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Agenda 06-03-2025; 8-q - Approval to Increase in the Letter of Credit Required from Travelers Indemnity Company for Secure Payment of Workers Compensation Deductibles
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Agenda 06-03-2025; 8-q - Approval to Increase in the Letter of Credit Required from Travelers Indemnity Company for Secure Payment of Workers Compensation Deductibles
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5/29/2025 1:43:13 PM
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BOCC
Date
6/3/2025
Meeting Type
Business
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Agenda
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8-q
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DocuSign Envelope ID: FCD9FE56-CF01-4E96-B983-B8E8DFE6811C <br /> 28 <br /> LOSS FUND EXHIBIT <br /> In connection with your Workers Compensation & Employers Liability program,we will make Plan Losses,Allocated Loss Adjustment <br /> Expenses and Claims Handling Charges(together referred to as"Loss Transaction"or"Loss Transactions")on your behalf under your <br /> insurance or self-insured program using checks drawn against one of our bank accounts. You acknowledge that these Loss <br /> Transactions are Obligations as defined in your Insurance Program Agreement. In exchange for our agreement to pay Loss <br /> Transactions on your behalf,you agree to the following: <br /> • You will designate a bank and account("Source Account")against which monthly Automated Clearing House("ACH")debits <br /> will be drawn by us as payment of your Loss Transactions. <br /> • You will provide us with the documentation authorizing Bank of America to make monthly charges and reimbursements at <br /> our direction including a signed authorization letter to direct Bank of America to draw ACH debits against your Source <br /> Account,along with the Source Account codes and Source Account's bank ABA Code. <br /> • We will determine the amount due to us by combining the monthly Loss Transaction payments,along with any corrections <br /> caused by edits on each Loss payment.This amount will be sent electronically to Bank of America with instructions to draw <br /> an ACH debit on your Source Account. <br /> In addition to deposit amount agreed to in the Loss Fund Requirements section of the applicable Program Exhibit,we will periodically <br /> perform an analysis of Loss Transactions based upon data from our billing systems to determine the adequacy of the deposit amount. <br /> If we, in the exercise of our good faith discretion, determine additional deposits to the Loss Fund Requirements are necessary, this <br /> amount will be sent electronically to Bank of America with instructions to draw an ACH debit on your Source Account. Upon request, <br /> we will provide you with documentation of the Loss Transactions payment analysis. <br /> Reports identifying Loss(es) and Allocated Loss Adjustment Expense payments must be accessed electronically by you via e-TRACER <br /> reporting.These reports identify the Loss Transactions and a premium tax,if applicable for your program with us. <br /> We may automatically continue these payment and billing arrangements if your Insurance program is renewed. If your Insurance <br /> program is cancelled or not renewed, we reserve the right to continue or discontinue these payment and billing. If TRACER is <br /> discontinued by either of us,your program will change to a monthly billed program,and each month after TRACER is discontinued,we <br /> will send you an invoice for the total amount of Loss Transactions due. Upon receipt,you will pay the amount due on or before the <br /> date set forth on the invoice. <br /> Version 08.19.19 Loss Fund Exhibit Orange County Page 21 <br /> ©(2019)The Travelers Indemnity Company.All rights reserved. <br />
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