INTERLOCAL
AGREEMENT
FOR THE
PUBLIC
UTILITY RISK MANAGEMENT SERVICES (“PURMS”)
JOINT
SELF-INSURANCE FUND
Amended and Restated as of December 7, 2001
For and
in consideration of the mutual covenants contained herein, the parties to this
Joint Self-Insurance Agreement (“SIA”) hereby amend and restate their
Predecessor Self-Insurance Agreements as follows:
1.
Predecessor Self-Insurance
Agreements. This SIA is based
upon and arises out of prior self-insurance agreements among most of the same
parties to this SIA. The original Predecessor
SIA was made and entered into as of December 30, 1976, by and between
certain public utility districts, most of which are signatory hereto, and was
previously amended and restated as of July 21, 1978, October 21,
1982, July 25, 1987, July 28, 1988, March 30, 1995,
February 27, 1997, and March 16, 2000.
All Predecessor SIAs prior to the February 27,
1997 amended and restated SIA were executed under the name
“Washington Public Utility Districts’ Utilities System Joint Liability
Self-Insurance Agreement.” The February 27, 1997 amended and
restated SIA added Property Coverage through the Property Risk Pool to the SIA,
and the word “Liability” was deleted from the title. Effective June 17, 1999, the name “Washington Public Utility
Districts’ Utilities System” was changed to “Public Utility Risk Management
Services” (or “PURMS”). On March 16,
2000 the SIA was again amended and restated to add a Health &
Welfare Risk Pool, effective as of April
1, 2000.
2.
Amended and Restated
Self-Insurance Agreement. By
this SIA, the Members of the Public Utility Risk Management Services Joint
Self-Insurance Fund (“Fund”) wish to redefine their duties and obligations to
and among themselves with respect to their participation in the PURMS Risk
Pools known as the Liability Pool and Property Pool, and also wish to establish
a separate but related Risk Pool to be known as the Health & Welfare Pool
(or “H&W Pool”) to provide self-insured Health & Welfare Benefits
Coverage (“H&W Coverage”) to Members.
The Members therefore agree that, as of the date hereof, this SIA
supersedes the Washington Public Utility Districts’ Utilities System Joint
Liability Self-Insurance Agreement dated December 30, 1976, and all subsequent restatements
thereof and amendments thereto. The
Members further agree that this SIA, the Operational Rules and any Procedural
Memoranda issued shall hereafter govern the operation of the Fund, the
Liability Pool, the Property Pool and the H&W Pool, and the rights and
obligations of their respective Members; provided, however, that Defense and
Coverage for Liability Claims and Coverage for Property Losses arising from
Loss Events which took place prior to the date of this SIA shall be determined
pursuant to the terms of the Predecessor SIA then in effect, except as may be
otherwise provided under ¶ 5.4 by the Board. Each Member signing this SIA hereby agrees to
be bound by its terms and all amendments hereto adopted by the Members in
accordance with the procedures contained in ¶ 5.2 of this Agreement, and
by the decisions of the Board.
3.
Definitions. The words defined in the Definitions section
of this SIA (which is set forth in § II as a separate document but which
is incorporated herein fully by this reference) shall have the meanings stated
therein when set out in initial caps and used in the SIA, Operational Rules or
Procedural Memoranda. Unless
specifically provided otherwise, for the Liability Coverage, the term
“Employee” shall include “Insured Agents” and “Insured Volunteers,” and with
respect to the H&W Coverage, “Employee” shall include such Employee’s
Dependents, unless otherwise inconsistent in the context.
4.
Status of the Parties, Purpose
of Agreement and Authority of the Fund.
4.1
Nature of Parties/Purpose and
Existence of Fund. The Fund
is an unincorporated association of Local Government Entities, and is organized
and existing under RCW 48.62.010 et seq., and other applicable
statutes enacted to permit and facilitate the joint exercise by Local
Government Entities of their powers. The
Fund consists of three Risk Pools, the Liability Pool, the Property Pool and
the Health & Welfare Pool, which are governed by a common Board of
Directors, subject to ¶¶4.4.2 and 6.3.1 regarding Board Votes on issues
affecting particular Risk Pools.
The Liability Pool has
been operating continuously since January
1, 1977, under the Predecessor Self-Insurance Agreements. The purpose of establishing and maintaining
the Liability Pool has been and is to allow the Members to achieve greater
economy and efficiency in their functions and operations regarding their
insurance coverages and risk management by providing Members and their
Employees with protection against liability for claims by Third-Parties through
joint self-insurance and the joint purchase of insurance or excess insurance.
The Property Pool has
been operating continuously since it was established on February 27, 1997 by the amended and
restated SIA of that date. The purpose
of establishing the Property Pool was to provide Members with coverage for
direct physical loss or damage to the property of Members or their Employees
through joint self-insurance and jointly purchased Excess Insurance.
The H&W Pool was
established by Unanimous Vote of the Board on March 16, 2000, effective April 1, 2000. The purpose of establishing the H&W Pool
was to permit each Member to provide its Employees and Dependants with
self-insured Health & Welfare Benefits Coverage tailored specifically to
each Member’s needs, as defined by each Member’s respective Coverage Booklet,
and to achieve cost savings for all Members through the joint administration of
their respective Benefits Plans and the joint purchase of Stop Loss Insurance
acquired by the H&W Pool.
4.2
Authority of Fund/Independent
Legal Entity. The Fund is an
independent legal entity with all of the authority granted or implied by
applicable Washington law and by this Agreement, including without limitation,
the authority to sue or be sued in its own name, the authority to hire
attorneys to defend Members and Employees against Liability Claims, and the
authority to settle or adjust Claims, defend or prosecute lawsuits, and pay
judgments on behalf of Members and Employees.
Without limiting the generality of the foregoing, the Fund shall have
the power and authority, exercised through the Board in accordance with this
Agreement, specifically:
(a)
To acquire, collect, hold and dispose of money and
other assets;
(b) To receive loans or grants and to incur
debts and liabilities;
(c) To enter into contracts;
(d) To
hire and terminate employees, agents and independent contractors;
(e) To
appoint a treasurer, who shall be the Auditor, and to invest Fund assets;
(f) To
establish and implement rules, policies and procedures governing the Fund’s
operations;
(g) To
establish and delegate authority to committees and subcommittees;
(h) To
decide issues and promulgate Board Decisions binding upon the Fund’s Members
and to amend the Agreement as deemed appropriate (in accordance with the Voting
Standards set forth in ¶ 5 of this Agreement);
(i) To establish and implement
Risk-Management Programs, including Loss Control Guidelines, in accordance with
¶ 17;
(j) To
establish and impose penalties upon Members, including withdrawal of Fund
Coverage or expulsion of Members, for violation of this Agreement or the Operational
Rules or Board Decisions, as provided in this Agreement; and
(k) To
possess and to exercise any other powers and to perform all other functions
reasonably necessary to effectuate the purposes of the SIA, as amended from
time to time.
It is the intent of
this Agreement to permit the Fund and its Board of Directors to exercise powers
to the full limit as permitted by RCW 48.62, et seq., and any
other applicable laws, so long as the exercise of such powers is not
inconsistent with this Agreement.
4.3
The Fund Distinguished from
the System. The System is an
unincorporated association formed for the purpose of obtaining group insurance
for its members. The System offers its
members the opportunity to participate in a number of different programs of
jointly acquired insurance. The Fund is
one such program, but it is a separate and distinct entity from the
System. Members of the Fund must also be
members of the System. However, members
of the System are not required to participate in the Fund, and membership in
the System does not by itself create any rights in or liabilities to the Fund
or any of its Risk Pools.
4.4.1
Participation in or Withdrawal
from Risk Pools at Members’ Choice. Local government entities that
are or become signatory to this Agreement may choose to become Members in any
or all of the Fund’s Risk Pools, subject to, where applicable, the terms for
New Members contained in ¶ 18, and the terms for Withdrawal contained in ¶ 20.
4.4.2
Common Board of Directors/Right
to Vote. The Board of
Directors for the Fund shall govern all of the Fund’s Risk Pools pursuant to
the terms of this SIA, subject to ¶ 6.3.1’s restriction on the right to
Vote on issues affecting a particular Risk Pool to the Directors representing Members
of that Risk Pool. Any issue affecting
the Fund generally, or all Risk Pools, shall be decided by the full Board of
Directors of the Fund by the Voting Standard applicable to the issue. The full Board, by Majority Vote, shall also
decide whether an issue affects the Fund generally or two or more of its Risk
Pools (and therefore should be decided by a Vote of the full Board) versus
whether the issue affects only one Risk Pool (and therefore should by decided
only by the Directors whose Members participate in that Risk Pool). (See also, ¶ 6.3.1.)
4.4.3
Separate Assessments and
Accountings for Risk Pools.
The Fund shall assess Members in each of the Risk Pools separately under
their respective Assessment Formulas and the assets of each Risk Pool shall be accounted
for separately and invested separately by the Fund.
4.4.4
SIA Provisions Applicable to
“The Fund” Govern the Risk Pools.
Throughout the SIA, “the Fund” used generally shall refer to the legal
entity that operates the Risk Pools and shall mean and include the Liability
Pool, the Property Pool and the H&W Pool and, where applicable in the
context, can refer to the Governing Bodies of the Fund and its Risk Pools. The
provisions of general application in this SIA regarding governing and operating
“the Fund” shall apply to all Risk Pools and Members therein, unless the
context indicates otherwise. A Member of any Risk Pool is deemed to be a Member
of “the Fund.” A Member that ceases
being a Member of any and all Risk Pools shall no longer be a Member of “the
Fund.”
4.5
Risk Pools Entitled to
Beneficial Use of Their Respective Assets. The Fund shall be deemed the legal owner of
all assets and investments generated by the Risk Pools through Assessments or
otherwise, which shall be held by the Fund in trust for the use and benefit of
its respective Risk Pools and their respective Members, and any other assets
coming into the Fund’s possession in connection with the Fund’s operations;
provided, however, that:
4.5.1
Assets generated by a particular Risk Pool through Assessments
or otherwise shall be used for the benefit of that Risk Pool and the Members
thereof, consistent with the terms of this SIA, and not for the direct benefit
of any other Risk Pools; provided, however, that Risk Pool Assets may be used:
(a) to make Inter-Pool Loans in accordance with ¶ 13.3.1; (b) for Program
Development in accordance with ¶ 13.3.2; and (c) for the establishment of a
Special Purpose Account in accordance with ¶ 13.4.4 (see also ¶ 13.1.2 re uses
of Actual Risk Pool Balances, and ¶ 13.2.4.2 re uses of H&W Pool Reserves).
4.5.2
The income and expenditures with respect to each Risk
Pool shall be accounted for separately and set forth separately on the Fund’s
financial statements;
4.5.3
Only Directors representing Members participating in a
particular Risk Pool may Vote on the use or disposition of the assets or
investments of that Risk Pool; and
4.5.4
Upon the Dissolution of a particular Risk Pool, the
assets and investments held by the Fund for the benefit of that Risk Pool shall
be used on behalf of or distributed to the Members of that Pool in connection
with the Dissolution, all in accordance with ¶ 21 governing Dissolution.
4.6
Members Have No Direct
Ownership Interest in Fund or Risk Pool Assets. Except as may be provided otherwise in this
Agreement, no Member or Employee or Former Member of any Risk Pool shall have
any claim to, nor any right, title, or interest in, any Assets held by the
Fund, regardless of whether such Assets are held by the Fund on its own behalf
or in trust for a particular Risk Pool and its Members. No Third-Party, including any creditor of any
Member or Employee, shall have any direct claim against, nor any right, title,
or interest in or to, any Assets held by the Fund at any time.
4.7
There are no Third-Party
Beneficiaries (Except Employees with Respect to Defense and Liability Coverage
and H&W Coverage). No
person or entity not a Member shall be construed to be a third-party
beneficiary of the SIA; provided, however, that Employees shall be third-party
beneficiaries but only with respect to those Substantive Rights applicable to
Employees arising out of the Liability Coverage, Defense, and to the extent
applicable, the Claims Resolution provisions of this Agreement (as set forth in
§§ III through VI, and § VII, respectively) with respect to Liability
Claims asserted against them, or arising out of the H&W Coverage as set
forth in § XIV, with respect to their own H&W Claims; and provided
further, that any such third-party beneficiaries shall be bound by the terms of
the SIA and the Operational Rules, and all procedures set forth therein, and by
the Procedural Memoranda.
4.8
Fund May Not Obligate Members
Directly. The amounts payable
under the Fund’s Coverages (§§ III through VI, §§ X – XI, and
§ XIV) as well as any other obligations of the Fund to or on behalf of
Members or Employees under this SIA, shall be paid only from the Assets
available in the Fund, subject to the restriction limiting the use of Assets
held on behalf a particular Risk Pool for the benefit of that Risk Pool and its
Members, as provided in ¶ 4.5. The
Fund shall not have authority to obligate any Member to independently pay any
amount except pursuant to the Fund’s authority to make Assessments of the
Members of its Risk Pools in accordance with ¶ 13.
4.9
Service of Process on Fund. The Fund hereby designates the Washington
State Risk Manager as its attorney solely for the purpose of receiving service
of all legal process issued against the Fund in Washington
based on causes of action arising in Washington. The Fund further designates its Administrator
to receive on behalf of the Fund all legal process against the Fund served upon
the State Risk Manager.
5.
Program Documents, Amendment
Procedures and Voting Standards.
5.1
Basic Self-Insurance Program
Documents. The Fund shall be governed by and operate in accordance
with the Program Documents, which shall consist of the Self-Insurance
Agreement; the Appendices to the Self-Insurance Agreement; the Operational
Rules; and Procedural Memoranda.
5.1.1
The Self-Insurance Agreement.
The primary Program Document is the Self-Insurance Agreement, or SIA, which
consists of fifteen (15) separate Sections (numbered § I - § XV) as follows:
§ I Interlocal
Agreement—executed by the Members pursuant to RCW 39.34 et seq.,
this Section establishes the structure and operations of the Fund, sets forth
the Members’ basic rights and obligations with respect to the Fund, and
incorporates by reference fourteen (14) additional Sections of the SIA.
§ II Definitions--
which are intended to have common meanings throughout the Program Documents,
except as otherwise provided;
§ III
Commercial General Liability Coverage--which includes the Insuring
Agreements and Conditions and the Exclusions for the Fund’s “CGL Coverage”;
§ IV Public
Officials and Entity Liability Coverage--which includes the Insuring
Agreements and Conditions and Exclusions for the Fund’s “PO&E Coverage”;
§ V Automobile
Liability Coverage--which includes the Insuring Agreements and Conditions
and Exclusions for the Fund’s “Auto Coverage”;
§ VI Pollution
Liability Coverage--which includes the Insuring Agreements and Conditions
and Exclusions for the Fund’s “Pollution Coverage”;
§ VII
Claims Resolution--which addresses, among other subjects, procedures for
the determination of Coverage, Members’ duties, Member participation in
litigation, selection of Defense Counsel for and Defense of Liability Claims,
and settlement and payment of Coverage;
§
VIII Liability General Assessment Formula--which determines the
respective amounts Members of the Liability Pool shall pay for their jointly
self-insured Liability Coverages under §§ III-VI;
§ IX Liability
Premium Assessment Formula--which determines the respective amounts Members
of the Liability Pool shall pay for their jointly purchased Excess Liability
Insurance;
§ X Property
Coverage--which includes the Interest and Property Insured and the
Conditions and Property and Perils Excluded with respect to the Fund’s “General
Property Coverage” (excluding Member’s Autos, which are covered separately
under § XI);
§ XI Auto
Physical Damage Coverage--which includes the Interest and Property Insured
and the Conditions and Property and Perils Excluded with respect to the Fund’s
Auto Physical Damage Coverage;
§ XII
Property General Assessment Formula--which determines the respective
amounts Members of the Property Pool shall pay for their jointly self-insured
Property Coverages under §§ X-XI;
§
XIII Property Premium Assessment Formula--which determines the
respective amounts Members of the Property Pool shall pay for their jointly
purchased Excess Property Insurance;
§ XIV
Health & Welfare Coverage--which contains the terms and conditions
for providing H&W Coverage for the Employees and Dependents of Members of
the H&W Pool based on the Benefits set forth in Members’ respective
Coverage Booklets; and
§ XV Health
and Welfare General Assessment Formula--which determines the respective
amounts Members of the H&W Pool shall pay as a result of their membership
in the H&W Pool for their own Employees’ H&W Claims, Shared H&W
Claims and Operational Costs, including Stop Loss Insurance.
5.1.2
Appendices to Self-Insurance
Agreement. The Appendices to the SIA are set forth in § XVI and
include: the Fund’s Investment Policy (Appendix A); the Administrator’s
Contract (Appendix B); the Broker’s Contract (Appendix C); and General
Counsel’s Engagement Letter (Appendix D). While the Appendices are referenced
in the SIA, they are not deemed a part of the SIA, and except for the
Investment Policy which can only be amended by a Two-Thirds Vote of the Board,
the other Appendices can be modified by the Administrative Committee, subject
to further modification or reversal by Majority Vote of the Board pursuant to §
I ¶ 6.2.8.
5.1.3
Operational Rules.
Another Program Document is the Operational Rules which is set forth separately
from the SIA under its own name. The Operational Rules are designed to provide
greater detail for the authority and operation of the Fund in supplement to the
SIA.
5.1.4
Procedural Memoranda.
Procedural Memoranda are documents which may be issued from time to time by the
Administrative Committee reflecting Administrative Committee decisions on
issues and procedures affecting the day-to-day practical operation of the Fund
and decisions regarding interpretation of various Program Documents. Procedural
Memoranda are subject to Board modification or reversal by Majority Vote
pursuant to § I ¶ 5.2.2(c).
5.1.5
Inter-Relation of Program
Documents. Although the Self-Insurance Agreement is set forth in
separate Sections, all Sections shall be deemed part of the same transaction
and shall be construed together. In the event of conflicting terms between or
among the Program Documents, such Documents shall govern in the following
descending order of authority: first the
SIA; next the Operational Rules; and last, the Procedural Memoranda.
5.2
Amendment Procedures.
5.2.1
Statement of Purpose. Based on experience under Predecessor SIAs, the Members of the Fund have determined that to
require that all current Fund Members unanimously approve every amendment to
the SIA and unanimously re-execute the Inter-local Agreement to make any such
amendment binding was cumbersome and inefficient. The Members therefore desire to establish
Amendment Procedures and Voting Standards for amending all Program Documents
that alleviate these problems by permitting the Board to amend most (but not
all) of the provisions of the Program Documents by a Voting Standard less
stringent than a Unanimous Vote, and any such amendments shall become effective
without the necessity of all Members executing a revised Inter-local
Agreement.
5.2.2
Warrant of Authority and
Voting Standards for Amending Program Documents. Each Member hereby agrees, represents and
warrants that such Member’s approval and execution of the Inter-local Agreement
Section of the Self-Insurance Agreement and adoption of the Operational Rules
incorporated therein is pursuant to specific authority granted by an
Authorizing Resolution duly enacted by such Member’s governing body. Each
Member further agrees, represents and warrants that such constitutes a lawful
agreement by such Member to be bound by the authority of the Board under this
SIA to amend the Program Documents, and bind such Member and its Employees
thereby, pursuant to the following Voting Standards:
(a) The
Self-Insurance Agreement may be amended by Super-Majority Vote of the Board,
except where a Unanimous Vote, together with an Authorizing Resolution from
each Member, is required in accordance with ¶¶ 5.3 and 5.5.
(b) The Operational Rules may be amended by a
Two-Thirds Vote of the Board, except for those provisions in the Operational
Rules dealing with subjects for which the SIA mandates amendment by a
Super-Majority Vote or Unanimous Vote; and
(c) The
Procedural Memoranda may be amended or reversed by a Majority Vote of the Board;
provided, however,
that any more specific provision in a Program Document that provides for
amendment on a particular subject by a different Voting Standard shall
supersede the general Voting Standards in sub-¶¶ (a) through (c) above; and
provided further, that the Voting Standards for amending the Program Documents
contained in sub-¶¶ (a) through (c) above shall be subject to the restrictions
contained in ¶¶ 5.3 and 5.4 below.
5.3
Provisions Subject to
Amendment Only by Unanimous Vote and Authorizing Resolutions. Any amendment to the SIA that requires a
Unanimous Vote shall also require approval by an Authorizing Resolution of the
governing body of each Member to become effective. (see ¶ 5.5). The following paragraphs shall only be
amended by Unanimous Vote:
(a)
The provisions in the following paragraphs dealing with
the following subjects: ¶¶ 4.2
through 4.8 (re basic Fund structure and authority); ¶¶ 5.2 through 5.6
(re Amendment Procedures and Voting Standards); ¶¶ 6.1- 6.3 (re the Board
of Directors); ¶ 7.6 (re Decisions on Issues not on Agenda); ¶ 13 (re
Assessments); ¶ 14 (re Fund’s Excess Insurance); ¶ 19 (re Appeal
Procedures); ¶ 20 (re Withdrawal from a Risk Pool or the Fund); ¶ 21
(re Dissolution of a Risk Pool or the Fund) and ¶ 24.5 (re Arbitration and
Venue); and
(b) Wherever
the SIA or Operational Rules specifically so provide with respect to specified subjects.
5.4
Conditions and Restrictions on
Amendment of Program Documents by Less than Unanimous Vote of the Board.
5.4.1
Prospective Amendments. Any and all provisions of the Program
Documents, whether dealing with Procedural or Substantive Rights, may be
amended by the applicable Voting Standard for prospective application with
respect to all Fund matters addressed by the Program Documents and all Loss
Events (and related Claim Resolution issues) that take place after the
effective date of the amendment. Unless
otherwise provided in the language of the Prospective Amendment, the effective
date thereof shall be the date the Board voted to approve the amendment.
5.4.2
Rules Regarding Amendments
Having Retroactive Effect.
5.4.2.1
Amendments Effecting Procedural Rights. Any amendment affecting a Member’s or
Employee’s Procedural Rights under the SIA shall, unless otherwise provided in
the amendment, automatically be given “retroactive” application in the sense
that, from its effective date, such Procedural Amendment shall govern the
resolution of all pending Claims and all Loss Events, known or unknown, even if
they happened prior to the effective date of the Procedural Amendment, and
regardless of the Procedural Rights that were in effect in the applicable SIA
at the time of the Loss Event. This
¶ 5.4.2.1 shall also apply to Members and their Employees who later become
Former Members.
5.4.2.2
Retroactive Grants of Coverage. By Super-Majority Vote, the Board may amend
the SIA to provide additional, expanded or different Liability or Property
Coverages retroactively, to a date certain specified in the amendment, which
shall apply to all unresolved known and unknown Loss Events that happened after
such amendment’s retroactive effective date; provided, however, that Former
Members on the date the amendment is approved by the Board shall not be
entitled to the benefit of such Retroactive Coverage. The cost of providing
such Retroactive Coverage shall be paid from the Assets constituting the Actual
Risk Pool Balance of the Risk Pool receiving the Retroactive Coverage, which
shall be replenished through normal General Assessments of the Risk Pool’s
Members; provided, however, any Risk Pool Member that voted against the
Retroactive Coverage that gives notice of its intent to withdraw under
¶ 20.1 within thirty (30) days of the Board Vote to adopt the Retroactive
Coverage shall not be entitled to such Coverage and shall be exempt through the
end of the calendar year of its Withdrawal from paying its Assessment Share of
the portion of any General Assessment relating to Coverage Payments and Defense
Costs or Property Claim Costs the Fund pays for Covered Claims arising from the
Retroactive Coverage, and shall remain exempt therefrom
as a Former Member. A Member or Employee
involved in a Covered Liability Claim arising out of the Retroactive Coverage
shall have the rights and obligations relating to Defense under the SIA
currently in effect.
Each Member of the
H&W Pool may provide for retroactive grants of H&W Coverage for their
respective Employees and their Dependants as provided for in the H&W
Coverage § XIV ¶ 2.2.3, with respect to providing a Benefit to Employees
generally, and in § XV ¶ 5.2, with respect to a specific H&W Claim which
has been denied.
5.4.2.3
No Amendment Shall be Applied Retroactively to
Deprive Members or Employees of “Vested” Substantive Rights for Covered Claims. No amendment of the SIA or Operational Rules
shall be applied to the extent that the effect would be to deprive a Member or
Former Member (or their Employees to the extent such Rights are applicable
hereunder, without such Member’s or Former Member’s written consent), of a
Vested Substantive Right with respect to Coverage for any Covered Claim arising
from any Loss Event that has taken place as of the date of the Board’s adoption
of the amendment. The Substantive Rights
of a Member (or Employee of a Member) of the Liability or Property Pools,
whether under the current Program Documents or under Predecessor SIAs, shall be deemed Vested as of the date of the Loss
Event. Except for the right of Appeal pursuant to ¶ 19.2.3 herein with respect
to the denial of Coverage for an H&W Claim, any “Substantive Rights” of Employees
and Dependants of Members of the H&W Pool, shall be determined in
accordance with such Members applicable Coverage Booklets, and are a matter
between such Member and its Employees.
5.5
Authorizing Resolutions by
Members. Each current Member
of the Fund that executes this SIA, amended and restated as of December 7,
2001, and each New Member that hereafter joins the Fund, shall provide the
Administrator with a formal Authorizing Resolution duly enacted by the Member’s
or New Member’s governing body. The Authorizing
Resolution shall specifically authorize the Member or New Member to execute the
SIA, or shall ratify the prior execution thereof by the Member’s or New
Member’s Director, and shall provide that the Member will be bound by any
amendments to the Program Documents approved in accordance with the Amendment
Procedures and Voting Standards contained in this ¶ 5. In addition, any
amendments to the Program Documents on subjects required under the terms of
¶ 5.3 to be passed by Unanimous Vote must also be approved by an
Authorizing Resolution enacted by each Member to become effective; provided,
however, that such Resolutions may ratify the prior Board Votes of Members’
Directors, the documents previously executed by Members’ Directors, and/or such
Member’s de facto operation under or acceptance of the benefits under and terms
thereof. The effective date for execution of the SIA or for any amendments
thereto shall be the effective date stated therefore in the Board’s Resolution
regarding the same, regardless of whether such Authorizing Resolution approves
prospective execution or ratifies prior execution by the Member’s Director.
Amendments on subjects governed by a Voting Standard other than a Unanimous
Vote shall become effective as of the Effective Date when passed by the Board
by the applicable Voting Standard, without the need for an Authorizing
Resolution from each Member and without each Member’s Director actually having
to execute a document reflecting such amendment.
5.6
Adoption of the SIA and
Operational Rules. The Fund
and each Member hereby adopts the SIA, amended and restated and effective as of
December 7, 2001, consisting of this Inter-local Agreement and SIA §§ II
through XV, which are set forth as separate documents in the SIA Notebook and
incorporated herein by this reference. (see ¶ 5.1). The Fund and each
Member also hereby adopt the Operational Rules, amended and restated and
effective as of April 1, 2000
(also set forth as a separate document in the SIA Notebook).
5.7
Documenting Amendments. Amendments requiring a Unanimous Vote shall
be prepared in writing for Board discussion and, if adopted, shall be signed by
the Director for each Member. As soon as
reasonably possible, all Members shall deliver copies of their Authorizing
Resolutions therefore to the Administrator.
Copies of the fully executed amendment shall be distributed to the
Members. Amendments requiring a less
than Unanimous Vote, and amendments to the other Sections of the SIA (i.e.,
Definitions, Coverages, Claims Resolution, and Assessment Formulas), and to the
Operational Rules, shall be prepared in writing and signed by any two Fund
Officers to establish the authenticity of the amendment. A copy of the amendment as signed by the Fund
Officers, and a revised version of the SIA Section reflecting the amendment,
shall be distributed to each Member.
6.1
Composition of Board.
6.1.1
Designation of Director. The business and affairs of the Fund and its
respective Risk Pools shall be managed and governed by a Board of Directors,
which shall be the policy-making body of the Fund. Each Entity that is a Member of a Risk Pool
shall be entitled and required to appoint one Designated Director to the Board,
and in addition, to identify a First and Second Alternate Director, in accordance
with the Operational Rules. With
respect to each Member that is a public utility district, its Designated
Director shall be one of its Commissioners.
With respect to each Member that is not a public utility district, it
may appoint any Officer or member of its board to act as its Director. Alternative Directors and Employee Designees
may be Employees. The specific procedures and timing for identifying Designated
Directors, First and Second Alternate Directors, and Employee Designees, and
their relative voting rights on behalf of the Member, are set forth in the
Operational Rules. (See Op. Rules, ¶ 6.1.1).
6.1.2
Employee Designees. In addition to the Director designation
required pursuant to ¶ 6.1.1, each Member shall, on an annual basis, in
writing, notify the Administrator of the identity of any of its Employees who
are entitled to vote on behalf of the Member at Board Meetings in the event the
Director or an Alternate Director is unable to attend, as more specifically
provided for in the Operational Rules.
6.1.3
Authority of Employee
Designees. Unless the context
of the SIA or Operational Rules clearly indicates otherwise, Employee Designees
shall be included within the meaning of “Director” and shall have all of the
same rights, authority and obligations as the Directors for whom they are
substituting.
6.2
Specific Authority and Duties
of Board. In addition to
managing and governing the overall affairs and business of the Fund, the
Board’s authority, obligations, duties and responsibilities under this Agreement
shall specifically include, but shall not be limited to:
6.2.1
By the applicable Voting Standards (see
¶¶ 5.2.2 and 5.3), amending the SIA, the Operational Rules or Procedural
Memoranda.
6.2.2
By Super-Majority Vote, amending the General Assessment
Formulas (§§ VIII, XII, and XV) and the Premium Assessment Formulas
(§ IX and XIII).
6.2.3
By Super-Majority Vote, setting the amounts of the
Designated Risk Pool Balances (see ¶ 13.1.1), the Coverage Limits
(e.g., § III, ¶ 2.2), and the Deductible for the Liability Coverage
(e.g., § III, ¶ 2.3), and determining whether to levy any
Discretionary General Assessment which would raise any Actual Risk Pool Balance
to an amount greater than the applicable Designated Risk Pool Balance
(¶ 13.2.3) and any Special Purpose Assessment that would increase the
money in a Special Purpose Account to an amount greater than the funding level
therefore originally established by Super-Majority Vote (¶ 13.2.4).
6.2.4
By Super-Majority Vote, determining whether any Local
Government Entity applying for membership in the Fund pursuant to ¶ 18
shall become a New Member and, if so, upon what terms and conditions.
6.2.5
By Majority Vote, reviewing and deciding, in accordance
with the Appeal Procedures contained in ¶ 19, any Appeal by a Member or
Employee of any decision made or action taken by the Administrative Committee
as reviewed and decided by the Executive Committee upon appeal, except as
otherwise provided in ¶ 19.1(a) and (b), and subject to the Board’s
authority in ¶ 6.2.11.
6.2.6
By Majority Vote, establishing Special Purpose
Committees composed of Directors and/or Members’ staff and, except for matters
requiring decision by a Voting Standard more stringent than a Majority Vote,
delegating such authority thereto as the Board deems appropriate (see
¶ 9.1).
6.2.7
By Majority Vote, determining what Primary and
Supplemental Excess Coverages and what Stop Loss Coverage the Fund will acquire
from insurance carriers on behalf of the Members of its Risk Pools pursuant to
¶¶ 14.1 and 14.2.
6.2.8
By Majority Vote, approving, rejecting or modifying the
contracts negotiated by the Administrative Committee with the Administrator,
the Broker and General Counsel, and with any Third-Parties on behalf of the
Fund or any of its Risk Pools. (see
Op. Rules, § I, ¶ 9.4.3(i)).
6.2.9
By Majority Vote, deciding any issue properly brought
before the Board by any Member, pursuant to the procedures for placing Decision
Issues on the Agenda in ¶ 7.4, or as otherwise provided for by the SIA (see
¶¶ 7.2, 7.3 and 7.6; see also, ¶ 19.1(a) and (b) and
¶ 6.2.11)).
6.2.10
By Majority Vote, reviewing and approving
recommendations by the Administrative Committee regarding the Fund’s Risk
Management Programs, and making decisions regarding Board Remedies for
violation of the same (see ¶ 17).
6.2.11
By Majority Vote, appointing and removing members of
the Operations and Administrative Committees, and delegating to or withdrawing
from such Committees and the Executive Committee (see ¶ 9.2) such
authority, duties and jurisdiction as the Board deems appropriate, regardless
of the authority, duties and jurisdiction established for such Committees in
the SIA or Operational Rules; provided, however, that, except for the
provisions specifically addressing such Committees’ duties, authority and
jurisdiction, the Board may not, under the power of this sub-¶¶, effectuate in
fact an amendment to the SIA on a related subject requiring amendment by more
than a Majority Vote unless the Board vote also satisfies the highest Voting
Standard applicable to all SIA provisions affected.
6.2.12
By Majority Vote (except where otherwise specifically
provided), ultimately deciding issues that reach the Board regarding Defense
and/or settlement of Covered Claims or prosecution and settlement of Coverage
Litigation or other suits involving the Fund or the System, including establishing
by Majority Vote any parameters on the Executive or Administrative Committees’
authority with respect thereto (see ¶ 9.2(b) and (c), and Op.
Rules, § I, ¶¶ 9.4.3(e) and (f)).
6.3
Quorum and Votes.
6.3.1
Member’s Vote, Quorum, and General Voting Standards. Each Director shall be entitled to one Vote
on all issues considered by the Board that relate to a Risk Pool in which the
Member that employs the Director participates.
Decisions on issues affecting the Fund generally, or two or more Risk
Pools, shall be made by the full Board representing all Members of the
Fund. (see also,
¶ 4.4.2.) Unless the SIA expressly
provides for decision by some other Voting Standard, all Board Decisions shall
be made by a Majority Vote of the Directors present or otherwise participating,
so long as there is a Quorum, which shall be the act of the Board and shall
bind all Members. The Board may by
Majority Vote withdraw authority from any Committee on any subject, as
permitted by ¶ 6.2.11. The SIA also
has established and employs Voting Standards for Board Decisions on specified
subjects that are more stringent than a Majority Vote, including a Two-Thirds
Vote, a Super-Majority Vote, and a Unanimous Vote. Board Decisions regarding amending the
Program Documents shall be governed by the Voting Standards contained in
¶¶ 5.2.2 and 5.3. The Board shall
not make any official Board Decision unless there is a Quorum of Directors
participating.
6.3.2
Participation in Meetings and Binding Acts of the
Board. Directors and members of any
Standing Committee or any Special Purpose Committee designated by the Board may
participate in a meeting of the Board or such Committee by means of telephone
or video conference or similar communications equipment by which all persons
participating in the meeting can hear and communicate with each other at the
same time. Participation by such means shall constitute physical presence at
the meeting and shall count toward a Quorum. All Members shall be bound by all Board
Decisions duly made in accordance with the terms of the SIA.
6.3.3
Absence of Directors/Binding Acts of Employee
Designees. If a Member’s Director
and Alternate Directors cannot attend or otherwise participate in a Board
meeting, any Employee Designee of the Member may attend such meeting and shall
be entitled to fully participate in the meeting. (see Op. Rules, § I,
¶ 6.1.2(A)). The presence or
participation of any such Employee Designee at the meeting shall be deemed to
be the presence of the Member’s Director, and the votes and other actions of
the Employee Designee shall be deemed to be the votes and actions of the
Member’s Director.
7.1
General Meetings.
7.1.1
Time, Place and Notice. The Board shall conduct an annual and a
semi-annual General Meeting each calendar year.
The Board’s General Meetings may coincide with similar meetings of the
System. The specific procedures for the
scheduling and providing notice of the General Meetings are set forth in the
Operational Rules.
7.1.2
Permitted Action/Agenda Issues. In addition to such other business as may
properly come before the Board, the Board shall hear and consider reports from
the Administrator, the Administrative Committee and the Auditor. The Board may decide or take action on any
issue raised at a General Meeting, whether or not the issue was included in the
Agenda; provided, however, the Board shall not decide or take action at such
meeting on any issue requiring approval by a Voting Standard more stringent
than a Majority Vote if the issue was not included in the Agenda, except as otherwise
permitted in ¶ 7.6, nor on any Appeal Issue that is subject to the
mandatory Appeal Procedures set forth in ¶ 19.2, except as otherwise
permitted in ¶ 19.1(a) or (b), unless and until such Issue has been
submitted to the Appeal Procedures and the Appeal Procedures have been fully
exhausted through the Executive Committee level.
7.2
Special Meetings. Special Meetings of the Board shall be held
at such times and places as designated by the Administrator within thirty (30)
days after receipt by the Administrator of a written request therefore from any
Director of a Member, any Fund Officer, any two members of the Administrative
Committee or the Administrator. A
Special Meeting may be called in whole or in part for the purpose of deciding
an Appeal Issue that has been submitted to the Appeal Procedures, even though
such Procedures have not been fully exhausted through the Executive Committee
level, so long as the requirements of ¶ 19.1(b) are satisfied. The specific procedures for notifying
Directors and other interested parties of Special Meetings are set forth in the
Operational Rules. The Notice shall
state the purpose(s) for the Special Meeting and shall be accompanied by an
Agenda identifying the Decision Issues, including those for which the Special Meeting
has been called and those which otherwise have been timely submitted to the
Administrator in accordance with ¶ 7.4.
The Board shall not decide any issue at the Special Meeting not
specified in the Notice of Special Meeting or in the accompanying Agenda.
7.3
Emergency Meetings. Emergency Meetings of the Board shall be held
at such times and places as designated by the Administrator upon the request of
any three Directors of Members, any two Fund Officers, or any three members of
the Administrative Committee. The
Emergency Meeting shall be held as soon as reasonably possible following the
Administrator’s receipt of the request.
The purpose of the Emergency Meeting may be in whole or in part to
decide an Appeal Issue that is subject to the mandatory Appeal Procedures of
¶ 19 and which would otherwise be required to proceed through exhaustion
of those Procedures before Board review and decision, so long as the
requirements of ¶ 19.1.(b) are satisfied.
The Board shall not decide any issues other than those specified in the
Notice of Emergency Meeting. The
specific procedures for notifying the Directors and other interested parties of
Emergency Meetings are set forth in the Operational Rules.
7.4
Meeting Agendas/Member
Submission of Issues for Decision by Board. The Administrator shall include all issues on
the Agenda for the next General Meeting, or Special Meeting, for which written
requests have been received by the Administrator from any Director, any Fund
Officer, or any member of the Administrative Committee, in accordance with the
Operational Rules. All issues submitted
to the Administrator at least fourteen (14) days prior to the date set for the
Meeting shall be deemed to be Discussion Issues which shall at least be
discussed at such Meeting. All written
requests to include Decision Issues on the Agenda to be voted upon by the Board
must be delivered to the Administrator at least thirty (30) days prior to the
date set for the General or Special Meeting.
No issue for which a vote is requested shall be included as a Decision
Issue on the Agenda if the issue is subject to the Primary Jurisdiction of the
Administrative Committee established in ¶ 9.4.4 and the Appeal Procedures
have not been exhausted, except as otherwise provided in ¶ 19.1(a) or
(b). The Board may defer action on any
Decision Issue properly on the Agenda by Majority Vote.
7.5
Waiver of Defects in Agenda or
Notice of Meeting. Defects in
the Agenda or Notice of Meeting for any Board meeting, including defects as to
content, timeliness or other defects, may be waived in writing by any Director
at any time, either before or after such meeting. Any such defects shall be deemed waived by
the presence of a Member’s Director at the meeting unless such Director shall,
prior to or at the commencement of such meeting, or, with respect to an Agenda
defect, prior to or at the commencement of consideration of the issue or item
of business omitted, deliver an oral or written objection to the President, or
any other person chairing the meeting, and to the Administrator.
7.6
Decisions on Issues Not on
Agenda or in Notice of Meeting.
So long as a Super-Majority of the Directors of all Members are present
at or otherwise participating in any General Meeting of the Board in accordance
with ¶ 6.3.2, the Board may by Majority Vote raise, discuss and decide any
issue, including any Appeal Issue otherwise subject to the Appeal Procedures in
¶ 19, by the Voting Standard applicable to such issue, regardless of
whether such issue was included in the Agenda or the Notice of the General
Meeting; provided, however, that this ¶ 7.6 shall not apply to any issues
requiring a Board decision Unanimous Vote, Super-Majority Vote or Two-Thirds
Vote. This ¶ 7.6 also shall not apply to Special or Emergency Meetings of
the Board.
7.7
Pre-Vote Analysis. The Administrative Committee shall conduct a
Pre-Vote Analysis of Decision Issues as set forth in the Operational Rules.
7.8
Rules of Conduct for Meetings. Meetings of the Board and any Committees of
the Fund shall be governed by Roberts Rules of Order.
7.9
Open Meetings, Executive
Sessions and Maintenance of Confidentiality and Privileges. It shall be the Board’s policy to conduct its
meetings openly, in compliance with the Open Public Meetings Act (RCW 42.30 et
seq.). The Board, however, shall
have the authority to meet confidentially in Executive Session, on its own
initiative or at the request of any Fund Officer, as permitted by the Open
Public Meetings Act and other applicable Washington
law. The Board shall attempt to conduct
its meetings so as to preserve the attorney-client and attorney work-product
privileges where appropriate and reasonably possible.
7.10
Recessed Meetings. So long as there is a Quorum, a recess of any
Board Meeting may be taken until such time and place as those present may determine
by Majority Vote, without new Notice being given or new Agendas being sent.
7.11
Members Involved in Pending or
Potential Litigation with the Fund.
All Employees and representatives of a Member, including its Director,
by Majority Vote, may be excused from the portions of the discussions at a
Board Meeting that relate to the subject of the pending or potential litigation
between the Fund and that Member or that Member’s Employee. Further, the
Minutes of the Board Meeting that reflect any discussions and or decisions
under these circumstances may be prepared as Confidential Minutes, and not
disseminated to the Members generally with the Published Minutes of such
Meeting.
8.1
Enumeration and Qualifications. The Fund Officers shall be a President, a
Vice-President, and a Secretary-Treasurer.
No person shall be eligible to serve as an Officer of the Fund unless he
or she is also a Commissioner of a Member of one of the Risk Pools, or other
member of the governing body of such a Member, and a Designated Director. The Fund Officers shall be nominated and
elected by the Board at its year-end General Meeting by Majority Vote.
8.2
Term of Office, Vacancies and
Removal. Except as provided
in ¶ 21.2, the Fund Officers shall hold office for a period of one year
commencing on January 1 and until their successor or successors are elected and
assume office on January 1 of the following year. The protocol for the succession of officers
and the filling of vacancies is set forth in the Operational Rules. Any Fund Officer may be removed from office
for any reason by a Two-Thirds Vote of the Board.
8.3
President. The President shall be the chief executive
and operating officer of the Fund and, subject to the authority of the Board,
shall have general charge, supervision, and control over the business and
affairs of the Fund, and shall be responsible for its management. The President shall preside over all Board
Meetings and Executive
Committee Meetings, oversee compliance with the procedures for the conduct of
the Fund’s business as required by the SIA and the Operational Rules, perform
such other duties as are assigned to the President in the SIA and the
Operational Rules, and perform such other duties as may from time to time be
assigned by the Board.
8.4
Vice-President. In the event of the absence or disability of
the President, the Vice-President shall have and may exercise the authority and
perform the duties of the President. In
addition, the Vice-President shall perform such other duties as the Board or
President may from time to time assign.
8.5
Secretary-Treasurer. In addition to the duties assigned to the
Secretary-Treasurer in the SIA and the Operational Rules, the
Secretary-Treasurer shall perform such other duties as the Board or President
may from time to time assign.
9.1
Special Purpose Committees. The Board, by resolution duly adopted by
Majority Vote, may designate from among its members or the members of the
Operations or Administrative Committees, one or more Special Purpose
Committees, each of which shall have such duration and shall exercise such
authority as designated by the Board in such resolution; provided, however,
that no such Committee shall be delegated the authority to make a Board
Decision with respect to matters which require approval by a Voting Standard
higher than a Majority Vote. (See also ¶ 6.2.6).
9.2
Executive Committee.
9.2.1
Composition and Duties. The Fund shall have an Executive Committee
whose members shall be composed of the three Fund Officers, the Standing AC
Members and the Annual AC Members. Each member of the Executive Committee shall
have one vote on matters addressed by the Executive Committee. The chairperson
of the Operations Committee and a representative of the Administrator shall be
non-voting, ex-officio members of the Executive Committee; provided, however,
in the event of a tie-vote, the chairperson of the Operations Committee shall
provide the tie-breaking vote. Except as
the Board may otherwise establish from time to time by Majority Vote, pursuant
to ¶ 6.2.11, and in addition to the duties assigned to the Executive
Committee elsewhere in the SIA and in the Operational Rules, the duties and
authority of the Executive Committee shall be to:
(a) Review
and approve all of the Fund’s Monthly Receipts and Expenditures Analyses when
the Executive Committee meets;
(b) Provide consultation and advice to the
Administrative Committee in connection with Coverage Litigation or the defense
or prosecution of any other lawsuit in which the System or the Fund is a party,
and make all decisions regarding settlement of same; provided, however,
pursuant to ¶ 6.2.11 and by Majority Vote, the Board may modify or
restrict the authority of the Executive Committee with respect thereto,
including establishing the conditions of prosecution or settlement of any such
lawsuit. (See also, ¶ 6.2.12 and Op Rules, § I,
¶ 9.4.3(f)).
(c) Subject to the Board’s authority in
¶ 6.2.11, decide issues with respect to potential or pending Covered
Claims transferred to the jurisdiction of the Executive Committee in accordance
with ¶ 6.2.12. (See also, Op. Rules, § I,
¶ 9.4.3(e)).
(d) Hear
and decide all Appeal Issues in accordance with the procedures in ¶ 19;
(e) Make
Emergency Decisions on any issues submitted by the Administrative Committee on
all matters that can be decided by the Board by Majority Vote.
(f)
The Executive Committee also shall perform such other duties and have
such other authority as the Board may from time to time assign.
9.2.2
Executive Committee Meetings. The Executive Committee shall meet as
required in the Operational Rules.
9.2.3
Additional Executive Committee
Authority for Initial Operation of H&W Pool. Because of the uniqueness of the H&W Pool
in permitting Members to have different types and levels of H&W Benefits,
and because it is not possible to anticipate all possible effects of this and
the Assessment Formulas provided for the H&W Pool, and notwithstanding any
of the provisions of the SIA, for an indefinite period of time after the
H&W Pool commences operations, and subject to termination of this authority
by Majority Vote of the Board, the Executive Committee shall have authority to
act on behalf of the Board with respect to any issue affecting only the H&W
Pool requiring less than a Super-Majority Vote, and notwithstanding the immediately
foregoing limitation re Voting Standards, the Executive Committee may also
approve adjustments in the H&W Assessment Formula to achieve fairness in
the operation of the H&W Pool even though such would otherwise require a
Super-Majority Vote of the Board; provided, however, that the Administrator
shall provide all H&W Pool Members with written notice of such decision by
the Executive Committee within seven (7) days thereof; and provided further
that any decisions made by the Executive Committee on issues that would
otherwise have required a Board Vote under any Voting Standard, shall
automatically be on the Agenda for review, and ratification or reversal, at the
Board’s next General Meeting, or sooner by a properly called Special or
Emergency Meeting. Should the Board
modify or reverse any such decision by the Executive Committee, all Members
agree that reasonable measures may be taken as necessary to return the
situation to the status quo, as if the Executive Committee had not made the
decision that was modified or reversed.
9.3
Operations Committee.
9.3.1
Composition and Duties of
Committee Members. The Fund
shall have an Operations Committee composed of one Employee from each Member
who has knowledge regarding the Member’s insurance and risk management
issues.
9.3.2
Duties of Operations Committee. The Operations Committee shall have such
duties and authority as may be assigned in the SIA and the Operational Rules,
subject to ¶ 6.2.11, and as may be designated by the Board from time to
time.
9.4
Administrative Committee.
9.4.1
Composition. The Fund shall have an Administrative
Committee consisting of four (4) Standing AC Members, and from time-to-time, up
to two (2) additional Annual AC Members.
All such Administrative Committee members shall be appointed by the
Board by Majority Vote from the Operations Committee. Pursuant to ¶ 6.2.11, members of the
Administrative Committee may be removed at any time by a Majority Vote of the
Board. One of the four Standing AC
Members shall be the Fund’s Auditor, with the qualifications required by
¶ 12.1. The Standing AC Members and any Annual AC Members shall be the Voting
AC Members. The chairperson for the
Administrative Committee shall be a Standing AC Member, and shall be chosen by
the Committee at the first Administrative Committee meeting of each new
calendar year. The chairperson of the Operations Committee and a representative
of the Administrator shall be non-voting, ex-officio members of the
Administrative Committee; provided, however, in the event of a tie-vote, the
chairperson of the Operations Committee shall provide the tie-breaking
vote. Additional persons may from time
to time be appointed as a Member’s Representative to the Administrative
Committee for specific purposes in accordance with the provisions of
¶¶ 15.3 or 19.2.6, or § VII, ¶¶ 3.1 and 3.2, and shall be
subject to any limitations contained therein and in the Operational Rules. In the event of a vacancy caused by a member
of the Administrative Committee resigning, becoming disabled or otherwise
becoming incapable of performing his or her duties under this ¶ 9.4, the
President may appoint an interim member to the Administrative Committee, who
shall serve until such time as the disability, other incapacity or reason for
vacancy is removed, or a permanent successor is duly appointed by the Board.
9.4.2
Term. The term for each Standing AC Member shall be
four calendar years and shall be staggered for the purpose of ensuring
continuity of experience within the membership of the Committee. The term for any Annual AC Member shall be
one (1) calendar year.
9.4.3
Authority and Responsibilities. Subject to ¶ 6.2.11, the Administrative
Committee shall have such duties and authority as may be assigned in the SIA
and the Operational Rules, and as may be designated by the Board from time to
time. (See Op. Rules, § I,
¶ 9.4.3).
9.4.4
Primary Jurisdiction and
Delegation of Authority. The
authority and duties identified in Op. Rules, § I, ¶ 9.4.3 shall be
deemed within the Administrative Committee’s Primary Jurisdiction and issues
relating to the subjects of such authority and duties shall be addressed by
Members and Employees in the first instance to the Administrative Committee (see
¶ 19.1); provided, however, that Appeal Issues may at any time be
addressed to the Board in the first instance as permitted in ¶ 19.1(a) or
(b); and provided, further, that the Administrative Committee’s Primary
Jurisdiction shall always be subject to modification or withdrawal by the Board
as provided in ¶ 6.2.11. The
Administrative Committee has the authority to delegate any ministerial portions
of its duties, including those contained in § 9.4.3, to the Administrator,
and any such delegations shall be specifically set forth in the Administrator’s
Contract; provided, however, that the Administrative Committee shall always be
accountable to the Fund for the performance of all its responsibilities.
10.1
Fund Administrator.
10.1.1
Administrator’s Duties.
The Fund shall retain an Administrator to assist in the operation and
administration of the Fund and its Risk Pools.
The Administrator shall have such duties and authority as provided in
the SIA and the Operational Rules, as well as such other duties and authority
as the Board and/or the Administrative Committee and the Administrator may
agree upon, including those set forth in the Administrator’s Contract, as
amended or re-executed from time to time.
The Administrator’s Contract currently in effect is contained as an
appendix in § XVI‑D. The term
of the Administrator’s Contract shall not be greater than one year unless a
longer term is approved by Super-Majority Vote.
The person or entity serving as the Administrator shall not also serve
as Broker for the Fund or any of its Risk Pools.
10.1.2
Procedures Governing Selection
or Renewal of Administrator.
Annually, the Board shall determine whether to renew the Administrator’s
Contract, and if so, upon what terms and conditions. In making this decision, the Board shall be
guided by the applicable standards for selecting an Administrator set forth in
the Operational Rules and by applicable law.
Decisions regarding the initial execution or the renewal of an
Administrator’s contract shall be by Majority Vote. Any decision to remove or replace the
Administrator during the term of the Administrator’s Contract, however, shall
require a Two-Thirds Vote.
10.1.3
Administrator’s Bond. The Administrator shall furnish such bonds
for the protection of the Fund, covering all persons in the Administrator’s
office having access to the Fund’s money or involved in any way with the Investment
Procedures or Disbursement Procedures, as may be requested and approved by the
Administrative Committee, in an amount established by the Administrative
Committee; provided, however, that the Administrator shall always provide such
bonds in such amounts as may be required by law, regardless of whether
requested by the Administrative Committee.
The Fund shall purchase any such bonds at its own expense. The Fund may indemnify the Administrator for
the loss of any security the Administrator may have pledged to secure any such
bond provided such indemnification is consistent with the terms of ¶ 23.2;
and provided further, that such indemnification shall not apply when the loss
covered by the bond resulted from the negligence, gross negligence or intentional
acts or omissions of the Administrator.
10.2
Fund Broker. The Fund shall retain a Broker to provide
insurance brokerage services to the Fund.
The Broker shall have such duties and authority as provided in the SIA
and the Operational Rules, as well as such other duties and authority as the
Board and/or the Administrative Committee and Broker may agree upon, including
those set forth in the Broker Contract, as amended or re-executed from time to
time. The Broker’s Contract currently in
effect is contained as an appendix in § XVI‑E. The term of the Broker’s Contract shall not
be greater than one year unless a longer term is approved by Super-Majority
Vote. The person or entity serving as
the Broker shall not also serve as Administrator for the Fund. Decisions regarding the initial execution or
the renewal of a Broker’s Contract shall be by Majority Vote. Any decision to remove or replace the Broker
during the term of the Broker’s Contract, however, shall require a Two-Thirds
Vote.
10.3
General Counsel. The Fund shall retain an attorney or law firm
to act as the Fund’s General Counsel to provide general legal advice to the
Fund and to handle such lawsuits, including subrogation claims and Coverage
Litigation, as may be assigned. General
Counsel shall take its day-to-day directions regarding the Fund’s legal work
from the Administrator, subject to superseding instructions from the
Administrative Committee, Executive Committee or the Board. General Counsel may also represent Members
individually, or their Employees, provided that there is no actual or
reasonably probable conflict of interest with the Fund inherent in such
representation. The General Counsel
Engagement Letter currently in effect is contained as an appendix in § XVI‑F.
11.1
Official Fund Records.
The Fund shall maintain complete and accurate records of its activities,
including records of all business brought before the Board and its
disposition. Without limiting the
generality of the foregoing, the Official Records of the Fund shall include
those records set forth in the Operational Rules.
11.2
Custodian and Right to Inspect
Records. The Administrator
shall be the custodian of all Official Records of the Fund, including those
relating to decisions by the Board and those reflecting recommendations and
decisions of the Executive, Operations and Administrative Committees. Directors and members of the Administrative
and Operations Committees shall have the right, upon reasonable written notice
to the Administrator, to inspect and copy any and all Official Records of the
Fund at the Administrator’s office upon payment of a reasonable copying
fee. Copies of the Fund’s Official
Records will be made available to the public in accordance with applicable
law. Specific procedures for public
access to such Records shall be set forth in the Operational Rules.
11.3
Board and Executive and
Operations Committee Minutes.
The Administrator shall ensure that all motions, their disposition and
all other proceedings of the Board and Executive and Operations Committees are
memorialized and transcribed into proposed Minutes. The proposed Minutes shall be reviewed,
approved and distributed in accordance with the Operational Rules.
11.4
Minutes of Administrative
Committee Meetings. The Administrative
Committee shall ensure that all actions taken at Administrative Committee
meetings are memorialized and converted to Minutes. Copies of the Administrative Committee
Minutes shall be distributed in accordance with the Operational Rules.
11.5
Confidentiality Rules. Discussions before the Board and Fund
Committees regarding subjects permitted by applicable Public Disclosure Laws to
be held confidential shall be conducted in Executive Session and shall not be
reflected in the published version of the Minutes. (See § I, ¶ 7.9). The
confidentiality of such discussions and of any documents reflecting such
discussions, and any privileges relating thereto, including the attorney-client
and work product privileges, shall be maintained to the maximum extent
permitted by law and circumstances.
12.1
Auditor’s Authority and Duties. The Fund shall have an Auditor who must be
both a Standing AC Member, elected from the members of the Operations Committee,
and a Financial Officer of a Member. In
addition to such other duties as the Board may from time to time assign, the
Auditor shall be responsible for and have control of the Assets held by the
Fund for the benefit of the Risk Pools and their respective Members, and any
Assets held by the Fund outside of and in addition to those held on behalf of
the Risk Pools. Subject to the authority
of the Board, the Auditor shall be responsible for the deposit or investment in
the Fund’s name of all monies held by the Fund in such financial institutions
or other investments as are in accordance with the Fund’s Investment
Policy. The Auditor shall provide to the
Board at its General Meetings, and at any other time upon the request of the
Board or a Fund Officer, a report of all of actions taken as Auditor. The Auditor shall have authority to perform
all acts necessary to permit the Fund’s Assets to be invested at the highest
return consistent with prudence and with the Fund’s Investment Policy,
including authority to transfer Assets from one investment to another by means
of wire, money market check, or other reasonable means. The Auditor shall have
such other duties as set forth in the Operational Rules. The Auditor has the
authority to delegate any ministerial portions of the Auditors duties to the
Administrator, and any such delegations shall be specifically set forth in the
Administrator’s Contract; provided, however, that the Auditor shall always be
accountable to the Fund for the performance of all of the Auditor’s
responsibilities.
12.2
Fund’s Investment Policy and
Procedures. The Fund shall
have an Investment Policy, which shall be established, and may be amended from
time-to-time, by a Two-Thirds Vote of the Board; provided, however, that such
Investment Policy shall be consistent with the requirements of Washington
law. The Fund’s Investment Policy is set
forth in § XVI, Appendix‑A. (See also, Op. Rules, § I, ¶
12.2). The Fund shall also have written Investment Procedures to implement its
Investment Policy. The Auditor, with the approval of the Administrative
Committee, shall have authority to delegate some or all of the ministerial
portions of the Investment Procedures to the Administrator, which duties shall
be reflected in the Administrator’s Contract; provided, however, that at all
times, the Auditor and the Administrative Committee shall generally supervise
and be accountable for the Administrator’s activities pursuant to any such
delegation.
12.3
Committee Bonds. The Auditor, and all other Voting AC Members shall
furnish such bonds, if reasonably available, as may be required by law or by
the Board. The Fund shall purchase any
such bonds at its own expense, and in addition, may, upon request, indemnify
the members of the Administrative Committee for the loss of any security that
such members may have personally pledged to secure such bond, subject to the
requirements of RCW 54.16.097.
12.4
Fund Disbursement Procedures.
All payments issued by the Fund shall be in accordance with the requirements of
this paragraph and the applicable procedures set forth in the Operational
Rules. The Auditor shall have primary responsibility for the Fund’s
Disbursement Procedures. Two (2) members
of the Administrative Committee, one of whom may but need not be the Auditor,
must approve the issuance of all payments drawn on the Fund, except as provided
below with respect to payments for H&W Claims. The Auditor, with the approval of the
Administrative Committee shall have authority to delegate some or all of the
ministerial portions of the Fund’s Disbursement Procedures to the
Administrator, which duties shall be reflected in the Administrator’s Contract;
provided, however, that the Administrator shall not be authorized to issue
payments drawn on the Fund without the written approval of two (2) members of
the Administrative Committee; and provided further that, because of the volume
of payments issued by the Administrator on a daily basis to pay for H&W
Claims, it is not practical to require the advance approval of two (2) members of
the Administrative Committee as a pre-condition for the issuance of such
payments, and such requirement shall not apply to such payments, but shall
apply to all other H&W Pool payments that are not directly for H&W
Claims. (See also, Op. Rules, §
I, ¶ 12.4).
12.5
Accounting Guidelines,
Financial Statements and Fiscal Year. (See Op. Rules, § I,
¶ 12.5).
12.6
Fund’s Monthly Receipts and
Expenditures Analyses. (See
Op. Rules, § I, ¶ 12.6).
12.7
Financial Reporting
Requirements. (See Op.
Rules, § I, ¶ 12.7).
12.8
Separate Accountings of Risk
Pools’ Income and Expenses.
The Fund shall separately account for the income and expenses of the
Fund and each of the Fund’s Risk Pools, although such information may be
presented on a single financial statement prepared at the Fund’s direction.
13.1
Liability and Property Risk
Pool Balances.
13.1.1
Designated Risk Pool Balance. The Liability Pool and Property Pool each
shall at all times have an established Designated Risk Pool Balance. The Designated Risk Pool Balance for the
Liability Pool shall equal $2,000,000, and the Designated Risk Pool Balance for
the Property Pool shall equal two (2) times the currently applicable Maximum
Property Retention (as set forth in the General Property Coverage Section,
§ X, ¶ 4); provided, however, that the Board may increase or decrease
the level of the Designated Risk Pool Balance(s) from time to time by
Super-Majority Vote; and provided further that the Board may increase or
decrease the amount of the Property Coverage Limit by Majority Vote so long as
the amount of any increase does not exceed the amount of the Maximum Property
Retention. Any changes in the amount of
any Designated Risk Pool Balance shall be reflected by an amendment attached to
this Agreement and in revised Operational Rules. The applicable Designated Risk Pool Balance
serves as a reference point for triggering and/or determining the amounts of
any Interim Automatic General Assessments and the Annual Automatic General
Assessment for the Liability and Property Pools, as provided in ¶¶ 13.4.1
and 13.4.2, and provides a maximum limit for the amount of any Interim or
Annual Automatic General Assessment which may not exceed the difference between
the Actual Risk Pool Balance and the applicable Designated Risk Pool Balance.
13.1.2
Actual Risk Pool Balance. The Actual Risk Pool Balance(s) for the
Liability and Property Pools shall be funded and replenished by General
Assessments. The money constituting the
Actual Risk Pool Balance of the Liability Pool shall be used to pay Liability
Pool Operational Costs, and the Actual Risk Pool Balance for the Property Pool
shall be used to pay Property Pool Operational Costs; provided, however, that
Assets constituting the Actual Risk Pool Balance(s) of such Risk Pools may be
used: (a) to make Inter-Pool Loans in accordance with ¶ 13.3.1.1; (b) for
Program Development in accordance with ¶ 13.3.2.1; and (c) for the
establishment of a Special Purpose Account in accordance with ¶ 13.4.4. While
the amount of a Risk Pool’s Actual Risk Pool Balance may at times exceed its
Designated Risk Pool Balance (see e.g. ¶ 13.1.3), its Actual Risk
Pool Balance shall not be greater than the Designated Risk Pool Balance solely
as a result of an Annual or an Interim Automatic General Assessment.
13.1.3
Determination of Amount and
Use or Disposition of “Surplus” Money Held on Behalf of Liability and Property Pools. From time to time, and for various reasons,
the amount of the Liability or Property Pool’s Actual Risk Pool Balance may
exceed the level of its Designated Risk Pool Balance, thereby creating a
“Surplus”. Such Surplus may be used for
any purpose for which the Actual Risk Pool Balance may be used; provided,
however, the Board may, by Super-Majority Vote, transfer some or all of such
Surplus to one or more Special Purpose Accounts as may exist or be created by
the Board in connection with the transfer; and provided further that,
notwithstanding the foregoing, the Board may, by Super-Majority Vote, determine
to distribute such Surplus to current Risk Pool Members in accordance with
¶ 13.1.4 below; and provided further that, to the extent the Actual Risk
Pool Balance (and, therefore, such Surplus) represents proceeds from Coverage
Litigation with an Excess Carrier, such monies shall be paid to the Members
whose claims were involved in the Coverage Litigation as provided in
¶ 15.9
13.1.4
Distribution of Surplus to
Members. By Majority Vote,
the Board shall determine the methodology for the allocation of any Surplus the
Board has, by Super-Majority Vote (see ¶ 13.1.3), determined should
be distributed to current Risk Pool Members.
The methodology chosen should take into consideration the source or
cause of the Surplus and should be designed as much as possible to return the
Surplus to the Members in such a manner as to avoid windfalls or penalties to
Members in relationship to such source or cause. For example, if the Surplus was generated by
payments recovered from a Former Member for back Assessment Shares the Former
Member failed to pay after its Withdrawal Date, the following methodology would
be reasonable: The total of the
Assessment Shares each Member paid for General Assessments during the relevant
time period (i.e., from the Former Member’s Withdrawal Date to the date
the Former Member paid such Assessments to the Fund), would be divided by the
total amount of General Assessments all Members paid during that relevant time
period, and the ratio resulting for each Member would then be multiplied by the
Surplus amount to establish the amount to be returned to each Member.
13.1.5
Allocation of Administrative
Expenses Among Risk Pools.
Each Risk Pool shall be responsible for financing its own Operational
Costs, including its Direct Administrative Expenses the Fund incurs in
connection with the operation of that Risk Pool, and its allocation of Shared
Administrative Expenses. All
Administrative Expenses that are not Direct shall be deemed Shared
Administrative Expenses. The Administrator,
in the first instance, subject to modification by the Administrative Committee,
shall determine whether a particular Administrative Expense is to be treated as
Direct or Shared. If an Administrative
Expense is Shared, it shall be allocated pro rata against the respective
Operational Costs of each of the Fund’s Risk Pools; provided, however, if there
is a reasonable basis for allocating a Shared Administrative Expense among the
Risk Pools in a proportion other than pro rata, the Administrator shall make
such non-pro rata allocation, subject to modification by the Administrative
Committee; and provided further, and notwithstanding the preceding clauses, at
the beginning of each calendar year the Administrative Committee shall (and at
any other times deemed appropriate, the Administrative Committee may) establish
the relative percentage of Shared Administrative Expenses to be allocated among
the respective Risk Pools based on prior experience regarding the relative
consumption of administrative services among the Risk Pools. Members shall be provided with reasonable
notice of any such percentage allocation of Shared Administrative Expenses
established by the Administrative Committee, and any modifications thereof. Any
allocation of Shared Administrative Expenses may be modified retroactively or
prospectively by the Board at any time by Majority Vote.
13.2
H&W Risk Pool Reserves.
13.2.1
H&W Pool Reserves Funded
by Initial Deposits. Prior to
commencement of the H&W Pool’s operation, each Initial H&W Member shall
pay the amount of its Initial Deposit to the Administrator. The amount of each Initial H&W Member’s
Initial Deposit is calculated to approximate three (3) months of reasonably
expected H&W Claims Experience for that Member (see Definition of
“Initial Deposit”, § II). As a
result, the total of all Initial Deposits of all Initial H&W Members should
approximate three (3) months of H&W Claims Experience for all Members, and
therefore, for the H&W Pool.
13.2.2
Adjustments to Amounts of
Initial Deposits. Every three
(3) years, and sooner if deemed appropriate by the Administrative Committee, the
amount of each Member’s Initial Deposit shall be reevaluated as to whether it
continues to approximate three (3) months of reasonably expected H&W Claims
Experience for that Member. Subject to
the Appeal Procedures in ¶ 19, the Administrative Committee may increase
or decrease the amount of a Member’s Initial Deposit to more accurately reflect
such Member’s current anticipated H&W Claims Experience. The Member shall pay the amount of any
increase in its Initial Deposit within sixty (60) days of notice thereof by the
Administrative Committee, even if the Member Appeals the increase. Upon request, the Administrator shall provide
the Member with the back-up data relating to the decision to make the increase
and the amount thereof. If the
adjustment is a decrease in the amount of a Member’s Initial Deposit, the
amount of the decrease shall be paid to the Member within sixty (60) days of
the date of the Administrative Committee’s decision.
13.2.3
Monthly H&W Assessments to
Maintain H&W Pool Reserves.
The Monthly H&W Assessments mandated for each Member of the H&W
Pool (as provided in § I, ¶ 13.4.5 and § XV, ¶ 2) are
designed to reimburse the H&W Pool each month for the prior month’s
expenditures on H&W Pool Operational Costs, which includes all H&W
Claims Costs. Members must pay such
Assessments in full within twenty (20) days of receiving written notice thereof
in accordance with and subject to the remedies provided for the Fund in
¶¶ 13.6 and 13.7 re “Assessments”.
As a result of this Assessment methodology, the authority of the H&W
Pool to make any adjustments deemed necessary to the amounts of Members’
Initial Deposits (see ¶ 13.2.2), and the Fund’s remedies for a
Member’s failure to timely pay its Monthly H&W Assessment in full (see
¶ 13.7), the H&W Pool Reserves should consistently approximate three
(3) months of H&W Claims Experience for all Members of the H&W Pool.
13.2.4
Ownership of Initial Deposits
and Uses of the H&W Pool Reserves.
13.2.4.1
Ownership of Initial Deposits. At all times, the
monies constituting each Member’s Initial Deposit, as replenished from time to
time under the terms of the H&W General Assessment Formula, shall be owned
by the Fund and, although such monies are held by the Fund for the benefit of
the H&W Pool and its Members, no H&W Pool Member shall have any right,
title or interest in or to such monies (see § I, ¶ 4.5);
provided, however, such Members shall have such rights as are provided in
¶ 20.3.2 regarding refund of the Initial Deposit to a Member that
withdraws from the H&W Pool, and as provided in ¶ 21.5.2 regarding
Dissolution of the H&W Pool. At no
time shall an H&W Pool Member be entitled to interest on the amount of its
Initial Deposit or Adjusted Initial Deposit, except as otherwise provided in
¶ 20.3.2 regarding the Fund’s late payment of a refund of a Former
Member’s Initial Deposit.
13.2.4.2
Uses of H&W Pool Reserves. The Assets
constituting the H&W Pool Reserves shall be used only to pay H&W Pool
Operational Costs; provided, however, that such Reserves may also be used to
make Inter-Pool Loans in accordance with ¶ 13.3.1, or for Program Development
in accordance with ¶ 13.3.2.
13.2.5
Determination of Amount and
Use or Disposition of “Surplus” Money Held on Behalf of H&W Pool. There shall be
deemed to be a “Surplus” in the H&W Pool if, and when, and to the extent
that the monies held on behalf of the H&W Pool exceed the total of the
amount of all H&W Members’ Initial Deposits, or current Adjusted Initial
Deposits, as applicable, times 133 (%) percent. If and to the extent the
H&W Pool ever develops a Surplus, the uses of such Surplus shall be
governed by the terms of this ¶ 13.2.5, the terms of ¶ 13.1.3 with respect to
all matters addressed there except how the “Surplus” is determined, and ¶13.1.4
with respect to distribution of a Surplus to Members, as if such Surplus
represented money in excess of a Designated Risk Pool Balance.
13.3
Short-Term Inter-Pool Loans;
Authority for Financing the Development of Additional Programs.
13.3.1
Short-Term Inter-Pool Loans.
13.3.1.1
Liability or Property Pools as Loaning Risk Pools.
If deemed reasonably necessary or appropriate by the Administrative Committee,
with the approval of the Executive Committee, which approval may be given in
separate telephone discussions with the Administrator, an Inter-Pool Loan may
be made by one Risk Pool to another for the short term financial needs of the
Borrowing Risk Pool, to be repaid in full within one hundred and eighty (180)
days, together with interest thereon measured by the amount of interest the
Loaning Risk Pool lost based on the average investment return the Loaning Risk
Pool was realizing on its assets at the time the Loan was made; provided,
however, that such Inter-Pool Loans shall only be made by the Loaning Risk Pool
if, and only to the extent, such Loans are from assets or monies clearly in
excess of liabilities for unpaid Claims and Claims adjustment expenses. Within seven (7) days of the occurrence
of an Inter-Pool Loan, the Administrator shall provide written notice thereof
to all Fund Members, explaining the reasons therefore. All Members of the Borrowing Risk Pool shall
be subject to one or more Discretionary General Assessments under
¶ 13.4.3, in addition to all other Assessments normally required, to be
paid at times specified by the Board, in order to repay the Inter-Pool Loan.
13.3.1.2
H&W Pool as Loaning Risk Pool. With respect
to any Inter-Pool Loan by the H&W Pool as the Loaning Risk Pool, the
conditions, terms and procedures set forth in ¶ 13.3.1.1 shall apply, and in
addition:
(a)
Any such Inter-Pool Loan shall not unreasonably impair the Reserves or the
H&W Pool’s ability to pay its debts as they become due, as determined in
the judgment of the Executive Committee (see ¶ 13.2.4.2);
(b)
In any event, no such Inter-Pool Loan shall be made that reduces the Reserves
to an amount less than 2 times the average of the monthly H&W Pool
Operational Costs, based on the previous six (6) months;
(c)
At the time such Inter-Pool Loan is made, and subject to the Appeal Procedures
in ¶ 19, the Executive Committee shall adopt an Assessment Methodology, and
provide H&W Pool Members with notice thereof, that will govern
replenishment of the H&W Pool Reserves to the level contemplated in ¶
13.2.1 in the event the Inter-Pool Loan is not repaid in full within the 180
days, as provided for in ¶ 13.3.1.1, or if, in the interim, it appears in the
judgment of the Executive Committee that the H&W Pool will imminently be
unable to pay its debts as they become due.
13.3.2.
Authority for Financing the
Development of Expanded or Additional Programs.
13.3.2.1.
Liability and Property Pools.
Notwithstanding the general restriction in the SIA that the Assets of a
particular Risk Pool shall be used only for the benefit of the Members of that
Risk Pool (see ¶¶ 4.5.1, 13.1.2 and 13.2.4), by Super-Majority Vote, the
Board may authorize and/or allocate the use of portions of existing or future
monies in the Actual Risk Pool Balance(s) of the Liability and/or Property
Pools for Program Development, including without limitation, the development or
establishment of additional or expanded self-insurance,
or other types of insurance, bonding, or risk management programs that, at the
time of the expenditures, may not directly benefit the current Members of such
Risk Pools, but which Programs will ultimately be available to all Members of
the Fund; provided, however, that the provisions of ¶¶ 4.4.2 and 6.3.1 shall
apply with respect to Votes on issues affecting a particular Risk Pool; and
provided further, that such use of the Actual Risk Pool Balance shall
not unreasonably impair the Liability or Property Pool’s ability to pay its
debts as they become due. The Actual Risk
Pool Balance(s) shall be replenished for any such expenditures in the normal
course through Assessments under the applicable General Assessment Formulas, or
may be replenished through one or more Discretionary General Assessments.
13.3.2.2.
H&W Pool. By Super Majority Vote, the Board may authorize
and/or allocate the use of portions of the H&W Pool Reserves for Program
Development under the circumstances and terms described in ¶ 13.3.2.1; provided,
however, that at the time of approving such use, the Board shall also
adopt an Assessment Methodology that will provide for replenishment within a
reasonable time of the portions of the H&W Reserves used for such Program
Development so that the H&W Pool Reserves are returned to and maintained at
approximately the level contemplated in ¶ 13.2.1; and provided further, that
such use of the H&W Pool Reserves shall not unreasonably impair the
Reserves or the H&W Pool’s ability to pay its debts as they become due.
13.4
Assessments.
13.4.1
Interim Automatic General
Assessments re Liability and Property Pools.
13.4.1(a)
Liability Pool. Except as
provided in ¶ 13.8.2(b), whenever the Actual Risk Pool Balance for the
Liability Pool is more than $500,000 below that Risk Pool’s Designated Risk
Pool Balance, there shall be an Interim Automatic General Assessment equal to
the amount by which the Actual Risk Pool Balance is less than the Designated
Risk Pool Balance on the date of the Assessment.
13.4.1(b)
Property Pool. Except as provided
in ¶ 13.8.2(b), whenever the Actual Risk Pool Balance for the Property
Pool is more than the amount of the currently applicable Property Coverage
Limit below that Risk Pool’s Designated Risk Pool Balance, there shall be an
Interim Automatic General Assessment equal to the amount by which the Actual
Risk Pool Balance is less than the Designated Risk Pool Balance on the date of
the Assessment.
13.4.2
Annual Automatic General
Assessments re Liability and Property Pools. At the beginning of each calendar year,
Annual Automatic General Assessments shall be levied for the Liability and
Property Pools in amounts necessary to make each Risk Pool’s Actual Risk Pool
Balance equal to its Designated Risk Pool Balance.
13.4.3
Discretionary General
Assessments re All Risk Pools.
13.4.3.1
Liability and Property Pools. With respect to
the Liability and Property Pools, by Majority Vote, the Board may levy a
Discretionary General Assessment at any time and in whatever amount the Board
shall determine, and the monies collected therefore shall be added to the
Actual Risk Pool Balance of the Liability Pool or Property Pool, as applicable;
provided, however, that any Discretionary General Assessment which would
increase the Liability or Property Pool’s Actual Risk Pool Balance to an amount
greater than its Designated Risk Pool Balance must be approved by
Super-Majority Vote; and provided further, that the foregoing requirement of a
Super-Majority Vote shall not apply to Discretionary General Assessments levied
in connection with the dissolution of the Liability or Property Pool after the
Dissolution Vote to dissolve such Risk Pool has taken place.
13.4.3.2
H&W Pool. At any time, by Super-Majority
Vote, the Board may levy a Discretionary General Assessment on the Members of
the H&W Pool in whatever amount the Board shall determine and the monies
collected therefore shall be added to the H&W Pool Reserves; provided
however, that no such Discretionary General Assessment shall increase the
H&W Pool Reserves to an amount greater than five (5) times the average
monthly H&W Claims Experience over the most recent twelve (12) months
period; and provided further, that said Super-Majority Vote shall also
establish an Assessment Methodology that would govern such Assessment, which in
the absence of agreement by Super-Majority Vote shall be the current H&W
General Assessment Formula; and provided further, that the requirements of a
Super-Majority Vote in this sub-¶ shall not apply to Discretionary General
Assessments levied in connection with the dissolution of the H&W Pool after
the Dissolution Vote to dissolve such Risk Pool has taken place, and in lieu
thereof shall be a Majority Vote requirement.
13.4.4
Special Purpose Account,
Special Purpose Assessments and Other Funding Mechanisms. At any
time, with respect to any one or more Risk Pools, by Super-Majority Vote, the
Board may: (a) establish a Special Purpose Account; (b) determine and authorize
the maximum amount of funding for such Account; (c) determine whether such
funding shall be by Special Purpose Assessment(s) under this ¶ 13.4.4, or by
some other funding methodology [e.g., by Discretionary General Assessments
pursuant to ¶ 13.4.3, or by the transfer or use of a specified amount of
existing or future Assets from the Actual Risk Pool Balance(s) or H&W Reserves
of one or more Risk Pools for Program Development under ¶ 13.3.2 (if the
purpose of establishing the Special Purpose Account is consistent with Program
Development), or by transfer of some or all of a Surplus under ¶¶ 13.1.3,
13.1.4 and/or 13.2.5], or by some specified and approved combination of funding
methodologies; and (d) if the funding is to be by Special Purpose
Assessment(s), establish the Assessment Methodology therefore.
Once the Special
Purpose Account and the method of funding therefore have been established by
Super Majority Vote, if the funding is to be in whole or in part by Special
Purpose Assessment(s), by Majority Vote, the Board may determine the amount(s)
of and levy one or more Special Purpose Assessments of the Members of such Risk
Pool(s) to finance that Account; provided, that such Assessments shall not
increase the money in such Account to an amount greater than the funding level
therefore originally established by Super-Majority Vote.
The Assessments
collected for the Special Purpose Account shall only be used for the purposes
for which the Account was created, which may include but shall not be limited
to, establishing additional reserves for payment of Covered Claims, or creating
the financial base for increasing a Risk Pool’s Coverage Limit, or developing
or establishing additional Risk Pools or other Fund Programs; provided,
however, that by Super-Majority Vote the Board may transfer all or a portion of
the money allocated to or held in a Special Purpose Account to the Actual Risk
Pool Balance or Reserves of the Risk Pool(s) that generated the money, in
proportion thereto, or return it to the Members of the appropriate Risk Pool in
accordance with ¶ 13.1.4 above.
Monies allocated to or held in any Special Purpose Account shall not be
counted in determining the level of any Risk Pool’s Actual Risk Pool Balance or
Reserves, or the need for or amount of any Assessment, and shall be identified
on the Fund’s Financial Statements as a line item separate from the Actual Risk
Pool Balance or H&W Pool Reserves, as applicable.
13.4.5
Monthly H&W Assessments
for H&W Pool. Each month,
to replenish the H&W Pool for the preceding month’s H&W Pool
Operational Costs, each Member of the H&W Pool shall pay its Monthly
H&W Assessment within twenty (20) days of receiving written notice
thereof. Each Monthly H&W Assessment
shall be composed of: (a) the
Direct H&W Claims Costs incurred with respect to a Member’s Eligible
Employees and Dependents (which are passed through directly to the Member,
unless and until they qualify for treatment as Shared H&W Claims); and
(b) the Member’s H&W Assessment Share of the Shared H&W Costs
(e.g., Administrative Expenses, Stop Loss Insurance Premiums, PPO Charges, and
Shared H&W Claims) calculated under the H&W General Assessment
Formula. (See § XV,
¶ 2).
13.5
Assessment Formulas.
13.5.1
General Assessment Formulas. The Fund shall have an established General
Assessment Formula for each of its Risk Pools to be used to calculate the
Assessment Share of each Member for General Assessments relating to each Risk
Pool. The Liability General Assessment
Formula is set forth separately in § VIII and is incorporated herein by
this reference as if fully set forth.
The Property General Assessment Formula is set forth separately in
§ XII and is incorporated herein by this reference as if fully set
forth. The H&W Pool General
Assessment Formula is set forth separately in § XV and is incorporated
herein by this reference as if fully set forth.
The Board may from time to time amend these General Assessment Formulas
by Super-Majority Vote and such change shall thereafter be reflected by an
amendment attached to this Agreement and in a revised General Assessment
Formula. The Assessment Share of each
Member for a General Assessment shall be calculated according to the General
Assessment Formula in effect at the time the General Assessment is made. Except as may be otherwise provided in
¶¶ 5.4.2.2, 14.5, and 20.2.1.1 and 20.2.1.3, each Member must pay its full
Assessment Share of all General Assessments; provided, however, that any Member
of the Property Pool that establishes one or more of its Assigned Deductibles
for Insured Property listed in the Schedule of Values at amounts equal to the
Fund’s Property Coverage Limit shall only be responsible for paying its
Assessment Share of a Property General Assessment to replenish the Actual
Property Pool Balance as follows:
(a) for Property Coverage Payments and Property Claim Costs, based
on the total of the Insured Values for the Member’s Insured Property with
Assigned Deductibles of amounts less than the Property Coverage Limit; and
(b) for Direct and Shared Administrative Expenses attributable to the
Property Pool, based on the total Insured Value for all of the Member’s Insured
Property, regardless of the amounts of the Assigned Deductibles applicable
thereto.
13.5.2
Premium Assessment Formulas. The Fund shall have an established Premium
Assessment Formula for its Liability and Property Pools to be used to calculate
each Member’s Assessment Share of a Premium Assessment relating to each such
Risk Pool. The Liability Premium
Assessment Formula is set forth separately in § IX and is incorporated
herein by this reference as if fully set forth.
The Property Premium Assessment Formula is set forth separately in
§ XIII and is incorporated herein by this reference as if fully set
forth. The premium cost for Stop Loss
Insurance for the H&W Pool is included in H&W Pool Members’ Monthly
H&W Assessments under the H&W General Assessment Formula (see
§ XV), and therefore, the H&W Pool does not have a separate Premium
Assessment Formula. The Board may from
time to time amend the Premium Assessment Formulas by Super-Majority Vote, and
such change shall thereafter be reflected in an amendment attached to this
Agreement and in a revised Premium Assessment Formula. Upon determining the amount of the premium
for any Excess Coverage procured by the Fund for the Liability and/or Property
Pools pursuant to the terms of ¶¶ 14.1 or 14.2, as applicable, the Board
shall levy a Premium Assessment equal to the amount of the premium to be paid
by the Fund. Except as may be otherwise
provided in ¶ 14.1.1 and ¶ 20.2.1.2, and in ¶ 16.1(E) of the
Operational Rules, each Member must pay its Assessment Share of all Premium
Assessments; provided, however, that a Member’s Assessment Share of a Property
Premium Assessment shall be based on the total Insured Value of all Insured
Property, regardless of the amounts of the Assigned Deductibles applicable
thereto; and provided, further, that a Member shall not have to pay any
Assessment Share of a Property Premium Assessment if, at the time of such
Assessment, the Total Insured Value of the Member’s Insured Property is less
than the amount of the Property Coverage Limit.
13.5.3
Reserves Assessment Formula
for Property Pool. The
Reserves necessary to commence operation of the Property Pool, and any
additional Reserves required as a result of increases in the Designated
Property Pool Balance, shall be collected pursuant to Reserves Assessments. The Reserves Assessment Formula shall
be: The Property General Assessment
Formula, applied to the Insured Value of all of a Member’s Insured Property to
the extent such Property has an Insured Value of less than the Property Coverage
Limit, without application of the Annual Assessment Limit (see
§ XII, ¶ 4), and without consideration of the amounts of the Member’s
Assigned Deductibles for its Insured Property below the amount of the Property
Coverage Limit.
13.6
Payment of
Assessments/Interest. General
Assessments for the Liability and Property Pools shall be due and paid within
thirty (30) days following receipt of written notice thereof. General Assessments for the H&W Pool (i.e.,
the “Monthly H&W Assessments”) shall be due and paid within
twenty (20) days of receiving written notice thereof (as provided more
particularly in ¶¶ 13.2.3 and 13.4.5).
Premium Assessments, Discretionary General Assessments (see
¶ 13.4.3), Special Purpose Assessments (see ¶ 13.4.4) and any
other types of Assessments shall be due and paid on or before the date
specified in the notice provided to Members.
If a Member fails to pay its Assessment Share of any Assessment when
due, the amount owed shall thereafter accrue interest at the rate of five
percent (5%) over the Treasury Bill Rate established as of December 31 of
year prior to the year of the Member’s default on the Assessment, or the rate
provided by Washington statutes for judgments not founded upon written
contracts (currently, RCW 4.56.110(2)) whichever is greater, from the date
due until paid.
13.7
Remedies for Unpaid
Assessments. If a Member of
any Risk Pool fails to pay its Assessment Share of any Assessment by the Date
of Default, in addition to any other remedies available under this Agreement or
as provided by law, the Fund shall have the following remedies:
(a) Setoff. The amount of the defaulting Member’s
indebtedness to the Fund, together with accruing interest, shall be offset
against any amounts the Fund then or at any time thereafter owes to or on
behalf of such Member or any of its Employees, for so long as such indebtedness
exists.
(b) Irrevocable Suspension of Liability or
Property Coverage During Loss of Coverage Period. Unless the remaining balance of all amounts
in default, including interest thereon, and any costs and attorneys fees the
Fund has incurred in connection with such default, are paid in full within 180
days of the Date of Default or, in the Board’s sole discretion, are otherwise
resolved or provided for to the satisfaction of the Board by Majority Vote, the
Fund shall have no obligation to provide Coverage for or pay Defense Costs or
Property Claim Costs with respect to any Claim made by or against the
defaulting Member or any of its Employees, as applicable, resulting from a Loss
Event which takes place during the period beginning 180 days after the Date of
Default and continuing until all amounts in default, including accrued interest
thereon and the Fund’s costs and attorneys fees incurred with respect thereto,
are paid in full. Upon such payment in
full, such Member’s Coverage with respect to such Risk Pool shall be reinstated
prospectively, as of the date of such full payment, but such Member and/or its
Employees, as applicable, shall not be entitled to Coverage for any Claims that
arise out of Loss Events that occurred during such Loss of Coverage
Period. Notwithstanding the irrevocable
suspension of the defaulting Member’s Coverage during the Loss of Coverage
Period, the Member shall remain liable for: (1) its Assessment Share of all
Assessments levied during such Loss of Coverage Period; (2) its Assessment
Share, whenever levied, of the Incurred Liabilities, Defense Costs, Property
Claim Costs, and all Direct Administrative Expenses related to resolving any
Loss Events that happen with respect to any and all other Members of the
defaulting Member’s Risk Pool during such Loss of Coverage Period; and (3) its
Assessment Share, whenever levied, of all Shared Administrative Expenses
incurred or paid during such Loss of Coverage Period.
(c) Termination of Membership. Unless all amounts in default, including
accrued interest thereon, and any costs and attorneys fees the Fund has
incurred in connection with such default, are paid within one (1) year of the
Date of Default or, in the Board’s sole discretion, are otherwise resolved or
provided for to the satisfaction of the Board by Majority Vote, the defaulting
Member shall automatically cease to be a Member of the Risk Pool as of the
first anniversary of its Date of Default.
In the event of such termination, the terminated Member shall have only
such rights and duties as are provided for a Former Member of such Risk Pool in
¶¶ 20.2 through 20.4.
(d) Suspension of H&W Claims Payments
and/or Loss of Coverage. In addition
to the remedies provided for in ¶¶ 13.7(a)‑(c) above, if a Member of
the H&W Pool fails to pay its Monthly H&W Assessment in full by the due
date, and after written notice from the Administrator regarding such failure,
if the Member fails to pay the balance due on such Assessment within twenty
(20) days from the date of receiving such notice, the H&W Pool shall have
authority to cease paying the H&W Claims of such Member’s Employees and
Dependents until such time as the Member’s default is completely cured,
including paying any accrued interest and Claim Resolution Costs due on the
delinquent Assessment; provided, however, that upon such payment in full (and
contrary to the Loss of Coverage provisions in ¶ 13.7(b) above), such
Member’s Coverage shall be reinstated retroactively to the date the Suspension
Period commenced; and provided further, that such Suspension of Coverage shall
become a Loss of Coverage 180 days after the Suspension Period commenced,
retroactive to the Suspension of Coverage Date, as provided in ¶ 13.7(b)
above.
13.8
Annual Assessment Limit.
13.8.1
Limit on General Assessments
for Liability and Property Pools.
Except as otherwise provided in this Agreement, the maximum amount a
Member of either the Liability or Property Pool may be required to pay in
General Assessments with respect to such Risk Pool in any one calendar year
shall equal the greater of: (1) 2%
of such Member’s Gross Revenues, or (2) an amount equal to 10% of the
total General Assessments levied by the Fund for that Risk Pool in the current
year divided by the total number of Members in the Risk Pool. Premium Assessments shall not be included
when determining whether a Member has paid its Annual Assessment Limit with
respect to the Liability or Property Pool, nor shall the Annual Assessment
Limit be applied to limit the amount of any Member’s Assessment Share of a
Premium Assessment for such Risk Pool.
The H&W Pool shall not have an Annual Assessment Limit.
13.8.2
Annual Assessment Limit Reset
and Additional Discretionary General Assessments for Liability and Property
Pools. If, during any
calendar year, all Members of the Liability or Property Pool reach their
respective Annual Assessment Limits:
(a)
The Formula Components for Liability General and Premium Assessments shall be
revised to reflect each Member’s Historical Claims Experience and Employee
Hours Worked as of the date all Liability Pool Members reached their Annual
Assessment Limits. The Formula
Components for Property General and Premium Assessments shall be updated, if
deemed reasonably necessary in the opinion of the Administrative Committee, as
of the date all Property Pool Members reached their Annual Assessment Limits;
(b)
For purposes of applying the Annual Assessment Limit for the remainder of the
year, the amount of Assessments paid by each Member of such Risk Pool for the
year to date shall be reset to zero, any Assessments levied thereafter for the
remainder of the calendar year shall be calculated as if a new calendar year
for the Risk Pool had commenced on the date all Members thereof reached their
Annual Assessment Limits;
(c)
There shall be no Interim Automatic General Assessments for that Risk Pool for
the remainder of the calendar year; provided however, that the Board may,
during the remainder of such calendar year, as deemed necessary, by Majority
Vote, levy one or more additional Discretionary General Assessments calculated
under the applicable General Assessment Formula with the updated Formula
Components, and each Member of that Risk Pool shall pay its Assessment Share
thereof; and
(d)
If the Administrative Committee determines that the Actual Risk Pool Balance
will not be sufficient to pay all of such Risk Pool’s obligations for the
remainder of the year, it shall so notify the Board of this conclusion and of
the amount of the expected shortfall, and the Board shall levy one or more
Discretionary General Assessments of the Members of such Risk Pool in amounts
sufficient to pay the projected shortfall in such Risk Pool’s financial
obligations for the remainder of such year.
14.
Fund’s Excess Coverages.
14.1
Mandatory Primary Excess and
Other Excess Coverages for Liability and Property Pools.
14.1.1
Minimum Excess
Coverage/Mandatory Member Participation. On behalf of the Liability Pool and its
Members, the Fund shall purchase Primary Liability Excess Coverage in an amount
not less than Five Hundred Thousand Dollars ($500,000.00), with an Attachment
Point at the Fund’s Liability Coverage Limit, from whatever Excess Carriers the
Board shall determine. On behalf of the
Property Pool and its Members, the Fund shall purchase Primary Property Excess
Coverage in an amount determined by the Board, in its discretion, with an
Attachment Point at the Fund’s Property Coverage Limit, from whatever Excess
Carriers the Board shall determine; provided, however, in determining the
amount of Primary Excess Property Coverage to acquire, the Board shall give
consideration to, but shall not be bound by, the total Insured Value of the
largest Member of the Property Pool based on the total value of its Insured
Property. In acquiring the Fund’s Primary
Excess Coverages, the Board shall make a reasonable attempt, given the
coverages available and the costs thereof, to minimize the differences in the
scope and nature of the coverage provided by the Primary Excess Coverage as
compared to the Coverage provided under the SIA; provided, however, the Board
shall have the reasonable discretion to omit Excess Coverage for any risks,
including risks for which Coverage is provided under the SIA, or to acquire
Excess Coverage that is broader for particular risks than the Coverage provided
by the SIA. All Members of the Liability
and Property Pools shall participate in the Excess Insurance the Board has
designated as the Fund’s Primary Excess Coverage for their respective Risk
Pools and shall pay their Assessment Shares of any Premium Assessments levied
to pay the premiums for such Excess Coverage, as provided in ¶ 13.5.2;
provided, however, that a Member of the Property Pool whose Insured Property
listed in the Schedule of Values has a total Insured Value of less than the
amount of the Property Coverage Limit shall not be required to participate in
any Excess Property Coverage or to pay its Assessment Share of any Property
Premium Assessments.
14.1.2
Multiple-Layer Primary Excess
Coverage. Subject to the
requirements of ¶ 14.1.1 above, the Board may, by Two-Thirds Vote, acquire
Primary Excess Coverage consisting of one or more Layers of Coverage having
different coverage limits, from either the same or different Excess Carriers;
provided, however, that every Member of the Risk Pool acquiring multiple-layer
Primary Excess Coverage shall participate in, and pay its Assessment Share of
the premium for, at least the first Layer of Coverage excess of the Fund’s
applicable Coverage Limit. The Members
participating in each Layer of Coverage above the first Layer shall be treated
as a separate Subgroup for purposes of determining Members’ Assessment Shares
of the Excess Premium attributable to their Layer, as provided in Op. Rules,
§ I, ¶ 16.1(E). Members that
fail to timely notify the Administrator which Layer of Coverage they wish to
participate in shall be deemed to have elected to participate only in the first
Layer of Coverage excess of the Fund’s Coverage Limit. By Majority Vote, the Board may apply any of
the provisions in ¶ 16 and Op. Rules, § I, ¶ 16.1 governing
Subgroups to the acquisition of Primary Excess Coverage in layers under this
¶ 14.1.2.
14.1.3
Establishment of Different
Coverage Limits for Specific Types of Fund Coverages. By Majority Vote, the Board may decrease prospectively
the amount of any Coverage Limit otherwise applicable for specific types of
Liability or Property Coverage offered by the Fund; provided that comparable
Excess Coverage is acquired that attaches and becomes effective at the lower
Coverage Limit for such specific types of coverage. By Super-Majority Vote, the Board may
increase prospectively the amount of any Coverage Limit otherwise applicable
for specific types of Liability or Property Coverage, provided that comparable
Excess Coverage is acquired that attaches and becomes effective at such higher
Coverage Limit for such specific types of coverage.
14.2
Supplemental Excess Coverage
for Liability and Property Pools.
14.2.1
Stop-Loss Insurance. The Fund may by Majority Vote purchase
Liability and/or Property Stop-Loss Insurance in whatever amount and from
whatever Excess Carrier the Board decides, unless the Board determines that the
cost of such insurance is unreasonably high and substantially exceeds its value
to the Fund. All Members of the Risk
Pool(s) benefiting therefrom shall be required to pay
their Assessment Shares of the premium for such Stop-Loss Insurance which shall
be calculated under the applicable Premium Assessment Formula.
14.2.2
Compulsory Participation in
Other Excess Insurance. By
Super-Majority Vote, the Board may direct the Fund to purchase any other
Supplemental Excess Coverage which the Board determines to be reasonably
necessary for the protection of the Members of the Liability and/or Property
Pool and/or their Employees. All Members
of the Risk Pool(s) benefiting therefrom shall be
required to pay their Assessment Shares of the Premium Assessments levied to
pay the premiums for such Excess Insurance which shall be calculated under the
applicable Premium Assessment Formula.
14.3
Mandatory Stop Loss Insurance
for H&W Pool. On behalf
of the H&W Pool and its Members, the Fund shall purchase Stop Loss
Insurance with H&W Pool Aggregate and Individual Stop Loss Points
acceptable to the Board. In acquiring
such Stop Loss Insurance, the Board shall make a reasonable attempt, given the
coverages available and the costs thereof, to ensure such Stop Loss Insurance
is following form to the H&W Coverage set forth in any and all H&W Pool
Members’ Coverage Booklets as of the effective date of such Stop Loss Policy. Members of the H&W Pool shall pay the
Stop Loss Insurance Premium therefore as a Shared H&W Cost as a part of
their respective Monthly H&W Assessments, as provided in § XV,
¶ 2.
14.4
Allocation of Expenses
Relating to Fund Excess Insurance and Stop Loss Insurance. The Fund shall pay and allocate to the
appropriate Risk Pool all Administrative Expenses arising from or incurred in
connection with any Excess or Stop Loss Insurance purchased by the Fund under
¶¶ 14.1, 14.2, and 14.3. The Fund
shall similarly pay all expenses and legal fees incurred in connection with
Coverage Litigation with any Excess or Stop Loss Carrier, as provided in
¶ 15.7 below, and allocate such costs and fees to the Risk Pool benefiting
therefrom.
14.5
Board Authority to Provide
Coverage for Gaps Relating to Primary Excess Insurance. By Super-Majority Vote, the Board may
authorize the Liability or Property Pool to provide Coverage, either
prospectively, or retroactively with respect to Loss Events that have already
taken place, for all or a portion of any gap between the Risk Pool’s Coverage
Limit and the Attachment Point of the coverage provided by a Primary Excess
Policy, or any “gap” resulting from a Primary Excess Policy providing the same
type of coverage but narrower in scope than that provided under the SIA;
provided, however, that this authority shall not be used to provide Coverage
through the Fund for a Claim that is in excess of the applicable Coverage Limit
to the extent it is for a type of Claim that is excluded under the applicable
Primary Excess Policy; and provided further, that any Member that voted against
providing the additional Coverage and that gives notice of its intent to
withdraw from the Risk Pool under ¶ 20.1 within 30 days of the Board’s
vote to adopt the Coverage shall not be entitled to such Coverage and shall be
exempt through the end of the calendar year of its withdrawal from paying its
Assessment Share of the portion of any General Assessment relating to Coverage
Payments, Defense Costs or Property Claim Costs the Fund pays for Covered
Claims arising from the additional Coverage, and shall remain exempt therefrom as a Former Member.
14.6
Individual Insurance. Nothing contained herein shall be construed
to limit the right of any Member, individually or in conjunction with any other
entity, including other Members of the Fund, to purchase insurance for the
benefit of itself or its own Employees; provided, however, that the Fund and
its Administrator shall have no responsibilities whatsoever with respect to
such insurance including procuring such insurance, submitting claims to the
insurer, or otherwise administering such insurance policy, and the Fund
specifically shall have no obligations with respect to any attorneys fees and
costs incurred in connection with any disputes regarding such insurance.
15.1
Right to Invoke Fund’s
Coverage Litigation Obligations.
A Member of any Risk Pool may request the Fund to pursue Coverage
Litigation against one or more Excess or Stop Loss Carriers if the Incurred
Liability for a Covered Liability Claim, or the Property Loss Amount for a
Covered Property Claim, is likely, or proven, to be in excess of the applicable
Coverage Limit or Coverage otherwise provided by the Fund, or where there is a
Colorable Dispute, as determined by the Administrative Committee; provided,
however, that the Board for the Risk Pool involved must approve the institution
of the Coverage Litigation by a Majority Vote.
An Employee may request the Fund to pursue Coverage Litigation under the
circumstances described in the foregoing sentence, but only with respect to
Liability Claims asserted solely against such Employee, or with respect to an
H&W Claim of such Employee or his/her Dependent, and then, only through the
Member and through a Representative appointed by the Member; provided, however,
that the Board for H&W Pool must approve the institution of the Coverage
Litigation by a Majority Vote. Insured Agents and Insured Volunteers that have
been named as Additional Insureds under an Excess Liability Policy shall have
no rights under this ¶ 15. Former
Members shall have only such rights under this ¶ 15 as are provided in
¶ 20.5.
15.2
Authority of Board and
Committees. The
Administrative Committee shall initially decide any issues relating to Coverage
Litigation (see Op. Rules, § I, ¶ 9.4.3(f)), subject to the
involvement of the Executive Committee and the Board pursuant to ¶¶ 9.2(b)
and 6.2.12, respectively.
15.3
Member Representative. The Member or Members whose Claims are
involved in the Coverage Litigation shall have the right to appoint a
Representative to the Administrative Committee with the rights and restrictions
as provided in § VII, ¶¶ 3.1 and 3.2.
15.4
Legal Counsel. The Administrative Committee shall select legal
counsel, which may be the Fund’s General Counsel or other attorneys, and shall
determine generally what actions counsel shall take. Counsel shall represent the Fund’s interests
and the interests of the Members that have claims involved in the Coverage Litigation.
15.5
Prosecution of Lawsuit. Any Members and/or Employees (and Former
Members, when applicable under ¶ 20.5) with claims involved in the
Coverage Litigation shall be deemed to have assigned to the Fund whatever
interests they might have under the Excess or Stop Loss Policy for coverage for
the Covered Claim. The Fund, through the
Administrative Committee, shall prosecute any Coverage Litigation on behalf of
such Members and/or Employees and distribute the Recovery Proceeds resulting
from the Coverage Litigation to the Members and/or Employees involved according
to ¶ 15.9 below. Notwithstanding
the foregoing, if its claim is independent and severable from those of any
other Members involved in the Coverage Litigation, as determined in the
discretion of the Administrative Committee, any Member, or Member and its
Employee, may prosecute its own suit against the Excess or Stop Loss Carrier to
recover any shortfall after exhaustion of Coverage provided under the SIA by
assuming its own legal expenses and waiving any rights to representation or
payment of legal costs by the Fund hereunder.
15.6
Joint Prosecution of Coverage
Litigation Under Reservation of Rights.
[RESERVED]
15.7
Legal Expenses. The Risk Pool involved shall pay for all
Coverage Litigation Costs the Fund incurs in connection with any Coverage
Litigation regarding a Colorable Dispute that the Board determines to pursue
against any of the Fund’s Excess or Stop Loss Carriers, including, but not
limited to, all attorneys’ fees and expenses arising from such Coverage
Litigation; provided, however, after initiating Coverage Litigation, the Board,
by Two-Thirds Vote, may determine that a Member’s Coverage dispute with an
Excess Carrier has ceased to be reasonable, in which event the Member seeking
coverage shall be responsible for any costs and legal fees thereafter incurred
in connection with any Coverage Litigation; and provided further, that the Risk
Pool involved shall reimburse such Member’s reasonable costs and attorney’s
fees thereafter incurred in the Coverage Litigation only as follows: if the Member obtains a judgment or settles
for an amount greater than 50% of the amount of its Claim (which Claim amount
shall be determined by the Administrative Committee after consultation with the
Member at the time the Risk Pool ceased financing the Coverage Litigation),
then the Risk Pool will reimburse at 100%; if the Member does not substantially
prevail at trial or settles for less than 50% of the amount of such Claim, then
the Risk Pool shall have no reimbursement obligation.
15.8
Settlement of Coverage
Litigation. Subject to
¶¶ 6.2.11 and 6.2.12, the Administrative Committee shall have the
authority provided and follow the procedures set forth in § VII,
¶ 6.1 in connection with settlement of any and all claims involved in the
Coverage Litigation.
15.9
Payment of Recovery Proceeds. The Recovery Proceeds received by the Fund on
behalf of the Members and/or Employees involved in the Coverage Litigation
shall be paid to or on behalf of such Members and/or Employees to the extent of
each’s
uncompensated Loss Amount; provided, however, that the Fund may retain
any Recovery Proceeds in excess of the total of all such Members’ and/or
Employees’ uncompensated Loss Amounts as reimbursement toward its Coverage
Litigation Costs. If the Net Recovery is
not sufficient to pay fully the uncompensated Loss Amounts of all the Members
and Employees with claims involved in the Coverage Litigation, it shall be paid
to each Member and/or Employee in the ratio of each’s
Loss Amount divided by the total Loss Amounts of all Members and/or
Employees. With respect to Coverage
Litigation relating to Liability Claims, the amounts the Fund incurred in costs
and legal fees in pursuing the Coverage Litigation, to the extent they are not
reimbursed to the Fund out of the Coverage Litigation, shall be allocated to
the Historical Claims Experience of the Members involved in accordance with
§ VIII, ¶ 4.2.1.
16
Subgroups and the Purchase of
Additional Excess or Stop Loss Insurance or Different Liability Insurance.
16.1
Subgroup Procedures and
Establishing Subgroup Participants.
In addition to the Primary Excess and Stop Loss Coverages the Fund
purchases on behalf of the Members of its various Risk Pools as required by
¶ 14.1 and ¶ 14.3, and any Supplemental Excess Coverages the Board
determines are reasonably necessary for the Fund to purchase on behalf of such
Members as permitted by ¶ 14.2, any two or more Members of a Risk Pool may
invoke these “Subgroup Procedures,” in accordance with the Operational Rules,
by which less than all Members of a Risk Pool may jointly purchase insurance
through the Fund with coverages in addition to those acquired by the Fund under
¶¶ 14.1 and 14.3. (The procedures
and rules governing the formation and operation of Subgroups are set forth in
detail in Op. Rules, § I, ¶ 16.)
17
Risk Management Program. This paragraph applies to all of the Fund’s
Risk Pools.
17.1
Authority and Adoption of
Programs. The Fund Board
shall establish and maintain a written Risk Management Program for the Liability
Pool and the Property Pool. Subject to
the Board’s authority under ¶ 6.2.11, the Administrative Committee shall
have the primary responsibility for implementation of the Programs. The Liability Risk Management Program shall
be designed to reduce the risks of losses from claims against Members (and/or
their Employees) and the legal exposure of the Fund through a program that may
include Member and Employee education, inspections of Members’ operations and
correction of risk problems discovered, review and supplementation of Members’
policies and procedures regarding subjects appropriately the focus of risk
management by the Fund, review and consultation with Members regarding
individual Member’s claims experience and remedying the causes of patterns of claims,
institution of more effective claims handling practices, and the implementation
of certain Loss Control Guidelines, among other things. The Property Risk Management Program shall be
designed to minimize the risks of Property Losses. Any risk management programs
relating to the H&W Pool shall be the responsibility of the respective
Members viv-a-vis their own Employees. The written
Liability and Property Risk Management Programs formulated by the
Administrative Committee shall be presented to the Board which may adopt all or
portions of such Programs by a Two-Thirds Vote.
Any Risk Management Program duly adopted by the Board pursuant to this
paragraph by Two-Thirds Vote shall be binding upon all Members and Employees,
and Members who violate any of the mandates of such Program shall be subject to
the procedures and Board Remedies set forth in ¶ 17.4 herein.
17.2
Formulation and Adoption of
Loss Control Guidelines. In
connection with the initial preparation of the Fund’s Risk Management Programs,
and thereafter, upon request of the Board or the Executive Committee, or from
time to time upon its own initiative, the Administrative Committee may
formulate Loss Control Guidelines which, if duly adopted by the Board by
Two-Thirds Vote, shall be binding upon all Members. The Loss Control Guidelines adopted by the
Board shall be deemed to establish the standards for certain aspects of
Members’ plant and/or business operations and shall be designed to reduce the
risks that particular types of losses will occur, or to reduce the severity of
such losses, or to increase the likelihood of successful Defense of Claims
arising from such losses. In formulating
and adopting Loss Control Guidelines, the Administrative Committee and Board
shall be guided by the following principles:
(a) Complying with the Fund’s obligations
regarding its Risk Management Program under State law;
(b) Balancing fairly the competing interests
of requiring fairness to all Risk Pool Members by ensuring that no Member’s
operations poses an unreasonable risk to the Fund in comparison to the
operations of other Members of the Risk Pool, versus ensuring that the Fund
does not unduly intrude on its Members’ prerogatives to control their own
business affairs; and
(c) Ensuring that any standards set are
reasonable to apply to all Members of the Risk Pool and that all such Members
can comply with reasonable effort and without unreasonable expense, given the
potential magnitude of the exposure presented by the Risk which is the subject
of the Guideline.
17.3
Members’ Actions Constituting
Violation of Risk Management Program. Members of any Risk Pool shall be subject to
the Board Remedies that may be imposed by a Two-Thirds Vote as set forth in
¶ 17.4 for engaging in the following actions or failures to act which
cause or fail to remedy Unreasonable Risks:
(a) Unreasonably failing to remedy any
Unreasonable Risk identified in a Member’s plant and/or operations as result of
a loss control review by the Fund, an agent of the Fund or the Fund’s Excess
Carriers before expiration of the Compliance Date identified in the Remediation
Letter sent to the Member by the Executive Committee;
(b) Unreasonably failing to correct any
violation by a Member of any Loss Control Guideline before expiration of the
Compliance Date identified in the Remediation Letter sent to the Member by the
Executive Committee;
(c) Unreasonably failing to correct any
pattern of acts or omissions that a Member has engaged in that has previously
caused at least one similar Loss Event before expiration of the Compliance Date
identified in the Remediation Letter sent to the Member by the Executive
Committee; or
(d) For any other reason recommended by the
Administrative Committee or Executive Committee and approved by the Board by
Super-Majority Vote.
17.4
Compliance Procedures and
Board Remedies for Violation of Risk Management Program.
17.4.1
Consultation with
Member/Issuance of Remediation Letter. Any time the Administrative Committee
determines that some aspect of a Member’s plant or operations presents an
Unreasonable Risk, the Committee shall so advise the Member in writing, stating
the date by which such Unreasonable Risk should be corrected or remedied. If, after such written notice from the
Administrative Committee, the Member fails to correct or remedy the Unreasonable
Risk within the time stated, the Administrative Committee shall meet with the
Member to determine why such Unreasonable Risk continues to exist and to
jointly explore with the Member methods for resolving the same. After such meeting, if the Administrative
Committee has not reached agreement with the Member satisfactory to the
Committee regarding resolution of the Unreasonable Risk, the Committee may
apply to the Executive Committee to authorize a Remediation Letter to be
prepared and sent by or on behalf of the Executive Committee to the
Member. At minimum, the Remediation
Letter shall: identify the nature of the
violation, describe the correction or remedy sought by the Fund, and state the
Compliance Date by which such correction or remedy should occur for the Member
to avoid possible imposition of Board Remedies under ¶ 17.4.2 herein.
17.4.2
Effect of Issuance of
Remediation Letter and Board Remedies for Violation. The Executive Committee’s issuance of a
Remediation Letter and the Member’s failure to correct or remedy the
Unreasonable Risk identified in the Remediation Letter by the Compliance Date
shall be preconditions to application of the Board Remedies provided for
hereunder. At any time after a Member has
received a Remediation Letter and the Compliance Date has expired without
correction or remediation of the Unreasonable Risk, the Board, in its sole
discretion, and at its own initiative or upon application by the Administrative
Committee or Executive Committee, may by Two-Thirds Vote:
(a) Deny Coverage from the Fund for any Claim
based on a Loss Event that arises out of the circumstances constituting the
Member’s violation any time on or after the date the Board votes to impose this
Board Remedy, as determined by the Board; or
(b) Terminate such Member’s membership in the
Risk Pool, or in the Fund, effective at the end of the calendar year in which
the Board votes to impose this Board Remedy, in which event the terminated
Member thereafter shall have only such rights and duties as are provided for a
Former Member in ¶ 20.
Notwithstanding any
other provisions in this ¶ 17, each Member shall retain ultimate control
of its own loss control efforts.
18.1
Admission.
Any Local Governmental Entity may be admitted as a New Member of one or
more of the Fund’s Risk Pools under the provisions set forth in the Operational
Rules upon approval by the full Board by Super-Majority Vote. Any New Member must also become a member of
the System.
18.2
Conditions to be Satisfied by New Member.
18.2.1
Conditions Applicable to All Risk Pools. Each New Member shall provide the
Administrator with an Authorizing Resolution, shall become a signatory to the
Interlocal Agreement, shall be bound by the provisions of the SIA and the
Operational Rules, and shall abide by any written conditions for the New
Member’s admission imposed by the Board.
The terms of the Board’s written approval of the New Member shall be
deemed accepted, effective and binding upon the New Member by such Member’s act
of joining the H&W Pool and participating in and accepting the benefits
thereunder. Furthermore, such terms are
binding on the New Member even if otherwise contrary to certain provisions of
the SIA.
18.2.2
Additional Conditions to Become New Member of
H&W Pool.
18.2.2.1
Information To Be Provided By New Member
Applicant. In connection with its
application for admission, the proposed New Member of the H&W Pool shall be
required to provide to the Administrative Committee information sufficient for
the Committee to calculate the amount of the Initial Deposit, in accordance
with ¶¶ 18.2.2.2, herein, that must be made by the New Member to become a
Member of the H&W Pool, together with any other information requested by
the Administrative Committee, including the information necessary to
preliminarily determine the results of application of the H&W General
Assessment Formula and Member Stop Loss Points to the New Member in connection
with the Committee’s review of the New Member’s application.
18.2.2.2
New Member’s Initial Deposit. As a condition of Membership in the H&W
Pool, the proposed New Member shall pay to the H&W Pool the amount of its
Initial Deposit, as determined by the Administrative Committee, prior to the
date H&W Coverage is first provided to the New Member. In determining the amount of the Initial
Deposit for a New Member, the Administrative Committee shall be guided by the
definition of “Initial Deposit” in § II, herein, but the Committee shall
have the discretion to increase or reduce the amount derived therefrom, subject to Board approval, based on the Committee’s
evaluation of the H&W Claims Experience likely to arise from the New Member
in the first three (3) months after the date the New Member proposes to join
the H&W Pool. The New Member’s
Initial Deposit shall be treated the same as Initial Members’ Initial Deposits
for all purposes, including the Withdrawal of the New Member from the H&W
Pool and upon Dissolution of the H&W Pool.
18.2.2.3
Effect of Admission of New Member, if any, Re Stop
Loss Insurance and Detrimental Impact on Existing Members. If the proposed effective date for the New
Member joining the H&W Pool is any time other than concurrent with
commencement of the Stop Loss Policy Year, in determining appropriate
conditions to propose to the Board for the New Member to join the H&W Pool,
the Administrative Committee shall consider what effect, if any, admission of
the New Member at that time would have on the Stop Loss Insurance in place, and
whether and to what extent such admission would likely otherwise have a
detrimental (or beneficial) financial impact on the existing Members of the
H&W Pool. In considering such
issues, the Administrative Committee shall be guided by the general policy
that, if reasonable under the circumstances, the New Member should bear some or
all of any increased costs arising from the Stop Loss Insurance as a result of
the New Member joining the H&W Pool.
To the extent there is any increase in the Stop Loss Rates for extending
coverage to the New Member, or other adverse financial impact on existing
H&W Pool Members, and to the extent such increase as it effects all
existing Members is not offset by conditions set by the Board for admission of
the New Member, all existing Members, including the New Member, shall share
such increase based on the number of their respective Eligible Employees if it
is a Per Capita Cost increase, and if otherwise, it shall be deemed a Shared
H&W Cost under the H&W General Assessment Formula. The respective Members, and not the H&W
Pool, shall be responsible for resolving any Stop Loss Rate increase issues
that may arise with their respective Eligible Employees as a result of such
increase.
18.2.2.4
Recalculation of Member Stop Loss Points if Stop
Loss Carrier Increases H&W Pool’s Stop Loss Points. If, as a result of admitting the New Member,
the Stop Loss Carrier imposes an increase in one or both of the H&W Pool’s
Stop Loss Points for extending coverage to the New Member, Members’
corresponding Stop Loss Points shall be recalculated and the new Stop Loss
Points shall become effective on the same date as the increases in the H&W
Pools Stop Loss Points imposed by the Stop Loss Carrier become effective. Thereafter, Members’ H&W Claims payments
accrued toward their respective Stop Loss Points shall be accounted for and
applied as if the increased Member Stop Loss Points were in effect at the
beginning of the Coverage Year; provided, however, that no retrospective
recalculations shall be made with respect to how H&W Claims already paid
prior to the effective date of the increased Stop Loss Points would have been
accounted for (i.e., whether they would have been paid as Direct H&W
Claims Cost vs. Shared H&W Costs) under the higher Stop Loss Points;
provided further, that if a Member has already previously reached a Stop Loss
Point in the Coverage Year, but has not accrued a sufficient amount of H&W
Claims Costs to satisfy the new, higher Stop Loss Point, such Member must pay
the additional H&W Claims Costs necessary to reach the higher Stop Loss
Point before its H&W Claims will again be treated as Shared H&W Costs;
and provided further, any resulting decrease in Member Stop Loss Points shall
be effective when the corresponding decreases in the H&W Pools’ Stop Loss
Points become effective, but there shall be no retrospective recalculations
regarding how Members’ H&W Claims would have been treated if the lower Stop
Loss Points had been effective since the beginning of the Coverage Year.
18.2.2.5
Operation of Stop Loss Points for New Member Joining
During Coverage Year. A new H&W
Member shall start with zero H&W Claims Costs accrued toward its Stop Loss
Points on its Date of Membership.
18.3
New Member Trial Period. Because it is not possible at the time of
admission of a New Member to anticipate all of the ramifications admission of
the New Member may have on the existing Members of the Risk Pool or on the
fairness of applying the Assessment Formulas provided for herein, each Risk
Pool shall have the right, by Unanimous Vote of its Board, excluding the vote
of the New Member, to terminate the New Member’s Membership in the Risk Pool
without cause, effective at the end of the Coverage Year in which the notice
thereof was given; provided that such written notice of termination shall be
given at least eleven (11) months prior to the end of the Coverage Year in
which the termination is to be effective; and provided further, that such
termination shall not be permitted after the end of the sixth (6th)
year from the New Member’s Date of Membership.
After the effective date of the termination, the New Member shall have
all of the rights and obligations of a Former Member under ¶ 18 herein.
18.4
Assessments.
Upon admission to one or more of the Fund’s Risk Pools, each New Member
shall be responsible for its Assessment Share of all Assessments levied
subsequent to the effective date of the New Member’s admission to the Risk
Pool; provided, however, that for a period of six (6) years following a New
Member’s admission to the Liability Pool, the New Member’s Assessment Share of
any Liability General Assessment to replenish the Actual Risk Pool Balance
shall not exceed its Assessment Share of all amounts paid by the Fund for
Coverage Payments, Defense Costs and Administrative Expenses attributable to
Post-Admission Loss Events; and provided, further, that all New Members of any
Risk Pool shall pay their Assessment Shares of any Special Purpose Assessments
levied in their Risk Pool subsequent to the effective date of their admission.
18.5
Readmission of Former Member. Any Former Member which applies for
re-admission to a Risk Pool shall be treated as a New Member to that Risk Pool
and subject to this ¶ 18.
19
Appeal Procedures and
Administrative Committee’s Primary Jurisdiction.
19.1
Primary Jurisdiction of
Administrative Committee and Exceptions Thereto. Subject to ¶ 6.2.11, the Administrative
Committee shall have Primary Jurisdiction over all issues relating to the
subjects identified as constituting the Administrative Committee’s authority
and responsibilities in Op. Rules, § I, ¶ 9.4.3, regardless of
whether the Administrative Committee has affirmatively made any decision or
taken any action with respect thereto. (See
also, ¶ 9.4.4). Any Members
wishing to raise any issues for decision with respect to such subjects shall
address them in the first instance to the Administrative Committee by
submitting them in writing to the Administrator; provided, however, that issues
otherwise subject to the Administrative Committee’s Primary Jurisdiction may be
addressed directly to the Board for decision in the first instance:
(a) As permitted by ¶ 7.6 in connection
with General Meetings; or
(b) As one of the stated purposes for calling
a Special Meeting under ¶ 7.2 or an Emergency Meeting under ¶ 7.3;
provided, however, that the Administrator determines from a telephone or other
poll of the Directors that, out of a Super-Majority of Directors contacted,
there is a Majority Vote to consider and decide the issue;
or, the Committee’s
authority with respect to such issue may be withdrawn by Majority Vote of the
Board at any time pursuant to ¶ 6.2.11.
19.2
Appeal Procedures.
19.2.1
Issues Subject to Mandatory
Appeal Procedures. These
Appeal Procedures shall apply to all Appeal Issues which are defined as:
(a) All issues relating to any Coverage
Determination;
(b) All
issues relating to subjects within the Administrative Committee’s Primary
Jurisdiction, regardless of whether the Administrative Committee has made any
decision or taken any action with respect thereto; and
(c) All
complaints, objections and grievances by any Member with respect to any
decisions made or action taken by the Administrative Committee on any subject,
regardless of whether the subject falls within the Administrative Committee’s
Primary Jurisdiction, or by the Executive Committee.
19.2.2
Exception to Appeal Procedures. Members that desire a hearing or a decision
by the Fund on any Appeal Issue shall comply with these Appeal Procedures;
provided, however, that Appeal Issues otherwise subject to these Appeal
Procedures may be addressed directly to the Board for decision by the methods
identified in the proviso contained in ¶ 19.1(a) or (b).
19.2.3
Standing to Appeal. Any Member may appeal any Appeal Issue from
any level of the Appeal Procedures, regardless of whether the Member previously
has been involved in the appeal or will be directly affected by the decision or
action under consideration. An Employee
may only appeal Appeal Issues relating to his/her own
Coverage Determination.
19.2.4
Modification of Requirements. The notice and other procedural requirements
contained in this ¶ 19.2 may be modified in accordance with Op. Rules,
§ I, ¶ 19.2.4.
19.2.5
Time Limits for Appeal. The time limits which Members or Employees
must adhere to in order to appeal an Appeal Issue are set forth in Op. Rules,
§ I, ¶ 19.2.5.
19.2.6
Appeal Representation and
Legal Counsel. Any Member
properly invoking these Appeal Procedures shall, for itself, or in the case of
a Request by an Employee, on behalf of its Employee, appoint a Representative
to be the spokesperson for the Member or Employee at all stages of the Appeal
Procedures. Subject to the restrictions
in § VII., ¶ 3.1.3, the Representative shall have the right to
participate in all non-privileged discussions and the right to vote in the
decisions of the Administrative and Executive Committees in connection with the
Appeal. Any tie vote shall be broken by the chairperson of the Operations
Committee. In addition, Members and
Employees shall be entitled, at their own expense, to representation by legal
counsel.
19.2.7
Processing of the Appeal. The procedures for processing an Appeal are
set forth in § I, ¶ 19.2.7 of the Operational Rules. Whether the full Board decides the Appeal
Issue or only the Directors of Members participating in the Risk Pool involved
shall be decided according to the principles set forth in ¶ 4.2.2. A Majority Vote shall decide the Appeal
Issue, unless a higher Voting Standard specifically applies to such Issue.
19.2.8
Exhaustion of Appeal
Procedures as Prerequisite to Arbitration. No Member or Employee may seek arbitration of
any issue under ¶ 24.4, or court resolution of any issue under
¶ 24.4.7 (except for subparagraphs (b) and (e) thereof), without first
exhausting all levels of the Appeal Procedures, or by other procedures in this
Agreement properly first addressing the issue to be arbitrated to the Board,
and providing a reasonable opportunity for the Board to decide the same. Any Member or Employee directly affected by
the Board Decision on the Appeal Issue may submit the Appeal Issue to binding
arbitration under ¶ 24.4, or to court resolution, as permitted by
¶ 24.4.7.
20
Withdrawal From a Risk Pool.
20.1
Notice of Intent to Withdraw.
20.1.1
Notice with Respect to
Liability and Property Pools.
Except under the special circumstances provided in ¶¶ 5.4.2.2 and
14.4, a Member may withdraw from a Risk Pool and cease to be a Member of that
Risk Pool, effective as of December 31 of any year, only by delivering written
notice of its intent to withdraw to the Administrator on or before October 1 of
the calendar year of withdrawal. If such
notice of intent to withdraw is not given in accordance with this ¶ 20.1,
the notice shall be ineffective and the Member giving such notice shall remain
a Member of the Risk Pool and subject to the SIA and all other Program
Documents, unless permitted to withdraw upon such terms and conditions as may
be imposed by the Board by Super-Majority Vote.
20.1.2 Notice with Respect to H&W Pool. A Member’s notice of intent to withdraw from
the H&W Pool shall be given in the manner provided in ¶ 20.1.1;
provided, however, that if the H&W Pool’s Coverage Year and Fiscal Year are
on a basis other than a calendar year (in order to conform to the period
covered by the Stop Loss Policy Year, see § XIV, ¶ 5), a
Member can only withdraw effective at the end of a Coverage Year, and a
Member’s written notice of intent to withdraw shall be given to the Administrator
on or before the 90th day preceding the end of such Coverage Year.
20.2
Obligations of Former Member
to the Fund.
20.2.1
Obligations to Former Member
with Respect to Liability and Property Pools.
20.2.1.1
Pre-Withdrawal General Assessments and Replenishment
of Actual Risk Pool Balance For Liability and Property Pools. A Former Member of the Liability or Property
Risk Pools shall be liable to the Fund for its Assessment Share of all General
Assessments levied for that Risk Pool prior to the Withdrawal Date. Interest shall accrue on any amounts not paid
when due as provided in ¶¶ 13.4. In
addition, a Former Member shall pay to the Fund an amount measured by what
would be its Assessment Share of an Interim Automatic General Assessment (but
without applying the Annual Assessment Limit) levied for the Risk Pool as of
the Withdrawal Date; provided that, with respect to the Property Pool, a Former
Member’s Assessment Share shall be based on the highest total Insured Value of
the Former Member’s Insured Property listed in the Schedule of Values at any
time in the calendar year of withdrawal.
Such amount shall be paid within thirty (30) days after the withdrawing
Member receives written notice of the amount thereof, and shall bear interest
at the rate provided in ¶ 13.4 if not paid when due. A Former Member shall have no obligation to
pay any share of any Special Purpose Assessments levied for the Risk Pool after
the Notice Date, except to the extent such assessments are for funding a
Special Purpose Account at a level established by the Board by Super-Majority
Vote prior to the Notice Date.
20.2.1.2
Premium Assessments. A Member which has given its notice of intent
to withdraw from a Risk Pool shall be liable for its Assessment Share of all
Premium Assessments levied for that Risk Pool for the purpose of paying the
premium for any Excess Insurance, Stop-Loss Insurance or Subgroup Policy under
which the Member or any of its Employees are or will be a beneficiary;
provided, however, that the Member may waive coverage, effective at any time after
the Notice Date, under any Excess Policy purchased by the Fund for the Risk
Pool. In Such event, the Member shall be
entitled to a credit against amounts which, as a Former Member, it becomes
obligated to pay pursuant to ¶¶ 20.2.1 and 20.2.3 equal to the amount of
premium saved by the Risk Pool as a result of the Member’s waiver of coverage,
if any. In no event shall a Member which
has given notice of its intent to withdraw be required to pay its Assessment
Share for any Premium Assessment levied for the Risk Pool for the purpose of
acquiring insurance for which neither the Member nor its Employees will ever be
a beneficiary.
20.2.1.3
Post-Withdrawal Expenses. A Former Member shall reimburse the Fund for
its Assessment Share of the costs the Fund ultimately incurs in resolving the
Incurred Liability Exposure of the Former Member’s Risk Pool as of its
Withdrawal Date, and all Administrative Expenses directly related thereto,
including but not limited to, legal fees incurred by the Fund in connection
with any legal action regarding Coverage for the Former Member by the Fund if
the Fund is the prevailing party, arising from Pre-Withdrawal Loss Events. Such Assessment Share shall be calculated
according to the applicable Formula for General Assessments based on the Formula
Component values in effect for the Former Member as of the Withdrawal Date;
provided, however, that the Annual Assessment Limit shall not apply and,
provided further that, with respect to the Property Pool, a Former Member’s
Assessment Share under the Property General Assessment Formula shall be based
on the highest total Insured Value of the Former Member’s Insured Property
listed in the Schedule of Values at any time in the calendar year of withdrawal
for all General Assessments levied after the Notice Date. The amount owed by a Former Member pursuant
to this paragraph shall be determined quarterly based upon the amount paid by
the Fund in such quarter for resolving the Incurred Liability Exposure of the
Former Member’s Risk Pool as of the Withdrawal Date, and shall be paid within
30 days after the Former Member receives written notice of the amount
thereof. If the Former Member fails to
make any payment when due, interest shall accrue on the unpaid balance at the
rate set forth in ¶ 13.4. A Former
Member’s obligation to make payments to the Fund pursuant to this paragraph
shall continue despite the Dissolution of the Risk Pool or the Fund pursuant to
¶ 21.
20.2.2 Obligations of Former H&W Member With Respect to the
H&W Risk Pool.
20.2.2.1
Pre-Withdrawal H&W Assessments. A Member that has given its notice of intent
to withdraw from the H&W Pool shall continue to be liable to the Fund for
all of its Monthly H&W Assessments for H&W Pool Operational Costs
incurred by the H&W Pool through the end of the Coverage Year/Stop Loss
Policy Year as if such Member had not given such notice.
20.2.2.2
Former H&W Member’s Assessment Obligations
During Mandatory H&W Claims Runout Period. A Former Member shall remain responsible for
paying its Assessment Share of each of the three (3) Monthly H&W
Assessments levied in the first three (3) months following the Former Member’s
Withdrawal Date (i.e., during the Mandatory H&W Claims Runout
Period), and for complying with any and all related obligations under the SIA
as if such Former Member continued to be a Member of the H&W Pool during
that time period; provided that such Former Member’s Monthly H&W
Assessments for the Mandatory Claims Runout Period shall be based on the amount
of its Incurred H&W Claims and its Extended Coverage H&W Claims paid in
the preceding month, and its Assessment Share of the total of all Members’
(including the Former Members’) Shared H&W Costs incurred in the preceding
month, calculated under the H&W General Assessment Formula, after deducting
the portion of the Stop-Loss Insurance Premium and Administrative Expenses
allocable to the ongoing operations of the H&W Pool in the preceding month.
20.2.2.3
Former H&W Member’s Assessment Obligations After
Expiration of Mandatory H&W Claims Runout Period and Prior to H&W
Claims Cutoff Date. Except as
otherwise provided in ¶ 20.4.2.1(b) regarding a Former Member establishing
an earlier H&W Claims Cutoff Date, for the time period after expiration of
the Mandatory H&W Claims Runout Period and before the H&W Claims Cutoff
Date, a Former Member shall be responsible for reimbursing the H&W Pool for
the amount the H&W Pool paid in the preceding month for such Member’s
remaining unpaid Incurred H&W Claims and Extended Coverage H&W Claims,
together with all related H&W Claims Handling Fees, and for paying its
Assessment Share of the amount the H&W Pool paid in the preceding month for
any remaining unpaid Incurred Shared H&W Claims.
20.2.2.4
Terms Governing Payment of Assessment by Former
H&W Member. With respect to
Assessments levied for a Former Member under ¶’s 20.2.2.1, 20.2.2.2 and
20.2.2.3, the amounts of such Assessments shall be paid within twenty (20) days
after the withdrawing Member receives written notice thereof, interest shall
accrue on any amounts not paid when due as provided in ¶ 13.5, and the
delinquent Member shall be subject to the H&W Pool remedies in ¶ 13.6.
20.3
Former Member’s Rights in Fund
Assets.
20.3.1
Former Member’s Rights with
Respect to Liability and Property Pool Assets. A Former Member shall have no claim to, nor
any right, title or interest in, any money or assets owned by the Fund or held
by the Fund on behalf of the Former Member’s Risk Pool, including any money or
assets attributable to the Former Member’s contributions or Assessments paid to
the Fund pursuant to this Agreement; provided, however, that if the Actual Risk
Pool Balance on the Withdrawal Date, after deducting the amount of the Fund’s
incurred but unpaid Administrative Expenses allocable to the Risk Pool as of
that date and the amount of any Recovery Proceeds constituting part of the
Actual Risk Pool Balance, is greater than the amount of the Designated Risk
Pool Balance in effect as of the Notice Date, the Former Member shall be
entitled to a setoff of that portion of such excess monies, calculated
according to the applicable Formula For General Assessments in effect on the
Withdrawal Date, against any amounts the Former Member becomes obligated to pay
pursuant to ¶ 20.2.1 or ¶ 20.2.3.
Similarly, the Former Member shall have no right, title or interest in
or to any money or assets allocated to any Special Purpose Accounts.
20.3.2 Former H&W Member’s Rights With Respect to H&W Pool
Assets ‑ ‑ Return of Balance of Former Member’s Initial Deposit. As specified in ¶¶ 13.2.3.1 and 13.3.5
above, the Former Member’s Initial Deposit (or Adjusted Initial Deposit, as
determined per ¶ 13.2.2) shall continue to be replenished by Monthly
H&W Assessments to be paid by the Former Member during the Mandatory
H&W Claims Runout Period. Within
forty five (45) days after the end of the Mandatory Claims Runout Period, and
provided the Former Member is current on all payments owed to the H&W Pool,
the H&W Pool shall pay fifty percent (50%) of the value of the Former
Member’s Initial Deposit (or Adjusted Initial Deposit) to the Former Member,
and shall retain the remaining fifty percent (50%) until the H&W Claims
Cutoff Date. Within forty five (45) days
after the H&W Claims Cutoff Date, and provided the Former Member is current
on all payments owed to the H&W Pool, any remaining balance of the remaining
50% of the Initial Deposit (or Adjusted Initial Deposit) shall be paid to the
Former Member; and provided further, that the Former Member shall continue to
remain responsible to pay its Assessment Share of Incurred Shared H&W
Claims paid in the preceding month, which shall be assessed to the Former
Member and paid in accordance with ¶ 20.2.2.4. Notwithstanding the provisions above for
return to the Former Member of the balance of its Initial Deposit, prior to the
date such balance is to be paid to the Former Member, the Former Member shall
have no right, title, or interest in or to any of the monies of the H&W
Pool, including the portion thereof otherwise attributable to the Former
Member’s Initial Deposit. Furthermore,
at no time shall any Former Member be entitled to interest on the amount of its
Initial Deposit or Adjusted Initial Deposit retained by the H&W Pool,
either during the time it is a Member of the H&W Pool, or thereafter while
such money is held by the H&W Pool pending expiration of the H&W Claims
Cutoff Date; provided, however, a Former Member shall be entitled to interest
from the H&W Pool at the rate provided for in ¶ 13.5 regarding
delinquent Assessments for any balance of its Initial Deposit not paid when due
under this paragraph.
20.4
Claims Relating to Former
Members.
20.4.1
Claims Involving Former Member
of Liability or Property Pools.
The Fund shall continue to provide Coverage, Defense, and services
related to those rights to a Former Member and its Employees for Covered Claims
based upon Pre-Withdrawal Loss Events; provided, however, that the Fund shall
not be obligated to make such payments or provide such services for the Former
Member or its Employees if the Former Member is in default under the SIA; and
provided, further, that a Former Member shall not be entitled to Coverage by
the Fund for any period of time during which the Former Member’s Coverage was
suspended under ¶ 13.7(b) for default in paying Assessments. For purposes of making Coverage
Determinations for Liability Claims made against a Former Member or any
Employee of a Former Member, or for Property Claims made by a Former Member,
the term “Member,” as used in the Exclusions contained in the Coverages
sections, shall include Former Members, and “Employee” shall include Employees
of a Former Member. The Former Member
shall be bound by the Claims Resolution Rules and Procedures in effect at the
time the Claim is asserted against, or the Property Claim is filed by, the
Former Member, as may be amended from time to time thereafter.
20.4.2 Claims Involving Former Member of H&W Pool.
20.4.2.1
H&W Claims Cutoff Date and Termination of
H&W Pool’s Obligations to Former H&W Member.
(a) Determination
and Effect of H&W Claims Cutoff Date.
After expiration of the H&W Claims Cutoff Date applicable to a Former
Member, the H&W Pool shall cease having any financial responsibility or
obligations under the SIA to provide H&W Coverage for or to pay any unpaid
Incurred H&W Claims or Extended Coverage H&W Claims with respect to the
Former Member’s Employees and Dependents.
The H&W Claims Cutoff Date shall be:
(a) the date the Stop‑Loss Carrier ceases coverage and making
payment for Incurred H&W Claims in accordance with the terms of the Stop‑Loss
Insurance in effect for Members of the H&W Pool on the Former Member’s
Withdrawal Date; or (b) the date the last known Incurred H&W Claim or
Extended Coverage H&W Claim involving the Former Member’s Employees or
Dependents is resolved, as determined by the Administrative Committee,
whichever date is later.
(b) Former
H&W Member’s Discretion to Establish Earlier H&W Claims Cutoff Date. A Former Member of the H&W Pool may
establish an H&W Claims Cutoff Date earlier than the Date that would
otherwise be applicable under ¶ 20.4.2.1(a) above, by including in its
notice of intent to withdraw a statement that, after the Withdrawal Date, such
Member agrees to assume all financial and related responsibility with respect
to any and all unpaid Incurred H&W Claims and Extended Coverage H&W
Claims relating to its Employees and their Dependents as of the date specified
in the notice. As of such date, the
H&W Pool shall have no further responsibility for or obligations with
respect to such unpaid Incurred H&W Claims or Extended Coverage H&W
Claims; provided that in no event shall such earlier H&W Claims Cutoff Date
take effect prior to the expiration of the Mandatory H&W Claims Runout
Period; provided further, that in giving such notice to the Fund, such Former
Member thereby agrees without more to indemnify the Fund, the H&W Pool, the
Administrative Committee and the Administrator, and to hold them harmless, from
any and all liability arising out of or related in any way to such unpaid
Incurred H&W Claims and Extended Coverage H&W Claims; and provided
further, that the establishment of an earlier H&W Claims Cutoff Date
hereunder shall not operate to terminate a Former Member’s obligation to
continue to pay its Assessment Share of any remaining unpaid Incurred Shared
H&W Claims. Notwithstanding any
earlier H&W Claims Cutoff Date established by the Former Member’s original
notice of intent to withdraw, such Former Member may extend or shorten such
Cutoff Date by written notice thereof to the Fund; provided such notice is
given at least thirty (30) days prior to the new Cutoff Date. In no event shall this Cutoff Date be
extended beyond the Date that would otherwise be applicable under
¶ 20.4.2.1(a) above.
(c) H&W
Coverage for Former Member Limited to Incurred H&W Claims and Extended
Coverage H&W Claims. After the
effective date of a Former Member’s withdrawal from the H&W Pool, the
Former Member shall only be entitled to H&W Coverage for Incurred H&W
Claims and Extended Coverage H&W Claims, and with respect to such Claims,
the Former Member shall remain bound by the applicable provisions of the SIA.
20.5
Former Members’ Rights
Regarding Coverage Litigation.
A Former Member, with respect to a Covered Liability Claim asserted
solely against it or one or more of its Employees, or with respect to a
Property Claim filed by the Former Member, or with respect to an H&W Claim
of its Employee and/or Dependent, may elect whether to invoke the Fund’s
Coverage Litigation obligations in ¶ 15.1, and be bound by the rights and
obligations set forth therein for Members and Employees, or whether to waive
the rights under ¶ 15 and seek coverage under the applicable Excess or
Stop Loss Policy on its own and bearing its own legal expenses. If the Former Member is involved in a
Multi-Member Claim where Coverage Litigation is anticipated, in its discretion,
the Administrative Committee may determine that it is in the best interests of
the Fund for any claim the Former Member wishes to make against the Excess or
Stop Loss Coverage to be prosecuted by
the Fund along with similar claims of the Members. In such event, the Former Member and/or its
Employee or Dependent shall be bound by the provisions of ¶ 15 as a
“Member,” provided, however, that if there is an actual conflict of interest
between the Former Member and the Members with respect to any material issues involved
in the Coverage Litigation preventing representation by common Defense Counsel,
the Former Member shall not be bound by nor have any rights under ¶ 15.
20.6
Indemnity of Fund. A Former Member shall indemnify, defend, and
hold the Fund harmless from any and all damages, loss, costs, or expenses of
every kind and nature, including attorneys’ fees, as to any and all causes,
claims, demands, actions, or suits asserted against the Fund or any of its
Members or their Employees related in any way to any Claim against the Former
Member or its Employees for which the Fund does not provide Coverage pursuant
to ¶ 20.4.
21
Dissolution of a Risk Pool or
the Fund.
21.1
Procedures. The full Board may dissolve the Fund by
Super-Majority Vote, effective at the end of the calendar year in which the
Vote to dissolve occurred. Even without
a Super-Majority Vote of the full Board, the Fund will be deemed to be
dissolved at the end of the calendar year in which the Fund’s last Risk Pool is
dissolved. Any Risk Pool may be
dissolved by a Super-Majority Vote of the Directors representing Members
participating in that Risk Pool, also effective at the end of the calendar year
in which the Vote to dissolve occurred; provided however, if the H& W Pool
Coverage Year and Fiscal Year are on a basis other than the calendar year (in
order to conform to the period covered by the Stop Loss Policy Year, see
§ XIV, ¶ 5), Dissolution of the H&W Pool shall only be effective
at the end of the Coverage Year/Stop Loss Policy Year in which the Vote to
dissolve occurred; provided however, that the H&W Pool shall be dissolved
the effective date the Fund is dissolved.
21.2
Post-Dissolution
Administration.
21.2.1
Provisions Applicable to All
Risk Pools. In the event a
Risk Pool is dissolved, the Directors representing Members participating in
that Risk Pool shall remain Directors for that Risk Pool and shall wind up the
affairs of the Risk Pool. In the event
the full Board dissolves the Fund, the Directors for the Board on the date of
the Dissolution Vote shall remain Directors and shall wind up the affairs of
the Fund. All Members of the Risk Pool
being dissolved, or the Fund, as of the Dissolution Date, and all Former
Members to the extent they remain responsible for a portion of the Fund’s
Incurred Liability Exposure with respect to a Risk Pool as of their Withdrawal
Dates, shall continue to be bound by the terms of the SIA and the Operational
Rules in effect on the date of the Dissolution Vote. A Member whose Director as of the Dissolution
Date resigns or becomes unable to serve shall appoint a successor
Director. In the event the Fund is
dissolved, the Fund Officers and members of the Administrative Committee as of
the date of the Dissolution Vote also shall continue to serve in such
capacities until wind up of all of the affairs of the Fund has been
completed. The Board shall appoint a
successor for any Fund Officer or member of the Administrative Committee who
shall resign or become unable to serve.
21.2.2
Additional Administrative
Provisions with Respect to H&W Pool. In addition, in connection with the Board’s
decision to Dissolve the H&W Pool, by Majority Vote the Board shall
determine the H&W Claims Cutoff Date applicable to the H&W Pool and its
Members; provided that if such a date is not established by Majority Vote, the applicable
H&W Claims Cutoff Date shall be when last known H&W Claim is resolved,
as determined by the Administrative Committee, and at the latest, conclusively
established when no H&W Claim is received by the Administrator for 4
consecutive months; and provided further, an Extended Coverage H&W Claim
shall not qualify as a “last known claim” in the preceding clause, and any such
Extended Coverage H&W Claim shall not prevent establishment of the H&W
Pool’s Claims Cutoff Date.
21.3
Coverage. Following dissolution of a Risk Pool, the
Fund shall continue to provide Coverage, and to pay Defense Costs, Property
Claim Costs and H&W Claim Costs, as applicable, in connection with all
Covered Claims resulting from Loss Events which took place prior to the Risk
Pool’s Dissolution Date; provided, however, that the Fund’s obligations with
respect to the H&W Pool herein are subject to the terms of and decisions
made by the Board pursuant to ¶21.2.2 above.
21.4
Post-Dissolution Assessments.
21.4.1
Post-Dissolution Assessments
for Liability and Property Pools.
As soon as practical following the Dissolution Vote for a Risk Pool, the
Board shall levy a Discretionary General Assessment in such amount as the Board
shall determine is necessary to provide the Fund with sufficient assets to pay
the Fund’s estimate of the Incurred Liability Exposure of the Risk Pool(s) as
of the Dissolution Date, together with related Administrative Expenses. Thereafter, the Board shall levy one or more
additional Discretionary General Assessments in whatever amounts the Board
shall determine are necessary to pay the Fund’s liabilities and obligations
under the SIA and the costs of winding up the Risk Pool’s affairs as they
become due. Any Assessments levied
pursuant to this paragraph shall be based on the applicable General Assessment
Formula in effect as of the Dissolution Date, and shall be paid in accordance
with the terms of ¶¶ 13.4 through 13.6; provided, however, that the Annual
Assessment Limit shall not apply. The
applicable Actual Risk Pool Balance may be raised in excess of the Designated
Risk Pool Balance by any Discretionary General Assessment levied pursuant to
this paragraph with only a Two-Thirds Vote.
21.4.2
Post-Dissolution Assessment
for H&W Pool. Subject to
¶ 21.2.2 above, after the Dissolution Date for the H&W Pool, Members
shall continue to pay Monthly H&W Assessments determined and calculated and
paid in the same manner as if the H&W Pool was not Dissolved; provided,
that the Formula Components for the H&W General Assessment Formula and the
underlying information of each Member with respect thereto in effect in the
last month preceding the Dissolution Date shall thereafter be used to calculate
all Monthly H&W Assessments; provided further, that the H&W Pool and
the Members shall retain their respective Stop Loss Points in effect on the
Dissolution Date, but, subject to the Board’s Majority Vote otherwise, each
Member’s H&W Claims payments accrued toward its respective Stop Loss Points
on the Dissolution Date shall be reset to zero for H&W Assessments levied
after the Dissolution Date; and provided further, the Board for the H&W
Pool shall have authority to levy one
or more Discretionary General Assessments and
deemed necessary in accordance with ¶ 13.4.3.2.
21.5
Distribution of Assets.
21.5.1
Distribution of Assets of
Liability and/or Property Pools.
If any assets generated by a dissolved Risk Pool remain in the Fund
after payment of all of the Fund’s Incurred Liability Exposure for such Risk
Pool as of the Dissolution Date and all Administrative Expenses and professional
fees incurred in winding up the Risk Pool’s affairs, the remaining assets shall
be distributed to the Members of the dissolved Risk Pool as of the Dissolution
Date; provided, however, with respect to Dissolution of the Property Pool, all
Members thereof on the Date of Dissolution shall be entitled to receive the
total amount of their Property Pool Investments, if any, before all Property
Pool Members share in the distribution of any remaining assets. Each Member’s share of the distribution shall
be calculated according to the applicable Formula for General Assessments in
effect as of the Dissolution Date; provided, however, that the Annual
Assessment Limit shall not be applied to limit the distributive share of any
Member. The Fund’s Incurred Liability
Exposure for the Risk Pool shall be considered to have been paid at such time
as the Administrative Committee determines and the Board agrees by
Super-Majority Vote that: (a) there
are no known Covered Claims pending against or by any Member or Employee; (b)
no Member is aware of any Loss Event which took place prior to the Dissolution
Date for which there is a reasonable possibility that a Covered Claim will be
asserted; and (c) a sufficient time has passed since the Risk Pool’s
dissolution that there is no reasonable possibility that a Covered Claim will
be made arising out of an unknown Loss Event which took place prior to the
Dissolution Date.
21.5.2
Distribution of Assets of
H&W Pool. After
expiration of the H&W Claims Cutoff Period established for the H&W Pool
pursuant to ¶ 21.2.2 above, the remaining assets of the H&W Pool shall
be distributed to the Members of the H&W Pool on the Dissolution Date based
on the proportion that the amount of each Member’s Initial Deposit or Adjusted Initial
Deposit on the Dissolution Date is to the total amount of all Members’ Initial
Deposits or Adjusted Initial Deposits.
21.6
Post-Distribution Claims. After distribution of a Risk Pool’s assets as
provided in ¶ 21.5, the Fund shall have no further liability to any Member
or Employee under the Coverages previously provided by the Risk Pool, and
thereafter each Member or Employee shall have sole responsibility for any
claims that, but for the dissolution, would have been Covered Claims.
21.7
Court Supervision of
Dissolution of Fund. At any
time following the Dissolution Vote for the Fund, a majority of Members may
petition the King County Superior Court to supervise the winding up of the
Fund’s affairs. In any such proceedings,
the Court shall have power to issue injunctions, to appoint a receiver or
receivers pendente lite,
with such powers and duties as the Court, from time to time, may direct, and to
take such other measures as may be necessary to preserve the Fund’s assets
wherever situated, and carry on the business of the Fund until a full hearing
can be had. After a hearing had upon
such notice as the Court may direct to be given to all Members, the Court may
appoint a receiver or receivers with authority to collect all Assessments levied
against the Members; to handle Defense of Covered Claims asserted against
Members or their Employees pursuant to § VII., ¶ 5, or to appoint, at
the Fund’s expense, professional adjusters to handle such Defense; to pay the
amount of any judgment entered or settlement made with respect to any Covered
Liability Claim; to adjust and pay for any outstanding Covered Property Claims
to pay for any H&W Claim; and to distribute any assets remaining in the
Fund to the Members after all of the Fund’s Incurred Liability Exposure and all
Administrative Expenses and professional fees incurred in winding up the Fund’s
affairs have been paid. The order
appointing such liquidating receiver or receivers shall state their powers and
duties. Such powers and duties may be
increased or diminished at any time during the proceedings.
22
Prohibited Remuneration and
Conflicts of Interest.
22.1
Member’s Officers and
Employees Serving the Fund.
No Employee of a Member may directly or indirectly receive anything of
value from the Fund for services rendered in connection with the operation or
management of the Fund other than the salary and benefits otherwise normally
provided by his or her Member employer; provided, however, that such persons
may be reimbursed for the expenses reasonably incurred in furtherance of the
operation or management of the Fund. No
Director of the Fund, nor any member of the Executive, Administrative or
Operations Committees, may accept or solicit anything of value for personal
benefit or for the benefit of others under circumstances from which it can be
reasonably inferred that such person’s independent judgment is impaired with
respect to operation and management of the Fund.
22.2
Prohibited Interests in
Transactions. No Director of
the Fund, nor any member of the Executive, Administrative or Operations Committees,
nor the Auditor, Administrator, Broker or General Counsel, shall;
(a) Receive directly or individually or be pecuniarily interested in any fee, commission,
compensation, or endorsement arising out of any transaction to which the Fund
is or is expected to be a party; provided, however, that the Administrator,
Broker and General Counsel may receive such compensation as agreed upon with
the Fund for professional services regularly rendered to the Fund;
(b) Receive compensation as a consultant to
the Fund while at the same time acting as a Director, member of the Executive
or Administrative Committees, or as Administrator;
(c) Have any direct or indirect pecuniary
interest in any loan or investment of the Fund; or
(d) Directly or indirectly receive or be pecuniarily interested in any commission or other
compensation arising out of any contract or transaction between the Fund and
any insurer.
Notwithstanding
subsections (a) through (d) above, the Broker may receive commissions for
insurance transactions performed within the scope of its license, provided such
commissions are first disclosed to and approved by the Administrative
Committee.
23
Fund Indemnifications. No indemnifications by the Fund pursuant to
¶¶ 23.1 through 23.3 below shall exceed the amount of $1,000,000 per indemnitee without approval by a Super-Majority Vote.
23.1
Mandatory Indemnification. Upon request, The Fund shall indemnify and
hold harmless its Directors, the Fund Officers, members of the Operations and
Administrative Committees, and Fund Employees, if any (collectively, “Indemnitees”), for all Claims based on culpability
standards of negligence or less, including strict liability, asserted against
one or more of them arising out of their performance or failure of performance
of duties for the Fund, and the Fund may, by a Two-Thirds Vote of the Board,
indemnify Indemnitees for Claims based on culpability
standards of gross negligence or higher; provided, however, that no
indemnification under this paragraph shall apply with respect to any Claim
where the Board determines the Indemnitee was not
acting in good faith or was not acting within the scope of his/her duties for
the Fund.
23.2
Discretionary Indemnification
of the Administrator, Broker and General Counsel. The Fund may, upon request at any time, and
by Majority Vote, indemnify and hold harmless the Administrator, Broker and/or
General Counsel for all Claims based on culpability standards of negligence or
less, including strict liability, asserted against one or more of them arising
out of their performance or failure of performance of duties for the Fund;
provided, however, that such indemnification shall not apply (a) with respect
to any Claim where the Board determines that the Administrator, Broker or
General Counsel was not acting in good faith or was not acting within the scope
of its duties to or for the Fund; and (b) with respect to any Claim brought by
the Fund arising from a breach of the Administrator’s, Broker’s or General
Counsel’s contracts with the Fund or duties owed to the Fund.
23.3
Discretionary Indemnification
of Agents and Volunteers. The
Fund may also, upon request at any time, by Majority Vote, agree to indemnify
and hold harmless one or more specified Agents of the Fund for any Claims made
against one or more of them arising out of their performance or failure of
performance of duties for the Fund; provided, however, that such
indemnifications shall not apply unless the same conditions set forth in
¶ 23.2 above for indemnification of the Administrator, Broker and General
Counsel are satisfied.
24
Miscellaneous Provisions.
24.1
Other Insurance and Third
Party Indemnifications. The
Coverage provided by the Fund under the SIA shall interface with any Other
Insurance and Third Party Indemnifications available to the Insured involved in
a Covered Claim as provided in § III, ¶ 2.7; § IV, ¶ 2.5;
§ V, ¶ 2.5; § VI, ¶ 2.1; § X, ¶ 18; and
§ XI, ¶ 16; and §XIV, ¶2.7.
24.2
Agreement Not a Substitute for
Bonds. The Coverage provided
to the Members and Employees pursuant to this Agreement is not a substitute for
and shall not be construed to supplement the protection provided by any bond
required to be obtained by the Members by the laws of the State of Washington,
including, but not limited to, any bond required by RCW 54.24.010.
24.3
Entire Agreement. The SIA, Sections I through XIV, and the
Operational Rules as now appearing or as amended by the Board from time to
time, constitute the entire agreement among the Members, and each Member hereby
acknowledges and agrees that it is not relying on any promises or
representations other than as set forth in these Program Documents.
24.4
Mandatory Binding Arbitration
and Venue.
24.4.1
“Disputes” Subject to
Mandatory Binding Arbitration.
Except as otherwise provided in ¶ 24.4.7 below, any Disputes among
the parties to this Interlocal Agreement, or between one or more such parties
and the Fund, arising out of or relating to the SIA, the Operational Rules or
other Program Documents, or breach thereof, or arising out of any action or
inaction by the Board or Executive, Operations or Administrative Committees,
shall be subject to this ¶ 24.4.
Venue for the arbitration proceedings and hearing shall be in Seattle,
Washington.
24.4.2
Required Exhaustion of Appeal
Procedures. No party to the
SIA, including the Fund, shall have the right to submit any Dispute to
arbitration hereunder until all Appeal Procedures have been exhausted through
the Board level, or the Board has otherwise considered and voted a decision on
the Dispute; provided, however that resort to proceedings in a court may occur
as permitted in ¶ 24.4.7(b) and (e).
24.4.3
Demand for Arbitration and
Establishment of Arbitrator(s).
Any parties to the Dispute, the Fund, and any Members affected by the
Board Decision, may invoke arbitration of the Dispute under this ¶ 24.4 by
filing a written Demand for Arbitration with the other parties involved and
with the American Arbitration Association.
The Demand for Arbitration shall be made within a reasonable time after
the Dispute arose, but, no Demand shall be filed prior to Board consideration
of and vote upon such Dispute, except as permitted by ¶ 24.4.2, and in no
event shall the Demand for Arbitration be recognized after the date when
institution of legal or equitable proceedings based on such Dispute would be
barred by the applicable statutes of limitations of repose. Resolution of the Dispute shall be in
accordance with the rules of the American Arbitration Association currently in
effect unless the parties mutually agree otherwise. The Arbitration shall take place before a
single arbitrator if the aggregate value of claims and counter-claims is less
than $250,000, exclusive of costs and attorneys fees. For claims and counterclaims having an
aggregate value of $250,000 or more, the American Arbitration Association shall
appoint a panel of three (3) arbitrators, one of whom shall be designated as
the chairman and shall be a lawyer. The
other two members of the Arbitration Panel shall, to the extent reasonably
possible, have knowledge regarding matters of insurance and Washington
law governing public entities.
24.4.4
Discovery. Following the filing of a Demand for
Arbitration, the parties involved shall cooperate in the exchange of
information relating to the Dispute being guided by the scope of the applicable
rules of discovery under the Federal Rules of Civil Procedure. Discovery shall not include interrogatories
or requests for admission. The parties
shall freely exchange documents relevant to the Dispute and depositions shall
be limited to those reasonably necessary for each party to prepare for, or
defend against, such Dispute. Subpoenas
for the production of documents and depositions of persons or entities not
parties to the Dispute should be authorized by the Arbitrator or Arbitration
Panel where reasonably necessary for a party to prepare its case. Disagreements regarding discovery shall be
resolved by the Arbitrator or, where there is an arbitration panel of three
Arbitrators, by the chairman of the Arbitration Panel.
24.4.5
Mandatory Mediation. Mediation is an express condition precedent
to the hearing of any Arbitration demanded hereunder. Mediation shall be conducted pursuant to the
Mediation Rules of the American Arbitration Association. Such mediation shall take place no later than
thirty (30) days prior to the date scheduled for the Arbitration hearing. Representatives of all parties involved in
the Dispute shall attend the mediation and each party’s representative shall
have full, unrestricted authority to enter into a binding settlement agreement
on behalf of that party. The mediation
proceedings shall be confidential and privileged to the extent permitted by
law.
24.4.6
Hearing Standards/Arbitration
Award/Costs and Attorneys’ Fees. The arbitration hearing shall be de novo on
all issues except issues relating to the number of occurrences involved in a
Covered Claim, which shall be governed by the standards set forth in
§ III, ¶ 2.9; § IV, ¶ 2.7; § V, ¶ 2.7; § VI,
¶ 2.1; § X, ¶ 16; and § XI, ¶ 15. In addition to the powers of the
Arbitrator(s) as set forth in the Rules of the American Arbitration
Association, the Arbitrator(s) shall also have the power to award the
prevailing party its reasonable attorneys’ fees and costs (including the costs
of arbitration and fees of the Arbitrator(s)).
The award rendered by the Arbitrator(s) shall be final, and judgment may
be entered upon it in the Superior Court for the State of Washington
in King County.
24.4.7
Resort to Proceedings in
Court/Costs and Attorneys’ Fees.
Any Disputes otherwise subject to submission for decision to the
mandatory binding arbitration provisions of this ¶ 24.4, instead may be
submitted, by any party having a legal interest therein, to the jurisdiction of
either the Superior Court for King County, State of Washington, or United
States District Court for the Western District of Washington at Seattle, as
follows:
(a) As
necessary to secure the value of or to enforce any arbitration award rendered
under ¶ 24.4;
(b) If,
and only to the extent necessary, to secure injunctive relief reasonably
necessary under the circumstances;
(c) For
Disputes relating to Coverage by the Fund or to a Member’s Assessment
obligations, so long as the amount in controversy is greater than $250,000;
(d) For
Disputes relating to the termination of a Member’s membership in a Risk Pool or
in the Fund, or a Member’s withdrawal from the Fund, regardless of the amount
in controversy;
(e) In
connection with Dissolution of the Fund as provided in ¶ 21.7; and
(f)
As permitted by the Board by Super-Majority Vote;
provided, however,
that no party to any Dispute may submit the Dispute to resolution by a court
under subparagraphs (c) and (d) above without first completing mandatory
mediation as provided in ¶ 24.4.5.
The prevailing party in any Dispute submitted to a court under this
¶ 24.4.7 shall be awarded its costs and reasonable attorney’s fees
incurred in connection with the judicial resolution of such Dispute, including
any appeals thereof and any prior arbitration proceedings.
24.5
Notices. Any notice required to be given under this
Agreement may be delivered in person, or sent by mail or by facsimile. Any notice sent by mail shall be deemed
received on the third day after it is mailed.
Unless otherwise provided in the SIA or in the Operational Rules, any
notice given to the Fund shall be delivered to the Administrator, and any
notice to a Member shall be delivered to a Director or the Manager for the
Member.
24.6
Construction. The SIA shall be construed pursuant to the
laws of the State of Washington. Any controversy over the construction of this
Agreement shall be decided neutrally and without regard to which party drafted
the Agreement.
24.7
Paragraph Headings. The paragraph headings in the SIA are
provided for the convenience of the parties and shall not modify or alter the
substance of this Agreement.
DATED
as of the 7th day of December, 2001.
ASOTIN COUNTY PUD BENTON COUNTY PUD
By__________________________ By____________________________
Its__________________________ Its____________________________
CLALLAM COUNTY PUD CONSERVATION
AND
RENEWABLE
ENERGY SYSTEM
By__________________________ By____________________________
Its__________________________ Its____________________________
GRAYS HARBOR COUNTY PUD JEFFERSON COUNTY PUD
By__________________________ By____________________________
Its__________________________ Its____________________________
KITSAP COUNTY PUD KLICKITAT
COUNTY PUD
By__________________________ By____________________________
Its__________________________ Its____________________________
LEWIS COUNTY PUD MASON
COUNTY PUD NO. 3
By__________________________ By____________________________
Its__________________________ Its____________________________
OKANOGAN COUNTY PUD PACIFIC
COUNTY PUD NO. 2
By__________________________ By____________________________
Its__________________________ Its____________________________
PEND ORIELLE COUNTY PUD SKAGIT COUNTY PUD
By__________________________ By____________________________
Its__________________________ Its____________________________
SKAMANIA COUNTY PUD STEVENS
COUNTY PUD
By__________________________ By____________________________
Its_________________________ Its____________________________
WAHKIAKUM COUNTY PUD NOANET
By__________________________ By
____________________________
Its__________________________ Its ____________________________