MISSISSIPPI SCHOOL BOARDS ASSOCIATION



MISSISSIPPI SCHOOL BOARDS ASSOCIATION

WORKERS' COMPENSATION TRUST

MEMBERSHIP PARTICIPATION AGREEMENT

THIS AGREEMENT made and entered into between the MISSISSIPPI SCHOOL BOARDS ASSOCIATION WORKERS' COMPENSATION TRUST (“Trust”) and  Jackson County School District , a political subdivision of the State of Mississippi (“Member”). The purpose of this Agreement is to facilitate effective risk management of the workers’ compensation obligations of the Members.

W I T N E S S E T H:

WHEREAS, Section 71-3-5 of the Mississippi Code of 1972 allows the Member to participate in the group-funded Trust; and

WHEREAS, the Trust has developed the Mississippi School Boards Association Workers' Compensation Self-Insurance Program (hereinafter, together with all modifications and amendments thereto, called the “Program”), a group self-insurance workers' compensation program for eligible Members; and

WHEREAS, the Member has evidenced its agreement to be bound by the terms and conditions of the Agreement and is duly authorized to enter into this Agreement; and

WHEREAS, the Member has determined that participation in the Program will reduce expenses related to securing workers' compensation benefits for its employees, and will be to the benefit of the Member; and

WHEREAS, the Member hereby agrees to pool its financial and administrative resources with other Members so as to provide a method for obtaining risk management, excess insurance, self-insurance, loss prevention, claims administration and other risk management services;

WHEREAS, the Member acknowledges that this Program exists in accordance with the provisions of Mississippi Code Sections 71-3-5 and 37-7-703, as amended, and that its continued existence is conditioned upon active participation by at least two (2) political subdivisions in maintaining the Program; and

WHEREAS, the Member desires to participate in the Program in accordance with the Contribution and Coverage Summary provided by the Trust to the Member and in accordance with all other terms and conditions of the Agreement.

NOW, THEREFORE, BE IT RESOLVED that the Trust and the undersigned Member for and in consideration of the promises contained herein, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, do hereby enter into this Agreement and agree and covenant as follows:.

TERMS AND CONDITIONS

1. Establishment of Agency. The Trust is hereby established as a risk management agency to provide workers’ compensation coverage desired by the participating political subdivisions as approved by the Mississippi Workers’ Compensation Commission (the “Commission”). By executing this Agreement, the Member hereby becomes a party to this Agreement and agrees to abide by all terms and conditions set forth herein.

2. Coverage/Participation. In consideration of payment of contributions as set forth hereinafter, the Member will be provided workers compensation insurance coverage in accordance with the Program and the terms and conditions provided to the Member by the Trust. The Member will become a Member of the Trust by adoption of the appropriate resolution (the “Resolution”) by its governing authority/school board (the “Governing Authority”), subject to the approval of the Board of Trustees of the Trust and, if approved, such Member shall execute and be subject to all provisions of this Agreement. The Resolution shall be in a form substantially similar to the Resolution attached hereto as Exhibit “A”.

3. Contribution and Coverage Summary. The Member agrees that the participation period and coverage provided hereunder shall be as specified in the Contribution and Coverage Summary.

4. Term. The term of this Agreement is for one (1) year and it automatically renews thereafter, unless sooner terminated as provided herein. The initial one (1) year term shall commence at 12:01 a.m. on October 1, 2009, and shall automatically renew on the following October 1, unless sooner terminated in accordance with the provisions of this Agreement, or any subsequent renewal thereof. Each subsequent automatic renewal shall be at 12:01 a.m. on each following October 1 and shall be subject to the provision of this Agreement, and expressly subject to the Trust’s right to recalculate and assign the Member’s contributions for such renewal terms.

5. Termination.

a. By Either Party. This Agreement may be terminated by either party on any successive renewal date by giving written notice to the other party no later than (90) days prior to the next anniversary date.

b. By Trust Member. This Agreement may not be terminated by the Program Participant during any annual participation period. To terminate this Agreement, to be effective at the next anniversary date, prior written notice must be given to the Trust by the Member no later than (90) days prior to the next annual renewal date.

c. By Trust. The Trust may also terminate this Agreement at any time by:

i. Giving ten (10) days written notice by certified mail to the Member if the Member does not make the payments or contributions as herein provided;

ii. Giving ten (10) written days notice by certified mail to the Member if the Member fails to cooperate and comply with any reasonable requests for information and/or records made by the Trust.

iii. Giving thirty (30) days written notice by certified mail to the Member if the Member fails or refuses to follow loss control recommendations made by the Trust or its designee; or

iv. Giving thirty (30) days written notice by certified mail to the Member if the Member fails or refuses to comply with any agreement or undertaking on its part, set forth in this Agreement or otherwise, breaches this Agreement.

6. Financial Responsibilities upon Termination. If the Member breaches this Agreement or if the Trust terminates participation of the Member under any provision of this paragraph, the Member shall bear the full financial responsibility for any unpaid contributions and shall forfeit all contributions or other payments already made to the Program. The Trust may seek any amount due as liquidated damages from the terminated member, including, without limitation, the initial estimated and adjusted contributions that may be due to the Trust. The Trust reserves the right to distribute premium reductions or refunds, if any, in a manner determined by its Board of Trustees. The Member shall remain jointly and severally liable for workers’ compensation obligations of the Trust and its members which were incurred during the cancelled or terminated Member’s period of membership.

7. Contributions.

a. Payment of Contributions. The Member agrees to pay contributions based on a plan developed by the Trust. The contribution will be based on the experience adjusted rates multiplied by the annual payroll as shown on the Contribution and Coverage Summary. Contributions are payable upon receipt of an invoice from the Fund.

b. Contribution Payment Plan. The Contribution Payment Plan requires the payment each Fund Year of the annual contribution in equal quarterly installments with the first such payment being due before the start of the Fund Year.

c. Estimated Contributions. The contribution(s) shown on the Contribution and Coverage Summary are estimated. Upon expiration of each annual participation period, the Member will report the actual payroll by classification code, on a form provided by the Trust or the Trust will conduct an on-site payroll audit. Application of the actual payroll by classification code will be applied to the rates as specified in the Contribution and Coverage Summary. As a result of this reconciliation, any additional contributions due shall be paid to the Trust by the Member within 30 days of receipt of invoice. Any overpayments of contributions due to the Member shall be credited or returned by the Trust. The Trust reserves the right to audit the payroll records of any Program Participant. Contributions will be calculated annually during the term of this Agreement and this Agreement is subject to the most recent Contribution and Coverage Summary.

d. Non-Payment and Late Charges. Any Member which fails to pay any contribution, or portion thereof, within twenty (20) days of the due date, may be terminated pursuant to Section 5(c) herein. A late payment charge of ten percent (10%) of the billing may be imposed and collected for any payment, or portion thereof, made after twenty (20) days following the due date.

e. All premiums and other payments by the Member to the Trust shall be made payable to the Mississippi School Boards Association Workers' Compensation Trust, and shall be mailed to P. O. Box 203, Clinton, Mississippi, 39060, or to such other address as the Board of Trustees of the Trust shall advise the Member.

8. Membership. Upon approval by the Board of Trustees of the Trust, satisfaction of all requirements of membership and upon the Effective Date, the Political Subdivision shall become a “Member” as that term is defined in the Mississippi School Boards Association Workers' Compensation Trust Agreement, a copy of which is attached hereto (hereinafter together with all modifications and amendments thereto called the “Trust Agreement”). The Trust shall pay, according to the provisions and procedures set out in the Trust Agreement, description of insurance coverage, and related documents, the workers' compensation obligations of the Members, and defend or settle any workers' compensation claim against a Member.

9. Agreement to be Bound. The Member does hereby agree to fully participate in and pay all premiums, contributions, deficiencies, assessments and billings required by the Program in accordance with the terms, provisions and conditions of said Program. The Member further agrees to adhere to and be governed by all provisions of the Trust Agreement, the terms of any agreement between the Trust and a Service Company, the Rules and Regulations of the Trust, any quotes, notice of coverage or other terms of the Program as determined by the Board of Trustees and any other directives of the Board of Trustees all as may now be in effect or as may be amended from time to time.

10. Attorney-in-Fact. The Member hereby appoints the Administrator of the Trust as its agent and attorney-in-fact to act in its behalf and to execute all contracts, reports, waivers, agreements, excess insurance contracts, and service contracts; and to make or arrange for payment of claims, medical expenses, and all other things necessary or desirable under Mississippi law and as covered by the terms of the Trust Agreement and the Rules and Regulations of the Trust as presently in effect or as hereafter promulgated by the Trustees or the Commission.

11. Prior Claims or Events. The Member shall be solely financially responsible for all workers' compensation claims that pre-date or that arise out of events or circumstances that pre-date the Effective Date of the self-insurance provided pursuant to the terms of this Agreement, and the Member shall hold the Trust financially harmless on such claims.

12. Law. The Member shall accept and be bound by the provisions of the Mississippi Workers' Compensation Law as it now exists or may be hereafter amended. All provisions of the Mississippi Workers' Compensation Law shall be and remain a part of the agreement between the Members and the Trust. This Agreement is executed in the State of Mississippi and all questions pertaining to its validity, construction, and administration shall be determined in accordance with the laws of this state, except to the extent preempted by federal law.

13. Joint and Several Responsibility. The Member shall be jointly and severally liable with all of the other Members of the Trust and the Trust for workers’ compensation obligations of the Trust and its members that were incurred during the Member’s period of Membership.

14. Risk Management. The Member shall adopt a loss prevention plan, which shall be coordinated with the Trust to make all reasonable efforts to eliminate and minimize hazards which would contribute to workers’ compensation losses. The Member shall comply with all reasonable requests concerning risk management and loss control by MSBA or other Service Company.

15. Claims Administration. The Trust shall handle any and all claims after the first notice of loss has been given by the Member to the Trust. The Member agrees to appoint the Trust, or its designee, to act in all matters pertaining to the proceeding and handling of any and all workers’ compensation claims arising from coverage with the Trust and shall cooperate fully in supplying all information needed to adjust, settle and defend such claims. The Trust, or its designee, shall administer the Program.

16. Payment of Claims or Awards. Each Member must give immediate notification to the service company of the Trust (the “Service Company”), on the prescribed forms or online, of any accident, reported claim or filing of suit for any benefits payable under the Mississippi Workers’ Compensation Law. Any penalty levied under Mississippi Workers’ Compensation Law for failure to pay compensation benefits, medical expenses or travel allowances within the time prescribed which results from a Member’s failure to give such timely notice to the Service Company may, by a vote of the Trustees, be assessed against the Member.

17. Unauthorized Payments by Members. No Member shall make voluntary payment of weekly benefits or medical expenses or enter into any agreement with any employee, or his or her agent, committing payment, admitting liability, assuming any obligation, or incurring any expense under the Mississippi Workers’ Compensation Law without the prior approval of the Board of Trustees. Any Member making such voluntary payment or entering into such an agreement may, by a vote of the majority of the Trustees, be held individually and separately liable for reimbursement to the Trust for all benefits and medical expenses paid or committed.

18. Employment of Persons without Workers’ Compensation Coverage. All Members should strive to never contract with any person, including contractors or subcontractors, who have not produced evidence of current workers’ compensation insurance according to the provisions of the Mississippi Workers’ Compensation Law. When this is not possible, a Member who contracts with any person who does not have current workers’ compensation insurance will be charged an additional non-discounted standard premium based upon the full amount of the contract.

19. Trust Agreement. The Member hereby agrees to abide and be bound by the provisions of the Trust Agreement.

20. Governance. The Trust shall be governed by its Board of Trustees in accordance with the provision of the Trust Agreement.

21. Contribution Adjustment. Nothing in this Agreement shall relieve the Member of its obligation as an employer self-insuring through this program. In the event that the Trust’s income from operations in any given Fund Year is inadequate to pay the ultimate cost of claims incurred during that Fund Year, the Trust may collect an adjusted contribution from the Member, regardless of whether the Member presently participates in the Program.

22. Refund Plan. The Trust at its sole discretion may declare and distribute a refund of the Member’s equity. The Member hereby acknowledges receipt of the Refund Plan of the Program attached hereto as Exhibit “B”.

23. Defense and Prosecution of Claims. Member authorizes the Trust to engage counsel and any and all necessary experts and consultants, in the Trust’s sole discretion, to handle the adjustment, settlement and defense of any claim or dispute involving the Member for which coverage is provided in accordance with the Program.

24. Investments. The Trust may invest Member contributions, or any portion thereof, in accordance with guidelines approved by the Board of Trustees.

25. Litigation. Member hereby agrees that any suit brought against the Member pursuant to the provisions of this Program may be defended in the name of the member by counsel selected in the sole discretion by the Trust, or its designee, on behalf of and at the expense of the Program as necessary for the defense and/or prosecution of any legal action. Member shall provide any and all information reasonably necessary or required to prosecute or defend any such legal action

26. Member Representative. Member agrees to identify and designate a representative who shall have authority from the Member’s board to represent and bind the Member and the Trust shall not be required to contact any other individual regarding any and all matters involving the Trust and affecting the Member. Any notice to or agreements with the Member representative shall be binding upon the Member, which reserves the right to change the Member representative by providing written notice to the program. Such notice shall not be effective until actually received by the program.

27. Notices. Any and all notices, statements, invoices and the like to be given the Member shall be addressed to the Member at the address on the records of the Association, which address the Member may change by appropriate written notice to the Trust at the address set forth below, which address may be changed by the Trust upon giving proper written notice to the Member:

Mississippi School Boards Association

Workers' Compensation Trust

P. O. Box 203

Clinton, MS 39060

28. Effect of Partial Invalidity. In case any provisions of this Agreement shall be held illegal or invalid for any reason, said illegality or invalidity shall not affect the remaining provisions of this Agreement.

29. Captions. The captions contained in this Agreement are for convenience of reference only, and in no way limit or enlarge the terms and conditions of this Agreement.

30. Amendments; Binding Effect. Except as provided in this Agreement, the Trust Agreement, or the Rules and Regulations of the Trust, this Agreement may not be altered, changed, or amended except by an instrument in writing signed by both parties hereto. The terms, provisions, covenants and conditions contained in this Agreement shall apply to, insure to the benefit of, and be binding upon the parties hereto, and upon their respective successors in interest, assigns and legal representatives, except as otherwise herein expressly provided.

[Signature Page to Follow]

IN WITNESS WHEREOF, the undersigned Member has executed this Membership Participation Agreement effective upon the Effective Date.

Jackson County School District _______________________________________

(NAME OF MEMBER)

_______________________________________

(SIGNATURE)

_______________________________________

(NAME AND TITLE OF PERSON SIGNING)

_______________________________________

(DATE)

ACCEPTED, this the ______ day of _____________________, 20____.

THE MISSISSIPPI SCHOOL BOARDS ASSOCIATION

WORKERS' COMPENSATION TRUST

BY: __________________________________________

ITS: __________________________________________

EXHIBIT “A”

CERTIFIED COPY OF A RESOLUTION OF

THE BOARD OF TRUSTEES OF

 Jackson County School District 

It is hereby certified that the following is a true and correct copy of a resolution duly adopted by the Board of Trustees of the above named school district at a meeting of the Board of Trustees of  Jackson County School District    held on the _______ day of _________, 20___ and that said resolution is in full force and effect and has not been revoked.

WHEREAS,  Jackson County School District    , a Political Subdivision of the State of Mississippi, desires to participate as a member of a self-insurance group according to the provisions of the Mississippi Workers' Compensation Law and the rules of the Mississippi Workers' Compensation Commission, and for that purpose desires to authorize Dr. Barry Amacker, Superintendent of said school district, to execute all instruments, agreements or other requirements of the Commission for acceptance of this school district as a member of a self-insurance group, including but not limited to, an application, indemnity agreement, power of attorney, and financial statement.

NOW, THEREFORE, BE IT HEREBY RESOLVED that

Dr. Barry Amacker, Superintendent of this school district, is hereby authorized to execute on behalf of this school district all instruments and agreements required by the Mississippi Workers' Compensation Commission for acceptance of this school district as a member of the Mississippi School Boards Association Workers' Compensation Trust.

IN WITNESS WHEREOF, I have affixed by signature and attached the seal of said school district on this the ______ day of _______, 20____.

__________________________________

Secretary

SEAL

EXHIBIT “B”

MISSISSIPPI SCHOOL BOARDS ASSOCIATION

WORKERS' COMPENSATION TRUST

REFUND PLAN

1. Any monies for a Fund Year in excess of the amount necessary to fund all obligations for that Fund Year may, in the sole discretion of the Board of Trustees, be declared to be refundable by the Board of Trustees on such terms as determined by the Board and approved by the Commission. Any refund declared shall be made in accordance with a formula that takes into account the loss experience of the Program, the payments of each Member, and the loss experience of the Member.

2. Any refund declared by the Board shall be payable not less than twelve (12) months after the end of the Fund Year.

3. A refund shall be paid only to those Members who remain Members of the Program for the entire Fund Year.

4. Refunds based on a premium Fund Year shall not be contingent upon continued membership in the Program after that Fund Year.

5. All terms used herein shall have the same meanings as set out in the Mississippi School Boards Association Workers' Compensation Trust Agreement.

6. This Refund Plan may be subject to change as required by the Mississippi Workers' Compensation Law or the rules of the Mississippi Workers' Compensation Commission.

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