policies meeting the LSRP eligibility requirements • This endorsement advises policyholders meeting the eligibility requirements of the applicable LSRP factors and how LSRP premium is calculated d. Renewal Quotes The assigned carrier must indicate on all renewal quotes to employers that payment of the renewal deposit constitutes knowledge and acceptance of the possible application of LSRP to the policy. Glossary The following definitions are provided for terms used in this brochure. The definitions apply to the way that terms are used in this brochure. Some terms may have different meanings in other contexts . Refer to the Basic Manual for detailed definitions . Basic Premium Factor (BPF) and Basic Premium (BP) The basic premium factor is a fixed factor used to determine the basic premium. Basic premium contributes to the recovery of expenses, such as those for servicing the LSRP policy, loss prevention services, premium audit, and general administration of the LSRP policy. Guaranteed Cost Polley Guaranteed cost policies are policies where the premium is a fixed cost based on a payroll base, manual rates, and any applicable pricing programs. Incurred Losses (ICL) Losses used in the LSRP calculation are those incurred losses (ICL) reported in accordance with the applicable statistical plan, subject to exclusions in Basic Manual Rule 4-C . Loss Conversion Factor (LCF) and Converted Losses A converted loss is the loss amount including an approximate load for claim adjustment expenses. Converted losses are determined by applying a loss conversion factor (LCF) to the actual incurred losses. The LCF contemplates the costs of the assigned carrier's claim services, such as investigating claims and filing claim reports, and claim adjustment services. LCFs vary by state. For purposes of LSRP, losses are not limited. 11 0 Copyright 2011 NatiOnal Council on Compensation Insurance, Inc. All R1ghts Reserved. Loss Development Factor (LOFt The loss development factor (LDF) applies on a state basis and is included in all four LSRP valuations. TheLDF: • Anticipates a pattern of increasing loss valuations during the adjustment periods • Stabilizes premium adjustments LSRP Standard Premium (SPt LSRP standard premium is determined on the basis of authorized rates (including premium developed from payroll assigned to aircraft classifications} and includes any: • Increased limits of liability • Experience rating modifiCation • Deductible credit, if applicable • Assigned Risk Adjustment Program (ARAP) and/or assigned risk surcharge programs and/or other assigned risk pricing programs other than LSRP • Minimum premium Determination of LSRP standard premium must exclude: • Premium resulting from non-ratable elements • Premium developed by the passenger seat surcharge under Code 7421 • Premium discount • Premium developed by the occupational disease rates for employers subject to the Federal Mine Safety and Health Act • Expense constant • Premium developed by catastrophe provisions in accordance with NCCI's Basic Manual Maximum Premium Factor (MaxPF) and LSRP Maximum Premium The maximum premium factor (MaxPF} is a fixed factor used to determine the greatest amount of premium that may be paid. The policyholder will not pay more than the calculated LSRP maximum premium. Minimum Premium Factor (MinPFt and LSRP Minimum Premium The minimum premium factor (MinPF} is a fixed factor used to determine the least amount of premium that may be paid. The policyholder will not pay less than the calculated LSRP minimum premium. Tax Multiplier (TMt The tax multiplier (TM) varies by state and includes licenses, fees, assessments, and taxes that an assigned carrier must pay on the premium it collects. The appropriate factors for these elements are located in the individual state Assigned Risk Miscellaneous Values pages in NCCI's Basic Manual- Rates/Loss Costs Index. Further Information • For general information regarding the LSRP, contact your producer of record, insurance carrier, or an NCCI Assigned Risk Analyst at 800-NCCI-123 (800-622-4123) or nccl.com. • For information regarding your policy, contact your producer of record or insurance carrier. • For information on the application of LSRP on North Carolina assigned risk policies, contact the North Carolina Rate Bureau at 919-783-9790 or www.ncrb.org. • For information on the application of LSRP on Indiana assigned risk policies, contact the Indiana Compensation Rating Bureau at 317-842-2800 orwww.icrb.net. ()Copyright 2011 National Council on Compensation Insurance, Inc. All Rights Reserved. 12 I r ' ' ' I I ' ' I ' r HARNETI ~COUNTY ·-. •. CHECKS PAID 711103-4130/14 --------· -. --· - 711,103 .. 6IJO,IO.f 711J04 lo 6I.JMI5 711111!1 .. 6I3MI6 7fiAI6 10 61JCW7 7111071• 6/lOIOII 7111111 .. 6flM)9 7(1109 .. 6130110 711/10 .. 6/30111 7/1/11 .. 61l0/ll mn1so 61l01U 711/U 1o .,.,14 TOiaiPoid T.call'lld Total Paid TolaiPaid Toc.l Paid Toal Paid T.caiPald T.caiPald Toal Pakl TeCal Paid Toal Paid Date of Accidnl S'H.MII 5161.637 5l6J,994 S4ll7.990 S.~7lll S.~414 SI,06J,J41 5.11166,661 Slll4,001 S91l,l57 S91l,l57 OOA ?!1103 . 613Ml4 194960 SI03 ,1~ $19551 SI9.H8 su 644 522.0H St7 738 Sl7 OS6 so so so OOA 7:1104 . 6130"0~ so 559491 S~7.1S6 $72.271 S4 672 so so so so so so OOA 7:11()5 • 600106 so so Sll7.ll7 5269.~80 5306.209 582.120 5246.023 5246 795 $58 1119 $193,660 $399 OOA 711106 . 6130107 so so so 596.581 $131081 $114 030 $9969~ suo S5 065 $23 -S6 OOA7:1107- 6130108 so so so so S91 139 5217,438 S50.826 $4,244 so so so OOA 7111()8 . ~'30."()9 so so so so so Sll-4 .. 1 SS77.2~ SS2.273 $165.759 SI48,SSI $217.275 OOA 7-"Jo"()9 . 6-'30-'10 so so so so so so $71.116 SIS6.S67 $117.713 $64.726 $1~.303 OOA N :IO · 6.'30:11 so so so so so so so SI9.SS2 576.217 5109 63C) $42,622 OOA 7·1:1J. ~/31 '12 so 0 so so so so so so S91 051 S213.1S4 $153.034 DOA7:1'12· 6-"30 ·13 so 0 so so so so so so so S2l6S42 S2SO 163 OOA 1:t:1J . 4-'30 14 so 0 so so so so so so so so 132,150 $94.960 5162637 SlU9M S4ll?"" S.~752 S570,414 SJ.on341 S.-661 Slll4,811 $966,.1G:Z SIU,.J41 ' HARNETI COUNTY-WORKERS COMPENSATION SELF-INSURED VS. GUARANTEED COST _TPA~•~ n&IMC.PAID 12003/04 $52,400.00 $18,000.00 $94,960.00 12004/05 $54,066.00 $18,000.00 $162,637.00 I"JMr.../06 $73,814.00 $19,000.00 $263,994.00 12006/07 $81 535.00 $19,000.00 $457,990.00 l2007/08 $74,306.00 $21,000.00 $546,752.00 I"JMR./09 $70,785.00 $22,500.00 $570,424.00 7nM/10 $78,992.00 $22,500.00 $1,063,361.00 7nuvu $86,711.00 $22,500.00 $566,668.00 7011./12 $83,265.00 $22,500.00 $514,001.00 701'./13 $110,177.00 $29,000.00 $966,302.00 'mV!4 ~--.... $126,945.00 $29,000.00 $843,341.00 2014/15 $181,327.00 $29,000.00 $0.00 TOTALS $1,074,323.00 $272,000.00 $6,050,430.00 1 l TQ'f~ I!~ no 1:1, ... , $165,360.00 $234,703.00 $356,808.00 $558,525.00 $642,058.00 $663,709 .00 $1,164,853.00 $675,879.00 $619,766.00 $1,105,479.00 $999,286.00 $210,327 .00 $7,396,753.00 Guaranteed cost estimate is manual premium without experience modification calculation I '!~~EST· -~ .EST. $565 000.00 $":1QQ~an nn ·---,_ --__ , $518,436 .00 $283, 733.00' $749,683.00 $392,875.00 $885,263.00 $326,738.00, $929,723.00 1.24 $287,flfll0 nn, $911,623 .00 1.20 $247,914.00, $901,706.00 1.28, $263,147.00, $775,438.00 $99,559.00 $889,135.00 $269.-:u;.Q nn $1,250,000.00 $144,521.00 $1,850,568 .00 $851,7R7M $1,850,568.00 $1,640,241 .00 $12,077,143.00 $4,flstn_":lqo_oo SUR R Y INSURANCE We s p e c i a l i z e i n i n s u r a n c e f o r P u b l i c E n t i t i e s Ab o u t S u r r y I n s u r a n c e We s t r i v e t o m a i n t a i n l o n g t e r m c u s t o m e r r e l a t i o n s h i p s , so m e o f w h i c h h a v e c o n t i n u e d o v e r 4 0 y e a r s . S u r r y In s u r a n c e h a s b e e n p r o v i d i n g p u bl i c e n t i t y i n s u r a n c e s i n c e 19 7 4 . W e s p e c i a l i z e i n p r o v i d i n g c o m p r e h e n s i v e i n s u r a n c e co v e r a g e a n d r i s k m a n a g e m e n t s e r v i c e s t o t h e p u b l i c s e c t o r . We c u r r e n t l y i n s u r e o v e r 2 0 0 c l i e n t s , o v e r 1 0 0 o f w h i c h a r e Pu b l i c E n t i t i e s . O u r c l i e n t s i n c l u d e N o r t h C a r o l i n a a n d S o u t h Ca r o l i n a p u b l i c s c h o o l s y s t e m s , c i t i e s , t o w n s , c o u n t i e s , co m m u n i t y c o l l e g e s a n d o t h e r e n t i t i e s . 2 3 Ha r n e t t C o u n t y ’ s P r o d u c e r De r e k S l a t e , C I C , C S R M Vi c e P r e s i d e n t o f S a l e s De r e k g r a d u a t e d f r o m E a s t C a r o l i n a U n i v e r s i t y w i t h a Ba c h e l o r o f S c i e n c e d e g r e e i n A d m i n i s t r a t i v e S e r v i c e s a n d In f o r m a t i o n P r o c e s s i n g i n J u n e 2 0 0 0 a n d w o r k s w i t h co m m e r c i a l a c c o u n t s . H e h o l d s t h e P r o p e r t y , C a s u a l t y , L i f e , Ac c i d e n t & H e a l t h o r S i c k n e s s l i c e n s e s a n d b o t h t h e C e r t i f i e d Sc h o o l R i s k M a n a g e r ( C S R M ) d e s i g n a t i o n a n d C e r t i f i e d In s u r a n c e C o u n s e l o r ( C I C ) d e s i g n a t i o n . D e r e k w o r k s i n t h e Do b s o n , N C o f f i c e a n d h a s o v e r 1 4 y e a r s o f e x p e r i e n c e i n t h e in s u r a n c e i n d u s t r y . D e r e k f o c u s e s o n i n s u r i n g s c h o o l s a n d pu b l i c e n t i t y a c c o u n t s f o r t h e a g e n c y . 4 Ha r n e t t C o u n t y ’ s Co m m e r c i a l L i n e s T e a m Me g a n U n s w o r t h , C I C , C S R M , A c c o u n t E x e c u t i v e Lo r i H i a t t , C I C , C S R M , S e n i o r A c c o u n t E x e c u t i v e Na n c y W r i g h t , C I C , C R M , A A I , C I S R , C S R M , Se n i o r A c c o u n t E x e c u t i v e / O f f i c e M a n a g e r Sa n d y L o v e , C S R M , S e n i o r C l a i m s A c c o u n t E x e c u t i v e Ra n d y C r a n f i l l , M E S H , C P S I , C S R M , D i r e ct o r o f S a f e t y a n d L o s s P r e v e n t i o n 5 Na n c y W r i g h t , C I C , C R M , A A I , C I S R , C S R M Se n i o r A c c o u n t E x e c u t i v e / O f f i c e M a n a g e r Na n c y h a n d l e s a l l o f t h e b i l l i n g f o r H a r n e t t C o u n t y . N a n c y gr a d u a t e d w i t h a B a c h e l o r o f S c ie n c e d e g r e e f r o m t h e U n i v e r s i t y of T e x a s M e d i c a l B r a n c h . S h e j o i n ed t h e a g e n c y i n 1 9 8 9 a n d w o r k s wi t h l a r g e c o m m e r c i a l a c c o u n t s . S h e a l s o h a n d l e s a l l t h e f i n a n c i a l as p e c t s o f t h e a g e n c y . S h e h o l d s t h e p r o p e r t y a n d c a s u a l t y in s u r a n c e l i c e n s e a n d b r o k e r l i c e n s e . H e r p r o f e s s i o n a l de s i g n a t i o n s a r e a s f o l l o w s : C e r t if i e d I n s u r a n c e C o u n s e l o r ( C I C ) , Ce r t i f i e d R i s k M a n a g e r ( C R M ) , C e r t i f i e d S c h o o l R i s k M a n a g e r (C S R M ) , C e r t i f i e d I n s u r a n c e S e r v i c e R e p r e s e n t a t i v e ( C I S R ) a n d Ac c r e d i t e d A d v i s o r i n I n s u r a n c e ( A A I ) . N a n c y h a s s e r v e d o n t h e In d e p e n d e n t I n s u r a n c e A g e n t s o f N o r t h C a r o l i n a F i n a n c e Co m m i t t e e . 6 Me g a n U n s w o r t h , C I C , C S R M Ac c o u n t E x e c u t i v e Me g a n g r a d u a t e d f r o m A p p a l a c h i a n S t a t e U n i v e r s i t y i n De c e m b e r 2 0 0 4 w i t h a B a c h e l o r o f S c i e n c e d e g r e e i n R i s k Ma n a g e m e n t a n d I n s u r a n c e . P r i o r t o j o i n i n g t h e a g e n c y , Me g a n w o r k e d a s a c o m m e r c i a l c l a i m s a d j u s t e r f o r 5 y e a r s . Sh e j o i n e d t h e a g e n c y i n S e p t e m b e r o f 2 0 0 8 . S h e s p e c i a l i z e s in i n s u r i n g P u b l i c E n t i t i e s a n d o t h e r l a r g e c o m m e r c i a l ac c o u n t s . S h e a l s o s e r v e s a s p r i m a r y b a c k - u p o n a l l c l a i m s - re l a t e d m a t t e r s . S h e h o l d s a P r o p e r t y & C a s u a l t y l i c e n s e an d h o l d s b o t h t h e C e r t i f i e d S c h o o l R i s k M a n a g e r ( C S R M ) de s i g n a t i o n a n d C e r t i f i e d I n s u r a n c e C o u n s e l o r ( C I C ) de s i g n a t i o n . 7 Lo r i H i a t t , C I C , C S R M Se n i o r A c c o u n t E x e c u t i v e Lo r i i s M e g a n ’ s b a c k - u p a n d w i l l a s s i s t y o u a n y t i m e M e g a n i s ou t o f t h e o f f i c e . L o r i g r a d u a t e d f r o m A p p a l a c h i a n S t a t e Un i v e r s i t y i n D e c e m b e r , 1 9 9 6 , w i t h a B a c h e l o r o f S c i e n c e de g r e e i n R i s k M a n a g e m e n t a n d I n s u r a n c e . S h e j o i n e d t h e ag e n c y i n D e c e m b e r , 1 9 9 7 a n d w o r k s w i t h c o m m e r c i a l ac c o u n t s . S h e h o l d s t h e P r o p e r t y , C a s u a l t y , L i f e , a n d Ac c i d e n t & H e a l t h o r S i c k n e s s i n s u r a n c e l i c e n s e s . L o r i h o l d s th e C e r t i f i e d I n s u r a n c e C o u n s e l o r ( C I C ) a n d C e r t i f i e d S c h o o l Ri s k M a n a g e r ( C S R M ) d e s i g n a t i o n s . S h e h a s 1 6 y e a r s o f ex p e r i e n c e a s a n A c c o u n t E x e c u t i v e w o r k i n g o n p u b l i c en t i t i e s , s c h o o l s , a n d o t h e r c o m m e r c i a l i n s u r a n c e a c c o u n t s . 8 Sa n d y L o v e , C S R M Se n i o r C l a i m s A c c o u n t E x e c u t i v e Ra n d y C r a n f i l l , M E S H , C P S I , C S R M Di r e c t o r o f S a f e t y & L o s s P r e v e n t i o n 9 Sa n d y g r a d u a t e d f r o m S u rr y C o m m u n i t y C o l l e g e wi t h a n A s s o c i a t e s D e g r e e i n B u s i n e s s Ad m i n i s t r a t i o n . S a n d y s p e n t 2 0 p l u s y e a r s i n th e m a r k e t i n g d e p a r t m e n t o f a l a r g e t e x t i l e fi r m . S h e j o i n e d t h e a g e n c y i n J u n e , 2 0 0 4 . S h e ho l d s a P r o p e r t y & C a s u a l t y i n s u r a n c e l i c e n s e . Sh e h o l d s t h e C e r t i f i e d Sc h o o l R i s k M a n a g e r (C S R M ) d e s i g n a t i o n . Sa n d y h a n d l e s c o m m e r c i a l cl a i m s a n d l o s s a n a l y s i s f o r t h e a g e n c y . S a n d y wo r k s i n t h e D o b s o n o f f i c e . Ra n d y w o r k e d 6 y e a r s a s a S a f e t y C o n s u l t a n t f o r th e N o r t h C a r o l i n a I n d u s t r i a l C o m m i s s i o n ’ s Sa f e t y E d u c a t i o n S e c t i o n a n d 5 y e a r s a s a Te c h n i c a l T r a i n i n g M a n a g e r f o r a m a n u f a c t u r i n g co m p a n y . H e h a s c o m p l e t e d t h e M a n a g e r o f En v i r o n m e n t , S a f e t y , a n d H e a l t h ( M E S H ) Ce r t i f i c a t e P r o g r a m , i s a n a u t h o r i z e d O S H A Ou t r e a c h T r a i n e r f o r G e n e r a l I n d u s t r y , C e r t i f i e d Pl a y g r o u n d S a f e t y I n s p e c t o r t h r o u g h t h e Na t i o n a l P l a y g r o u n d S a f e ty I n s t i t u t e , c e r t i f i e d in s t r u c t o r o f S t a n d a r d F i r s t A i d - C P R - A E D t h r o u g h th e N a t i o n a l S a f e t y C o u n c i l , & C e r t i f i e d S c h o o l Ri s k M a n a g e r d e s i g n a t i o n . R a n d y h a s o v e r 1 0 ye a r s e x p e r i e n c e i n d e v e l o p i n g , p l a n n i n g , co o r d i n a t i n g , s c h e d u l i n g & c o n d u c t i n g s a f e t y & he a l t h t r a i n i n g f o r i n d u s t r i e s , s t a t e , & l o c a l go v e r n m e n t s . Ag e n c y S e r v i c e T e a m R o l e s 10 Pr o d u c e r – Wi l l m e e t w i t h y o u t o d i s c u s s c o v e r a g e a n d p r i c i n g f o r y o u r a c c o u n t , a n s w e r q u e s t i o n s y o u h a v e a b o u t y o u r co v e r a g e , o b t a i n r e n e w a l i n f o r m a t i o n , c o n d u c t c l a i m s r e vi e w m e e t i n g s , c o o r d i n a t e t h e i n t e r n a l m a r k e t i n g o f yo u r c o v e r a g e w i t h t h e c o m p a n i e s , a n d c o o r d i n a t e l o s s c o n t r o l w i t h t h e c o m p a n i e s Pr o d u c e r – Wi l l m e e t w i t h y o u t o d i s c u s s c o v e r a g e a n d p r i c i n g f o r y o u r a c c o u n t , a n s w e r q u e s t i o n s y o u h a v e a b o u t y o u r co v e r a g e , o b t a i n r e n e w a l i n f o r m a t i o n , c o n d u c t c l a i m s r e vi e w m e e t i n g s , c o o r d i n a t e t h e i n t e r n a l m a r k e t i n g o f yo u r c o v e r a g e w i t h t h e c o m p a n i e s , a n d c o o r d i n a t e l o s s c o n t r o l w i t h t h e c o m p a n i e s Ac c o u n t E x e c u t i v e – Wi l l p r o c e s s a n y r e q u e s t e d ch a n g e s o n y o u r a c c o u n t , i s s u e Ce r t i f i c a t e s o f I n s u r a n c e , r e v i e w po l i c i e s f o r a c c u r a c y , a s s i s t y o u r Pr o d u c e r w i t h t h e i n t e r n a l ma r k e t i n g o f y o u r a c c o u n t a n d w i l l an s w e r a n y q u e s t i o n s y o u h a v e ab o u t y o u r c o v e r a g e o r b i l l i n g Ac c o u n t E x e c u t i v e – Wi l l p r o c e s s a n y r e q u e s t e d ch a n g e s o n y o u r a c c o u n t , i s s u e Ce r t i f i c a t e s o f I n s u r a n c e , r e v i e w po l i c i e s f o r a c c u r a c y , a s s i s t y o u r Pr o d u c e r w i t h t h e i n t e r n a l ma r k e t i n g o f y o u r a c c o u n t a n d w i l l an s w e r a n y q u e s t i o n s y o u h a v e ab o u t y o u r c o v e r a g e o r b i l l i n g Cl a i m s E x e c u t i v e – Wi l l a s s i s t y o u i n r e p o r t i n g c l a i m s to t h e c o m p a n i e s , f o l l o w i n g u p o n th e s t a t u s o f c l a i m s u n t i l c l o s e d , pr o v i d e l o s s i n f o r m a t i o n t o y o u an d a s s i s t i n c l a i m s r e v i e w me e t i n g s Cl a i m s E x e c u t i v e – Wi l l a s s i s t y o u i n r e p o r t i n g c l a i m s to t h e c o m p a n i e s , f o l l o w i n g u p o n th e s t a t u s o f c l a i m s u n t i l c l o s e d , pr o v i d e l o s s i n f o r m a t i o n t o y o u an d a s s i s t i n c l a i m s r e v i e w me e t i n g s Di r e c t o r o f S a f e t y & Lo s s P r e v e n t i o n – Wi l l w o r k w i t h y o u t o d e v e l o p a n d st r e n g t h e n y o u r s a f e t y a n d l o s s pr e v e n t i o n p r a c t i c e s . H e a l s o ho l d s t r a i n i n g a n d e d u c a t i o n a l cl a s s e s f o r o u r c l i e n t s . Di r e c t o r o f S a f e t y & Lo s s P r e v e n t i o n – Wi l l w o r k w i t h y o u t o d e v e l o p a n d st r e n g t h e n y o u r s a f e t y a n d l o s s pr e v e n t i o n p r a c t i c e s . H e a l s o ho l d s t r a i n i n g a n d e d u c a t i o n a l cl a s s e s f o r o u r c l i e n t s . Cu s t o m e r S e r v i c e S t a n d a r d s Su r r y I n s u r a n c e i s o p e n M o n d a y t h r o u g h Fr i d a y f r o m 8 : 3 0 a m t o 5 : 0 0 p m . Y o u r se r v i c e t e a m w i l l b e a v a i l a b l e d u r i n g t h es e h o u r s t o a n s w e r a n y q u e s t i o n s o r ad d r e s s a n y c o n c e r n s y o u m a y h a v e . D u ri n g b u s i n e s s h o u r s , y o u w i l l n e v e r g e t vo i c e m a i l . I f w e a r e u n a v a i l a b l e t o t a ke y o u r c a l l , r e t u r n c a l l s w i l l b e m a d e wi t h i n o n e h o u r . I n t h e e v e n t y o u r A cc o u n t E x e c u t i v e o r C l a i m s E x e c u t i v e i s ou t o f t h e o f f i c e , y o u w i l l b e d i r e c t e d to o t h e r o f f i c e p e r s o n n e l t h a t c a n a s s i s t yo u i f n e e d e d . Ce r t i f i c a t e s o f i n s u r a n c e a r e i s s u e d w i t h i n a n h o u r o f t h e r e q u e s t . Su r r y I n s u r a n c e s t r i v e s t o p r o v i d e p r o m p t an d c o u r t e o u s s e r v i c e t o o u r c l i e n t s . We a l w a y s e x e m p l i f y a p o s i t i v e a t t i t u d e a n d m a i n t a i n t h e hi g h e s t e t h i c a l a n d pr o f e s s i o n a l p r i n c i p a l s . W e p l e d g e t o co n t i n u a l l y i d e n t i f y w a y s o f i m p r o v i n g yo u r o v e r a l l p r o g r a m a n d w i l l w o r k w i t h y o u t o i d e n t i f y a n d a c h i e v e y o u r go a l s . 11 Cl a i m s M a n a g e m e n t By u s i n g o u r o n l i n e c l a i m s r e p o r t i n g v i a o u r w e b s i t e , c l a i m s a r e r e p o r t e d in le s s t h a n o n e s e c o n d to t h e i n s u r a n c e c o m p a n y , w h o w i l l c a l l w i t h i n th r e e b u s i n e s s h o u r s t o p r o v i d e a d j u s t er c o n t a c t i n f o r m a t i o n a n d a c l a i m nu m b e r . Y o u r C l a i m s E x e c u t i v e f o l l o w s t h e p r o g r e s s o f t h e c l a i m t o en s u r e i t i s p r o p e r l y m a n a g e d . Ou r C l a i m s E x e c u t i v e i s a v a i l a b l e 2 4 ho u r s a d a y , 7 d a y s a w e e k v i a o u r em e r g e n c y a f t e r h o u r c l a i m s r e p o r t i n g p h o n e n u m b e r . Ou r C l a i m s A c c o u n t E x e c u t i v e w i l l b e r e sp o n s i b l e f o r r e v i e w i n g y o u r c l a i m s i n ho u s e . S h e m o n i t o r s l o s s i n f o r m a t i o n q u a r te r l y t o r e v i e w r e s e r v e s a n d o b t a i n up d a t e s f r o m t h e c a r r i e r . S h e w a t c h e s la r g e r e s e r v e s a n d c h e c k s o n t h e s e cl a i m s e v e r y 3 0 - 6 0 d a y s t o t r a c k d e v e l o pm e n t . A d d i t i o n a l l y , w e c a n a r r a n g e cl a i m s r e v i e w s w i t h o u r i n su r a n c e c a r r i e r s . O u r a g e n c y w i l l l o o k t o i d e n t i f y tr e n d s i n c l a i m s a n d m a k e r e c o m m e n d at i o n s t o c l i e n t s a i d i n g i n l o s s pr e v e n t i o n a n d r e d u c t i o n . 12 Ri s k C o n t r o l S e r v i c e s P h i l o s o p h y Te c h n o l o g y R e s o u r c e s : Th e l a t e s t s a f e t y r e s e a r c h a n d in d u s t r y a n a l y s i s Sa m p l e s a f e t y , h e a l t h , a n d r e t u r n - to - w o r k p r o g r a m Cl a s s r o o m / w e b i n a r s a f e t y t r a i n i n g Sa f e t y v i d e o s , l i t e r a t u r e , p o s t e r s an d o t h e r m a t e r i a l s In p e r s o n s u p p o r t : De v e l o p p a r t n e r s h i p s w i t h c l i e n t ’ s de p a r t m e n t s t o d e v e l o p s a f e t y pr o g r a m s a n d l o s s p r e v e n t i o n se r v i c e Co n d u c t o n - s i t e a n a l y s i s o f fa c i l i t i e s , s a f e t y c o n c e r n s , a n d un i q u e r i s k s i t u a t i o n Pr o v i d e s o l u t i o n s t h a t a r e p r a c t i c a l an d r e a s o n a b l e t o i m p l e m e n t 13 On - s i t e T r a i n i n g a n d S e m i n a r s Ex a m p l e s o f p r o g r a m s i n c l u d e : De v e l o p i n g S a f e t y C o m m i t t e e s W/ C C o s t C o n t a i n m e n t a n d R T W pr o g r a m s Co n t r o l l i n g s l i p s , t r i p s a n d f a l l s Po w e r e d I n d u s t r i a l S a f e t y Fa l l P r o t e c t i o n S a f e t y El e c t r i c a l S a f e t y NF P A 7 0 - E A r c F l a s h / A r c B l a s t Bl o o d b o r n e Ch e m i c a l S a f e t y i n c l u d i n g t h e n e w GH S s t a n d a r d 14 Tr a i n i n g p r e v i o u s l y p r o v i d e d t o H a r n e t t Co u n t y b y S u r r y I n s u r a n c e Su r r y I n s u r a n c e h a s p r e v i o u s l y d e m o n s t r a t e d a c o m m i t m e n t t o s u p p o rt i n g t h e C o u n t y ’ s R i s k M a n a g e m e n t p r o g r a m t h r o u g h a n a r r a y o f lo s s p r e v e n t i o n s e r v i c e s p r o v i d e d b y o u r i n - h o u s e D i re c t o r o f S a f e t y a n d L o s s P r e v e n t i o n , R a n d y C r a n f i l l : Tr e n c h i n g a n d S h o r i n g T r a i n i n g f o r C o m p e t e n t P e r s o n s t w o d a t e s 2/ 2 6 / 2 0 1 4 an d 3/ 1 9 / 2 0 1 4 Pr o v i d e d a s a m p l e “ V i o l e n c e I n c i d e n t R e p o r t F o r m s ” 5/ 8 / 2 0 1 3 Ge n e r a l P h y s i c a l E n v i r o n m e n t A s s e s s m e n t f o r H a r n e t t C o u n t y 4/ 1 7 / 2 0 1 3 Lo c a t i o n s Ch i l d S u p p o r t E n f o r c e m e n t S e r v i c e s i n E r w i n De p a r t m e n t o f S o c i a l S e r v i c e s i n L i l l i n g t o n Pr o v i d e d a s a m p l e ‘ W o r k p l a c e V i o l e n c e H a z a r d A s s e s s m e n t F o r m ” 4/ 1 4 / 2 0 1 3 Pr o v i d e d a s a m p l e “ T r e n c h i n g a n d S h o r i n g P o l i c y ” 12 / 6 / 2 0 1 3 Bl o o d b o r n e T r a i n i n g f o r S o l i d W o r k s / P u b l i c W o r k s 10 / 2 / 2 0 1 3 t w o s e s s i o n t h a t d a y Co n f i n e d S p a c e T r a i n i n g f o r P u b l i c W o r k s 7/ 1 9 / 2 0 1 1 Tr a i n i n g p r o v i d e d f o r D e p a r t m e n t o f S o c i a l S e r v i c e s 4/ 2 3 / 2 0 1 4 “S a f e D r i v i n g ” “W o r k p l a c e V i o l e n c e P r e v e n t i o n ” 15 Ex a m p l e o f c l i e n t s a v i n g s a f t e r m o v i n g t h e i r Wo r k e r s C o m p e n s a t i o n t o S u r r y I n s u r a n c e 16 De p t . FY 0 8 FY 0 9 FY 1 0 FY 1 1 FY 1 2 FY 1 3 FY 1 4 AC $3 0 0 $ 1 3 , 6 6 2 $ 1 , 4 5 1 $ 5 , 0 0 6 $ 1 4 , 9 8 3 $ 2 , 3 2 1 $1 , 1 2 6 CA $0 $ 0 $ 0 $ 0 $ 0 $ 0 0 BO E $0 $ 0 $ 0 $ 0 $ 0 $ 0 0 Bu d g e t $0 $ 0 $ 0 $ 0 $ 0 $ 0 0 CE $0 $ 7 2 $ 0 $ 1 , 4 1 0 $ 9 8 $ 0 0 ES $1 3 3 , 3 5 9 $ 1 8 , 8 8 7 $ 6 1 , 6 3 8 $ 4 7 , 9 2 0 $ 1 3 7 , 1 3 6 $ 1 3 0 , 5 8 7 $7 , 5 4 2 EA P $0 $ 2 7 , 5 0 9 $ 0 $ 0 $ 2 4 1 $ 0 $2 4 4 FI N $1 , 0 2 4 $ 0 $ 1 , 0 7 5 $ 0 $ 0 $ 0 0 GS $2 , 9 6 2 $ 1 2 0 , 8 1 6 $ 1 , 2 1 1 $ 2 6 , 3 8 9 $ 1 0 , 4 8 6 $ 1 1 , 0 6 3 $1 9 , 9 4 6 HO U $0 $ 0 $ 0 $ 0 $ 0 $ 0 0 HR $0 $ 3 7 1 $ 7 5 $ 0 $ 0 $ 0 0 IN T E R $0 $ 0 $ 0 $ 0 $ 0 $ 0 0 LI B $4 5 5 $ 7 5 $ 2 2 , 5 0 2 $ 9 , 2 4 4 $ 3 9 0 $ 1 , 9 4 8 0 MG R $0 $ 0 $ 0 $ 0 $ 0 $ 0 0 MI S $2 9 9 $ 3 7 9 $ 0 $ 2 0 2 $ 0 $ 0 0 P& R $1 , 9 9 0 , 4 7 0 $ 2 1 , 8 0 3 $ 1 7 , 7 1 5 $ 4 1 , 4 2 9 $ 3 , 1 4 0 $ 1 , 8 3 9 $5 0 , 7 9 7 PH $1 3 , 0 0 6 $ 7 , 6 8 6 $ 4 , 7 3 5 $ 3 3 , 5 9 2 $ 3 , 9 2 4 2 , 2 8 6 $4 4 8 RO D $0 $ 0 $ 0 $ 0 $ 2 9 7 $ 0 0 SO $1 0 2 , 9 5 9 $ 9 0 7 , 8 3 1 $ 2 2 7 , 5 2 7 $ 8 5 , 9 9 4 $ 2 9 0 , 3 8 9 $ 1 1 3 , 3 6 7 $5 1 , 0 3 1 SS $1 0 3 , 7 8 2 $ 1 9 , 0 9 8 $ 1 6 , 7 6 3 $ 2 1 6 , 4 5 0 $ 2 4 , 6 3 0 $ 1 , 3 2 1 $1 7 , 8 1 5 TA X $6 8 9 $ 0 $ 1 , 2 5 2 $ 1 4 2 $ 7 8 , 8 1 4 $ 0 0 YO U $1 , 3 6 3 $0 $5 0 8 , 0 3 6 $0 $0 $2 3 , 0 5 2 0 To t a l $ 2 , 3 5 0 , 6 6 8 $ 1 , 1 3 8 , 1 8 9 $ 8 6 3 , 9 8 0 $ 4 6 7 , 7 7 8 $ 5 6 4 , 5 2 8 $ 2 8 7 , 7 8 4 $ 1 4 8 , 9 4 9 Su r r y I n s u r a n c e O f f e r s : My W a v e ® Po r t a l Po s t i n g C e n t e r Al l o w s a s e a m l e s s e x c h a n g e o f i n f o r m a t i o n Be n c h m a r k S u r v e y s Pa r t i c i p a t e i n P & C s u r v e y s a n d s e e h o w y o u s t a c k u p . Co m m u n i t y Co n n e c t w i t h t h o u s a n d s o f p r o f e s s i o n a l s i n y o u r fi e l d . He a l t h C a r e R e f o r m Ac c e s s v a l u a b l e e d u c a t i o n a l a n d l e g i s l a t i v e in f o r m a t i o n . My W a v e ® OS H A Tr a c k a n d a n a l y z e O S H A i n j u r i e s a n d i l l n e s s e s . My W a v e ® RM Sa f e t y Z o n e Re a d y - t o - p r i n t n e w s l e t t e r s de s i g n e d t o s u p p o r t y o u r sa f e t y p r o g r a m s a n d m e s s a g e s Do c u m e n t s o n C o m m a n d In s t a n t a c c e s s t o a l i b r a r y o f d o w n l o a d a b l e br o c h u r e s , f o r m s a n d r e p o r t s On l i n e S e r v i c e s Ma k e o n l i n e r e q u e s t s r i g h t t o o u r c u s t o m e r s e r v i c e de p a r t m e n t . Re s o u r c e s Li n k s , a r t i c l e s a n d r e s o u r c e s o n a v a r i e t y o f t o p i c s 17 iA u d i t o r An A p p t h a t m a k e s s a f e t y i n s p e c t i o n / a u d it s m o r e c o n v e n i e n t t o p e r f o r m . T h e Ap p w i l l w o r k o n i P h o n e , i P a d , a n d A n d r o i d d e v i c e s . Pr o g r a m s c u r r e n t l y b e i n g u s e d : Fa c i l i t y S e c u r i t y A s s e s s m e n t Sl i p - T r i p - F a l l P r e v e n t i o n Ac c i d e n t I n v e s t i g a t i o n AD A C h e c k l i s t f o r E x i s t i n g F a c i l i t i e s 18 An n u a l E E O / S e x u a l Ha r a s s m e n t Tr a i n i n g Tr a i n i n g p r o v i d e s i n f o r m a t i o n t o h e l p yo u r e c o g n i z e , p r e v e n t a n d r e p o r t a n y be h a v i o r s o r a c t i o n s t h a t c o u l d b e c o n s i d e r e d h a r a s s m e n t . Se x u a l H a r a s s m e n t Ho s t i l e E n v i r o n m e n t Bu l l y i n g Th i r d P a r t y H a r a s s m e n t Ag e D i s c r i m i n a t i o n Di g i t a l H a r a s s m e n t 19 Sa f e t y P o s t e r s We p r o v i d e p o s t e r s t h a t c o v e r a r a n g e o f t o p i c s su c h a s : Sl i p s , T r i p s a n d F a l l s La d d e r S a f e t y Ba c k S a f e t y Ac c i d e n t P r e v e n t i o n Su r r y I n s u r a n c e Sa f e t y a n d L o s s P r e v e n t i o n S e r v i c e s 20 Sa f e t y T a r g e t s We p r o v i d e p o s t e r s t h a t c o v e r a r a n g e o f t o p i c s su c h a s : Ba c k I n j u r y P r e v e n t i o n T e c h n i q u e s Su r g e P r o t e c t o r a n d P o w e r S t r i p S a f e t y Fi r e E x t i n g u i s h e r S a f e t y Su r r y I n s u r a n c e Sa f e t y a n d L o s s P r e v e n t i o n S e r v i c e s 21 Su r r y I n s u r a n c e Sa f e t y a n d L o s s P r e v e n t i o n S e r v i c e s Tr a i n - 2 - T r a i n P r o g r a m Th e s e p r o g r a m s p r o v i d e t o ma n a g e r s / s u p e r v i s o r s t h e ne c e s s a r y i n f o r m a t i o n s o t h e y c a n co m m u n i c a t e s a f e t y a w a r e n e s s to p i c s t o t h e i r s t a f f . T h e s i g n - i n sh e e t s w o u l d d o c u m e n t s t a f f tr a i n i n g a n d c o u l d b e u s e d a s a n ac c o u n t a b i l i t y t o o l t h a t t h e ma n a g e r s / s u p e r v i s o r s h a v e co m p l e t e d t h e t r a i n i n g w i t h t h e i r st a f f . T h e t i m e n e e d e d t o t r a i n st a f f c o u l d b e d o n e i n a b o u t 5 mi n u t e s o r l e s s . 22 • OS H A T r a i n i n g f o r t h e 10 / 3 0 H o u r G e n e r a l In d u s t r y • Th e O S H A t r a i n i n g i s au t h o r i z e d t h r o u g h th e F e d e r a l O u t r e a c h Pr o g r a m a n d c a n b e ta u g h t o n s i t e . Su r r y I n s u r a n c e Sa f e t y a n d L o s s P r e v e n t i o n S e r v i c e s 23 Sa m p l e S a f e t y Pr o g r a m s As s i s t i n d e v e l o p i n g sa f e t y p r o g r a m s a n d he l p i n r e v i e w i n g ex i s t i n g p r o g r a m s . Su r r y I n s u r a n c e Sa f e t y a n d L o s s P r e v e n t i o n S e r v i c e s 24 Au t o L o s s P r e v e n t i o n De v e l o p w r i t t e n p o l i c y s t a t e m e n t s a n d c o m m u n i c a t e t o a l l e m p l o y e e s Es t a b l i s h i n s p e c t i o n / m a i n t e n a n c e i n t e r v al s u s i n g y o u r v e h i c l e o w n e r ’ s m a n u a l Da i l y v e h i c l e i n s p e c t i o n Ac c i d e n t r e p o r t i n g i n f o r m a t i o n p a c k e t s i n a l l v e h i c l e s An a l y z e a c c i d e n t s p e r i o d i c a l l y t o i d e n t i f y c a u s e s a n d t r e n d s s o t h a t e f f e c t i v e co n t r o l s c a n b e d e v e l o p e d Tr a i n i n g o n “ D r i v i n g S a f e t y ” 25 Sa f e t y L e a d e r s h i p P r o g r a m fo r M a n a g e r s a n d S u p e r v i s o r s - 3 Y e a r P l a n St a r t w i t h d e v e l o p i n g a S a f e t y C o m m i t t e e Tr a i n i n g P r o g r a m s Ef f e c t i v e S a f e t y P r o g r a m s Tr u e C o s t o f A c c i d e n t s Ac c i d e n t I n v e s t i g a t i o n Jo b S a f e t y A n a l y s i s Ef f e c t i v e C o m m u n i c a t i o n Ma n a g e r s / S u p e r v i s o r ' s S a f e t y R e s p o n s i b i l i t i e s Co n d u c t a n d a n a l y z e “ S a f e t y S u r v e y s ” b y d e p a r t m e n t s 26 AssociATION oF CouNTY CoMMISSIONERS May 21,2014 Harnett County PO Box 759 Lillington, NC 27546 Attn: Melinda Bethune Risk Manager & Safety Coordinator Melinda, The North Carolina Association of County Commissioners Joint Risk Management Agency (NCACC Risk Pools) would like to thank you for the opportunity to provide a quotation to Harnett County for its insurance program. Enclosed in the attached packet is the overall premium and premium by line of coverage. The NCACC doesn't charge a fee for providing membership in the pools or for most of its Risk Control Services. Deductible options are provided along with coverage limits, excess limits and a $1,000,000 Cyber Liability limit. Brochures highlighting our work with county government and the services provided by our Risk Control team are also included. The NCACC Risk Pools has provided a Property and liability proposal but has decided not to provide a proposal for Workers Compensation due to the County's recent loss history. We look forward to once again working with Harnett County. Sincerely; (__ -~n:·west {Jxf Underwriter ALBERT COATES LOCAL GOVERNMENT CENTER • 215 NORTH DAWSON STREET, RALEIGH, NC 27603 • phone 919 .715.2893 • fox 919.733.1065 RISK MANAGEMENT POOLS • phone 919.719.1100 • fox 919 .719.1101 www.ncacc.org AssOCIATION oF CouNTY CoMMISSIONERS Physical Damage Actual Cash Value Replacement Cost $2,000,000 Uability NCACC rusk Management Pools Liability and Property Date of Quote Payroll (Entity) $0 Fire Legal AdditionaJ Um its $0 Number of BATs 0 0 0 0 104 3 1 ,067 $0 $0 Payroll (Entity) AssociATION OF CouNTY CoMMISSIONERS Payment Plan Available: Liability & P roperty P ool County or Entity: HARNEn COUNTY Annual Payment Plan: (due on or before August 1, 2014) NCACC Risk Management Pools Liability and Property Quoted on : 512312014 I understand that changes made to the exposures subsequent to submission of the renewal application may result in chang.es to the Estimated Contribution : Accepted by: Signature Printed Name Print Title Date This ~Instrument has been pre-audited In the manner required by the Govemment Budget and Flscat Control Act. Financial Officer. Signature Date NCACC 512312014 NORTI-I AssoctATtON OF CouNTY CoMMJSSIONERS NCACC Risk Management Pools Liability and Property J U.t.:Y 1,2014 TO J ULY 1,2015 Ouotedon: Renew•l Eatinwte Councy Of Entity. HARNETT COUNTY Deductible Adjustment •Options Per Occunwnce 1DeducdbiM u.bl!~· Une $500 11 ,000 12.500 $5,00(1 110000 $25,000 150,000 PROPERTY (INLAND) --so so $19,746 $39,492 $62.355 $95.265 $120,553 INLAND MARINE (INLAND) $0 so $273 $570 $1 003 $1 .869 $2.780 GENERAL UABILilY $2.545 $4128 $5,768 $7.294 $9,1 04 $12.497 $15,607 AliTO UABIUTY SS .-475 $9,530 $17.236 $24,536 $33.863 $47,652 $57,790 I AUTO PHYSICAL DAMAGE so $0 $4,505 $8,357 $11,868 S14,4n $15,534 CRIME so $0 S23 I $48 S85 $1591 5236 'I PUBliC OFfiCIALS UAB. $0 so $0 $0 $2,527 $7 516 $12,699 I LAW ENFORCEMENT LIAS. I so so $0 _JQ_ $6122 518,208 ! 530,765 I[ EMPLOYMENTPRACTICESUA SOl so ~ so $1 .385 $4404 $7,620 512312014 m .ooo 1100,000 $135,103 $146188 $3,532 $4,079 $18,095 $20243 !64,685 $6$1·,348 $16,062 $16.279 S300 5347 $16,004 s1a.on $38.770 $43 792 $9"599 $1~ 512312014 NCACC No~AROI .INA AssoCIATION oF CouNTY CoMMISSIONERS JULY 1, 2013 TO JULY 1. 2014 NCACC Risk Management Pools Liability and Property Quoted on: Rtnewal Estimate EXCESS UABIUTY County or Entity: HARNEn COUNTY Excess Uablllty provides excess General l..lability, Automobile Uabillty, PIJ)IIc Officials or Law Enforcement uablllty limits. The ~ Uability comes Into play when the primary llrnlts :have been exha~ted. The Excess Uabllity ,aJiows tM member to purchase a single increased limit, and use lhe Omit where it Is necessary. The Excess Uaoility does not increase each individual Uabllity limit, but Is available In any covered Uabillty arn shoUld the need arise. The Pc:lOI's E£ess Uabillty extends limits above· the p.oot's contract only. Higher limits can be ~hased In the tonn of the Excess Uabillty options as fOllows : ANNUAL EXCESS LI ABILITY CO NTRI BUTION $1.000,000 excess of $2,000,000 underlying ._1 .;..l __ .... u..., .... 21.;.;2_,1 $2,000,000 excess of $2;000,000 under1ying ..,l¥.._. __ 82; ..... !!!j_ ..... l $3,000,000 excess ot $2,0001000 under1'ying ._11.;., __ ... 7i .... ;.;.IOI.;.o .... 1 $4,000,000 excess. of $2,ooo,ooo underlying ._li ... ___ ._:m...__.l' To purchase the EKCe$8 UabitHy Coverage. please' lndJGate the fi mils you w ant Return a copy of this form with your signed !Participatioo Agreement Ac(:e,pted by. Signature Prtnted Name Print Trtte Date I I UMITYOU SELECTED X I This Instrument has been pre--audited In lhe manner required lby Ult GovefM'Ient Budget and Flsoal Control Act. Financial ·Officer: Signature 1Date 10:49 AM AssOCIATION OF CouNTY CoMMISSIONERS NCACC Risk Management Pools Liability and Property Pleue Nlum tha. form with your confirmation lndatfng your dtlducttb6e c:noa.. tr we do not rec.~¥e ttw compa.t.t form, .. will procen your,., .... using tM 1Jt8nd81'd deductlb'" (shown In bold, lt811cs type). HARNETT COUNTY UABUL TY AND PROPERl'V DEDUCtiBlE OPTIONS 7 -1-14 to 7-1-15· COVERAGE X DEDUCTIBLE COVERAGE X DEDUCTIBLE Property $1,000 lna.ndMerlne $1,000 These factors are applicable only $2,500 These factors are $2,500 to non-alaStal counties. $5,000 applicable only to $5,000 $10,000 non-coastal countles. $10,000 $25,000 ' $25,000 I I $50,000 $50,000 $75,000 $75,000 $100,000 $100,000 Coastal county membenl only -Yoot proposal Includes the standard deOJc:lllle for wind covetage for all You may ..a.ct a 2% Wind Deduct. property exposures . To aocepe a 2% wind daductllle for lhe aavllgs shown n your ptOpOISat, check the block at. the left. Ctlme $1 ,000 GerMnl LJ8blllty $0 $2,500 ~ ~. $500 $5,000 $1 ,000 $10,000 ' $2,500 $25,000 $5,000 $50,000 $10,000 I $75,000 $25,000 . $100,000 $50,000 .. Automobile Liability I $0 Auto Phy. O.mege IMIDO , $500 $2~500 $1,000 $5,000 $2,500 $10,000 $5,000 $25,000 $10,000 $50,000 $25,000 $75,000 $50~000 I $100,000 Law Enforwment $5,000 Public Offlcl•l• $6,000 $10,000 $10,000 $25,000 $25,000 $50,000 $50,000 $75,000 $75,000 $100,000 I .$100.000 Employment Pncttc.. $5,0DD Boiler ...ci118Chlnery ..,.. ...... _,.... $10,000 • The deductible for Boiler and Machinery Is $1 ,000 for $25,000 Direct Damage IUld 24 hours for Indirect Damage at the $50,000 request of the reinstKer. Other options are not avail8ble $75,000 for Boiler & Machinery. $100,000 NCACC 512312014 AssOCIATION OF CouNTY CoMMISSIONERS Prior Acts Proposal for Harnett County Prior Acts Liability: __ Optionl Terms: One (1) year retroactive event period One (1) year reporting period Public Officials Liability: Employment Practices Liability: Prior Ads Coverage: Public Officials: Accept: __ _ Employment Practices: Accept: __ _ Accepted By: Signature: Print Name : Title: Date: $23,140 $17,671 Reject:. __ _ Reject: __ _ NCACC Risk Management Services Mailing-2/J .\'.Dawson Strt?d, Raleigh .VC 27603 • Physical-323 »'. }ont?s Street, Suitt? 500, Raleigh Ph. (919) 719-1100 • Fax (919) 719-1101 • M'M'M'.ncacc.orglrmp.htm AssociATION OF CouNTY CoMMISSIONERS INTERLOCAL AGREEMENT FOR A GROUP SELF-INSURANCE FUND FOR RISK SHARING OR GROUP PURCHASE OF COVERAGE This Agreement is made and entered into by and between all the parties who join together to become Members of the North Carolina Association of County Commissioners Risk Management Agency (hereinafter referred to as the •Risk Poon. The Risk Pool acts by and through its Board of Trustees as provided herein and as provided within the Bylaws of the Risk Pool. The Risk Pool encompasses the North Carolina Association of County Commissioners Joint Risk Management Agency Workers' Compensation Fund (hereinafter referred to as the 'Workers' Compensation Pool") and the North Carolina Association of County Commissioners North Carolina Counties Liability And Property Joint Risk Management Agency (hereinafter referred to as the "Liability and Property Pool"; both are referred to collectively as "Pools"). ARTICLE I. PURPOSE 1. To carry out the desire of certain counties and governmental entities of the State of North Carolina to create and become the Risk Pool, and to enable these counties to pool the retention of their risks, liabilities or payments, or for the group purchase of coverage, pursuant to the provisions of North Carolina General Statutes 153A-92(d), 153A-445(a)(1) and 160A-460 through 160A-466. 2. To be governed and directed through the efforts of the Risk Pool Board of Trustees, as described in the Bylaws of the Risk Pool, which are incorporated by reference into this Agreement. 3. To provide for the discharge, from the assets of the Risk Pool, from funds collected from Members, and through excess or other insurance purchased by the Risk Pool, in accordance with the terms and scope of the contracts of coverage and as determined by the participation of the individual Members of the Risk Pool, of any: a) insurance premiums; b) covered property losses incurred; c) lawful liability claims against any member of the Liability and Property Pool in which awards have been sustained by final judgment or by the rules of the Risk Pool if settlement is made; and d) lawful workers' compensation claims against members of the Workers' Compensation Pool, when awards have been sustained by final judgment or by the rules of the Risk Pool if settlement is made. 4. To provide for payment by Members of the Risk Pool of contributions based upon appropriate classifications, rates, experience modifications, or other methodologies, out of a portion of which the Risk Pool will establish and maintain a fund for the payment of covered claims, losses and the administrative costs of operating the Risk Pool. lnterlocal Agreement Amended June 2012 Page 1 of 6 ARTICLE II. EFFECTIVE DATE, DURATION AND MEMBERSHIP Any qualifying county or governmental unit that formally applies for membership in the Risk Pool will be admitted and become a Member. This Agreement is effective as of the date the Resolution adopting this Agreement is executed, and the membership application and fully executed Resolution are incorporated by reference into this Agreement. This Agreement replaces all prior lnterlocal Agreements and Participation Agreements, is effective from year to year, and shall remain in force unless terminated in writing by the Risk Pool, the Member, or the Board of Trustees as specified herein. Risk Pool Members may join the Workers' Compensation Pool, and Liability and Property Pool, or may elect to only join one or two of these offered Pools. Members shall designate the membership election on the Resolution and provide a new, fully executed Resolution if individual Pool membership changes. Under the plans offered by the Risk Pool, a Member's coverage will be automatically renewed on the termination date of the coverage regardless of whether payment for the subsequent coverage period has been received by the Risk Pool. The continuation of coverage will be pursuant to the same terms and conditions as the expiring coverage and as set forth in this Agreement. Each renewal shall be subject to a recalculation of contributions by the Risk Pool. ARTICLE Ill. TERMS AND CONDITIONS 1. The coverage terms, deductibles, conditions, limits of liability, exclusions, exceptions, agreements, requirements for cooperation of Members, subrogation and other tenns of membership shall be governed primarily by the Coverage Documents and secondarily by the Member Guide distributed to the Members. 2. A Member may be eligible for a multi-pool discount if the Member is a member of both Pools. Any Member that has outstanding contributions due to the Risk Pool from the most recent fully completed fiscal year will have their multi-pool discount adjusted by the amount of those outstanding contributions. 3. Changes in funding types, rates and plan specifications will occur only on the Member's renewal date and will remain in effect for the coverage period. However, the Risk Pool reserves the right to make adjustments to the Member's contribution and/or the plan specifications if a material, substantive amendment or modification to coverage must be made to comply with state or federal law. It is the responsibility of the Risk Pool to provide notice to the Member sixty (60) days prior to any such contribution change, amendment or modification. 4. If a Member fails to remit the required contribution, the Risk Pool may suspend the payment of the Member's claims in accordance with the Payment Policy adopted by the Board of Trustees. In the event of termination of this Agreement, the Member remains responsible for any contributions payable up to and including the date of termination. 5. All claims for employees and authorized individuals are required to be timely reported to the Claims Administrator. Failure to do so may result in the claim not being reimbursed. lnterlocal Agreement Amended June 2012 Page 2 of 6 6. The Member shall cooperate with the Risk Pool concerning settlement efforts, litigation or anticipated litigation of any claim. If a claim is made, a lawsuit is filed or court notices are received by a Member or its representative that may fall within the scope of Risk Pool coverage, the Member shall immediately forward to the Risk Pool every document received. Pursuant to the Risk Pool's request and payment by the Risk Pool of reasonable expenses, the Member shall attend hearings, trials and other proceedings if requested and will assist in effecting settlements, in securing and providing evidence, in attaining the attendance of witnesses and in fully cooperating with the Risk Pool and its designee with regard to the defense of the claim. 7. No Member shall make voluntary and direct payment of a claim or a claims-related expense without the prior approval of the Board of Trustees or its designee. Any Member making a voluntary payment or entering into an agreement to pay without approval will be responsible for the claim and any expenses paid or committed, including the cost of a legal defense. 8. The Risk Pool may use and disclose the Personal Health Information of individuals subject to this coverage only in compliance with the HI PAA Privacy Rule and other applicable provisions. 9. This Agreement and coverage with Pool(s) may be canceled by the Risk Pool on the renewal date after providing written notice by certified mail, return receipt requested, to the Member at least sixty (60) days prior to the renewal date. The Risk Pool may also cancel this Agreement and/or the coverage provided at any time pursuant to the following: (a) after giving ten (10) days written notice to the Member in accordance with the terms of the Payment Policy adopted by the Board of Trustees; (b) if the Member reorganizes or dissolves; or (c) if the Member fails to initiate and administer any reasonable loss prevention recommendation submitted by the Risk Pool to the Member. 10. The Member may cancel this Agreement or membership in an individual Pool without penalty on the renewal date of coverage if it provides written, advance notice to the Risk Pool at least sixty {60) days prior to the coverage renewal date. If notice of termination to the Risk Pool is provided less than sixty (60) days before the Member's renewal date, but prior to the renewal effective date, ten percent (10%) of the annual estimated renewal contribution must be paid by the Member. If notice to the Risk Pool is provided after the renewal date, the total annual estimated renewal contribution must be paid by the Member. The Member may file an Appeal with the Board of Trustees, pursuant to Paragraph 12 of this Article., 11. The Member shall have the right to file an Appeal concerning any action taken or decision made by the Risk Pool in accordance with the Appeals Procedures adopted by the Risk Pool, by requesting review by the Risk Pool's Board of Trustees, whose decision will be final. Any Appeal shall be submitted in writing to the Director of Risk Management Services within thirty (30) days of the challenged decision or action. 12. In the interest of providing effective governance, the Member, a county with appointive authority for the Member's board, or at least one of the Member's budgetary contributors, must be a member of the North Carolina Association of County Commissioners (hereinafter "Association"). lnterlocal Agreement Amended June 2012 Page 3 of 6 13. The Association is designated as the Administrator of the Risk Pool unless otherwise designated by the Board of Trustees. As detailed further in the Service Agreement between the Risk Pool and Association, the Administrator supervises all other service contractor(s), deposits all contributions as collected to the bank account(s) designated by the Board of Trustees, and disburses monies as provided by the policies, rules, regulations and Bylaws of the Board of Trustees, and in compliance with the Service Agreement(s) executed with the service contractor(s). 14. In its discretion, the Board of Trustees shall determine and may modify the timing of payments made by Members and the amount of Member contributions to maintain the soundness and financial security of the Risk Pool. 15. A certified public accounting firm shall audit the Risk Pool annually and report to the Board of Trustees as detailed in the Bylaws. The Risk Pool retains the right to audit and review a Member's financial and business records relevant to the subject matter of this Agreement or any dispute regarding this Agreement. 16. Notice: Any written notice to the Risk Pool shall be made by certified mail and delivered to the Director of Risk Management Services, North Carolina Association of County Commissioners, 215 N. Dawson Street, Raleigh, NC 27603. ARTICLE IV. AMENDMENTS The Board of Trustees is authorized to make any changes or amendments to this Agreement that would not fundamentally alter the substance of the contemplated Agreement. This Agreement may be substantively amended after adoption of this Agreement by the Members by either 1) approval of the specific amendment by the Board of Trustees and approval in writing by a simple majority of the Members, or 2) approval of the Board of Trustees of a revised Agreement and subsequent presentation to Members for execution of a new Resolution during the renewal period. ARTICLE V. SEVERABILITY AND CHOICE OF LAW This Agreement shall be governed by the laws of the State of North Carolina. The Members and the Risk Pool agree that in the event there is a disagreement between them regarding this Agreement, or its terms, any legal action shall be filed in the General Court of Justice, Superior Court Division, Wake County, North Carolina. The Members and the Risk Pool agree that the terms of this Agreement are contractual and not a mere recital, and that its provisions are severable in nature such that if any particular provision is stricken by a Court of competent jurisdiction, no other provision will be affected. IN WITNESS WHEREOF, the undersigned signify their acceptance of this Agreement by executing this Resolution by action of the Board of Commissioners or other Governing Board: lnterlocal Agreement Amended June 2012 Page 4 of 6 RESOLUTION TO ADOPT THE INTERLOCAL A~GREEMENT AND TO JOIN THE NCACC RISK MANAGEMENT POOL WHEREAS, (County or local government agency) desires to pool the retention of their risks, liabilities and/or payments, or for the group purchase of coverage, and has completed a Pre-Audit Certification in compliance with N.C.G.S. § 159-28; and WHEREAS, the North Carolina Counties Risk Management Agency d.b.a. NCACC Risk Management Pools (hereafter called the "Risk Poor), has been established pursuant to G.S. §153A- 445 (a)(1) and G.S. §16D-A-460 through §160A-464; and WHEREAS, it is desirable for ---------(County or local government agency) to join the Risk Pool to obtain the opportunity for risk sharing and/or group purchase of coverage: NOW, THEREFORE, BE IT RESOL VEO that the Board of Commissioners or Governing Board of _________ (County or local government agency) hereby adOpts the foregoing lntertocal Agreement and hereby joins and agrees to participate in the Risk Pool as indicated: 0 North Carolina Counties liability and Property Joint Risk Management Agency d.b.a. NCACC Liability and Property Pool 0 North Carolina Workers' Compensation Joint Risk Management Agency d.b.a. NCACC Workers' Compensation Pool BE IT FURTHER RESOL VEO that (authorized county or entity official) is duly authorized to execute the application to join the Risk Pool and hereby executes the Agreement on behalf of ---------------(County or local government agency). Witnessed wherefore, this the ____ day of ____ , 20_. Attest: ______________________ _ NORTH CAROLINA -----------COUNTY Personally appearing before me this day of 20_, ~~----------' who, being first duly sworn, acknowledged the execution of the foregoing Agreement for the purposes and considerations therein and herein expressed. My Commission expires: lnterlocal Agreement Amended June 2012 Notary Public Page 5 of 6 Our only business 11 North Carolina counties. As a result. the Poots are designed to meet the ever· changing needs of county governments by gi\ting you a vo6ce In how they are operated. While no one can control all of the factors that impact the Insurance fn8rt(et- place, your Board of Trustees welcomes your Input to guide the long-term decisions they make. 2014 ao.d of Tru ..... Chair: Ann Hollon (Pamlco) Vlc»a.ir. Viola ._,. (Ec:tu-conlbe) Mtmbets: Wayne Abele (Burtce) JenyA~(VMCe) Anna Baucom (Anion) Jeff Dixon (Paequotank) Eileen GanNr (Bnmlwidt) Deron Geouque (Welauga) Fannie Greene (Nofthlmplon) Tracey Johnson (Waetrington) Kevin King (Swain) Ernest Lankford (S1okee) Llonell Midgett (Onslow) Russell Overman (Carteret) Kevin Paltel'lon (Scdland) Jean Powell (Hoke) Ronnie Smith (Martin) Richard Wella (Randolph) Joe Wiggins (Jones) Loria D. Williams (Henfold) Robert WIHcaJ'Yer (Davie) Why is the Association in the insurance business? New commissioners and county officials often ask questions trying to understand how the Pools fit in with the work of their Association. As with all services provided by the NCACC, the Pools were formed to meet an expressed need of the members. During the ear1y 1980s, Boards of County Commissioners and County Managers were faced with difficult budget choices due to escalating costs for workers' compensation and liability and property coverage. The Workers' Compensation Pool was created first in 1981, when the traditional insurance market began to stop covering public entities, which they Vance County Courthouse perceived as unprofitable. The Liability and Property Pool, formed in 1986, responded to similar conditions, when liability coverage for public officials and law enforcement officers seemed, to many, impossible to obtain at any price. Isn 't 'pool' just another word for 'I nsurance company'? It is easy to be confused by the contrast in pooling and insurance. Their terms and functions are similar, but the differences to members are significant. While insurance companies offer standard coverage forms priced at state-regulated rates, our Pools are able to design their own coverage fonns and establish their own rates, weighted heavily on the individual loss experiences of the members. Insurance companies' primary focus is making a profit for their stockholders. The Pools were formed to provide a stable source for insurance coverage, with the least amount of price or coverage volatility. Any member who has had their coverage cancelled by an insurance company understands the need for stability. P age 2 Dare County water tower NCACC Ri sk Managemen t Low'-risk alternative to insurance At its core, pooling is a means of risk-sharing among members. While pooling is technically not pure insurance, the Pools do purchase excess insurance coverage above a shared limit of liability that varies by line of coverage. This limits the individual impact of severe or frequent losses. This coverage, together with strict financial controls and under- writing standards, provides peace of mind and security to our members. Long-term~ availability and affordability Since inception, the Association's Risk Management Pools have focused on providing long-term coverage availability and affordability for members. To ensure that funds are available to meet the financial demand of claims and expenses, rates and loss reserves are reviewed annually by accredited actuarial finns. We require an annual financial audit by a rep- '7o have an insurance utable Certified Public Accounting finn so members can be assured that company or companies the Pools are financially sound. 1 that can speak the local government language is so important, and we found that to be the case with the Risk Management Pools." -Jerry Ayscue (Vance) Governance As non-profit, joint agencies focused on the long-tenn needs of our members, the Association's Risk Management Pools are not motivated by short-term financial return, as are many of the companies who compete against the Pools. The Pools are governed by a Board of Trustees, which is comprised of county commissioners and county officials. Trustees must represent a 1 participating member county and are appointed to three-year terms by the NCACC President. The Trustees are responsible for the strategic direction and meet quarterly to review the opera- tions of the Pools, provide guidance to NCACC staff and make program decisions on behalf of the members. NCACC R.k ~~ olfkft Ptrya:.l ~tlon: The Quorum Center 323 w. Jones St., S u ite 500 Raleigh, North CaroiiNI Mtllllng lldd,. .. : 215 N. Dewson Street Raleigh NC 27603 Ph. 919.719.1100 Fa x 919.719.1101 Email nnpOncecc.org Workera· Compenaatlon Pool & Property end L•eblhty Pool o Property rates are competitively priced based on historical damage to county buildings as a class, which typically are of superior construction and are a better risk than some insurance company rating models dictate. o Package policy combines and provides multiple lines of coverage in one policy. o Coverage is designed and provided for unique county exposures that are often difficult to place. o Real property and mobile equipment appraised on a rotating schedule with detailed reports provided to document values. In addition to establishing appropriate limits of coverage, these reports may also assist in other financial reporting requirements. 0 Criminal justice services assist in managing liability exposures of law enforcement detention centers with an emphasis on policy and procedures. 0 Concentrated attention to exposures relating to the operation of emergency vehicles. Claim• Philosophy & Service The Liability & Property Pool does not simply seek the least expensive way to settle a claim, as a traditional insurance company might do, but instead will aggressively defend the Members, upholding a legal reputation of being tough but reasonable. Our legal defense firms are widely known and respected for their knowledge and experience in governmental defenses and county-specific Issues, especially in the area of law enforcement. 0 A variety of options are available, including standard and large deductible/ seH-insured retention products. Claims Philosophy & Service Benefits are provided in accordance with North Carolina statutes under the jurisdiction of the NC Industrial Commission. Claims legal defense is provided through major law firms with extensive experience in workers' compensation and county-specific issues. 0 Members choosing a large deductible/self-insured retention product are provided with an annual actuarial review of their losses at no charge. o Nurses specializing in occupational injuries assist injured workers in under- standing their medical treatment. o Criminal justice services emphasize policies and procedures to assist In managing the risk of injury to employees associated with law enforcement activities, including detention centers. 0 On-site visits to conduct comprehensive reviews of safety programs. accidents and loss trends. We also review employee relations and communications and departmental organization to look for areas that can be improved. 0 Payroll audits conducted annually at no cost. 0 Aetum-to-work programs development to help get employees back on the job while accommodating those restrictions outhned by their treating physicians. o Minimal safety standards assist members to develop programs that impact the frequency of claims and provide a safer working environment. "IS IT REAllY THAT DIFFERENT? After all, Isn't It just one line Item In our budget?N While Ins u ranc e costs may be only one lin e Item, they represent a sl1nfficant In· vestment I n protectin1 your employees, p r operty and othe r assets . The Pools are the predom i nant provi der of covera1e to the m ,ajorlty of North Carolina counties . In addition, the Pools provide a number of ancillary services desl1ned to meet the unique needs of counties. 24-Hour Services 24-hour claims reporting line assures members that claims staff can be immedi- ately available in emergency situations . Coverage Coverage documents are reviewed annu- ally for appropriate enhancements based on: • statutOty & administrabve changes • claims issues • specific member needs Statistical Reporllng Members receive claims and risk control reports intended to help them identify causes of loss, make recommendations for improvements and mitigate future losses. We're on the Web! www.ncacc.org/ rmp.htm Training I Consultative Services Assistance provided on: • coverage and plan design • deductible and fundllg options • limits of liability • expense allocations A training schedule is developed annually based on identified claims trends or chang- ing exposures. Seminars are held through- out the state on such issues as: • claims reporting • management of specific hazards • changes In laws • fleet management • wellness • program administratiOn Risk and criminal justice assessments are conducted for members to identify specific needs and risks. Multi-Pool Dlacount Program After one year, members eam discounts for participating In both pools. Awards Program A Safety and Wellness award program provides cash incentives to recognize members in each pool that have taken steps that positively impact their rates: • innovative programs • best overall loss ratio • most improved loss experience For more infonnation or to request a quote, please contact: Michael A. Kelly, CPCU, CIC, CRM, ARM-P Risk Management Director Ph. 919.719.1124 michael.kellyO ncacc.org NCACC Risk Management Covering the Counties that cover our state Charles D. Eaton, CPCU, AU Property & Casuahy Program Specialist Ph. 919.719.1130 charlie.eatonO ncacc.org 215 N. Dawson Street Raleigh NC 27603 ph. 919.719. 1100 fax 919.719.1101 RMP@ncacc.org No~AROLINA AssociATION OP CoUNTY CoMMISSIONII&S Robert W. Carruth, CSP, ARM Risk Control Manager Ph. 919.719.1150 bob.carruthOncacc.org Richard F. Barnes Underwriting Manager Ph. 919.719.1135 richard.bamesO ncacc.org NCACC Risk Management The NCACC Risk Control team is dedicated to providing Pool members with superior risk control support to help each member with hazard assessment, risk identification, claims analysis and safety program design. Our goal is to ..... ~. help all members achieve a reduction in both the frequency and severity of claims through training and one-on-one interfaces with our staff. Over time. staff has collected and created hundreds of documents to assist us in helping our members reach that goal. They include an extensive library of Best Practices handouts, manuals, checklists, safety tips, presentations, and form and policy templates on a wide variety of risk control topics. All of the paper resources are available in either hard copy or electronic format, so our members may customize them to fit their own specific needs and policies. We also contracted with an outside vendor to lease a series of 12 training DVDs to form a lending library. At present, those DVDs are still available. However, we have now upgraded this service with the addition of access to an extensive online streaming video library. This added resource gives our members access to near1y 70 streaming videos on a wide range of risk control topics. While long enough to convey important safety tips, these videos are short enough to anchor a member's next staff or safety committee meeting or kick off a training session. For additional information, including assistance in implementing any of the guidelines suggested by our resource materials, setting up training and/or customizing this material to fit your needs, please contact your regional Risk Control Specialist, the NCACC Risk Control Manager or the Risk Control Resources Librarian (see box on left). We will be glad to assist you. Now Available on Request: • Best Practices handouts • Presentations Form and policy manual templates DVD Lending Library (12 titles) • Streaming Video Library (more than 65 titles) Risk Manage ~ment Handouts are available ln hard copy or electronic format: L•derahlp: lit-Management Role in Controlling Risk 12--Adopting a Safety Poley 113-Providing Feedback to I~ Performance 14-Executive Safety Committee Steenng Team Organizational Checklist Safety Program81Sahrty Committee: Providing a Safe Wortplace Minimum Requirements for an Adequate Safety Program Adopting a Safety Prog~ety by the Numbers Creating a WOfUbkt Employee Safety Incentive Program Safety Inspection Checklist OSHA Guidelines-First Aid vs. Recordable vs. Reportable Safety Tips Series: #1--Chemicals 12-Your Safety Attitude 13-Trips and Fans t+-lndOOr Trips and FaJis 15-0utdoor Trips and Falls IS-Protecting your Bad( 17-Avoiding AggnlesiYe Behavior I&-Housecleanlng 19-Cooking Ito-Driving 111-Eiectrical Safety 112-Extension Cords 1113-Aammables 114-Contagious Diseases 1 15-Handting St1'86s 116----ladder Safety Return to Work Programs Bloodbome Pathogens Emergency Management: #1---Fiood Procedures 12-Tornado Preparedness t3-FEMA Tornado Fact Sheet IJ4-Hurricanes: Before/During/ After •s--tturricane Preparedness Checklist Sheriffs Office Operations Solid Waste Management Transportation 11-Working with Clients in Wheelchairs 12-Transporting Clients 13-0riving Safety 101 lf4-Safe Passing Procedures Use of Cruise Control & Hydroplaning Office Ergonomics: Office Ergononucs Evaluation Checklist Workstation Setup Ergonomics Checklist UCLA Flexibility/Strelehing Exercises MSDs-Safety Activity Measurements Hazardous Materials: Asbestos Management Plan Carbon Monoxide-The Facts Indoor Mold and Fungus Elements of a Respiratory Protective Program Personal Protective Equipment: PPE-Eyewear Policy PPE-Footwear Policy PPE-Headgear Policy PPE-Respiratory ProtectiiiEI Policy Building Maintenance/Public Utilities Electrical Safety Extension Cord Safety Ladder Safety Forklift Operation Safety Preventing Hot Work Fires Machine Safety Water Damage Prevention Work Zone Safety Heat Expoaure: Avoiding Heat-related Injuries Supervisor's Daily Heat Safety Checklist Mlscellaneoue: Cell Phone Use and Driving Dealing with Domestic Violence in the Wor'ltplace Scabies Exposure and Infestation Space Heater Safety Handling an Irate Caller Handling a Bomb Threat over the Phone Stress in the Workplace NCACC Risk Control Among our addltlonalllbnlry, we feature: Accident and Injury Response: OSHA Forms for Reporting Wort<-related Illness/Injury Accident Investigation· Witness Statement (form) Near Miss Accident/Injury Report (fonn) Employee Accident/Injury Report (fonn) Bloodbome Pathogens Exposure Control Plan (manual) Confined Space Entry (manual and How chart) Construction Safety (pre-planning worksheets and manuals on Digging and Waking) Dam Operation, Maintenance & Inspection (manual) Dam Safety (report, chect<list, flow chart, classifications chart) Disaster Management (Homeland Security manual, FEMA report, DENA guidelines) Driver Safety and Fleet Management (manuals) Electrical Safety (CDC and NFPA manuals) Ergonomic&--4ighting and ventilation (NLB manual) Fire Safety (report on smoke detectors) For1dlft Safety (OSHA standard report and guidelines) Hazardous Materials (charts. forms, manuals. reports. infonnation guides) Heahh Department: Heanh Department Accreditation (NACCHO manual) Patient Fall Prevention Policy (manual) Job Safety Analysis (fonn templates) Machine Safety report Safety items Info sheets: fence guards, grill guards, pressure mats, smoke detectors Return to Wort< (manuals and transitional duty forms) Supervisor Safety Training (OSHA manual) Solid Waste Management (EPA manual) Substance Abuse (US DOL manual) Workzone/Fiagger Safety (US DOL and NC DOT reports) We also have training presentations available on the following topics: Back Safety Bloodbome Pathogens Chemical & Detergent Suicides Confined Space Entry Distracted Driving Fire Safety Hazard Communications Incident Reporting Office Safety OSHA Programs for Law Enforcement PPE-Personal Protective Equipment Respirators Safety Committees Slips, Trips and Falls Wort<place Violence Workplace Violence (TX HSS Commission) To order any of these risk control resources, please: Contact the Resources Librarian 0 By phon&-919.719.1117 (leave voicemail if needed) 0 By emaU-RMP Oncacc.org o By fax--919. 719.1101 Specify: 0 Your name. county or entity and phone number o The item(s) you wish to order 0 Whether you want the item electronically or hard copy 0 If hard copy, supply your mailing address and the quantity needed 0 If electronic, supply your email address These short videos (average length 15-20 minutes) are the perfect tool to anchor your nexl staff or safety committee meehng or to use in conjunction with a training session. NCACC Risk Control features specific strearmng videos fYo18fY month, but any video may be requested by a member at any time. At::.cess is through a link and passcode which is supplied via email. Members are then entitled to view the video twice (2 times) at any time of their choosing. Although our intention is that you view these videos in a group setting using a computer or laptop and projector, members may use their two views any way they'd like. Also. as circumstances require It (I.e., the size a your intended audience or the shift nature of a specific department), additional access may be granted. Monthly announcements of featured videos are emalled to our "Member Safety Contacts" distribution list. Instructions are included in those weekly emails. If you are not receiving these emails, please contact the Resources librarian. A Clear Picture: Harassment In The Public Sector Accident Investigation: The Accident: What To Do Avoiding Utigation Landmines: A Survival Guide For Managers Back Protection: Defending Your Safety Zone Back Safety For First Responders Back Safety: lilt Well live Well Bloodborne Pathogens for Corrections Bloodborne Pathogens for Custodians Bloodbome Pathogens: For Fire And Rescue Bloodborne Pathogens: Just The Facts Bloodborne Pathogens: Protecting Law Enforcement Confined Space Entry Keeping Public Employees Safe Confined Space Entry: Plan And Prepare Contractor Safety: It's Everyone's Business Defensive Driving For Government Employees Defensive Driving: 15 Passenger Vans Disaster Safety: Aftermath & Cleanup Driven To Distraction Driven To Distractton II Emergency Action Plan: Crisis Under Control Emergency Action Plan: The Team Approach Emergency Evaucation: Getting Out Alive Emergency Response Driving Employee Involvement: The Key To Safety Ergonomics: The 2-4-hour Body Ergonomics: Solving the Puule Ergonomics: Watch Your Back Facility Security: The Critical Unk Fall Protection: The Right Connection Fire Safety: Alert Aware Alive Golf Cart And LSV Safety: On And Off The Course Groundskeeping Safety: Be A Pro! Groundskeeping Safety: Dealing With Bugs & Critters Handwashing: Avoiding Germs & Viruses At Wot1< Harassment ls ... Govemment Version Hazard Communication: It's a Two-Edge Sword Heat Stress For Public Employees: Seeing Red Holiday Safety: AI The Top Of Your list Incident Investigation: Analyzing The Facts & Causes Incident Investigation: Forming a Team & Gathering Information Incident Investigation: Process and Follow-up Job Safety Analysis: Proactive Planning lockout Tagout: Make No Mistake MRSA Awareness Office Ergonomics: It's Your Move OffiCe Safety: It's A Jungle In There OSHA Recordkeeping: True To Foon OSI: Office Safety Investigation Personal Protective Equipment: Don1 Start Wor1t Without It Personal Protective Equipment: Reality In The Public Sector Powered low-lift Trucks: Walkie & Walkie I Aider Safety Pro-Active Safety Attitudes: Looking Out Number One Pro-Active Safety Attitudes: Target Zero Public Building Safety: It's EV8f)'On8's Concem Recognizing Drug And Alcohol Abuse For Employees Recognizing Drug And Alcohol Abuse For Managers Red Aags Rule: Preventing Identity Theft Roadway Worker Safety: In The Zone Safe Winter Driving Safety Attitude: Food For Thought Safety First: PPE Hazard Assessment Safety Meetings: Supervisor Series Safety Orientation: II Takes A Winning Attitude Safety Orientation: On Alert Sexual Harassment: A Manager's Guide Slips Trips And Falls: Taking The Right Steps Stairways & Ladders Stormwater Runoff: I Can Make A Difference Strains And Sprains: Avoiding The Pain The Pro-Active Safety Committee: A Team For Success The Stress Beater Walking And Working Surfaces: Watch Your Step Winter Safety Working Outdoors : Mosquitos & TICks Wort<place VIOlence: First line Of Defense Woftq)lace Violence: The Calm Before The Storm NORTH CAROLINA AsSOCIATION OP CouNTY COMMISSIONERS NCACC RISK MANAGEMENT Mailing address: 215 N. Daw.son Street, Raleigh NC 27603 Physical Location: 323 W. Jones Street, Suite 500 (Quorum Center), Raleigh Ph. (919) 719-1100 I Fax (919) 719-1101 I rmpOncacc.org STAFF DIR,ECTO'RY MICHAEL A. KELLY, CPCU. CIC, CRM, ARM-P Risk Management Director Ph: (919) 719-11 24 michael.kellyOncacc.org Manages the overall operation tor the Woriters' Compensation and Liability & Property pools. CHARLES D. EATON, CPCU, AU Property & Casualty Program Specialist Ph: (919) 719-11 30 charlie .eaton @ ncacc.org Serves as a technical resource on property, casualty and risk management matters for existing, new and prospective members. WILLIE ALLEN Underwriter Ph: (919) 719-11 33 will ie .allen @ncacc.org Assesses risk for Liability & Property and Woriters' Compensa- tion Pool members, reviews and writes policies, and ensures compliance with underwriting policies for the Western and Piedmont areas of the state. ..._ ____ _. !RICHARD F. !BARNES Underwriting Manager Ph: (919) 719-11 3 5 richard.bamesOncacc.org Manages underwriting operations for Liability & Property and Woriters' Compensation pools, drafts requests for proposale and other service contract documents, manages bidding process and negotiates with prospective service partners. stays current with daims activities. supervises the rating process, drafts and issues coverage and policy documents. member billing and reinsurance placements. JO-ANN WEST Underwriter Ph: (919} 7 19-11 3 1 jo-ann. west@ ncacc.org Assesses risk for Liability & Property and Workers' Compensa- tion Pool members, reviews and writes policies, and ensures compliance with underwriting policies for the Southeast and Northeast areas of the state. ROBERT W. CARRUTH, CSP, ARM Risk Control Manager Ph: (919) 719-1150 bob.carruth@ ncacc.org Manages the operation of the Risk Control Unit, develops safety policies and programs, identifies liability exposures, and provides recommendations and training to minimize Pool members' risk and development of risk management program. STUART DARDEN Risk Control Specialist Central Region Ph. (919) 719-1152 stuart.darden@ ncacc.org Conducts risk profile evaluations. plans and strategizes risk control services, develops loss trend analysis reports and practical risk control services plans, develops and presents supenrisory safety management training; assigned to Central Region of the state. KATHY DEMAY Executive Assistant Member Resources Librarian Ph: (919) 719-1117 kathy.demayOncacc.org Provides support to the NCACC R1sk Management Pools and Risk Control Services, serves as clerk to the Risk Management Board of Trustees, and provides other administrative support to Risk Management Department as needed. GERALD HONEYBLUE Risk Control Specialist Eastern Region Ph. (919) 719-1153 gerald.honeyblue@ ncacc.org Conducts risk profile evaluations, plans and strategizes risk control services, develops loss trend analysis reports and practical risk control services plans, develops and presents supervisory safety management training; assigned to Eastern Region of the state CRAIG SAPPENFIELD Risk Control Specialist Western Region Ph: (919) 719-1151 criag.sappenfield 0 ncacc.org Conducts risk profile evaluations, plans and strategizes risk control services, develops loss trend analysis reports and practical risk control services plans. develops and presents supervisory safety management training; assigned to Western Region of the state. AMY BASON General Counsel Ph: (919) 719-1430 ll.ll<.o&---'""'"""-.. amy .bason@ncacc.org Serves as counsel to the Executive Director across all service areas including the Risk Management Pools, advocacy, member services and internal support functions. Toll free claim reporting: 1-8n-NCACCRM (1-877-622-2276) or 1-800-822-4469 Sedgwick Claims Management Services: PO Box 24115, Charlotte NC 28224-1125 Contact: Charles D'Angelo, NCACC Account Representative Ph. (919) 934-1049, Fax (919) 934-0991, cdangelo@sedgwickcms.com --.' . • N o R r 11 · ~ C A " o 1 1 s A NCACC RISK MANAG,EMEN1 T AssociA.IION ot Col>Nl v <:oMMISslost Rs Covering the counties that cover our state ---- Underwriting Territories Jo-Ann West E~'il ' C:en'tr.lll South fH9-H 9· n J1 )f>-,;"1"1"' ~1!.\@,nc,J!CC org: Risk Control Specialists' Territories Craig Sappenfield WHtem Region 121f011121 cralg.uppenftefdCinc..:c.org Ger ald Hon eyblue Eastem Region 919-811-6331 geraJd.honeybluectncacc .org 2014--2015 Property and Liability Insurance Quotes *Note· cu"ent coverage premium reflects annualized updated premium theft Includes multiple endorsements during this policy year (mine resistant vehicle, VIPER system, Solid Waste equipment, etc.) 2014-2015 Workers Compensation -Self Insured Total Combined Premiums Combined Premi ums 2014-2015 Property and Uabil Insurance Deductible Options line •Note-cu~nt «werage premium reflects annualized updated prtmlum that Includes multiple endorsements during this polfcy year (mint resistant vehicle, VIPER system, Solid Waste equipment, etc.} 2014-2015 Workers Com Total Combined P·remlums • excludes property and liabillty co~rage • excludes worlc.ers comp Broker Proposal Review Total Annual Total Annual A. Form of Business Total Staff Total Professionals Premiums Public Median Client Size Premiums Entity NCACC pool 37 11 $ 38,386,940.00 $ 38,386,940.00 s 339,735.00 Snipes corporation 18 Snipes 118 15 Snipes $ 2,300,000.00 $ 200,000.00 $ 150,000.00 Keystone 36 Keystone Surry corporation 11 11 $ 36,832,000.00 s 32,020,000.00 s 308,500.00 -------- 1 P.op J iation.t . -. B tu---1 ., -, ·b·l _ _ -How ~-ny P.ublic , twa... Overall Number oJ Nitlfllt\tf'Jdt.'Expenence .. 1 '_.. 11fw;.un· m nsU(once ll'iltlrl '" PU lr..Sector· ~--larg-~ .. 1 Gov -_ 1 ~ · -..,..-ct~Ciients -:Ciiunl!. Pt.ib ic Secto t cr ent -!I -- NCACC Snipes Surry Notes: 33 62 Snipes 31 Keysone 79 I I I I I 33 40Snlpes Keystone 37 NCACC Client to Professional Ratio Snipes Client to Proffesionai Ratio Surry Client to Professional Ratio 31 I 113 9 Snipes 382 Keystone over 100 10:1 367:1 18:1 190,000 122,000 Snipes 162,000 Keystone 467,000 113 5,500 Snipes 900,000 Keystone over 200 coveraae only provided in ; NC I Snipes -none outside of 1 NC Kevstone -9 states sped I In public _or; insure more publk: entitles In NC and SC than any other aaent/broker in the carolinas ----- 'WhotW i!f'MG~aio · · --~w.ha .wru.s_eJiii~~ - c. C u~ (iov 'Cli en ts Btfere11ce i ----.A_ccount ..Aecou~l _ ------- I Watauga County -Deron Geoque i Charlie Eaton Charlie Eaton carteret County -Russell Overman NCACC I I Washington County -Frank Milazi ' I Rowan County -Yvonne Moebs H men County -excess we only I City of Dunn -Ronnie Autry ICilY of Dunn-all lines Harnett County Schools -Deborah Kitchens I Town of Angier-all lines ' Town of Blowing Rock -Nichole Norman I Town of Erwin -all lines except we Vanessa Youns -former Finance Director Town of Lillington-all lines except we I Snipes Town of Blowing Rock-all lines except we Dal Snipes Amy Hartley Town of Newton Grove-all lines except we 1-t rn tt County Board of Education -all lines exQep -property ·Town of Lillington Fire Dept/Flatwoods Fire Oept -all lines .. ---·-. ··--.. ---· --. Abbeville School District -Ronnie Scott Town of Cornelius -Jackie Huffman Forsyth County -Teresa Everhart County of Greenville -Steward Lawrence Megan Unsworth, Greenwood School District 52 -Emily Temple proprietary Info but please see references Madison County -Marla Gouge SUny and map for more Info Derek Slate sandy Love, Randy McCormick County Schools -Shatlka Spearman Cranfill Town of Morrisville-Chuck Queen Yancey County -Lynne Hensley York School District -Amy Hasner I School District of Greenville Co (former) -Jamie I McCuttheon ; · ,.._--: -licensed/ -------- ·D. t.enifent Annu_<!_1 1 R~ports -Acco~n!S~L!P Seryic~/:rech.nical ·n.._ . ---------------------. ·--------- I NCACC n/a1 attached multiple individuals assi gned to handle account anlv work with NC will provide upon request ! over 40 years providing Oal Snipes and Amy Hartley. Multiple other Individuals to serve risk mgmt solutions and Snipes yes once confidentiality as back up service to towns, cities, ' agreements are in place counties, schools I ' I Cl er 24/7 claim 11epo ng do not release info on via website; website also agency, but flnancials on Derek Slate, Megan Unsworth, Lori Hiatt, Sandy Love, Randy assists with maintaining Surry yes Cranfill, each with a minimum of 10 years of insurance OSHA records, provides companies can be I provided I experience and all have at least one designation ready to print flyers, I I reporting and analysis features I I ' 0 mpr.:l'l rll -IP f . '_ · : ·· · Avj Response llr·-• r;.o_ e_sstona.L , ,, --_ .-_ ~ _ than.&~ --ne ·oi.-el..-n!ril ' Relattonship1w/ dteJ!'3J ftisk: e/ f {IOSurc In o NCACC none 24 hours I I I ' immediate until close of ' Snipes none business day depending on urgency cont ed both inside and outside org all professionals extensive cont ed only work with NC counties which provides a greater understanding of coverage and application; work directly with county's risk mgmt team the county will have an assigned risk management specialist sit down and discuss expecta-tions, act a5l liason between carriers and county, 1 . Inspection, site visit, County Risk Mgmt be open to IIJ-adlity inspections; c ie.r recommendations of broker and carrier will also be Involved but 1 all have minimum of I one designation and participate In cont ed; attend annual updates based on their professional have designations, I ' ' I and provide info needed In accurate and only after dearing this r------~~------------t------------------t--------------+---------~t~im~e~l~y~m~a~n~n~e~r--------~~~--~th~r~u~o~u:r~affi~tc~e~__J I I In house risk management along with carrier risk management; online tralnins thru carrier, risk evals of property, policy review, Surry none no volcemall, only people; calls returned 1 within one hour during business hours designation role of Surry is to provide the absolute best service possible; worked with County for three years so relationship already lestab lshed· focus on public sector· here 0 I I I work hand In hand with County c:on rad review; In 1 p rson training as requested ----- D. Loss Control Services Servic·e'Standard -1Renewal Metnoi:i ~ NCACC -------------~~-------- In house loss control professionals; risk analysis and exposure Identification, trainl"l for any and all employees, access to video : library and customizable forms and policies (no additional cost) a good loss ratio along with monitoring of I service to the county within the scope of our guidelines; added risk control services ' provided as needed (see page 13, question 18) risk control agency has written policies/procedures In Included by carrier but also available through loss reports sent quarterly; applications sent out mid-March; renewal quotes provided mid- April; contracts delivered earty July begins approx 6 mths before renewal, offers I Snipes division of Keystone -East Coast Risk Manangement (additional fees apply) place for every account manager and producer; weekly audits and checks presented to client 45-60 days prior 1 I in house loss cotnrol professional; multiple 1 trainings already provided along with sampe Surry policies as requested; In house loss control available upon request for variety of needs and materials (no additional cost) retain current service team; follow servicing chart for each client Initial risk evaluation application will be completed; work with underwriters to develop ' a tailored plan; claim reviews recommended at least twice per year; multiple meetinss during year to discuss needs and renewal; once policy Is received It Is reviewed for accuracy before delivery I quarterly claim activity reports; risk control NCACC services; financial projections can be I provided after Board's spring meeting annual regional meetings; monthly newsletter see folder Insert; region meetings provided in spring and educational seminars provided in fall Snipes Surry D. NCACC Snipes Surry monthly claim activity reports; financial projection 90 days prior to expiration account executive reviews claims In house, monitors loss Info, and obtains updates from 1the carrier; claim reviews; Identify trends and make loss control recommendations r din articles/journals; carrier m n s~ loss control services to various governmental mon tor all credit ratings; conferences and . departments and have personally facilitated trade shows; Dal Snipes sits on National them; Affordable Care Act seminars for benefit Board of Independent Asents and Brokers clients; brought speakers to depts such as of America police/sheriff for driving safety members of NC and SC Public Risk Management Associations, Independent Asents of NC, Independent Insurance Agents & Brokers of America Other Info see attached Pool currently covers 67 counties in one or both pools; administered by Counties for Counties; In house services are inclusive over 40 years working with public entities; now partnered with KeyStone (based in PA); we are the local provider so premium dollars stay in HC and helps provide jobs In HC and are reinvested in HC largest school client has approximately 17,500 employees; largest county has population of 467,000; online services; In house loss control services ---------------- f P&C Carrier~ wrth Grt•Jtl'~t Bu~rnc>s<.. Propo'>.JI Ruv 'd but Not Pldced Carrrf'r~ O!'~rred NCACC The POOl works with c.-. ... lck Calms Management for all claim related services Araonaut Great Central Alterls Snipes Travelers n/a Allied Wortd Employers Mutual Casualty (EMC) Genesis One Beacon Uberty Mutual Houston Casualty Company One Beacon Surry Berkley Insurance Companies Brit Argonaut One Beacon American Public Risk Brit E Recommended TPA~ 1\ccess to Exce<.s/Surplu '> NCACC The pool works with --• aalms Manapment for all dalm related services Selewlck Oalms Manqement Snipes Key Risk Manaaement as a Keyston partner, we have access to virtually every excess and Galtqher Bassett Services surplus line market York Risk Services PMA SUrry Hewitt, Coleman & Associates access to approximately 30 markets for excess and surplus lines Key Risk Manaaement -- f.; . Broker. Insurance COl to tieProvided -- Broker fie$ -------- I nfa. n/a ----- NCACC nfa , I $48,000 for year 1 Snipes i S 5,000,000.00 $40,000 for years 2-3 yes •Does not include 15" commission on Safety National WC Excess (approximately $18,900) ' ' •Does not Include lass control services ($85 per hour plus travel or negotiated monthly fee) , - I Commission -All services are free when commission based Fee -$30,000 annually Surry $ 15,000,000.00 yes •Includes loss control services I •No other commission received 1121 Pemberton Hill Road Apex, NC 27502 Toll Free 888-303-9690 Phone 919-303-9690 Fax 919-303-9691 www.thebenefitadvisors.com Harnett County Government Health Plan Risk Evaluation May 22, 2014 1) The BCBSNC medical loss ratio report through March 2014 a. The report is an incurred claims report and not a paid claims report. b. The incurred report includes gross claims and does not take into account stop-loss credits. c. Incurred claims in March show a 104% loss ratio over current premiums. The estimated paid claims in March are approximately $4,150,000. 2) Claims incurred 5/1/2013 through 4/30/2014 and paid through 5/19/2014 claims over $500 – HSA plan Total claims: $3,893,179 on all members that are currently active. Projected HSA claims for FY 2015: $4,416,825. 3) Offering a dual choice HSA + PPO Plan. PPO Plan’s adjusted projected paid claims increased by 31% to account for the richer benefits. 4) IBA’s commission has been removed from $10 to $7 PEPM since the on-line system will not be implemented for FY 2015. Additionally, IBA negotiated a $3 PEPM reduction in BCBSNC’s stop loss fee from $33.26 to $30.26 PEPM. Benefits Network In-Network Out-of-Network In-Network Out-of-Network Annual Deductible (Individual / Family)$2,700 / $5,450 $5,400 / $10,900 $3,000 / $6,000 $6,000 / $12,000 Out-of-Pocket Maximum* (Individual / Family)$4,000 / $7,500 $8,000 / $15,000 $6,350 / $12,700 $12,700 / $25,400 Physician Office Services Primary Care 80% after deductible 70% after deductible $25 copay 50% after deductible Specialist 80% after deductible 70% after deductible $50 copay 50% after deductible Preventive Care Routine Exams, Well Child Care, Immunizations, Gynecological Exams, Cervical and Ovarian Cancer Screenings, PSA Tests, Screening Mammograms, Colorectal Screening, Bone Mass Measurement, Newborn Hearing Screening 100% covered 70% after deductible 100% covered 50% after deductible Hospital Services Inpatient & Outpatient 80% after deductible 70% after deductible 70% after deductible 50% after deductible Emergency & Urgent Care Urgent Care Centers Emergency Room Visit Prescription Drugs Generic (30 Day Supply)$10 copay Preferred Brand (30 Day Supply) Non-Preferred Brand (30 Day Supply) Specialty Brand (30 Day Supply) Mail Order (90 Day Supply) and Retail 3X Not covered 3X Not covered Diagnostic Tests (Non-Preventive) MRI, MRA, CT Scan, & PET Scan. (Prior BCBSNC Approval Required)80% after deductible 70% after deductible 70% after deductible 50% after deductible Therapies Physical, Occupational, & Chiropractic. (Combined Maximum of 30 Visits)80% after deductible 70% after deductible $50 copay 50% after deductible Medical Supplies Diabetic Supplies 80% after deductible 70% after deductible 100% covered 50% after deductible *The PPO Out-of-Pocket Maximum includes deductible, coinsurance, and medical copays, but not Rx copays. 80% after deductible $500 copay 80% after deductible Out-of-network cost differential in addition to in-network charge. Out-of-network cost differential in addition to in-network charge.50% ($100 Maximum) 80% after deductible $50 copay Current HSA Renewal Option PPO i Harnett County Government Health Insurance Renewal Benefits Comparison BCBSNC Effective Date: July 1, 2014 Report Date: May 23, 2014 Employee Employee & Dependent Family Monthly Total Annual Total Annual Change Percent Change March 2014 Enrollment 656 88 52 796 9,552 NA NA Total Cost $445.05 $622.56 $825.15 $389,646 $4,675,751 NA NA Employee Contribution $0.00 $177.51 $380.10 $35,386 $424,633 NA NA Employer Contribution $445.05 $445.05 $445.05 $354,260 $4,251,118 NA NA Total Cost $580.77 $812.42 $1,076.77 $508,470 $6,101,641 $1,425,891 30.5% Employee Contribution $0.00 $231.65 $496.00 $46,177 $554,126 $129,493 30.5% Employer Contribution $580.77 $580.77 $580.77 $462,293 $5,547,515 $1,296,397 30.5% Total Cost $583.02 $815.55 $1,081.00 $510,442 $6,125,298 $1,449,548 31.0% Employee Contribution $0.00 $232.53 $497.98 $46,358 $556,291 $131,658 31.0% Employer Contribution $583.02 $583.02 $583.02 $464,084 $5,569,007 $1,317,889 31.0% Renewal Effective Date: July 1, 2014 i Harnett County Health Plan Cost & Contribution Comparison Summary Benefit Plan: HSA vs. PPO Financial Arrangement: Fully-Insured vs. Self-Funded Current HSA Fully-Insured 2013 - 2014 Renewal HSA Fully-Insured 2014 - 2015 Renewal Option PPO Self-Funded 2014 - 2015 Report Date: May 22, 2014 Plan Year Employee Employee & Dependent Family Monthly Total Annual Total Annual Change Percent Change March 2014 Enrollment 656 88 52 796 9,552 NA NA Total Cost $445.05 $622.56 $825.15 $389,646 $4,675,751 NA NA Employee Contribution $0.00 $177.51 $380.10 $35,386 $424,633 NA NA Employer Contribution $445.05 $445.05 $445.05 $354,260 $4,251,118 NA NA Projected Claims $492.51 $725.04 $990.49 $438,396 $5,260,747 NA NA Fixed Cost $66.51 $66.51 $66.51 $52,942 $635,304 NA NA IBNR $24.00 $24.00 $24.00 $19,104 $229,248 NA NA Total Cost (Premium Equivalent)$583.02 $815.55 $1,081.00 $510,442 $6,125,298 $1,449,548 31.0% Employee Contribution $0.00 $232.53 $497.98 $46,358 $556,291 $131,658 31.0% Employer Contribution $583.02 $583.02 $583.02 $464,084 $5,569,007 $1,317,889 31.0% $36.25 $30.26 $66.51 Renewal Effective Date: July 1, 2014 Breakdown of Fixed Cost: Administrative Charges (PEPM): i Harnett County Health Plan Cost & Contribution Comparison Detail Current Fully-Insured HSA vs. Renewal Self-Funded PPO BCBSNC Current HSA Fully-Insured 2013 - 2014 Renewal Option BCBSNC ASO 2014 - 2015 Report Date: May 23, 2014 Plan Year $175,000 SSL (PEPM): Total Fixed Cost (PEPM): Annual Individual Deductible (Applies to Basic and Major Services)$25 Annual Family Deductible (Applies to Basic and Major Services)$75 Maximum Annual Benefit $1,000 Routine Oral Examinations 100% Cleanings 100% (2 X Year) X-rays 100% (Various Frequencies for Different Types of X-rays) Fluoride Treatment 100% (2 X Year for Dependents up to Age of 19) Sealants 100% (1 X 5 Years for Dependents Ages 5 to 16) Fillings 80% Periodontics 80% Endodontics 80% Crowns 50% Bridges 50% Onlays & Inlays 50% Dentures 50% Coinsurance 50% (All Eligible Members to Age of 19) Lifetime Maximum $1,000 i Harnett County Government Dental Plan Benefits Renewal Effective Date: July 1, 2014 Report Date: May 20, 2014 General Provisions Diagnostic and Preventive Services Basic Services Major Services Orthodontia Services Incurred February 1, 2013 - January 31, 2014 Paid March 2014 1. Total Paid Claims $305,021 2. Total Number of Employees 7,404 3. Average Cost PEPM $41.20 4. Trend a. Annual Trend (BCBSNC Current Market Trend)5.0% b. Adjusted Trend (15 Months)6.0% 5. Trended Claim Cost PEPM $43.67 6. Administrative Cost PEPM (BCBSNC or Delta Dental)$4.78 7. Total Cost (617 ee)$358,724 Total Cost PEPM $48.45 8. Current Funding (617 ee)$381,312 Current Funding PEPM $51.50 9. Projected Renewal Change -5.9% 10. Recommended Renewal Change -3.0% Employee membership includes both employees and Pre-65 retirees. i Harnett County Preliminary Self-Funded Dental Renewal Analysis Projection Period: July 1, 2014 - June 30, 2015 Report Date: May 19, 2014 Experience Period: Employee Employee & Dependent Family Monthly Total Annual Total Annual Change Percent Change March 2014 Enrollment 391 134 92 617 7,404 NA NA Current Fully-Insured 2013 - 2014 Premium $31.80 $62.59 $119.05 $31,773 $381,282 NA NA Renewal Self-Funded 2014 - 2015 Premium Equivalent $30.87 $60.77 $115.58 $30,847 $370,161 -$11,121 -3.0% The administrator for the self-funded renewal plan is either BCBSNC or Delta Dental. Plan Year i Harnett County Voluntary Dental Plan Cost Comparison Current Fully-Insured Plan vs. Renewal Self-Funded Plan Renewal Effective Date: July 1, 2014 Report Date: May 20, 2014 Coverage Rate Monthly Cost Annual Cost Rate Monthly Cost Annual Cost Savings Employer Life $0.10 $3,290.07 $39,480.84 $0.08 $2,632.06 $31,584.67 $7,896.17 Employer AD&D $0.02 $640.94 $7,691.28 $0.02 $640.94 $7,691.28 $0.00 Dependent Life $0.70 $170.10 $2,041.20 $0.66 $160.38 $1,924.56 $116.64 Voluntary Life Age Banded $10,909.27 $130,911.24 Age Banded $10,363.81 $124,365.68 $6,545.56 Voluntary AD&D $0.03 $603.30 $7,239.60 $0.03 $542.97 $6,515.64 $723.96 Voluntary STD Age Banded $7,026.14 $84,313.68 Age Banded $5,620.91 $67,450.94 $16,862.74 $32,145 $7,896 $24,249 $96,435 $23,688 $72,747 Total Annual Savings: Reliance Standard (Proposed)USAble (Current) i Harnett County Life Insurance Cost Comparison USAble vs. Reliance Standard Renewal Effective Date: July 1, 2014 Report Date: May 20, 2014 Total Savings Over 3 Years: Employer: Employee: Employer: Employee: