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Home My WebLink AboutWorkers_Compensation_Program_2022-23 WORKERS' COMPENSATION • •• EMPLOYER'S LIABILITY PROGRAM RS GOB"\NOINTEGRITY f �- EXCELLENCE Ai INN l ' • • Protection period: TEAMWORK July 1,2022 to July 1,2023 Overview................................................1 Detail......................................................2 Schedule of Insurers.................................3 Members Roster.....................................A C\I.I IF OP NIA I - A CALIFORNIA 166 J , P , I , A Providing innovative risk management solutions for our public agency partners WORKERS' COMPENSATION & EMPLOYER'S LIABILITY PROGRAM Overview • July 1,2022 WC 21 Program Workers'Compensation losses are pooled by California JPIA Members to $2 million.Coverage above$2 million is purchased with statutory limits. Employer's Liability losses are pooled by California JPIA Members to $2 million.Coverage from $2 million to$5 million is purchased.Any loss from $5 million to$10 million will be pooled by California JPIA Members. Protection Period July 1,2022 at 12:01 a.m.to July 1,2023 at 12:01 a.m.Pacific Time Protects California JPIA Members that participate in the Workers'Compensation Program • through resolution of the agency's legislative body,and their employees (including the Member's city council,board of directors,or other legally authorized or appointed committees or commissions of the Member)for statutory benefits allowed under California's workers'compensation laws. • Covers Statutory liability under California Workers'Compensation Law; and Employer's Liability. • Limits Workers'Compensation:Scheduled Statutory Benefits Employer's Liability:$10,000,000 per Occurrence Coverage Note Volunteers covered only if Workers'Compensation coverage has been extended to them by resolution of the member's legislative body. Facultative reinsurance is provided by Safety National Casualty Company.Some exclusions and sub-limits apply,see coverage documents for more information. z Facultative reinsurance is provided by Safety National Casualty Company.Some exclusions and sub-limits apply,see coverage documents for more information. THE ABOVE IS A SUMMARY ONLY.IT DOES NOT MODIFYTHE MEMORANDUM OF COVERAGE, NOR THE REINSURANCE OR EXCESS INSURANCE DOCUMENTS. FOR FULL COVERAGE DETAILS,SEETHE FULL CONTRACTS AND POLICIES ON FILE AT THE CALIFORNIA JPIA OFFICE. EFFECTIVE JULY 1,2022 Rev:7/1/22 Page 1 WORKERS' COMPENSATION & EMPLOYER'S LIABILITY PROGRAM Detail • July 1, 2022-July 1,2023 Covered Parties California Joint Powers Insurance Authority and participating members LAddress 8081 Moody Street,La Palma,California 90623 Coverage Workers'Compensation:Statutory Employer's Liability:$3,000,000 excess of$2,000,000 Facultative Reinsurance Certificate Number:FCS4066721 Protection Period July 1,2022 at 12:01 a.m.to July 1,2023 at 12:01 a.m.Pacific Time Coverage Provided By Safety National Casualty Corporation • A.M.Best Rating A+(Superior) Financial Size Category of XV($2 Billion or greater) California Status Authorized Reinsurer • Limits Workers'Compensation:Statutory Employer's Liability: $3,000,000 Each Accident for Bodily Injury by Accident $3,000,000 Policy Limit for Bodily Injury by Disease $3,000,000 Each Employee for Bodily Injury by Disease Self-Insured Retention $2,000,000 Per Occurrence Self-insured retention is eroded by allocated claims expense. Major Exclusions War and Civil War (Including but not limited to) Nuclear Incident • Extra Contractual Obligations • Loss in Excess of Policy Limit Claims Reporting Sedgwick Claims Management Services 8855 Haven Ave Rancho Cucamonga,CA 91730 Phone: (909)942-5445 Fax: (866)548-2637 Memorandum of Coverage contains full reporting requirements. Broker Guy Carpenter Mike Waterman,Managing Director and Public Entity Segment Leader;Chicago,IL Isabella Pang,Vice President;Chicago,IL James Turner,Vice President;Philadelphia,PA THE ABOVE IS A SUMMARY ONLY.IT DOES NOT MODIFYTHE MEMORANDUM OF COVERAGE, NOR THE REINSURANCE OR EXCESS INSURANCE DOCUMENTS. FOR FULL COVERAGE DETAILS,SEETHE FULL CONTRACTS AND POLICIES ON FILE ATTHE CALIFORNIA JPIA OFFICE. EFFECTIVE JULY 1,2022 Rev:7/1/22 Page 2 WORKERS' COMPENSATION & EMPLOYER'S LIABILITY PROGRAM Schedule of Insurers • July 1, 2022-July 1, 2023 WORKERS'COMPENSATION AND EMPLOYER'S LIABILITY COVERAGE - Limit: Worker's Compensation (WC): Statutory Excess of$2,000,000 Employer's Liability(EL): $3,000,000 Each Accident for Bodily Injury by Accident $3,000,000 Policy Limit for Bodily Injury by Disease $3,000,000 Each Employee for Bodily Injury by Disease Excess of$2,000,000 • REINSURED BY SAFETY NATIONAL FACULTATIVE CERTIFICATE NUMBER:FCS4066721 CASUALTY CORPORATION GC RISK REFERENCE NUMBER:UA8T00022201 -WC-Statutory -EL-$3,000,000 • California Status: Admitted Standard&Poor's Rating: A+(Positive) Best's Guide Rating: A+(Superior) Financial Size Category of XV($2 Billion or greater) Rev:7/1/22 Page 3 WORKERS' COMPENSATION & EMPLOYER'S LIABILITY PROGRAM Member Roster • July 1, 2022-July 1,2023 Agoura Hills Lake Elsinore AHCCC Lake Forest Aliso Viejo Lakewood Apple Valley Lawndale Arroyo Grande Loma Linda Artesia Lomita Atascadero Malibu Bell Gardens Mammoth Lakes Bellflower Midpeninsula ROSD Big Bear City Community Services District Mission Viejo Big Bear Fire Monrovia Big Bear Lake Monterey Peninsula RPD Bishop Moorpark • Bradbury Morro Bay Brawley Mountain Area RTA Buellton Needles Calabasas Norwalk California JPIA Ojai • Camarillo Palm Desert Carpinteria Palos Verdes Estates CASA Paramount Cerritos Paso Robles Chino Hills Pismo Beach Claremont Pomona Valley TA Dana Point Port Hueneme Diamond Bar Poway Duarte Rancho Palos Verdes El Centro Rolling Hills ESTA Rolling Hills Estates Fillmore Rosemead Gateway Cities COG San Dimas Goleta San Gabriel Grand Terrace San Juan Capistrano Grover Beach San Luis Obispo Guadalupe Santa Fe Springs Hawaiian Gardens Santa Paula Imperial SCAG Indian Wells SEAACA Indio Seal Beach Irwindale Seaside La Canada Flintridge Signal Hill La Habra Heights Solvang La Mirada South El Monte La Palma Temple City La Puente Ventura Port District La Quinta Villa Park La Verne Walnut Laguna Niguel Westlake Village Laguna Woods *Azusa,Alhambra,Hemet,Lemon Grove,Pacific Grove,Santa Clarita,Stanton,West Covina and West Hollywood participate in the Excess Workers' Compensation Program Rev:7/1/22 Page