HomeMy WebLinkAbout2008 Workers Compensation Policy~~
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I N S U R A N C E
826 west Main Streef, New Albany, IN 47150
Phone: 812-941-4110 Fax: 812-944-8010
June 10, 2008
City of Jeffersonville
Mayor Thomas Galligan
500 Quartermaster Ct.
Jeffersonville, IN 47130-3672
Deaz Mayor,
W e are pleased to enclose the worker's compensation renewal policy for your commercial
insurance. Although we have proofed your policy for accuracy, it is always beneficial for you to
review them as well. Should you discover an ertor, kindly notify us so that we can make the
correction immediately.
Should you have any questions after reviewing the policies, please do not hesitate to call me or
Peggy Fawcett, who assists in the handling of your account.
On behalf of Maverick Insumnce, thank you for placing your trust in us to assist you with your
insurance needs.
Enclosed is an invoice that is due by July 1, 2008. Please make check payable to Maverick
Insurance and mail to 826 W. Main St., New Albany, IN 47150.
Sincerely,
Lcrw~v~ C C~odiF./
Edwazd C. Cooper
MAVERICK INSURANCE
Enclosures
CITY OF JEFFEnSONVILLE
JUL 0 ~ 7nnA
CLERr(-1 REf;sURER
www. maverick-insurance.<om
ROUNDING UP THE SOLUTIONS FOR ALL YOUR INSURANCE NEEDS TODAY!
MAVERICK INSURANCE SERVICE TEAM FOR
CITY OF JEFFERSONVILLE
Office Phone ..Fax
Maverick Insurance (NA)
826 West Main Street 812-941-4110 812-944-8010
New Alban , IN 47150
Name Title Direct Phone E-Mall
Edward C Coo er Sr. Account Executive 502-558-2525 coo er maverick-insurance.com
Jud Kem Account Mana er 812-941-4123 ~kem maverick-insurance.com
Pe Fawcett Account Coordinator 812-941-4125 fawcet[ maverick-insurance.com
Maverick Insurance is dedicated to delivering the best insurance and risk management
services to individual and business clients in our marketing territory.
We will:
• Provide prompt responses to our customers' inquiries
• Continually develop and enhance our portfolio of products and services
• Advance our capabilities through training and professional development
programs for our people
Maverick Insurance will work aggressively to accomplish its stated mission in order to
achieve above average growth and customer satisfaction.
[PEP
INDIANA PUBLIC EMPLOYERS' PLAN. INC.
05/20/2008
Jeffersonville; City of
500 Quartermaster Ct.
Jeffersonville, IN 47130
Dear IPEP member:
We are attaching for your information, a copy of the IPEP bylaws which was
reviewed and updated by the board of directors in September 2007. The basic
reason for the update was to add clarity to the following areas:
• Payment terms,
• Accessibility provision,
• Various issues relating to the board of directors,
• Termination of membership provision.
We suggest that you carefully review this document and retain it along with your
coverage documents for safe keeping. Thank you.
Since ~ly~, , ~ '~'/~~~/~~'
Indiana Public Em oyers' PlarMnc.
302 South Reed Road ~ P.O. Box 1249 ~ Kokomo, IN 46903 ~ toll &ee 800382.8837 ~ phone 765.457.9161 ~ fax 765$683310
Adminls[ered by Downey Insurance www.downeyins.wm
~~'EP
ivn~~NO GIIBLiC EMPLOVER$' PLAN, INC.
INDIANA PUBLIC EMPLOYERS' PLAN, INC.
B Y-LAW S
(Amended September 72, 2007)
ARTICLE I
Name and Prineinal Office
1.1 The name of this corporation shall be [he INDIANA PUBLIC EMPLOYERS'
PLAN, INC., au Indiana no[-for-profit corporation, hereinafter referred to as the "Plan".
12 The principal office of the Plan shall be at such place as may be designated by the
Plan's Board of Directors ("Board").
ARTICLE II
Pumose
2.1 The purpose of [his corporation is to establish and operate a group self-funded
program among Indiana governmental entities and political subdivisions [as dofincd in IC 34-6-
2-49, IC 34-6-2-110 and IC 34-13-3-22], pursuant to_IC 23-7 (amended to IC 23-17 in 1991), IC
22-3-6-2 (c), [C 36-1-7 , as applicable, for the purpose ofsatisfying their respective obligations
to persons covered under the Indiana Workers' Compensation Act ([C 22-3-2 through IC 22-3-G),
the Indiana Worker's Occupational Diseases Act QC 22-3-7) and the Indiana Employers'
Liability Act pC 22-3-9), as from rime to time amended, hereinafter referred to as the "Acts".
ARTICLE III
Membership
3.1 To be eligible, an applicant muse be a governmental entity or political subdivision
of the State of Indiana as described in IC 34-G2-49, IC 34-6-2-110 and 1C 34-13-3-22 and shall
be known as `Snembcrs", and shall:
(a) file with the attorney-in-fact an application prescribed by the Board pursuant to
Section 3.6, below;
(b) be approved for membership by its attorney-in-fact;
(c) execute, by a duly authorized executive officer of the entity, a Membership
Agreement agreeing to compliance with these By-Laws;
(d) execute any and all documents as may be necessary and required by the Board
hereunder, or arty agency of the State of htdiana; and
Page 1 of 10
302 Sowh Reed Road ~ P.O. Box I1A9 ~ Kokomo, IN 46903 ~ wll free 800382.8877 ~ phone 965A5]9161 ~ fex ]65.868:1310
Administered by Downey Insurance www.downeyins.com
(e) submit ro inspections by the Board or its attorney-in-fact or its designee(s).
32 Upon the filing of an application for membership in the Plan, the attorney-in-fact
shall investigate the applicant to assure that only applicants appropriately within the Plan's field
of membership described above and with acceptable safety, risk management and financial
practices become members of the Plat.
33 Upon approval of an application for membeship in the Plan by the attorney-in-fact
the applicant shall adopt a resolution by its legislative body approving membership in the Plan
and directing an executive officer to execute a Membership Agreement thereby being admitted to
membership and shall continue as a member thereof unless and until such membership is
terminated as hereinafter provided.
3.4 By accepting membership in the Plan, the member agrees that it may be sued by
the Plan in any court of general jurisdiction of the State of Indiana for any contributions, charges,
penalties or other monies that are not paid to the Plan when due and payable, including
reasonable attorney's fees and other related litigation expenses incurred in collecting same.
3.5 Each member shall agree, by entering into the membership agreement, with
each other member to pay an annual amount in excess of the fiscal year (July 1 -June 30) annual
contribution in the event that the fiscal ycar contributions of the Plan create a deficit so
significant as to threaten the financial viability of the Plan as determined by the Board. Such
assessment would be applied to meet the outstanding unpaid liabilities attributable to that fiscal
year. The assessment would be based on a member's pro rata share of its contributions during
that fiscal year to the total contributions for all members during that fiscal ycar. If the member's
membership period does not coincide with the Plan fiscal year its membership year would be pro
rated. The members agree to be liable to the Plan for such assessment for a period of two (2)
years following the termination of its membership in the Plan.
3.6 The member acknowledges and agrees that if membership in the Plan is
facilitated by an intermediary or agent designated by the member, the Plan, through its ahomey-
in-fact, may compensate that person on a commission basis from the proceeds of the member's
contribution.
37 All member conttibutions, including any additional contributions determined
upon audit, are due and payable upon billing to the member and, except as otherwise provided
herein, upon receipt become non-refundable and fully earned assets of the Plan.
Page 2 of 10
ARTICLE IV
Board of Directors
4.1 The Plan shall be governed by a Board of Directors ("Board") elected by the
membership and consisting of not Less than three (3) nor more than seven (7) persons, the exact
number to be determined from time to time by the Boazd, from within or without the membership
of the Plan. Further:
(a) Tho term of directors shall be three (3) years
(b) Begimting with the annual meeting held in 2008 a candidate for election to the Board
or appointment to 511 a vacancy pursuant Section 4.5, below, at the time of such election or
appointment to the Board, shall be an elected or appointed official or employee of a member of
the Plan. Notwithstanding those persons presently serving on the Board who do not meet this
requirement may serve the remainder of their term without regard to this section.
(e) The directors may receive reasonable compensation for their services and shall be
reimbursed for their reasonablc and necessary expenses incurred in attending to the business of
the Plan upon such terms as the Board may from time to time determine.
(d) To promote organizational continuity, the terms of the directors shall be
staggered. The terms of the following persons shall be until the conclusion of the annual
membership meeting appearing next to their respective names:
Dan Gammon 2010
Michael McCormick 2070
Jean Luskin 2010
Sue Paris 2008
Gary Eakin 2008
Frank Short 2009
Timothy R. Downey 2009
42 The Presidenf shall appoint a nominating committee, and a chairperson thereof,
not less than thirty (30) calendar days prior to the date set for the annual meeting or special
meeting for the purpose of preparing and presenting a slate for election at the meeting.
4.3 In addition to the powers and duties permitted by law, it shall be the responsibility
and duty of the Board to contract with an attorney-in-fact who shall be responsible for marketing,
the collection of contributions and charges, investigation of applicants, obtain excess insurance
coverage, general administration, investment management, underwriting and claims
administration, safety, and loss control, and such other duties as the Board may from time to
time determine. The attomey-in-fact may subcontract any or all of these duties, at its expense,
Page 3 of 10
but shall retain fully responsibility for their performance. The attorney-in-fact shall:
(a) cause each member to execute a Membership Agreement and such other
documents necessary to affect the purpose of the Plan;
(b) obtain necessary and appropriate insurance coverage to protect the Plan and
its members including general liability coverage, excess insurance, both
specific and aggregate;
(c) establish underwriting standazds for the admission of members to the Plan
necessary to promote the safe and proper operation of [he Plan;
(d) be the fiscal agent of the Plau; and
(e) keep a record of all the members subscribing to the Plan, and shall keep or
cause to be kept a ledger account of assessments, and shall invoice members when
any such amounts aze due.
(~ maintain, in the name of the Plan, such accounts necessary for the operations of
Plan.
4.4 Auy director may, by majority vote of the Boazd, be removed at any time for
failure to attend meetings of the Board on a regular basis, or for other misconduct or
malfeasance.
4.5 Subject to the qualifications set forth in Section 41 (b), above, whenever any
vacancy shall have occurred in the Board by reason of death, resignation, removal, or otherwise,
a successor shall be elected by the Board at a Special Meeting or Regular Meeting to be called by
the president for the purpose of filling such vacancy and any other business of the Plan deemed
appropriate by the Boazd, subject to the provisions ofparagraph 4.2, above. A person elected to
fill a vacancy shall hold office for the unexpired teen of the previous director or until such time
as his or her successor is elected and qualified. The resignation of a dircctor shall be effective
upon its receipt by the Board or a subsequent time as set forth in the notice of resignation.
4.6 Subject to any specific limitation or restriction imposed bylaw or these By-Laws,
[he Board is authorized to direct, by appropriate action, the carrying out of the purposes as set
forth in these By-Laws, and to exercise all of the powers of the Board, and any and all parties
dealing with the Plan shall have the right to rely upon any action taken pursuant to authority of
the Board.
Page4 of ]0
ARTICLE V
Officers
5.1 The directors shall elect, by majority vote, a President, (chief executive officer), a
Vice President, a Secretary, a Treasurer, and such other officers as the directors shall deem
necessary for the transaction of the business of the Plan. All officers so elected or appointed
shall serve a one (1) year tear or until their successor is elected. Any two (2) or more offices may
be held by the same person, except that the duties of the President and the Secretary shall not be
performed by the same person
52 The President shall act as the chief executive officer of the Plan and have overall
responsibility for the operation of the Plan, including but not limited to, the supervision of the
officers, hiring and firing of employees, retaining of legal counsel and other professionals,
negotiating and execution of contracts for and on behalf of the Plan.
5.3 The President shall preside at al] meetings of the Board and at all
membership meetings. In his or her absence from any meeting, the Vice President shall preside.
5.4 The Secretary shall attend all meetings of the members of the Plan and the Board,
and shall record the minutes of all proceedings and record all votes in a book to be kept for that
purpose. In his or her absence the Board shall designate an Acting Secretary to record the
minutes of the meeting. He or she shall also perform such other duties as maybe delegated and
supervised by the President.
5.5 The Board shall be responsible for all monies paid to and collected by the
Plan, and shall be responsible for the supervision of the attorney-in-fact in the collection from
each member of the agreed contribution to build the Plan to a level adequate for the proper
adntinistra[ion of the program. The officers and directors shall assist the attorney-in-fact in
collection of all monies due and owing the Plan. Further:
(a) the Board shall cause to be prepared and presented to the Board, no later than
ninety (90) days after the end of each annual accounting period, a certified, audited financial
statement of the of the Plan based upon accounting principles and guidance provided by the
pronouncements of the Governmental Accounting Standards Board ("GASB"), where applicable,
and the pronouncements of the Financial Accounting Standards Board, where applicable. Further,
where applicable, these matters may be presented as a consolidated financial statement which
includes any wholly owned subsidiary of [he Plan.
Page 5 of 10
ARTICLE VI
Meetings of the Board of Directors
6.1 The Roard shall meet at least twice during the fiscal year at such place as may be
designated by the President For the transaction of such business as may properly be brought
before the meeting.
62 The President ortwo-thirds (213) or more of the directors may call a
special meeting of the Board at any time, to be held at the office of the Plan in Indiana, or such
other place within the State of Indiana as the person or persons calling the meeting shall
designate.
6.3 Written notice of the time, place and purpose of all meetings of the Board shall
be mailed to each director by [he Secretary not less than ten (] 0) nor more than thirty (30)
calendar days before the meeting unless the meeting had previously been agreed to by the
members of the Board at a previous regular or special meeting of the Board and recorded in the
minutes of the meeting. Meetings of the Board may be held on less than ten (10) calendar days
notice iCconsented to by a majority of the directors. Whenever any notice is required by this
section, attendance at the meeting by a Board Member shall constitute a waiver of notice.
6.4 Fifty (SO%) percent of members of the Board shall constitute a quorum
for the transaction of business and the action of a majority of the directors present at a meeting at
which a quorum is present shall be the act of the Board, unless otherwise specifically required by
these By-Laws.
ARTICLE VII
Mentbershi_n Meetings
7.1 The annual meeting of the members of the Plan shall be held before the end of
the second quarter of each year following the and otthe Plan's fiscal year at such date, time and
place as may be determined by the Board.
72 The members of the Plan present at a meeting of the members shall constitute a
quorum at all meetings of the membership of [he Plan for the purpose of conducting the business
of the Plan..
7.3 Each member shall have one (1) vote, by its representative upon written authority
on a form prescribed by the Board, on all matters coming before any meeting of the membership
and shall designate its representative, for that purpose on a form prescribed by the Board for
recording in the minutes of the Plan. Such properly executed form shall constitute the necessary
authority for the designee to cast votes for the member. One (1) person may not represent more
than one (1) member at the same meeting of the members of the Plau.
Bylaws Effective 091207 Page 6 of 10
AR"LICLE VIII
Termi ~aiion of Mcmbershin
8.1 The Board may terminate any member oCthe Plan prior to the anniversary date oC
its membership by action of the attorney-in-fact, in the event oCany of the following:
(a) failure to pay any amounts when due and payable; or
(b) failure to carry out the recommendations of any loss control inspections or to
follow accepted financial and loss control prevention standards prescribed by the Roard; or
(c) for such other act or omission which violates themembership agreement or could
jeopardize nc~ integrity of the Plan.
82 In the event of termination pursuant to Paragraph 9.1 Lhe attorney in fact shall give
notice of termination to [he member by certified mail. Such notice shall slate with specificity the
reason or reasons for the termination and the date upon which the termination is effective, the
same not being more than ten Q 0) calendar days from the date of receipt of the notice by the
member.
(a) The member may request the Board to review the termination by filing a
reyuest for review with the attorney-in-fact within ten (10) calendar days following receipt of the
notice of LerminaGon. The request shall sllt[c the reasons, including any mitigating circumstances,
which [he member desires the Board to consider in reconsidering Ore termination- The member is
entitled to a hearing at a regular or special meeting ofthe Board within thirty (30) calendar days
of its receipt of the reyuest for reconsideration if requested by the member. The member's
termination shall be siayul pending action of the Board. The decision of the Board on the
member's request for review is f incl.
(b) Upon termination of membership by action of the attorney-in-fact under this
article the member may request a refund of contribution equal to contribution of the member for
the membership year terminated Icss the following: any unpaid amounts for previous
membership years, the member's paid and incun-ed claims for the membership year, excess
insurance prcmimns paid on behalf of the member, actor's commissions, and attorney-in-fact
charges incurred by the Plan. The written request for a refund must be received by the attonmy-
in-fact within Courcen (l4) calendar days of receipt of notice of termination by the attorney-in-
fact or receipt of notice of decision of the Board under 82(a), above, by the member, whichever
later occurs.
B3 A member may terminate its membership at any time prior to [hc anniversary dart
of its membership by giving sixty (60) calendar days written notice to the attorney-in-fact.
Bylaws GCfeclive 091207 Page 7 OL' 10
I~ ,~
D_ OWNEY_
INSURANCE
Protecting Those Who Serve'"
WORKERS' COMPENSATION PHARMACY PROGRAM
IPEP has a pharmaceutical program through Modern Medical, Inc. This program
allows the employee to obtain prescriptions without any out of packet expense.
If an employee is required to fill a prescription as a result of an on the job injury,
he/she should go to any major pharmacy chain and request that the prescription be
billed through Modern Medical. The employee should give the pharmacist
Modem Medical's phone number, which is 800-547-3330. Modern Medical will
pay the pharmacy and forward a bill to Downey Insurance for reimbursement.
If multiple refills aze required, Modern Medical will issue the employee a
pharmacy card, which should be submitted to the pharmacy each time a
prescription is filled. The adjuster, with Downey Insurance, will be responsible for
notifying Modern Medical when the workers' compensation claim has been closed.
If you have any questions, please contact the claims department of Downey
Insurance at 800-382-8837.
302 South Reed Road ~ V.O. Box ]249 ~ Kokomo, M 46903 ~ roll &ec 800382P839 ~ phone Jbi45Z9161 ~ fax 965.8683310
www.downeYins.com