Res 1601 - Workers Comp Voluntr
COUNCIL BILL NO. 2265
RESOLUTION NO. 1601
A RESOLUTION EXTENDING WORKERS' COMPENSATION COVERAGE TO
CERTAIN VOLUNTEERS OF THE CITY OF WOODBURN.
WHEREAS, the City wishes to protect its volunteer workers from injuries arising
out of or in the scope of their service to the City, now, therefore,
THE CITY OF WOODBURN RESOLVES AS FOLLOWS:
Section 1. Pursuant to ORS 656.031, the City of Woodburn elects to provide
workers' compensation insurance to the following classes of volunteer workers listed on the
attached Volunteer Election Form (Exhibit A), by reference incorporated herein.
Section 2. Hours worked by non-public safety volunteers will be accounted for
on an hourly basis and hours worked will be reported in the correct class code for the type of
work being performed using Oregon minimum wage.
Section 3. A roster of active volunteers will be kept monthly for reporting
purposes. It is acknowledged that City/County Insurance Services (CIS) may request copies of
these rosters during year-end audit.
Section 4. Unanticipated volunteer projects or exposures not addressed herein
will be added onto the City of Woodburn's coverage agreement (1) by endorsement, (2) with
advance notice to CIS, and (3) allowing two weeks for processing, It is hereby acknowledged
that coverage of this type cannot be backdated.
Approved as to for:n~ (?Jv:O
City Attorney
q- Zz- 201)'0
Date
Passed by the Council
Submitted to the Mayor
Approved by the Mayor
Filed in the Office of the Recorder
ATTEST b ~
Mary Tennan Recorder
City of Woodburn, Oregon
September 25, 2000
September 27, 2000
September 27. 20QO
September 27, 2000
Page 1 - COUNCil... BILL NO. 2265
RESOLUTION NO. 1601
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VOLUNTEER ELECTION FORM
Keep monthly rosters! CIS may request copies o/rosters during year-end audit.
Public Safety Volunteers
The following volunteer positions are reported in NCCI Classification Code 8411, using an assumed monthly wage
of no less than $800 per month (regardless if one day or 30 are worked) for premium payment and calculation of
benefits. This assumed monthly wage may be increased at the employer's discretion in increments of$100. Please
refer to your entity's volunteer resolution for the amount to use infilling out Column No.2 below.
City/County Insurance Services
Volunteer Election Form for Coverage Year 7/112000 to 613012001
Multiply (1) x (2) = Estimated Assumed Payroll
Volunteer Category NeCI (1) (2) (3)
Code Est. No. of Assumed 2000-01 Estimated
Volunteer Monthly Assumed Payroll
Months* Wage
Ambulance Driver 8411 ~
Ambulance Technician 8411 -
Crime Prevention Unit 8411 -
Deputy Sheriff 8411 -
Emergency Medical Technician 8411 -
Explorer Scout 8411 -
Fire Chief/Asst. Fire Chief 8411 ....
Firefighter 8411 -
Police Officer 8411 -
Police Reserve 8411 -
Probation Officer 8411 -
Search and Rescue 8411 -
Sheriff's Posse 8411 -
Surf Rescue 8411 -
Other (please specify) 8411 -
.Using last year's rosters, estimate the number of volunteer months for each position and enter the total on the appropriate line in
Column (1). Some volunteers are not active evCty month, i.e.. one volunteer firefighter may be active five months out of the year, two
volunteer firefighters may be active 12 months out of the year, and five volunteer firefighters may be active only one month out ~fthe
year. Thus, th~ number.ofvolunteer firefighter months would be 34. . .;'/' ..:
..
lof3
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Other Volunteers
Unpaid boards, commissions, councils, and public officials: If these officials receive any "remuneration," they
would be considered subject workers and reported using regular payroll categories. If they receive no remuneration
and you wish to provide workers' compensation benefits, you will need to either establish an assumed monthly wage
or keep monthly time records and estimate/report assumed payroll using Oregon minimum wage. CIS has
designated Class Code 8742V for this type of exposure. Please call if you have questions or need advice.
Inmates/Community Service Workers: If your entity uses workers from the correctional system (i.e., community
service workers, inmates on work release, peer review crews, etc.), it is important to address and clarify in writing
PRIOR to work inception which entity will be responsible for covering this exposure. CIS recommends you obtain
a Certificate of Coverage for Workers' Compensation from the sentencing court or make arrangements to provide
coverage through your own entity. If the second option is chosen, keep monthly time records and report these
workers using Oregon minimum wage. CIS has designated Class Code 7720V for this type of exposure.
Miscellaneous: Assumed payroll for all other volunteer elections should be computed at Oregon minimum wage
using actual hours worked and reported in the appropriate NCCI classification code with a "V" added to the end.
Unanticipated volunteer projects or exposure can be added on throughout the coverage year (1) by endorsement,
(2) with advance notice to CIS, and (3) allowing two weeks for processing. Coverage of this type cannot be
backdated.
City/County Insurance Services
Volunteer Election Form for Coverage Year 711/2000 to 6/30/2001
Multiply (1) x (2) x (3) x (4) = Estimated Assumed Payroll
Volunteer Category NCCI (1) (2) (3) (4) (5)
Code Est. No. of No. of No. of Oregon 2000-01
Volunteers Hours Months Minimum Estimated
per month per month per year Wage Assumed
Payroll
Boards, Commissions, 8742V
Councils, Public Officials
Building Maintenance 9015V
Clerical 8810V IDA;~ ,/-0 /;)... &,.5'0 3,,1:20 ~
Community Center 9102V
Community Service Workers 7720V
Community Project
(please call CIS for proper class code)
Community Sponsored Events
(please call CIS for proper class code)
Emergency Telecommunicators 8810V
Fireworks 9410V 3x(P~ -: /rA~h !r (,,- SD //7,00
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City/County Insurance Services
Volunteer Election Form for Coverage Year 7/112000 to 6/3012001
Multiply (1) X (2) x (3) X (4) = Estimated Assumed Payroll
Volunteer Category NCCI (1) (2) (3) (4) (5)
Code Est. No. of No. of No. of Oregon 2000-01
Volunteers Hours Months Minimum Estimated
per month per month per year Wage Assumed
Payroll
Garbage/Refuse 9403V
Hospital
(please call CIS For proper class code)
Inmates on Work Release 7720V
Interpreters 8810V
Janitorial 9015V
Landscaping 9102V
Library 8810V 1/ tt<<' I h .;1.5 /~ 4-,s-0 ;; lj SO c.,E
--
Lifeguards (pools) 9015V
Lifeguards (beaches & rivers) 9102V
Mealsite Volunteers 9079V
Parks & Drivers 9102V
Planting 0042V
Public Health
(please call CIS for proper class code)
Replacement Workers
RV Park 9015V
Senior Center 9061V
Sewer & Drivers 7580V
Sewer/Street Cleaning 9402V
~,
Snow Removal 9402V
Street/Road Maintenance 5506V
Victim Assistance 8810V
Waterworks & Drivers 7520V
30f3
*Estimate the number of volunteer hours in each class code and enter it in Column (1).
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