2021-22 Exhibit_J_Workers_Compensation_Coverage
2021-22 Property/Liability Coverage Documents T. 800.537.7790
Special District Risk Management Authority F. 916.231.4111 Rev. 07/1/2021 www.sdrma.org
Workers’ Compensation and
Employers Liability Coverage
Exhibit J
Public Risk Innovation, Solutions, and Management (PRISM)
Policy No. PRISM-PE 21 EWC-30
Page 1 of 2
PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT
EXCESS WORKERS' COMPENSATION PROGRAM
CORE TOWER
MEMORANDUM OF COVERAGE DECLARATIONS
ITEM 1: COVERED PARTY: Special District Risk Management Authority (SDRMA)
ITEM 2: MEMORANDUM PERIOD: From July 1, 2021 to July 1, 2022, 12:01 a.m. local time of the Covered Party as stated herein
ITEM 3: STATE: California
ITEM 4: RETENTION AND INDEMNITY:
A. COVERED PARTY’S RETENTION:
$ 750,000 each occurrence
B. LIMIT OF INDEMNITY:
Statutory (See attached Schedule of Limits and Coverage Providers)
PRISM’s limit of indemnity, as set forth in ITEM 4 B includes pooled limits that apply to all
Members and all Covered Parties combined for all losses as a result of any one occurrence.
ITEM 5: MEMORANDUM NUMBER: PRISM-PE 21 EWC-30
ITEM 6: ESTIMATED PAYROLL: $ 623,828,517
ITEM 7: DEPOSIT PREMIUM: $ 2,391,725 (inclusive of all layers & fees)
This premium is auditable based on final audited payroll
ITEM 8: FORMS AND ENDORSEMENTS ATTACHED AT INCEPTION: EWC MOC 7/1/2021, Endorsement No. U-1, U-2, U-3, U-4, U-5, 1
Notice: The limits of indemnity shown below include various reinsurance and excess placements with specific limits which are inclusive and not excess of the limits stated above in Item 4.B. The limits of
indemnity shown in Item 4.B. apply to all Members and all Covered Parties combined in the Core
Tower for all losses as a result of any one occurrence. Each Coverage Provider listed on the Schedule of Limits and Coverage Providers provides coverage on its own form so there may be some coverage variances as a result of different policy language. Please carefully review all coverage forms.
Countersigned by: Issue Date: June 29, 2021
Authorized Representative Public Risk Innovation, Solutions, and Management
Page 2 of 2
PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT
EXCESS WORKERS' COMPENSATION PROGRAM SCHEDULE OF LIMITS AND COVERAGE PROVIDERS July 1, 2021 to July 1, 2022
Notice: The limits of indemnity shown below include various reinsurance and excess placements with specific limits which are inclusive and not excess of the limits stated herein. The limits of indemnity shown below apply to all Members and all Covered Parties combined in the Core Tower for all losses as a result of any one occurrence. Each Coverage Provider listed below provides coverage on its own
form so there may be some coverage variances as a result of different policy language. Please carefully review all coverage forms.
No. Limit of Indemnity Coverage Coverage Provider Policy Number
A) $4,250,000 excess of $750,000
This layer is reinsured by Great American Insurance Company
Workers’ Compensation and Employers’ Liability
Public Risk Innovation, Solutions, and Management
PRISM-PE 21 EWC-30
B) $45,000,000 excess of $5,000,000
This layer is reinsured by ACE American Insurance Company
Workers’ Compensation Public Risk Innovation, Solutions, and Management
PRISM-PE 21 EWC-30
C) Statutory excess of $50,000,000 Workers’ Compensation Liberty Insurance Corporation EW7-64N-444785-011
EWC MOC 7/1/2021 Page 1 of 9
PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT (PRISM)
EXCESS WORKERS’ COMPENSATION PROGRAM
MEMORANDUM OF COVERAGE
Public Risk Innovation, Solutions, and Management (hereinafter PRISM) agrees with the Covered Party named in the Declarations made a part hereof, in consideration of the payment of the premium and subject to all of the terms of this Memorandum, as follows: COVERAGE AGREEMENTS
I. APPLICATION OF MEMORANDUM: This Memorandum applies to loss sustained
by the Covered Party because of liability imposed upon the Covered Party by:
A. The Workers’ Compensation Act of California or the Workers’ Compensation Act of any state other than California, provided that California is the injured employee’s normal state of employment or
residence, or
B. “Employers’ Liability”
on account of bodily injury or occupational disease sustained by employees of
the Covered Party, while engaged in operations of the Covered Party, as a result of occurrences taking place during the coverage period and while this Memorandum is in force. The indemnity afforded by this Memorandum under Coverage Agreement I.B. for loss because of liability imposed by “Employers’ Liability” applies only as respects such operations in California including employees who are regularly engaged in such operations in California but who may be temporarily outside California in connection with such operations. As respects liability imposed by “Employers’ Liability”, PRISM shall have no obligation to indemnify the Covered Party for
damages imposed in any lawsuit brought in, or any judgment rendered by, any court outside of the United States of America, its territories or possession, or Canada, or to any action on such judgment wherever brought.
PRISM’s liability under Coverage Agreement I.B. includes bodily injury or occupational disease to the master and members of the crew of a vessel, subject to the following: A. The bodily injury or occupational disease must occur in the territorial limits of, or the operation of a vessel sailing directly
between the ports of the Continental United States of America, Alaska, Hawaii, or Canada. B. This coverage does not apply to:
1. bodily injury or occupational disease covered by a
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protection and indemnity coverage or similar policy issued to or on behalf of the Covered Party
2. The duty to provide transportation, wages, and maintenance. II. RETENTION AND INDEMNITY: As respects loss, which the Covered Party sustains as a result of each occurrence, the Covered Party shall retain loss in the
amount of the Covered Party’s Retention specified in the Declarations, and PRISM
agrees to indemnify the Covered Party against loss in excess of such Retention. Notwithstanding the application of this Memorandum to loss sustained by the Covered Party under Coverage Agreements I.A. or I.B., and regardless of the number of entities named in the Declarations, or otherwise qualifying as Covered
Parties, the maximum amount of the Covered Party’s Retention and the maximum
limit of PRISM’s indemnity hereunder shall not exceed the amounts specified in the Declarations. DEFINITIONS
Wherever used in this Memorandum, the following definition of terms shall apply:
I. BODILY INJURY: The term bodily injury shall include death resulting therefrom but shall not include occupational disease.
II. COMMUNICABLE DISEASE shall mean a disease caused by an infectious organism, which is transmissible from one source to another, directly or indirectly. III. COVERED PARTY shall include all entities named in the Declarations and any
related “employer” as defined by any applicable Workers’ Compensation Act.
IV. EMPLOYEE: The term employee shall mean any person performing work which renders the Covered Party liable under any Workers’ Compensation Act for bodily injury or occupational disease sustained by such person.
V. JOINT POWERS AGREEMENT or AGREEMENT shall mean the Joint Powers Agreement, as amended, creating PRISM.
VI. LOSS: The term loss shall mean only such amounts as are actually paid by the Covered Party as benefits under the applicable Workers’ Compensation Act, or in payment of amounts imposed upon the Covered Party by “Employers’ Liability”, in settlement of claims for such benefits or damages, or satisfaction of awards or judgments for such benefits and damages, including court costs, interest upon awards or judgments, and allocated investigation, adjustment and legal expenses, but the term loss
shall not include as expenses, salaries paid to employees of the Covered Party, nor fees and retainers paid to any service organization.
Notwithstanding the foregoing, loss does not include any amounts paid by the Covered Party as benefits, or in payment of amounts imposed upon the Covered Party by Employers’ Liability, deriving solely from any Covered Party’s enactment,
resolution or other act establishing either a presumption of work- related illness or
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injury or any other expansion of benefits beyond those prescribed by the applicable Workers’ Compensation Act. Despite any such enactment resolution or act, the
Covered Party shall retain the burden of establishing loss within the Memorandum
of Coverage.
VII. OCCUPATIONAL DISEASE: The term occupational disease shall include death resulting therefrom and cumulative injuries.
VIII. OCCURRENCE: (A) All bodily injury sustained by one or more employees, as a result of a single accident or event, shall be deemed to arise from a single occurrence. (B) Occupational disease sustained by each employee shall be deemed to arise from a separate occurrence, and the occurrence shall be
deemed to take place on the last day of the last exposure, in the employment of
the Covered Party, to conditions causing or aggravating the disease or the date upon which the employee first suffered disability and either knew, or in the exercise of reasonable diligence should have known, that such disability was caused by his or her employment with the Covered Party, whichever comes first. (C) All
occupational disease sustained by one or more employees as a result of an
outbreak of the same communicable disease shall be deemed to arise from a single occurrence. An outbreak of the same communicable disease that spans more than one coverage period shall be deemed to take place during the first such coverage period.
IX. WORKERS’ COMPENSATION ACT: The term Workers’ Compensation Act shall include any separate occupational disease act, but shall not include the non-occupational disability benefit provisions of any such act. The term Workers’ Compensation Act includes the United States Longshore and Harbor Workers
Compensation Act (33 USC Sections 901-950). Coverage for loss shall be limited,
by amount and time of payment, to the benefits, which would be available under the Workers’ Compensation Act of the state where the injured employee is normally employed, if that law applied.
EXCLUSIONS
Liability under Coverage Agreement I.A. does not apply to:
I. The Covered Party’s obligation to pay salary in lieu of temporary disability benefits
as required by Labor Code Section 4850 or the Covered Party’s obligation to pay wages or salary as required by Education Code Sections 44984 and 45192, except to the extent that the Covered Party would be obligated to pay temporary disability benefits if Labor Code Section 4850 or Education Code Sections 44984 and 45192 did not apply;
II. The Covered Party’s obligations pursuant to Labor Code Section 4856;
III. Punitive or Exemplary Damages, fines or penalties assessed against or imposed
upon the Covered Party: A. On account of bodily injury or occupational disease sustained by any
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employee; or
B. On account of the conduct of the Covered Party or any of its agents (i)
in the investigation, trial or settlement of any claim for benefits under the applicable Workers’ Compensation Act or for damages at law, or (ii) in failing to pay or delaying the payment of any such benefits or damages; or
C. On account of violation of any statute or regulation; or D. On account of bodily injury or occupational disease intentionally caused or aggravated by the Covered Party; or
E. On account of bodily injury arising out of termination of employment; or F. On account of bodily injury arising out of the coercion, demotion, reassignment, discipline, defamation, harassment or humiliation of, or
discrimination against any employee.
Liability under Coverage Agreement I.B. does not apply to: I. Liability assumed by the Covered Party under any contractual agreement;
II. Bodily injury or occupational disease to an employee while employed in violation of law with the actual knowledge of the Covered Party;
III. Any obligation imposed by a workers’ compensation, occupational disease,
unemployment compensation, or disability benefits law, or any similar law;
IV. Bodily injury or occupational disease intentionally caused or aggravated by the Covered Party;
V. Loss arising out of the coercion, criticism, demotion, evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination against or termination of any employee or any personnel practices, policies, acts or omissions;
VI. Fines or penalties assessed against or imposed upon the Covered Party on account of violation of any statute or regulation;
VII. Loss arising out of operations for which the Covered Party has violated or failed to
comply with any Workers’ Compensation Law;
VIII. Loss arising out of operations for which the Covered Party has rejected any Workers’ Compensation Law;
IX. Punitive or Exemplary Damages, fines or penalties assessed against or imposed upon the Covered Party.
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CONDITIONS
I. PREMIUMS: The Board of Directors of PRISM shall assess the premium for the
Excess Workers’ Compensation Program to participating Covered Parties. Such
premiums shall be calculated in accordance with Article 14 of the Joint Powers Agreement.
II. VOLUNTEERS: This Memorandum shall apply to loss on account of bodily injury
or occupational disease sustained by volunteer workers while acting within the
scope of their duties for or on behalf of the Covered Party, provided that, prior to the occurrence, the Governing Board of the Covered Party has adopted a resolution as provided in Division 4, Part 1, Chapter 2, Article 2, of the California Labor Code, declaring such volunteer workers to be employees of the Covered
Party for purposes of the Workers’ Compensation Act; or provided that such
volunteer workers are statutorily deemed by the Workers’ Compensation Act to be employees for the purposes of workers’ compensation.
III. ADMINISTRATION AND REPORTING OF CLAIMS: The Covered Party shall be
responsible for the investigation, settlement, defense or appeal of any claim made or suit brought, or proceeding instituted against the Covered Party, and the Covered Party shall have the duty to give immediate notice to PRISM upon learning of any of the following:
A. Any occurrence for which total incurred (paid to date plus remaining reserves) exceeds 50% of the Covered Party’s Retention;
B. Any occurrence which causes serious injury to two or more employees;
C. Any occurrence which results in:
1. A fatality; 2. An amputation of a major extremity;
3. Any serious head injury (including skull fracture or loss of sight of
either or both eyes); 4. Any injury to the spinal cord; 5. Any second or third degree burn of 25% or more of the body; 6. A permanent total disability as defined in the Workers'
Compensation Act of the State of California;
D. The reopening of any case in which a further award might exceed 50% of the Covered Party’s retention.
The Covered Party shall not make any voluntary settlement or voluntarily make a
lump sum payment or commutation or one-time payment in lieu of periodic indemnity payments to employees or their dependents involving loss to PRISM except with the prior written consent of PRISM.
The Covered Party shall promptly forward to PRISM any requested information on
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individual occurrences claims, or cases, and shall provide such information to PRISM within thirty (30) days in a form satisfactory to PRISM, including the
amounts paid and the estimated future payments or outstanding reserves.
PRISM, at its own election and expense, shall have the right to participate with the Covered Party in, or to assume in the name of the Covered Party, control over the investigation, settlement, defense, or appeal of any claim, suit, or proceeding,
which might involve liability of PRISM.
IV. SERVICE ORGANIZATION: As a condition precedent to recovery hereunder, it is
agreed that the Covered Party will engage one or more service organizations and/or in-house staff acceptable to PRISM to perform on behalf of the Covered Party, and without charge to PRISM, such services as may be acceptable to PRISM during the currency of this Memorandum and until the final settlement of all claims arising out of occurrences which take place while this Memorandum is in
force. The performance of such services shall not constitute any undertaking on behalf of PRISM, nor relieve the Covered Party of any of its obligations under the terms of this Memorandum.
V. ASSISTANCE AND COOPERATION: In the event PRISM elects to participate with
the Covered Party in, or to assume in the name of the Covered Party, control over the investigation, defense, or appeal of any claim, suit, or proceeding, the Covered Party shall cooperate to the fullest extent with PRISM and its representatives.
Upon PRISM’s request, the Covered Party shall direct its service organization
and/or other representatives to cooperate with and assist PRISM in all matters relative to such investigation, settlement, defense, or appeal.
If PRISM elects to assume control as described above, PRISM shall give written
notice of such election to the Covered Party. Upon receipt of such written notice,
the Covered Party shall not, except at its own cost, voluntarily make any payment, assume any obligation, or incur any expense other than such immediate medical or other services at the time of injury as are required by the Workers’ Compensation Act or such immediate medical and surgical relief as may become imperative at the
time of an occurrence.
VI. LOSS PAYABLE: PRISM shall pay any loss for which it may be liable under this Memorandum in the following manner:
A. As respects Coverage Agreements I.A., payment shall first be made by
the Covered Party in accordance with the provisions of the Workers’ Compensation Act, and PRISM shall reimburse the Covered Party for such loss periodically, at intervals of not less than one (1) month, upon receipt from the Covered Party of proofs of payment which is acceptable
to PRISM in content and form.
B. As respects Coverage Agreement I.B., liability under this Memorandum with respect to any occurrence shall not attach unless and until PRISM’s
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liability shall have been fixed and rendered certain either by final judgment against the Covered Party after actual trial or by written
agreement of the Covered Party, the claimant, and PRISM. Such losses
shall be due and payable within thirty (30) days after they are respectively
claimed and proven in conformity with this Memorandum.
VII. PAYMENTS THE COVERED PARTY MUST MAKE: The Covered Party shall be
responsible for any payments in excess of the benefits regularly provided by the Workers’ Compensation Act, including but not limited to those required because: A. of serious and willful misconduct on the part of the Covered Party;
B. the Covered Party knowingly employs an employee in violation of the law; C. the Covered Party fails to comply with a health or safety law or
regulation; however, this does not apply to recommendations
promulgated by the Joint Commission for Accreditation of Health;
D. of discharge, coercion, or discrimination against any employee in violation of the Workers’ Compensation Act;
E. of claims relating to or in any way arising out of California Labor Code Section 132(a);
F. of the unreasonable delay or failure to make payments of compensation
by or on behalf of the Covered Party, including the legal fees associated
with defending resulting claims or suits; G. the Covered Party violates or fails to comply with the Workers’ Compensation Act.
If PRISM makes any payments on behalf of the Covered Party in excess of the benefits regularly provided by the Workers’ Compensation Act, the Covered Party will reimburse PRISM promptly.
VIII. SUBROGATION: In the event of any payment under this Memorandum, PRISM shall be subrogated, to the extent of such payment, to all the Covered Party’s rights of recovery therefore, and the Covered Party shall execute all papers required and shall do everything that may be necessary to secure such rights. Any
amount recovered as a result of such proceedings, together with all expenses
necessary to the recovery of any such amount shall be apportioned as follows: PRISM shall first be reimbursed to the extent of its actual payment hereunder. If any balance then remains, said balance shall be applied to reimburse the Covered Party. The expenses of all proceedings necessary to the recovery of such amount
shall be apportioned between the Covered Party and PRISM in the ratio of their
respective recoveries as finally settled. If there should be no recovery in proceedings instituted solely on the initiative of PRISM, the expenses thereof shall be borne by PRISM.
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IX. INSPECTION AND AUDIT: PRISM shall be permitted but not obligated to inspect the Covered Party’s operations at any time. Neither PRISM’s right to make inspections nor the making thereof nor any report thereon shall constitute an undertaking on behalf of or for the benefit of the Covered Party or others to
determine or warrant that such operations are safe or harmful, or are in compliance with any law, rule or regulation. PRISM may examine and audit the Covered Party’s books and records at any time during the currency hereof and until three (3) years after the final settlement of all claims or payments made on account of accident or disease occurring during the term of this Memorandum as far as such
books and records relate to the subject matter of this Memorandum. X. OTHER COVERAGE: If the Covered Party has other coverage against a loss covered by this Memorandum, PRISM’s coverage shall apply in excess of any other coverage.
XI. BANKRUPTCY AND INSOLVENCY: In the event of the bankruptcy or insolvency of the Covered Party or any entity comprising the Covered Party, PRISM shall not be relieved thereby of the payment of any claims under this Memorandum because
of such bankruptcy or insolvency.
XII. ASSIGNMENT: No assignment of the Covered Party’s interest hereunder shall be binding upon PRISM unless its consent is endorsed hereon.
XIII. NOTICE OR PAYMENT: If more than one entity qualifies as a Covered Party under
the definition of Covered Party or by endorsement to this Memorandum, all notices, stipulations and payments to or by the entity first named in the Declarations shall be binding upon all other Covered Parties.
XIV. CHANGE OR WAIVER: The terms of this Memorandum shall not be waived or
changed except by endorsement issued to form a part hereof, signed by a duly authorized representative of PRISM.
XV. CANCELLATION: This Memorandum may be canceled by the Covered Party only
at the end of the Memorandum Period and pursuant to the provisions of Article
20(b) of the Joint Powers Agreement. PRISM may cancel this agreement pursuant to the provisions of Article 21 (a)(1) and (a)(2) of the Joint Powers Agreement or PRISM’s invoice and premium payment policy as established by the Board of Directors. This Memorandum does not apply to any loss as a result of any
occurrences taking place at or after the effective date of any such cancellation.
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Any return of unearned premium in the event of cancellation by PRISM shall be
determined pursuant to Article 22 of the Joint Powers Agreement.
XVI. ACCEPTANCE: By acceptance of this Memorandum, the Covered Party agrees that each of the persons, firms or organizations named in the Declarations as the Covered Party is, or upon learning of the necessity therefore will become, qualified
to operate with the permission of the proper authorities as a self-insurer under the Workers’ Compensation Act of California; that the statements in the application for this Memorandum are the Covered Party’s agreements and representations; that this Memorandum embodies all agreements existing between the Covered Party and PRISM or any of its agents relating to this coverage; and that full
compliance by the Covered Party with all the terms of this Memorandum is a condition precedent to PRISM’s liability hereunder. XVII. CONFORMANCE WITH WORKERS’ COMPENSATION ACT: Any term of this Memorandum which conflicts with any provision of the California Workers’ Compensation Act is changed by this provision to conform to said law. XVIII. CARVE OUTS: In the event a Covered Party is considering entering into a labor management agreement that establishes an alternative dispute resolution process pursuant to Labor Code Section 3201.7, with one or more bargaining unit(s), to
amend any portion of the Workers’ Compensation claims process, that proposed carve out agreement must be submitted to PRISM for review prior to implementation. Failure to provide such documentation prior to implementation may result in the benefits provided under such carve out agreement, and any expenses related thereto, not being covered under this Memorandum of Coverage.
IN WITNESS WHEREOF, PRISM has caused this Memorandum to be executed and attested, but this Memorandum shall not be valid unless countersigned by an authorized representative of PRISM.
Authorized Representative Public Risk Innovation, Solutions, and Management
ENDORSEMENT NO. U-1
PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT (PRISM)
EXCESS WORKERS’ COMPENSATION
WAR AMENDATORY ENDORSEMENT
It is understood and agreed that this Memorandum shall not apply to loss directly or indirectly
caused by, resulting from or in connection with war, invasion, acts of foreign enemies,
hostilities or warlike operations (whether war be declared or not), civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power, regardless of any other cause or event contributing concurrently or in any sequence to the loss.
This Memorandum shall also not apply to loss directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to the above.
It is further agreed that nothing herein shall act to increase PRISM's limit of indemnity.
This endorsement is part of the Memorandum of Coverage and takes effect on the effective date of the Memorandum of Coverage unless another effective date is shown below. All other
terms and conditions remain unchanged.
Effective Date: Memorandum No.: PRISM 21 EWC-00
Issued to:
Issue Date:
ALL MEMBERS
July 1, 2021
ENDORSEMENT NO. U-2
PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT (PRISM)
EXCESS WORKERS’ COMPENSATION
WAIVER OF SUBROGATION ENDORSEMENT
It is understood and agreed that Section VIII. SUBROGATION of the CONDITIONS section
of the Memorandum of Coverage is deleted in its entirety and replaced by the following:
VIII. SUBROGATION: In the event of any payment under this Memorandum, PRISM shall be subrogated, to the extent of such payment, to all the Covered Party’s rights of recovery
therefore, and the Covered Party shall execute all papers required and shall do everything
that may be necessary to secure such rights. Any amount recovered as a result of such proceedings, together with all expenses necessary to the recovery of any such amount shall be apportioned as follows: PRISM shall first be reimbursed to the extent of its actual payment hereunder. If any balance then remains, said balance shall be applied to reimburse the
Covered Party. The expenses of all proceedings necessary to the recovery of such amount
shall be apportioned between the Covered Party and PRISM in the ratio of their respective recoveries as finally settled. If there should be no recovery in proceedings instituted solely on the initiative of PRISM, the expenses thereof shall be borne by PRISM.
However, in the event of any loss payment under this Memorandum for which you have
waived the right of recovery in a written contract entered into prior to the loss, we hereby agree to also waive our right of recovery but only with respect to such loss.
It is further agreed that nothing herein shall act to increase PRISM's limit of indemnity.
This endorsement is part of the Memorandum of Coverage and takes effect on the effective
date of the Memorandum of Coverage unless another effective date is shown below. All other terms and conditions remain unchanged.
Effective Date: Issued to: ALL MEMBERS
Issue Date: July 1, 2021
Authorized Representative
Public Risk Innovation, Solutions, and Management
Memorandum No.: PRISM 21 EWC
Authorized Representative Public Risk Innovation, Solutions, and Management
ENDORSEMENT NO. U-3
PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT (PRISM)
EXCESS WORKERS’ COMPENSATION
LOSSES INVOLVING MULTIPLE MEMBERS
It is understood and agreed that this Memorandum shall apply, as follows, to losses involving
multiple members:
Each member’s final retention allocation will be calculated based on its pro rata percentage share of the “final loss valuation” times its retention specified in the Declarations of this
Memorandum. The retention specified in the Declarations of this Memorandum will be applied
until the “final loss valuation” is determined, as outlined below. The total incurred for all members in a particular tower involved in the loss will be evaluated five years from the end of the coverage period in which the loss occurs, and will be used as
the “final loss valuation” for determination of the final retention and limits allocations.
If the total loss for all members in a particular tower involved in a single occurrence exceeds the maximum Program limit of indemnity, allocation of liability for the excess amount will also be determined based on each member’s pro rata percentage share of the “final loss
valuation”.
It is further agreed that nothing herein shall act to increase P's limit of indemnity.
This endorsement is part of the Memorandum of Coverage and takes effect on the effective date of the Memorandum of Coverage unless another effective date is shown below. All other
terms and conditions remain unchanged.
Effective Date: Memorandum No.: PRISM 21 EWC-00
Issued to:
Issue Date:
ALL MEMBERS
July 1, 2021
Authorized Representative
Public Risk Innovation, Solutions, and Management
ENDORSEMENT NO. U-4
PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT (PRISM)
EXCESS WORKERS’ COMPENSATION OFF-DUTY, OUT-OF-STATE PEACE OFFICER INJURY (AB 1749) ENDORSEMENT
It is understood and agreed that this Memorandum shall not apply to bodily injury or occupational disease sustained by a peace officer who was at the time of the occurrence: a. off-duty, b. not acting under the immediate direction of his or her employer, and c. outside the state of California.
However, this exclusion shall not apply to bodily injury or occupation disease sustained by a peace officer under such circumstances if: a. the peace officer was engaging in the apprehension or attempted apprehension of law violators or suspected law violators, or protection or preservation of life or property, or
the preservation of the peace; and b. prior to the occurrence, the Governing Board of the Covered Party has adopted a resolution, as provided for in California Labor Code Section 3600.2, subdivision (b)(4), accepting liability for such injury under the Workers’ Compensation Act.
“Peace officer” for purposes of this Endorsement has the definition stated in Section 50920 of the California Government Code. It is further agreed that nothing herein shall act to increase PRISM’s limit of indemnity.
This endorsement is part of the Memorandum of Coverage and takes effect on the effective date of the Memorandum of Coverage unless another effective date is shown below. All other terms and conditions remain unchanged.
Effective Date: Memorandum No.: PRISM 21 EWC-00
Issued to: ALL MEMBERS
Issue Date: July 1, 2021
ENDORSEMENT NO. U-5PUBLIC RISK INNOVATION, SOLUTIONS AND MANAGEMENT (PRISM) EXCESS WORKERS’ COMPENSATION
COMMUNICABLE DISEASE AMENDATORY ENDORSEMENT
It is understood and agreed that the DEFINITIONS section of the Memorandum of Coverage is
amended as follows:
Section VIII. OCCURRENCE is hereby deleted and replaced by the following:
VIII. OCCURRENCE: (A) All bodily injury sustained by one or more employees, as a result
of a single accident or event, shall be deemed to arise from a single occurrence. (B)Occupational disease sustained by each employee shall be deemed to arise from aseparate occurrence, and the occurrence shall be deemed to take place on the last dayof the last exposure, in the employment of the Covered Party, to conditions causing oraggravating the disease OR the date upon which the employee first suffered disability and
either knew, or in the exercise of reasonable diligence should have known, that suchdisability was caused by his or her employment with the Covered Party, whichever comesfirst. (C) As to any Covered Party who was a member during the July 1, 2019 to July 1,2020 coverage period, all communicable disease sustained by one or more employeesdue to the outbreak of COVID-19 that began during the July 1, 2019 to July 1, 2020
coverage period shall be deemed to be a part of the same outbreak of a communicabledisease that constitutes a single occurrence during the July 1, 2019 to June 30, 2020coverage period. Otherwise, communicable disease shall be treated like any otheroccupational disease under Part (B) of this definition.
It is further agreed that nothing herein shall act to increase PRISM’s limit of indemnity.
This endorsement is part of the Memorandum of Coverage and takes effect on the effective date of the Memorandum of Coverage unless another effective date is shown below. All other terms
and conditions remain unchanged.
Effective Date: Memorandum No.: PRISM 21 EWC-00
Issued to: ALL MEMBERS
Issue Date: July 1, 2021
Authorized Representative Public Risk Innovation, Solutions and Management