Boone%20County%20BOE%202024%20proposal.pdf

Parent document: REVISED - Regular Meeting - Meeting #41-06-17-2024.pdf

Text

encova

INSURANCE

400 Quarrier St.
Charleston, WV 25301

NOTICE OF DEPOSIT PREMIUM DUE

Boone County Board of Education
69 Ave B
Madison, WV 25130

Quote Number: Q755602-000

Renewal Of: WCN6006986

Quote Date: 05/30/2024

Deposit Due Date: 07/01/2024
Total Policy Premium: $236,199.00

Agency: Ferrell & Hill Insurance Agency LLC
Phone: (304) 369-1111

Workers’ Compensation Policy Effective 07/01/2024-07/01/2025

Minimum Deposit Premium Due 07/01/2024

Total Premium: $225,079.00

Total Surcharge: $11,120.00

Total Policy Premium: $236,199.00
Quote Deposit: $35,430.00

Payments Applied to Quote: $0.00

$35,430.00 |

You must pay the minimum deposit amount due to activate coverage.

If you have any questions concerning account payment, please call between the hours of
8:00AM and 5:00PM Monday through Friday at 844-362-6821 or 1-304-941-1000 or visit us

at www.encova.com

Remove the stub below and return with your payment

encova _

INSURANCE

Q755602-000
07/01/2024

Quote Number:
Due Date:

Amount Enclosed:

Boone County Board of Education
69 Ave B
Madison, WV 25130

0000000000

Make checks payable to:

Encova Insurance
Credit Card Payments:

Please pay online at www.encova.com
* please do not remit cash

PAYMENT MUST BE RECEIVED BY DUE DATE

PTET TT EPP tt tet tt

Send Payments to:

Encova Insurance

PO BOX 11285

CHARLESTON, WV 25339-1285

533368901 000000Q755602000


encova

INSURANCE

Workers’ Compensation Insurance

Quote Date: 05/30/2024
Quote #: Q755602-000
Proposed Policy Period: 07/01/2024 - 07/01/2025

Installment Schedule

Installments Due Date Installment
Deposit Premium 07/01/2024 $35,430.00
Installment 08/21/2024 $20,077.00
Installment 09/21/2024 $20,077.00
Installment 10/21/2024 $20,077.00
Installment 11/21/2024 $20,077.00
Installment 12/21/2024 $20,077.00
Installment 01/21/2025 $20,077.00
Installment 02/21/2025 $20,077.00
Installment 03/21/2025 $20,077.00
Installment 04/21/2025 $20,077.00
Installment 05/21/2025 $20,076.00

Please note this Installment Schedule is valid for this quote as written, any change in this
quote or its resulting policy is not reflected here in. A $0 fee will be charged for each
installment listed above.

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QP0001 Page 2 of 7

(Ed. 7-21)


encova

INSURANCE

Workers' Compensation Insurance
Proposed Policy Period: 07/01/2024 - 07/01/2025 Quote # Q755602-000

Coverage
Part I. Workers’ Compensation Insurance - Statutory

Part II. Employer's Liability Limit:

$1,000,000.00 Bodily injury by accident, each accident
$1,000,000.00 Bodily injury by disease, policy limit
$1,000,000.00 Bodily injury by disease, each employee

West Virginia Broad Form Employers Liability excluded.

States Covered
WV

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QP0001 Page 3 of 7

(Ed. 07-21)


encova

INSURANCE

Workers' Compensation Insurance
Proposed Policy Period: 07/01/2024 - 07/01/2025

Code
State: WV

Description

Premium Period: 07/01/2024 - 07/01/2025

Location: 33

7380

8868

9101

9812
9898
9889

0900
9740
9741

9703
9704

DRIVERS, CHAUFFEURS,
MESSENGERS AND THEIR HELPERS
NOC-COMMERCIAL

COLLEGE: PROFESSIONAL
EMPLOYEES & CLERICAL

COLLEGE: ALL OTHER EMPLOYEES

Employers Liability Limits
Experience Modification Premium
Schedule Rating Premium

Total Standard Premium

Expense Constant

Terrorism

Catastrophe (Other than certified acts of
terrorism)

WV Regulatory Budget Surcharge
WV Fire and Casualty Surcharge

Policy Estimated Annual Premium
Policy Total Amount Due

Quote # Q755602-000

Exposure Rate

$1,359,367.00 2.41

$22,885,095.00 0.24

$1,988,007.00 2.71

0.014
1.44
1.05

0.01
0.02

0.05
0.0055

Total

$32,761.00

$54,924.00

$53,875.00

$1,982.00
$63,158.00
$10,335.00
$217,035.00
$175.00
$2,623.00
$5,246.00

$11,104.00
$16.00

$225,079.00
$236,199.00

NOTE: Premium listed is an estimated annual premium based upon submitted payroll exposures.

This proposal shows the premiums for the coverages described, but in no way changes or affects any terms,
conditions or exclusions of the policies currently in existence. Proposed premiums shown are based on information
furnished to us. If accepted, the coverages in this proposal will commence upon the expiration of any policies
currently in effect. Coverage comparisons are available if desired. This proposal will expire 30 days from the quote
date or at the requested effective date whichever occurs first. Please note that the premium indicated may be
subject to change prior to activating coverage due to state rate approval that may occur after the quote was issued.

QP0001
(Ed. 07-21)

.€ncova.com

Page 4 of 7


encova

INSURANCE

Workers' Compensation Insurance
Proposed Policy Period: 07/01/2024 - 07/01/2025 Quote # Q755602-000

IMPORTANT NOTICE REGARDING EXPIRATION OF CURRENT WORKERS’
COMPENSATION INSURANCE COVERAGE.

The current workers compensation insurance coverage provided by Policy Number WCN6006986 is scheduled to
expire at 12:01 am on 07/01/2024 In the event this proposal is not accepted and the initial premium for a renewal
policy is not received on or before 07/01/2024, your current policy will lapse (expire) at the time and on the date
identified above and the lapse (expiration) of workers’ compensation insurance coverage will be reported to the
appropriate state regulatory body.

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QP0001 Page 5 of 7

(Ed. 07-21)


encova

INSURANCE

Workers' Compensation Insurance
Proposed Policy Period: 07/01/2024 - 07/01/2025 Quote # Q755602-000

POLICYHOLDER DISCLOSURE
NOTICE OF TERRORISM
INSURANCE COVERAGE

Coverage for acts of terrorism is included in your quote You are hereby notified that under the Terrorism Risk
Insurance Act, as amended in 2015, the definition of act of terrorism has changed. As defined in Section 102(1) of
the Act: The term “act of terrorism” means any act or acts that are certified by the Secretary of the Treasury --in
consultation with the Secretary of Homeland Security, and the Attorney General of the United States --to be an act
of terrorism; to be a violent act or an act that is dangerous to human life, property, or infrastructure; to have resulted
in damage within the United States, or outside the United States in the case of certain air carriers or vessels or the
premises of a United States mission; and to have been committed by an individual or individuals as part of an effort
to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United
States Government by coercion. Under your coverage, any losses resulting from certified acts of terrorism may be
partially reimbursed by the United States Government under a formula established by the Terrorism Risk Insurance
Act, as amended. However, your quote may contain other exclusions which might affect your coverage, such as an
exclusion for nuclear events. Under the formula, the United States Government generally reimburses 85% through
2015; 84% beginning on January 1, 2016; 83% beginning on January 1, 2017; 82% beginning on January 1, 2018;
81% beginning on January 1, 2019 and 80% beginning on January 1, 2020, of covered terrorism losses exceeding
the statutorily established deductible paid by the insurance company providing the coverage. The Terrorism Risk
Insurance Act, as amended, contains a $100 billion cap that limits U.S. Government reimbursement as well as
insurers' liability for losses resulting from certified acts of terrorism when the amount of such losses exceeds $100
billion in any one calendar year. If the aggregate insured losses for all insurers exceed $100 billion, your coverage

may be reduced.

The portion of your annual premium that is attributable to coverage for acts of terrorism is $2,623.00 , and does not

include any charges for the portion of losses covered by the United States government under the Act.

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QP0001 Page 6 of 7

(Ed. 07-21)


encova

INSURANCE

Encova 360° Team Approach

Account Management:

Post-sale and day-to-day servicing of all accounts
Liaison for client, broker and Encova Insurance
Orientation and On Boarding

Account/claim reviews

WC practices and RTW training

Benchmarking claim performance

Medical Provider Selection Assistance

Vendor Management

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Loss Control Services:

On-site Risk Assessment

Documented Workplace Safety Recommendations
OSHA Approved Safety Training

National Safety Council Approved Training

Free Access to Extensive Safety Video Library
Web Based Safety Resources

Industry Experienced Safety Specialists

laims Services:

Twenty four (24) Hour Contact

Cost Reduction Programs
Case Management Services
Medical Cost Containment
Procedure/Bill Review by Medical Specialists
Return to Work/Rehabilitation Services
Medical Provider Selection Assistance
Vendor Management
§ Special Investigative/Fraud Units
§ Pro-Active Claims handling
§ Specialized Services

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Litigation Management:

§ Reduce frequency and extent
§ Panel counsel

§ Litigation strategy

§ Savings to policyholders

Underwriting Services:

Competitive Coverage and Pricing Options
Prompt Response to Coverage Questions
Flexible Premium Payment Options

Small and Large Deductible Programs
Association Safety Discount Programs
Dividend Programs

Incurred Loss Retrospective Rating Programs
Premium Finance Availability

Specialized Team Approach

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Audit Services:

On-Site Payroll and Classification Verification
Telephonic and Mail Audit Options
Recordkeeping Assistance

Class Dispute Resolution Assistance

Detailed Audit Results Statement

Extensive Classification Consultation Resource
Industry Experienced Premium Auditors

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QP0001 Wwww.encova.com Page 7 of 7
(Ed. 7-21)