4.1. SR 09-28-1998ity of
River
TO:
FROM:
Item #4.1.
MEMORANDUM
Mayor & City Council
Lori Johnson, Asst. City Administrator/
Finance Director
DATE: September 28, 1998
SUBJECT: Workers' Compensation Insurance
Renewal
At last Monday's Council meeting, the city's workers' compensation insurance
renewal with the League of Minnesota Cities was discussed briefly. The
Council requested additional information to determine whether it may be
beneficial to increase the deductible from $5,000 to $10,000. Increasing the
deductible from $5,000 to $10,000 increases the city's exposure per
occurrence by $5,000 and offers an annual premium savings of $3,477.
Attached are claims reports for October 1995 through August 1998. The
majority of the claims are less than $1,000 with a few claims in the $1,000 to
$2,000 range. In the past three years we have not experienced any claim in
excess of our $5,000 deductible. When reviewing the report, please note that
some of the amounts are held in reserve and may not be or were not spent.
For instance, in the 1996/1997 claim report, one claim shows a total cost of
$13,085. The total amount actually paid out on that claim was $1,330.34.
Based on the three year historical information, it appears as though the city
would not have occurred any additional cost by increasing the deductible
from $5,000 to $10,000. However, as you are well aware, one claim in excess
of $8,500 would result in additional cost to the city. The last major claim in
excess of $10,000 occurred in January, 1995.
Action Requested
The City Council is asked to approve the insurance renewal with the League
of Minnesota Cities with the managed care option and either a $5,000 or
$10,000 deductible as determined by the City Council.
13065 Orono Parkway · P.O. Box 490 · Elk River, MN 55330 · TDD & Phone: (612) 441-7420 · Fax: (612) 441-7425
MTHCLLS
CLAIM
NUMBER CLAIMANT
306490 C
310207
316702
3~9586
3212~3
328388
3287S3
331431
3344o4
TOTALS THIS TOTAL
\qq~ -IqqL~
WORKERS' COMPENSATION CLAIMS REPORT
ABRIDGED : ALL CLAIM DETAIL FOR POLICY YEARS WITH OPEN CLAIMS
CLAIMS REPORT FOR ELK RIVER, ELK RIVER
GROUP NO. 02 ACCT # 000513 POLICY YR. 10/01/1995 TO 10/01/1996
INJURY DESCRIPTION
liED ONLY CLMS IBIDEM
DAYS DATE OF
OF TTD LOSS MEDICAL
o 10/05/95 o.oo
0 11/14/95 166.08
0 11/27/95 0.00
0 01/05/96 0.00
0 03/04/96 0.00
0 03/18/96 0.o0
0 03/24/96 1690.06
0 03/27/96 1998.49
0 06/19/96 134.69
o 07/03/96 o.oo
o 08/05/96 o.oo
0 08/07/96 0.00
0 09/14/96 0.00
DATE OF REPORT 10/01/96
........ PAID TO DATE ........
INDEM. EXPENSE RESERVE
0.00 0.00 0.00
0.00 0.00 0.00
0.00 0.00 0.00
0.00 0.00 0.00
0.00 0.00 0.00
0.00 0.00 0.00
0.00 5.34 1354.60
0.00 14.88 1036.63
0.00 0.00 340.31
0.00 0.00 375.00
0.00 0.00 350.00
0.00 0.00 250.00
0.00 0.00 850.00
CLMS CLOu=u DAYS PAID PAID PAID
OPEN---CLSD NO PAY OF TTD MEDICAL INDEMNITY EXPENSE
0 0 5 0 3989.32 0.00 20.22
DISTRIBUTION OF RESERVES -> 4126.76 0.00 429.78
TOTAL
525
TOTAL CL A
COST ST M
o.00 C P5
166.08 C P5
0.00 C P5
0.00 C P5
0.00 C P5
0.00 C P5
3050.00 0 P5
3050.00 0 PS
475.00 0 P5
375.00 0 PS
350.00 O PS
250.00 0 P5
850.00 O P5
TOTAL
POLICY YEAR # CLMS OPEN---CT'SD
13 7 I
RESERVE
4556.54
COST
8566.08
MTHCLLS
CLAIM
NUMBER CLAIMANT
339969
342405
346748
349795
351754
352391
354616
3s63o6 _ ¢~.~.
TOTALS THIS
TOTAL
WORKERS' COMPENSATION CLAIMS REPORT
ABRIDOED : ALL CLAIM DETAIL FOR POLICY YEARS WITH OPEN CLAIMS
CLAIMS REPORT FOR ELK RIVER, ELK RIVER
GROUP NO. 02 ACCT # 000513 POLICY YR. 10/01/1996 TO 10/01/1997
INJURY DESCRIPTION
DATE OF REPORT 10/01/97
DAYS DATE OF
OF TTD LOSS
0 12/11/96
0 12/11/96
0 12/12/96
2 12/30/96
0 01/17/97
5 03/14/97
0 05/02/97
0 06/03/97
0 06/11/97
0 07/09/97
0 07/21/97
0 08/14/97
........ PAID TO DATE ........
MEDICAL
53.53
0.00
0.00
790.38
0.00
460.83
0 00
0 00
191 60
0 00
0 00
0 00
602
TOTAL CL A
INDEM. EXPENSE RESERVE COST ST M
0.00 0.00 0.00 53.53 C Z1
0.00 0.00 0.00 0.00 C D9
0.00 0.00 0.00 0.00 C D9
215.19 120.00 0.00 1125.57 C D9
0.00 0.00 0.00 0.00 C D9
495.43 367.49 11761.25 13085.00 0 D9
0.00 50.00 0.00 50.00 C (]1
0.00 50.00 0.00 50.00 C
0.00 55.00 103.40 350.00 O Z1
0.00 50.00 550.00 600.00 O D9
0.00 0.00 0.00 0.00 C Z1
0.00 0.00 0.00 0.00 C Z1
MED ONLY CLMS INDEM CLMS CLOSED DAYS
PAID PAID PAID TOTAL TOTAL
POLICY YEAR
# CLMS
12
OPEN---CLSD OPEN---CLSD NO PAY OF TTD
2 3 I i 5 7
DISTRIBUTION OF RESERVES ->
MEDICAL INDE24NITY EXPENSE RESERVE COST
1496.34 710.62 692.49
7797.57 4389.57 227.51 12414.65 15314.10
IqR "l .-- I q
SEP 1 0
MTHCLLS
CLAIM
NUMBER CLAIMANT
900407
900598
900952
901115
9ozo87
901088
901089 ¢ ~'~.~
901090
901091
901092
901703
902065
902771
902580
902712
902824
902976
903735
903967
TOTALS THIS
WORKERS' COMPENSATION CLAIMS REPORT
ABRIDGED : ALL CLAIM DETAIL FOR POLICY YEARS WITH OPEN CLAIMS
CLAIMS REPORT FOR ELK RIVER, ELK RIVER
GROUP NO. 02 ACCT # 000513 POLICY YR. 10/01/1997 TO 10/01/1998
INJURY DESCRIPTION
To~AL MEo o~Y c~s'
DATE OF REPORT 09/01/98
DAYS DATE OF ........ PAID TO DATE ........
OF TTD LOSS MEDICAL INDEM. EXPENSE
0 10/09/97 134.25 0.00 0.00
0 10/13/97 56.50 0.00 0.00
0 11/18/97 148.68 0.00 50.00
0 12/02/97 0.00 0.00 50.00
2 12/11/97 519.37 245.55 361.92
0 12/14/97 0.00 0.00 50.00
0 12/14/97 0.00 0.00 50.00
0 12/14/97 0.00 0.00 0.00
0 12/14/97 0.00 0.00 0.00
0 12/14/97 0.00 0.00 0.00
0 12/14/97 0.00 0.00 50.00
0 02/05/98 130.84 0.00 50.00
0 03/18/98 0.00 0.00 0.00
0 04/22/98 101.10 0.00 0.00
0 05/11/98 0.00 0.00 0.00
0 05/20/98 184.58 0.00 0.00
0 05/28/98 0.00 0.00 50.00
0 06/04/98 990.37 0.00 50.00
0 07/02/98 0.00 0.00 0.00
0 07/31/98 101.70 0.00 0.00
0 08/27/98 0.00 0.00 0.00
RESERVE
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
169.16
600.00
448.90
0.00
815.42
0.00
1059.63
350.00
198.30
2600.00
TOTAL
COST
134.25
56.50
198.68
50.00
1126.84
50.00
50.00
0.00
0.00
0.00
50.00
350.00
600.00
550.00
0.00
1000.00
50.00
2100.00
350.00
300.00
2600.00
58O
CL A
ST M
C Z1
C Zl
C Z1
C Zl
C D9
C Zl
C Z1
C ~.1
C Z1
C Z1
C Z1
0 Z1
0 Z1
0 Z1
C Zl
O Z1
C Zl
O Z1
O Z1
0 D9
0 Z1
CLMS CLOSED DAYS
PAID PAID PAID TOTAL TOTAL
POLICY YEAR ~ CLMS OPEN---CLSD
21 8 8
OPEN---CLSD NO PAY OF TTD
0 i 4 2
DISTRIBUTION OF RESERVES ->
MEDICAL INDEMNITY EXPENSE RESERVE COST
2367.39 245.55 761.92
4791.41 0.00 1450.00 6241.41 9616.27
League of Minnesota Cities Insurance Trust
Group Self-Insured Workers' Compensation Plan
Administrator
Berkley Administrators
145 University Avenue West St_ Paul, MN 55103-2044 Phone (612) 215-4173
Self-insured Workers' Compensation Quotation
(RENEWAL of Agreement No. 02-000513-18)
ELK RIVER, ELK RIVER kJTILITES, HRA & EDA ~sED
10/01/1998 [0/01/1999 REV
ESTIMATED DEPOSIT
CODE RATE PAYROLL PREM I UPI
SEE ATTACHED SCHEDULE FOR DETAILS
Manual Premium
Experience Modification 0.?4
Standard Premium
Managed Care Credit 10.00~
Deductible Credit O~
Premium Discount
Discounted Standard Premium
LMC Insurance Trust Discount 0~
Net Deposit Premium
104404.
77859.
7786.
.
6865.
68668.
0.
68668.
The foregoing quotation is for a deposit premium based on your estimate of payroll. Your final actual premium will
be computed after an audit of payroll subsequent to the close of your agreement year and will be subject to
revisions in rates, payrolls and experience modification. While you are a member of the LMCIT Workers'
Compensation Plan, you will be eligible to participate in distributions ~om the Trust based upon Claims experience
and earnings of the Trust.
If you desire the coverage offered above, please complete the enclosed '2qotice of Premium Options" and remm it
and your check for the deposit premium (made payable to the LMCIT) to us at the above address.
LM 4410 (12/97)