HomeMy WebLinkAboutRES 17-12-452 - 12/04/2017 - Georgia Interlocal Risk Management AgencySTATE OF GEORGIA RESOLUTION NO. 17-12-452
COUNTY OF FULTON
A RESOLUTION TO ADD MEMBERSHIP TO A FUND OF THE GEORGIA INTERLOCAL RISK
MANAGEMENT AGENCY (GIRMA)
THE COUNCIL OF THE CITY OF MILTON HEREBY RESOLVES while in regular session
at 6:00 PM on the 4" day of December 2017 as follows:
WHEREAS, the City of Milton, Georgia, located in Fulton County, Georgia was
incorporated upon the passing of House Bill 1470 in the 2006 Legislative Session of the Georgia
General Assembly; and
WHEREAS, the Mayor and the Council of the City of Milton (the "Council") are the
governing authority of the City of Milton; and
WHEREAS, the Mayor and Council are charged with the protection of the health, safety
and welfare of the citizens of Milton; and
WHEREAS, the City of Milton, is a current member of the Georgia Interlocal Risk
Management Agency ("GIRMA"), an interlocal risk management agency formed pursuant to
Chapter 85 of Title 36 of the Official Code of Georgia Annotated; and
WHEREAS, the City of Milton is currently a member of a GIRMA Fund for insurance
purposes and desires to add membership in an additional GIRMA Fund to satisfy the requirements
of House Bill 146, which was passed in the 2017 Legislative Session of the Georgia General
Assembly and requires that public entities provide certain cancer insurance coverages for firefighters;
and
WHEREAS, the Mayor and the Council have reviewed the Fund Election Form attached as
Appendix A and find that it is in the best interest of the City of Milton to be a member of the Funds
indicated on the Fund Election Form which will provide the required lump sum cancer benefit and
long-term disability (income replacement) benefits required by HB 146.
NOW, THEREFORE, BE IT RESOLVED BY THIS COUNCIL OF THE CITY OF MILTON,
GEORGIA, AND IT IS RESOLVED BY THE AUTHORITY OF SAID CITY COUNCIL THAT:
1. The Mayor of the City of Milton is authorized to execute the GIRMA Fund Election
Form attached as Appendix A on behalf of the City and all documents necessary
for membership in the GIRMA Funds elected on said Form;
2. The Mayor is designated as the City's representative to GIRMA;
3. The City may change its representative by making a written request to Georgia
Municipal Association, Inc., the Program Administrator for GIRMA; and
4. This resolution shall be effective on the date of adoption.
RESOLVED this 4t" day of December 2017.
Approved:
Joe c ood ayor
Attest:
Resolution Appendix A
Georgia Interlocal Risk Management Agency ("GIRMA")
GIRMA Fund A Participation Statement and GIRMA Fund B Election Form
Name of GIRMA Member: City of Milton. Georgia
As stated in Section 6.1 of the Intergovernmental Contract, a GIRMA member must participate in at least
one Fund established by the GIRMA Board of Trustees. The Intergovernmental Contract and GIRMA
Bylaws apply to all GIRMA members, regardless of the Fund or Funds in which they participate. Terms and
conditions specific to a Fund are set forth in the Coverage Description for the Fund.
Fund A Participation Statement: Until January 1, 2018, GIRMA offered only Fund A, which is a
combination of property damage, motor vehicle liability and general liability coverage. As a GIRMA
Member who ioined GIRMA before January 1 2018, the entitv named above is a member of GIRMA's
Fund A. The Coverage Description for GIRMA provided before January 1, 2018 is also the Coverage
Description for Fund A.
Fund B Application Information: GIRMA will establish Fund B on January 1, 2018. Fund B will provide fully -
insured lump sum cancer coverage and disability coverage for firefighters that meet the requirements of
Georgia law. A coverage description for Fund B will be filed with the Georgia Department of Insurance and
made available to Fund B members upon request after approval of membership in Fund B by Georgia
Municipal Association, Inc., the Program Administrator for GIRMA, and the insurance carrier.
In order to join Fund B, GIRMA Members in Fund A must complete a Resolution to Add Membership in a
GIRMA Fund similar to the sample Resolution attached, and must complete the attached Firefighter
Cancer Coverage Application and Participation Agreement. Membership in Fund B is effective when the
Application is approved by the Program Administrator and the carrier.
GEORGIA INTERLOCAL RISK MANAGEMENT (GIRMA)
FIREFIGHTER CANCER COVERAGE APPLICATION AND PARTICIPATION AGREEMENT
Employers eligible to participate in GIRMA (hereinafter a "Participating Employer" or "Employer") shall
complete this Application and Participation Agreement in order to purchase firefighter cancer coverage
fully insured by The Hartford under the GIRMA Fund B Master Policy for Lump Sum Cancer Benefit or
Master Policy for Long -Term Disability (Income Replacement) or under both Policies. Once approved by
GIRMA's Program Administrator, the Participating Employer will receive a one-page Schedule of Benefits
identifying the purchased coverage(s) and a link to the Policy for the purchased coverage(s), so it may make
these available to Eligible Firefighters.
Who Does What?
• GIRMA is the Policyholder of two firefighter cancer coverage policies (together, the "Firefighter
Cancer Policies" insured by The Hartford: Lump Sum Cancer Benefit and Long -Term Disability
(Income Replacement). These coverages together are designed to meet the requirements of Georgia
House Bill 146 (2016-2017), an Act effective January 1, 2018.
• Georgia Municipal Association, Inc., ("GMA") is the Program Administrator for GIRMA. GMA uses
information from the Eligible Firefighter census data provided by the Participating Employer to bill for
the Firefighter Cancer Policies, and maintains (either directly or through the broker for the Firefighter
Cancer Policies) Participating Employers' Application and Participation Agreements.
• Participating Employers are responsible for identifying all Eligible Firefighters, submitting complete
and accurate census data to GMA, paying premiums to GMA, communicating with Eligible Firefighters
about the coverages it provides, providing the Schedule of Benefits and link to the applicable Policies
to Eligible Firefighters, and providing all requested information and documentation to The Hartford
when an Eligible Firefighter makes a claim under one or both of the Firefighter Cancer Policies.
• The Hartford evaluates and pays claims under the Firefighter Cancer Policies. All claims for benefits
must be submitted to The Hartford. Neither GIRMA nor GMA have any role in claim determination or
payment.
• The Hartford provides tax services related to payments under the Long -Term Disability (Income
Replacement) Policy.
Definition of Eligible Firefighter: An "Eligible Firefighter" is a recruit or a trained individual who is a
full-time employee, part-time employee, or volunteer for a legally organized fire department of a
Participating Employer and as such has duties of responding to mitigate a variety of emergency and
nonemergency situations where life, property, or the environment is at risk, which may include without
limitation fire suppression; fire prevention activities; emergency medical services; hazardous materials
response and preparedness; technical rescue operations; search and rescue; disaster management and
preparedness; community service activities; response to civil disturbances and terrorism incidents;
nonemergency functions including training, preplanning, communications, maintenance, and physical
conditioning; and other related emergency and nonemergency duties as may be assigned or required;
provided, however, that a firefighter's assignments may vary based on geographic, climatic, and
demographic conditions or other factors including training, experience, and ability. A firefighter is an
"Eligible Firefighter" as soon as he or she meets the description above, even though coverage under the
Firefighter Cancer Policy(ies) does not become effective until completion of a waiting period as set forth
in O.C.G.A. § 25-3-23.
Employer Obligations:
• Employer shall not require any kind of contribution from Eligible Firefighters for the coverage(s)
provided under the Firefighter Cancer Policies.
• Employer is solely responsible for identifying all Eligible Firefighters (as defined above), keeping an
accurate list of all Eligible Firefighters, and providing correct and complete information to GMA.
• Employer shall submit initial Eligible Firefighter census data to GMA in the form requested, and must
update this census data as needed in order to ensure that all Eligible Firefighters are identified.
• The Employer's cost for coverage under the Firefighter Cancer Policy(ies) will be based on the most
recent census data at the time of billing.
• A claim by an Eligible Firefighter may be denied if the Eligible Firefighter was not timely listed in the
census data.
• Employer shall provide the Schedule of Benefits and a link to the applicable Policy(ies) to all Eligible
Firefighters at no charge, and shall provide a copy of the applicable Policy(ies) to an Eligible Firefighter
upon request.
• If the Policy(ies) are terminated for any reason, Employer shall provide notification of termination to
all Eligible Firefighters.
• When a firefighter submits a claim to The Hartford, Employer shall provide The Hartford the
information requested so that The Hartford may evaluate the claim, and shall affirm that this
information is accurate and complete.
If the Employer is purchasing Long -Term Disability (Income Replacement) coverage, the Employer agrees
as follows.
Employer Authorization for Tax Services: By completing this Application and Participation Agreement,
Employer authorizes The Hartford to report, withhold and deposit the taxes described below, and agrees to
provide The Hartford with accurate and timely information to provide these tax services. Employer
acknowledges that The Hartford, GIRMA, and GMA, singularly and collectively, shall have no
responsibility for any liability in connection with these tax services that may result from inaccurate,
untimely or incomplete information provided by Employer to any of them, including but not limited to fines
or penalties.
• The Hartford will withhold and deposit applicable and properly elected additional United States federal
income taxes (FIT) and state income tax (SIT) as well as applicable Employee FICA taxes from
disability benefits/sick pay. The Hartford will make timely filings with the appropriate United States
federal and state agencies. The Hartford will deposit the taxes using The Hartford's tax identification
number and will timely notify the Employer of these payments. This notification is provided on the EOB
(Explanation of Benefits).
• The Hartford will prepare Forms W-2 for payees and pay the Employer's share of FICA taxes, and submit
such forms and payments to the appropriate United States federal and state agencies. The Hartford will
postmark by January 31 st of each year, or such other date required by law, Forms W-2 containing
disability benefits/sick pay information to payees and make information return filings in accordance
with Federal and State requirements regarding income tax, Social Security, and Medicare tax. The
Hartford will issue Forms W-2 using The Hartford's tax identification number. If the Policy is
terminated, The Hartford will continue to provide Forms W-2 and make information return filings for
disability benefits/sick pay payments on all claims incurred prior to termination of the Policy.
• The Hartford assumes no responsibility for any other payroll or employment related tax, fee, premium
or the like including Federal Unemployment Insurance (FUTA) and State Unemployment Insurance
(SUTA), State Disability Insurance, State or Local Occupational Taxes, other jurisdictional taxes such
as municipal, city or county taxes, or any Workers' Compensation Tax which may be applicable to the
disability benefits The Hartford is paying.
0 The Hartford will prepare and deliver to Employer the annual summary reports of benefits paid.
Desired Coverage (See Attached Proposal for Estimated Annual Premiums):
Participating Employer is applying for and agreeing to purchase both the Lump Sum Cancer Benefit &
Long Term Disability (Income Replacement) coverages unless either of the following options is checked.
MLump Sum Cancer Benefit Only* OR
ElLong Term Disability (Income Replacement) Only*
* Alone, this coverage does NOT meet the requirements of HB 146.
The coverage elected above automatically renews at each anniversary of the effective date, based on then
current premiums established by the Administrator. Coverage may be terminated in accordance with the
GIRMA Bylaws rules for termination of membership in a GIRMA Fund.
On behalf of the City of Milton, Georgia, located in Fulton County, Georgia, I submit this Application
and Participation Agreement and agree to its terms.
Signature:
Print Name:
Title:
Date:
APPROVED BY GIRMA PROGRAM ADMINISTRATOR: . Date:
EFFECTIVE DATE OF COVERAGE: