human resources administrative services

Request for Proposal

Your company has been selected to provide a proposal for HUMAN

RESOURCES ADMINISTRATION services for the CITY OF RIDGECREST. All

proposals must be submitted according to the submission guidelines below.

Please NOTE:

This information has been submitted to your company for the

purposes of providing a proposal ONLY. This information is to be treated as

highly confidential and must not be used or shared with any other companies or

individuals. This information is not to be shared with any brokers, agents,

agencies, or any outside parties without the prior written consent of the CITY OF

RIDGECREST.

Please submit all communications to:

CITY OF RIDGECREST RACHEL J FORD

100 W CALIFORNIA AVE. RIDGECREST, CA 93555

760-499-5002

Proposal Submissions Guidelines Please submit 3 of each of the following:

Hard copies of HUMAN RESOURCES ADMINISTRATION proposal no

later than July 30, 2011.

o Proposal to include list of services and pricing including setup fees,

administrative fees as a percentage of gross wages, outline of all

employer taxes, workers compensation rates etc.

Benefits Proposal including:

o All available benefits including overview of coverage and rates

Completed RFP Questionnaire (attached)

Marketing packages including collateral about HUMAN RESOURCES

ADMINISTRATION

HUMAN RESOURCES ADMINISTRATION Company Overview including

o HUMAN RESOURCES ADMINISTRATION accomplishments and

pertinent Press Releases

o Key executive Bios

o Accreditations

o Independent (third party) accounting procedure review

Client references including company name, contact and phone number

Client List

Letter or recommendations (if available)

Company Profile Established 1963 Line of work LOCAL GOVERNMENT SIC Code 9199

Ownership PUBLIC AGENCY Number of employees 188 Annual Gross Wages $6,279,380 BASE SALARY RATE

Payroll Distribution 7720 SAFETY/ANIMAL CONTROL $2,131,820 8810 CLERICAL $1,719,637 9410 MUNICIPAL NON MANUAL $998,548 9420 MUNICIPAL (WWT/MNTC) $1,209,443 9422 STREETS $219,932

Other Items - Attached Scope of Work

3 Years loss runs Organizational Chart

Employee census Summary Section 125 Cafeteria plan description

Health – CalPERS major medical Dental – Self-Insured Vision – Self-Insured Supplemental Health - AFLAC 457 Deferred Compensation – ICMA-RC Term Life Insurance – UNUM & MetLife

This Page Intentionally Left Blank

RFP Questionnaire 1. When was your company founded?

2. How many Clients are currently using the company?

3. Please give a brief description of the types of clients you serve.

4. Please describe your current Workers’ Compensation offering including

carrier information, policy administration, and safety services.

5. How many employees is your company currently administering?

6. How many employees are part of the actual PEO group (in-house

administrative group)?

7. Please describe the 2010 performance of your Large Group Health Plan (if

offered).

8. Please describe your current Time and Attendance tracking offering.

9. Please submit a sample of the following:

a. New hire packet

b. Payroll job costing report

10. Does your company have any Spanish-speaking employees or materials

available for assistance with Spanish-speaking employees?

11. What is your company’s Involvement in NAPEO?

12. Is your company a member of any Trade Associations or the Better

Business Bureau?

13. Is there any training offered (safety, HR, etc.)?

14. Are training costs included in the annual fee for service? If not, what is the

cost for training services.

15. What is your mission statement?

16. What is your company’s experience with Public Sector Clients?

17. What is your company’s experience working with California Public

Employee Retirement System (CalPERS)?

18. Please describe your customer service levels.

19. What is your company’s experience or level of accessibility (i.e. electronic,

telephonic, in-person)?

20. Please outline your company’s procedures and recommendations for on-

site presence.

21. What is your company’s experience in California?

22. Does your company have a plan for emergency response after normal

working hours? If so, please outline the plan including methods of

communication, response time, availability, and unscheduled on-site visits.

23. Please describe your experience managing a Section 125 Cafeteria Plan

and third party administration of individual health plans.

City of Ridgecrest is accepting bids for a full service firm to perform administrative functions in areas of Human Resources and Risk Management. The functions listed below occur on annual or monthly basis and are generally intermittent in nature. This RFP is for administrative services as outlined in this scope of work.

Scope of Work Recruitment/Employment Administration

• Administer Recruitment Process including advertising, application review, applicant communications, assessment testing, interview assistance, contingent job offer, backgrounds, new hire packets, and employee orientation

• Administer forms and publications for employees including but not limited to handbooks, personnel rules and policies, mandated notifications, health and dental benefits, safety training, etc.

• Maintain City’s Diversity and Affirmative Action Plan • Produce and File Annual State and Federal Affirmative Action Plan

reports. Health Plan/Benefits Administration

• Organize and Assist with Annual Open Enrollment Processing, Employee Health Fair, Consulting Services.

• Provide On-Going Enrollment Services for employees • Provide Benefits Knowledgebase & Decision Support Tools for Employees • Provide and maintain Employee Benefits Communications/Forms • Assist in the design, implementation and administration of new and

existing programs • Make recommendations for items of negotiation with benefit plan providers

including, but not limited to, plan design, cost (rates), and quality of services

• Review and analyze all benefit plan provider agreements for compliance with all applicable federal and state laws, statutes and regulations and the City agreement

• Assist HR in the preparation and/or review and updating of benefit plan documents and benefit summary plan descriptions for self-funded benefit plans

• Regularly and timely communicate to the City changes and proposed changes in state and federal laws, statutes and regulations that may impact the City’s employee benefit plans and programs. Recommend procedures and/or policies the City should implement to comply with federal and state statutes and regulations

• Administer City’s self-insured dental plan enrollment, forms, claims, and billing.

• Provide research and responses to technical questions posed by HR staff

Life Insurance Administration

• Administer Enrollments into City sponsored MetLife term Life Insurance Benefit • Coordinate bi-weekly adjustments and reconciliations • Provide claims assistance to employees and/or beneficiaries as needed.

COBRA Benefits • Administer Qualifying Events determinations & Election Processing • Provide Initial Notification Services to eligible employees • Provide Monthly Premium Billing, Collection, and reconciliation as needed. • COBRA Health Care Continuation • Enrollment & Eligibility Administration FMLA Administration

• Administer Enrollment • Maintain Forms and Notifications in compliance with State and Federal

law • Assist Payroll with Monitoring FMLA Time used. • Generate Annual Reports

FLSA Administration

• Monitor, Update, and Maintain Council Adopted Classification Specification Plan as needed

• Monitor City Compensation Plan and make recommendations as necessary to maintain standard compensation rates.

• Update and maintain Administrative and Personnel Policies and Procedures

• Monitor and assist with State and Federal Law Compliance ADA Administration

• Update and maintain Administrative and Personnel Policies, Procedures, Classification Specifications to ensure compliance with ADA Requirements.

• Administer and document the ADA Interactive Process as needed. • Conduct Job Analysis of current and new classification specifications to

identify essential functions. • Provide forms, analysis, and recommendations for reasonable

accommodation as needed.

Human Capital Management (HCM) • Provide Human capital management and succession planning support and

training. • Assist with Performance management and evaluations. • Provide assistance, technically and creatively, in the on-going

development and preparation of various employee communication materials

• Provide Absence and Protected Leave Management, Tracking, and Reports (FLSA, FMLA, CFRA, SDI, FEHA, ADA, PFL)

Risk Management

• Provide Third Party Workers Compensation Claims Administration • Provide Monthly Loss Run Reports for Workers compensation and Liability

Claims. • Provide Annual OSHA 300 Log • Assist with renewals and communications with the City’s Self-Insurance

Plan & Joint Powers Authority Excess Coverage Pool • Provide Regulatory Compliance and Administration of State and Federal

Labor Laws • Provide DOT Federal Compliance Assistance • Provide Workplace Violence Prevention Training • Provide Bi-Annual Ethics Training for elected/appointed officials,

management, and classifications identified in the City’s Code of Ethics • Provide Sexual Harassment Training for all elected & appointed officials,

management, supervisors, and other staff as identified by Administration. • Provide legal assistance as needed for analysis and

Retirement Processing

• Assist employees with processing application for CalPERS retirement, disability retirement, or employer generated industrial disability retirement

• Assist staff with resolutions and staff reports, documentation, and processing of industrial disability retirement applications and determinations in compliance with CalPERS regulations.

General Administration

• City intends to maintain one part-time clerical staff member to serve as a direct contact for employees and a liaison between the contractor and the City employee’s. Contractor is to work with HR clerical staff to ensure proper record retention and maintenance of all mandated personnel files.

• Assist Payroll with information and regulatory reports as needed. • Provide regular on-site visits to meet with individual employees. • Maintain confidentiality of employee personal information and health data.

http://www.ceridian.com/employee_retention_productivity_nav/1,6267,15629,00.html�




Page: 1 of 29Run Date: 05/18/2011Run Time: 10:20:30

City of RidgecrestDetail Claim Summary w/ Net Incurred

04/01/2011 - 04/30/2011

Paid Outstanding IncurredReserve Ch.this Period

Paidthis Period

Claims with Incident Dates from 01/01/2008Group by Fiscal Year, Sorted by Claimant Name

Fiscal Year : 2007-2008

Claim Type:Claim Number:Claimant Name:

Claimant Status:Examiner:Litigated:

Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00327.67 327.670.000.00

327.67 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

327.67

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00

488-05 PoliceCity of Ridgecrest

2008072196First Aid

Account:Org. Level 1:Org. Level 2:

Injury Date

Open Date:Closed Date

Adj. Loc. Recd.

Account Claim Number:2007-2008

02/14/2008

02/21/2008

02/21/200802/19/2008

Fiscal Year:

Incident Desc: left thumb was punctured when he picked up a manila envelope which had a expended taser dart inside.Body Part PunctureNature:Thumb Cause: Cut - Object Lift Or Handled

$0.00Recoveries $0.00Net Incurred 327.67



Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00

488-03 Public ServicesCity of Ridgecrest

2008075113First Aid


Injury Date


Adj. Loc. Recd.


04/15/2008

05/09/2008

05/06/200805/06/2008

Fiscal Year:

Incident Desc: was opening school bus entrance door when her thumb got pinched tearing skin off.Body Part PunctureNature:Thumb Cause: Caught In Or Between




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.0031,883.71 31,883.710.000.00

17,061.58 0.009,881.56 0.00

0.00 0.000.00 0.000.00 0.00

4,940.57 0.00

17,061.58

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

9,881.560.000.000.00

4,940.57


2009087898Indemnity


Injury Date


Adj. Loc. Recd.


06/10/2008

05/28/2010

04/06/200904/01/2009

Fiscal Year:

Incident Desc: EE was arresting suspect. Suspect had several bandages on both arms and during search ee found pills in pocket when asked what the pills where suspect indicated they were antibotics for MRSABody Part All Other Specific InjuriesNature:Multiple Body Parts Cause: Absorption, Ingestion, Inhalation Noc

$0.00Recoveries $0.00Net Incurred 31,883.71

Run By: Herb McDuffee on PRODUCTIONCity of Ridgecrest - Confidentiald_claim_summary_loss7_hm



04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.001,500.52 1,500.520.000.00

1,066.09 0.000.00 0.000.00 0.000.00 0.00

434.43 0.000.00 0.00

1,066.09

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.00

434.430.00

488-02 Administrative ServicesCity of Ridgecrest

2008071138Indemnity


Injury Date


Adj. Loc. Recd.


01/22/2008

05/22/2008

01/23/200801/23/2008

Fiscal Year:

Incident Desc: While ee was maning the office and answering a high volume of calls he felt pain in his chest with irregular heartbeat and felt that his blood pressure spikedBody Part All Other Specific InjuriesNature:Multiple Upper Extremities Cause: Misc - Other Than Physical Cause




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00304.84 304.840.000.00

304.84 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

304.84

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008077716Medical


Injury Date


Adj. Loc. Recd.


06/30/2008

08/28/2008

07/15/200807/11/2008

Fiscal Year:

Incident Desc: While employee was reaching inside file folder she cut her left pinky finger on a 2" prong fastenerBody Part LacerationNature:Finger(s) Cause: Injury - Reaching




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00176.34 176.340.000.00

176.34 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

176.34

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00

488-01 AdministrationCity of Ridgecrest

2008075493Indemnity


Injury Date


Adj. Loc. Recd.


05/13/2008

08/28/2008

05/19/200805/15/2008

Fiscal Year:

Incident Desc: was stacking eight foot tables outside, he turned and heard a pop, injuring left ankle.Body Part SprainNature:Ankle Cause: Injury - Twisting





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00179.81 179.810.000.00

179.81 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

179.81

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008075039Medical


Injury Date


Adj. Loc. Recd.


05/02/2008

05/29/2008

05/06/200805/05/2008

Fiscal Year:

Incident Desc: was getting out of her chair when she stepped incorrectly twisting her left ankleBody Part SprainNature:Ankle Cause: Injury - Twisting




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00300.68 300.680.000.00

300.68 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

300.68

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008073241Medical


Injury Date


Adj. Loc. Recd.


03/14/2008

04/29/2008

03/17/200803/14/2008

Fiscal Year:

Incident Desc: In pursuit of suspect was assisting Ofc. Sparks over a fence when Ofc Sparks' knee hit Sgt. McLaugling in the eyeBody Part LacerationNature:Eye(s) Cause: Struck - Other Worker




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008070671First Aid


Injury Date


Adj. Loc. Recd.


01/09/2008

01/10/2008

01/10/200801/09/2008

Fiscal Year:

Incident Desc: filing papersBody Part LacerationNature:Thumb Cause: Cut - Object Lift Or Handled





04/01/2011 - 04/30/2011


Paidthis Period





Open

Total

MedicalTDPD

Voc RehabExpenses

485016,604.5013,247.38 29,851.880.000.00

4,037.70 16,454.500.00 0.00

9,209.68 0.000.00 0.000.00 150.000.00 0.00

20,492.20

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.009,209.68

0.00150.00

0.00


2008073551Indemnity


Injury Date


Adj. Loc. Recd.


03/22/200803/25/200803/24/2008

Fiscal Year:

Incident Desc: While cleaning outside dog kennels, she slipped on wet surface twisting right ankle and fellBody Part SprainNature:Ankle Cause: Slip/Fall - Same Level


Fiscal Year Total:

Fiscal Year TotalRecoveries

Net Incurred

10 0.000.000.000.000.000.000.00

39,909.2123,454.71 16,454.509,881.569,881.56 0.009,209.689,209.68 0.00

0.000.00 0.00584.43434.43 150.00

0.00 4,940.574,940.5764,525.4547,920.95 16,604.50

0.000.000.000.000.000.000.00

64,525.450.00

MedicalTDPD

Voc RehabExpenses

4850




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009084810First Aid


Injury Date


Adj. Loc. Recd.


01/05/2009

04/01/2009

01/13/200901/13/2009

Fiscal Year:

Incident Desc: While securing wheel chair with metal tiedown ee's left ring finger nail jammed causing it to liftBody Part CrushingNature:Finger(s) Cause: Caught In Or Between





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00534.53 534.530.000.00

534.53 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

534.53

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00

488-04 Parks and RecreationCity of Ridgecrest

2008079011Medical


Injury Date


Adj. Loc. Recd.


08/11/2008

09/30/2008

08/12/200808/12/2008

Fiscal Year:

Incident Desc: When stacking chairs they became unbalanced tumbling down on ee hitting her right sideBody Part ConcussionNature:Skull Cause: Struck - Lifted/Handled Object




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008082304First Aid


Injury Date


Adj. Loc. Recd.


10/26/2008

12/04/2008

10/31/200810/31/2008

Fiscal Year:

Incident Desc: EE was in pursuit of a suspect when he jumped over a fence falling in a hole and twisting his left kneeBody Part SprainNature:Knee Cause: Injury - Jumping




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.002,541.89 2,541.890.000.00

2,532.15 0.000.00 0.000.00 0.000.00 0.009.74 0.000.00 0.00

2,532.15

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.009.740.00


2008083250Medical


Injury Date


Adj. Loc. Recd.


11/19/2008

08/28/2009

12/01/200811/26/2008

Fiscal Year:

Incident Desc: When ee got up from her desk she tripped over a file box sitting on the floorBody Part ContusionNature:Multiple Upper Extremities Cause: Slip/Fall





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.001,926.48 1,926.480.000.00

1,504.85 0.00281.08 0.00

0.00 0.000.00 0.000.00 0.00

140.55 0.00

1,504.85

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

281.080.000.000.00

140.55


2009087289Indemnity


Injury Date


Adj. Loc. Recd.


03/13/2009

05/19/2010

03/20/200903/18/2009

Fiscal Year:

Incident Desc: Patrol Officer performing regular duties of the job.Body Part StrainNature:Multiple Body Parts Cause: Injury - Holding/Carrying




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009091193First Aid


Injury Date


Adj. Loc. Recd.


05/06/2009

08/20/2009

06/29/200906/26/2009

Fiscal Year:

Incident Desc: dog was loose and big volunteer when she came in through the doorBody Part LacerationNature:Lower Leg Cause: Struck - Animal/Insect




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.0026,975.15 26,975.1515.0015.00

294.79 0.002,830.30 0.00

12,000.00 0.000.00 0.00

11,850.06 0.000.00 0.00

294.79

0.00

0.000.000.000.00

15.00

0.000.000.000.00

15.000.00

2,830.3012,000.00

0.0011,850.06

0.00


2009092511Indemnity

üAccount:Org. Level 1:Org. Level 2:

Injury Date


Adj. Loc. Recd.


04/19/2009

05/19/2010

08/05/200907/30/2009

Fiscal Year:

Incident Desc: when ee was stepping out of jacuzzi the plastic stairs gave way causing him to fall 3-4 feetBody Part StrainNature:Lower Back (muscle) Cause: Slip/Fall - Stairs





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00286.99 286.990.000.00

286.99 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

286.99

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008078985Medical


Injury Date


Adj. Loc. Recd.


07/19/2008

11/26/2008

08/12/200808/12/2008

Fiscal Year:

Incident Desc: When transferring kitten into Cat Cage kitten bit ee on left index fingerBody Part PunctureNature:Finger(s) Cause: Struck - Animal/Insect




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00267.22 267.220.000.00

267.22 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

267.22

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008081209First Aid


Injury Date


Adj. Loc. Recd.


09/12/2008

10/27/2008

10/07/200810/03/2008

Fiscal Year:

Incident Desc: Canine handler was performing training while ee was playing the role of the agitator when K9 "Nitto" bit down he went through the protective gear causing puncture woundBody Part PunctureNature:Hand Cause: Struck - Animal/Insect




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.0097.71 97.710.000.00

97.71 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

97.71

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009091194First Aid


Injury Date


Adj. Loc. Recd.


05/28/2009

08/25/2009

06/29/200906/26/2009

Fiscal Year:

Incident Desc: when escorting involved party out the dog bite eeBody Part LacerationNature:Lower Leg Cause: Struck - Animal/Insect





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00300.50 300.500.000.00

300.50 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

300.50

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009091195Medical


Injury Date


Adj. Loc. Recd.


05/30/2009

11/06/2009

06/29/200906/26/2009

Fiscal Year:

Incident Desc: upon contacting female suspect and during a brief struggle suspect bit eeBody Part LacerationNature:Hand Cause: Struck Or Injured By




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00379.52 379.520.000.00

379.52 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

379.52

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009086888First Aid


Injury Date


Adj. Loc. Recd.


03/06/2009

05/26/2009

03/12/200903/10/2009

Fiscal Year:

Incident Desc: while moving the small dog when ee opened cage dog bitBody Part PunctureNature:Wrist Cause: Struck - Animal/Insect




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00460.85 460.850.000.00

460.85 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

460.85

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009089380Indemnity


Injury Date


Adj. Loc. Recd.


04/29/2009

08/20/2009

04/29/200905/13/2009

Fiscal Year:

Incident Desc: after 2 days of roto-tilling areas in the park, employee experienced pain in lower back. thought it would go away but is still in pain. twisting, pushing, pulling tillerBody Part StrainNature:Lower Back (muscle) Cause: Injury Rep. Motion





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00558.57 558.570.000.00

558.57 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

558.57

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009085077Medical


Injury Date


Adj. Loc. Recd.


01/20/2009

04/01/2009

01/27/200901/20/2009

Fiscal Year:

Incident Desc: employee was moving a rolling trash dumpster and a wheel broke causing employee to strain his backBody Part StrainNature:Lower Back (muscle) Cause: Injury - Pushing/Pulling




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00120.68 120.680.000.00

120.68 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

120.68

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009088592Medical


Injury Date


Adj. Loc. Recd.


04/20/2009

08/21/2009

04/21/200904/21/2009

Fiscal Year:

Incident Desc: when ee was removing pipe bolt broke support arm spun and struck ee in the back of the head and across the shoulders.Body Part ContusionNature:Multiple Body Parts Cause: Strike - Object Lifted/Handled




Open

Total

MedicalTDPD

Voc RehabExpenses

485029,236.60763.40 30,000.000.00333.21

403.40 24,596.600.00 0.000.00 0.000.00 0.00

360.00 4,640.000.00 0.00

25,000.00

0.00

0.000.000.000.000.00

333.210.000.000.000.000.00

0.000.000.00

5,000.000.00


2010111210Indemnity


Injury Date


Adj. Loc. Recd.


01/05/200912/10/201012/09/2010

Fiscal Year:

Incident Desc: injured his neck when he bent forward to reach down and to get the clipboard and the seatbelt locked but he kept on going.Body Part StrainNature:Multiple Body Parts Cause: Injury - Reaching





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00210.18 210.180.000.00

210.18 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

210.18

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008078421Indemnity


Injury Date


Adj. Loc. Recd.


07/25/2008

10/21/2009

07/30/200807/29/2008

Fiscal Year:

Incident Desc: exposure to the sunBody Part CancerNature:Other Facial Soft Tissue Cause: Absorption, Ingestion, Inhalation Noc




Open

Total

MedicalTDPD

Voc RehabExpenses

485012,080.0569.95 12,150.000.000.00

69.95 11,930.050.00 0.000.00 0.000.00 0.000.00 150.000.00 0.00

12,000.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.00

150.000.00


2010109627Indemnity


Injury Date


Adj. Loc. Recd.


02/24/200911/03/201010/22/2010

Fiscal Year:

Incident Desc: tested positive for TB exposure after she came in contact with an exposed victim.Body Part All Other Specific InjuriesNature:Body Systems & Multi Body Sys Cause: Absorption, Ingestion, Inhalation Noc




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00259.01 259.010.000.00

259.01 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

259.01

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008080408Medical


Injury Date


Adj. Loc. Recd.


09/08/2008

11/05/2008

09/12/200809/16/2008

Fiscal Year:

Incident Desc: A suspect slammed the door on EE's right handBody Part ContusionNature:Hand Cause: Caught In Or Between





04/01/2011 - 04/30/2011


Paidthis Period





Open

t

Total

MedicalTDPD

Voc RehabExpenses

485042,521.7468,529.63 111,051.3712,197.6810,440.23

23,056.63 21,943.9429,860.80 7,464.80

0.00 4,830.000.00 0.00

682.28 817.7214,929.92 7,465.28

45,000.57

0.00

0.0011,197.68

0.000.00

1,000.00

1,820.155,599.08

0.000.00

221.642,799.36

37,325.604,830.00

0.001,500.00

22,395.20


2010104400Indemnity


Injury Date


Adj. Loc. Recd.


04/03/200906/03/201006/03/2010

Fiscal Year:

Incident Desc: injured his left shoulder while arresting a combative suspect that was resisting arrest.Body Part StrainNature:Shoulder(s) Cause: Struck - Object Handled By Others




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008078976Medical


Injury Date


Adj. Loc. Recd.


07/09/2008

02/06/2009

08/12/200808/12/2008

Fiscal Year:

Incident Desc: Dove in off the diving board to retrieve rings and went in too deep too fast hitting the bottom of the poolBody Part FractureNature:Finger(s) Cause: Strike - Stationary Object




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.004,748.07 4,748.070.000.00

4,748.07 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

4,748.07

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008082302Indemnity


Injury Date


Adj. Loc. Recd.


10/30/2008

12/28/2010

11/04/200810/31/2008

Fiscal Year:

Incident Desc: While subduing one dog 2 others attackedBody Part PunctureNature:Multiple Body Parts Cause: Struck - Animal/Insect





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009091196First Aid


Injury Date


Adj. Loc. Recd.


05/30/2009

08/21/2009

06/29/200906/26/2009

Fiscal Year:

Incident Desc: Upon contact with female suspect and during brief struggle ee was kicked in the eye by suspectBody Part ContusionNature:Eye(s) Cause: Struck Or Injured By




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00192.50 192.500.000.00

192.50 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

192.50

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008081210Medical


Injury Date


Adj. Loc. Recd.


10/03/2008

12/04/2008

10/07/200810/03/2008

Fiscal Year:

Incident Desc: When trying to make an arrest the suspect charged at the Detective causing his hand to make contactBody Part ContusionNature:Wrist(s) & Hand(s) Cause: Misc - Robbery/Criminal Assault





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00355.85 355.850.000.00

355.85 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

355.85

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2008079139First Aid


Injury Date


Adj. Loc. Recd.


08/05/2008

09/05/2008

08/15/200808/15/2008

Fiscal Year:

Incident Desc: While opening the can lid cut into the side of left palmBody Part LacerationNature:Hand Cause: Cut - Hand Tool, No Pwr


Fiscal Year Total:


Net Incurred

25 2,153.365,599.08

0.000.00

236.642,799.36

10,788.44

95,104.5436,633.95 58,470.5940,436.9832,972.18 7,464.8016,830.0012,000.00 4,830.00

0.000.00 0.0018,509.8012,902.08 5,607.72

7,465.28 22,535.7515,070.47193,417.07109,578.68 83,838.39

0.0011,197.68

0.000.00

1,015.000.00

12,212.68

193,417.070.00

MedicalTDPD

Voc RehabExpenses

4850




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00194.26 194.260.000.00

194.26 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

194.26

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2010105570Indemnity


Injury Date


Adj. Loc. Recd.


06/28/2010

11/30/2010

07/08/201007/02/2010

Fiscal Year:

Incident Desc: had a seizureBody Part All Other Specific InjuriesNature:Body Systems & Multi Body Sys Cause: Misc - Other Than Physical Cause





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009095753First Aid


Injury Date


Adj. Loc. Recd.


10/14/2009

12/31/2009

10/21/200910/19/2009

Fiscal Year:

Incident Desc: Very windy that morning and during her pre-inspection a foreign object flew into her left eyeBody Part Foreign BodyNature:Eye(s) Cause: Misc - Foreign Body In Eye




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.0047.20 47.200.000.00

47.20 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

47.20

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009098445First Aid


Injury Date


Adj. Loc. Recd.


12/02/2009

02/02/2010

12/23/200912/22/2009

Fiscal Year:

Incident Desc: opened her bus door and her left pinky finger got smashed between the door and the poles at the gas pump.Body Part ContusionNature:Finger(s) Cause: Caught In Or Between




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.001,108.18 1,108.180.000.00

686.84 0.000.00 0.000.00 0.000.00 0.00

421.34 0.000.00 0.00

686.84

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.00

421.340.00


2009094031Indemnity


Injury Date


Adj. Loc. Recd.


08/31/2009

04/21/2010

09/11/200909/08/2009

Fiscal Year:

Incident Desc: UnknownBody Part InfectionNature:Abdomen Incl. Groin Cause: Absorption, Ingestion, Inhalation Noc





04/01/2011 - 04/30/2011


Paidthis Period





Open

Total

MedicalTDPD

Voc RehabExpenses

485014,835.0326,945.44 41,780.470.0071.91

9,640.52 10,359.4811,902.97 0.003,877.14 4,000.36

0.00 0.001,524.81 475.19

0.00 0.00

20,000.00

0.00

0.000.000.000.000.00

57.770.000.000.00

14.140.00

11,902.977,877.50

0.002,000.00

0.00


2009096783Indemnity


Injury Date


Adj. Loc. Recd.


10/29/200911/12/200911/10/2009

Fiscal Year:

Incident Desc: upon loading wheelchair ee was bending over tieing dow wheelchair and felt strain in lower backBody Part StrainNature:Lower Back (muscle) Cause: Injury - Lifting




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009092477First Aid


Injury Date


Adj. Loc. Recd.


07/16/2009

08/20/2009

07/30/200907/30/2009

Fiscal Year:

Incident Desc: when tearing down walls and moving them ee pinched his left fingers between the wallsBody Part All Other Specific InjuriesNature:Finger(s) Cause: Caught In Or Between




Open

Total

MedicalTDPD

Voc RehabExpenses

485015,051.577,098.43 22,150.000.0010.50

7,098.43 14,901.570.00 0.000.00 0.000.00 0.000.00 150.000.00 0.00

22,000.00

0.00

0.000.000.000.000.00

10.500.000.000.000.000.00

0.000.000.00

150.000.00


2009098446Indemnity


Injury Date


Adj. Loc. Recd.


12/16/200912/23/200912/22/2009

Fiscal Year:

Incident Desc: sat in an office chair and the back of the chair broke causing him to fall back, catching his right foot under the desk and torquing his upper torso, back and neck.Body Part StrainNature:Multiple Body Parts Cause: Injury - Twisting





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2010102454First Aid


Injury Date


Adj. Loc. Recd.


03/29/2010

05/13/2010

04/14/201004/13/2010

Fiscal Year:

Incident Desc: when unloading boxes felt something bite himBody Part All Other Specific InjuriesNature:Hand Cause: Struck - Animal/Insect




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00310.53 310.530.000.00

310.53 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

310.53

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2010103617Medical


Injury Date


Adj. Loc. Recd.


05/04/2010

07/14/2010

05/12/201005/12/2010

Fiscal Year:

Incident Desc: While unloading truck and box of laundry soap broke and he fell down and braced himself with his right arBody Part ContusionNature:Multiple Upper Extremities Cause: Slip/Fall




Open

Total

MedicalTDPD

Voc RehabExpenses

48500.0065.00 65.0065.0065.00

65.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

65.00

0.00

65.000.000.000.000.00

65.000.000.000.000.000.00

0.000.000.000.000.00


2011113342Medical


Injury Date


Adj. Loc. Recd.


03/22/201002/14/201102/14/2011

Fiscal Year:

Incident Desc: While ee jumped over brick wall due to the gate being lock he landed improperBody Part StrainNature:Multiple Lower Extremities Cause: Slip/Fall - Different Level





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00314.19 314.190.000.00

314.19 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

314.19

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009093561Medical


Injury Date


Adj. Loc. Recd.


08/25/2009

09/30/2009

09/01/200908/26/2009

Fiscal Year:

Incident Desc: While ee was trimming trees branch came down hit loppers knocking from his hand and the swung around and hit him in the right handBody Part ContusionNature:Hand Cause: Strike - Stationary Object




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009095751First Aid


Injury Date


Adj. Loc. Recd.


09/30/2009

12/31/2009

10/21/200910/19/2009

Fiscal Year:

Incident Desc: while trying to restrain subject officer was bit on the left forearmBody Part PunctureNature:Lower Arm Cause: Struck Or Injured By




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00617.07 617.070.000.00

617.07 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

617.07

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009097377First Aid


Injury Date


Adj. Loc. Recd.


10/27/2009

02/02/2010

11/30/200911/24/2009

Fiscal Year:

Incident Desc: During training the K-9 police dog pulled bite sleeve off and bitting officerBody Part PunctureNature:Multiple Upper Extremities Cause: Cut/Punct/Scrap





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.001,693.91 1,693.910.000.00

1,693.91 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

1,693.91

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2010099792Indemnity


Injury Date


Adj. Loc. Recd.


12/18/2009

03/29/2011

02/02/201002/02/2010

Fiscal Year:

Incident Desc: was taken down by a K-9 Officer during an aggression training and twisted his left knee.Body Part StrainNature:Knee Cause: Injury - Twisting




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00138.36 138.360.000.00

138.36 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

138.36

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2010099791First Aid


Injury Date


Adj. Loc. Recd.


12/11/2009

03/31/2010

02/02/201002/02/2010

Fiscal Year:

Incident Desc: While ee was cleaniing down walls he turned to get the mop and the handle was lying out of the bucket causing him to trip,slip and fallBody Part SprainNature:Ankle Cause: Injury - Twisting




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.0067.43 67.430.000.00

67.43 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

67.43

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009093627Medical


Injury Date


Adj. Loc. Recd.


07/14/2009

09/30/2009

08/28/200908/27/2009

Fiscal Year:

Incident Desc: ee states that over the course of 3 years of riding a dual sport motorcycle it has caused cumulative trama to his mid/lower back and tailbone.Body Part All Other Specific InjuriesNature:Multiple Trunk Cause: Injury Rep. Motion





04/01/2011 - 04/30/2011


Paidthis Period





Open

Total

MedicalTDPD

Voc RehabExpenses

4850189,583.33117,505.92 307,089.2515,760.074,468.98

70,419.23 139,580.7742,582.57 14,194.18

0.00 27,312.500.00 8,000.00

4,504.12 495.880.00 0.00

210,000.00

0.00

0.0015,760.07

0.000.000.00

2,285.262,183.72

0.000.000.000.00

56,776.7527,312.508,000.005,000.00

0.00


2009095947Indemnity


Injury Date


Adj. Loc. Recd.


10/06/200910/23/200910/22/2009

Fiscal Year:

Incident Desc: injured his back on 10/06/09 while he was riding the mower over rough terrain and jolted his back. Then on 10/20/09 his leg gave out as he was climbing up the mower trailer.Body Part StrainNature:Lower Back (muscle) Cause: Injury - Using Tool Or Machine




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00403.17 403.170.000.00

403.17 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

403.17

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2010103870Medical


Injury Date


Adj. Loc. Recd.


05/11/2010

12/19/2010

05/19/201005/19/2010

Fiscal Year:

Incident Desc: while trying to remove injured dog from roadway, Officer was bitten on left palm of hand.Body Part LacerationNature:Hand Cause: Struck - Animal/Insect




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.001,136.27 1,136.270.000.00

1,136.27 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

1,136.27

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009092465Medical


Injury Date


Adj. Loc. Recd.


07/05/2009

04/29/2010

07/30/200907/30/2009

Fiscal Year:

Incident Desc: Officer step on a 2ft high block wall to look over a 6ft fence when he lost his footing slipping down the wallBody Part All Other Specific InjuriesNature:Multiple Lower Extremities Cause: Slip/Fall - Different Level





04/01/2011 - 04/30/2011


Paidthis Period





Open

Total

MedicalTDPD

Voc RehabExpenses

485016,355.922,746.94 19,102.860.0012.28

1,749.44 14,353.420.00 0.000.00 0.00

997.50 1,502.500.00 500.000.00 0.00

16,102.86

0.00

0.000.000.000.000.00

12.280.000.000.000.000.00

0.000.00

2,500.00500.00

0.00


2009095752Indemnity


Injury Date


Adj. Loc. Recd.


10/06/200910/21/200910/19/2009

Fiscal Year:

Incident Desc: over the past 10 years cumulative, repetative keyboardingBody Part Carpal Tunnel SyndromeNature:Wrist(s) & Hand(s) Cause: Injury Rep. Motion




Open

Total

MedicalTDPD

Voc RehabExpenses

4850119,182.44100,420.42 219,602.860.002,363.65

51,700.27 43,299.7330,730.16 1,520.222,526.71 61,700.79

0.00 0.0098.40 11,901.60

15,364.88 760.10

95,000.00

0.00

0.000.000.000.000.00

1,326.830.00

949.570.00

87.250.00

32,250.3864,227.50

0.0012,000.0016,124.98


2010102453Indemnity


Injury Date


Adj. Loc. Recd.


04/05/201004/15/201004/13/2010

Fiscal Year:

Incident Desc: reported a cumulative trauma injury to his neck and bilateral shoulders over 23 years of his employment.Body Part StrainNature:Multiple Body Parts Cause: Injury Rep. Motion




Open

Total

MedicalTDPD

Voc RehabExpenses

485018,272.691,727.31 20,000.000.001,727.31

0.00 10,000.000.00 0.000.00 0.000.00 0.00

1,727.31 8,272.690.00 0.00

10,000.00

0.00

0.000.000.000.000.00

0.000.000.000.00

1,727.310.00

0.000.000.00

10,000.000.00


2011112706Indemnity


Injury Date


Adj. Loc. Recd.


04/19/201001/26/201101/26/2011

Fiscal Year:

Incident Desc: over 23 years of service, cumulative tramaBody Part Multiple Physical Injury OnlyNature:Body Systems & Multi Body Sys Cause: Misc - Other Than Physical Cause





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00159.58 159.580.000.00

159.58 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

159.58

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009095083Medical


Injury Date


Adj. Loc. Recd.


09/30/2009

11/17/2009

10/02/200910/01/2009

Fiscal Year:

Incident Desc: while ee was during yard work he felt something bite himBody Part All Other Specific InjuriesNature:Elbow Cause: Struck - Animal/Insect




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2010105036First Aid


Injury Date


Adj. Loc. Recd.


05/20/2010

07/28/2010

06/18/201006/18/2010

Fiscal Year:

Incident Desc: When attemptimg to contain loose dog ee was scratch by citizen with possible MRSABody Part LacerationNature:Multiple Upper Extremities Cause: Cut/Punct/Scrap




Open

Total

MedicalTDPD

Voc RehabExpenses

485049,741.3849,196.65 98,938.030.001,620.51

24,395.38 35,604.6220,480.53 0.002,038.79 4,918.71

0.00 4,000.002,281.95 5,218.05

0.00 0.00

60,000.00

0.00

0.000.000.000.000.00

257.330.000.000.00

1,363.180.00

20,480.536,957.504,000.007,500.00

0.00


2009096072Indemnity


Injury Date


Adj. Loc. Recd.


10/21/200911/02/200910/26/2009

Fiscal Year:

Incident Desc: While triming and cutting bushes on median his w rist and hand started sw ellng and it began hurting. He w as using toppers, rakes and shovels.Body Part SprainNature:Wrist(s) & Hand(s) Cause: Injury Rep. Motion





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00382.33 382.330.000.00

382.33 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

382.33

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2010100442Medical


Injury Date


Adj. Loc. Recd.


02/16/2010

04/29/2010

02/18/201002/18/2010

Fiscal Year:

Incident Desc: EE was switching out acid barrel and wrenched his back while trying to make sure it didn't fall over.Body Part StrainNature:Lumbar & Sacral Verte Cause: Injury - Lifting




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009092478First Aid


Injury Date


Adj. Loc. Recd.


07/06/2009

08/18/2009

07/30/200907/30/2009

Fiscal Year:

Incident Desc: when ee went to sit down on the chair it slid out from under himBody Part All Other Specific InjuriesNature:Lower Arm Cause: Slip/Fall




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00334.80 334.8010.5010.50

334.80 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

334.80

0.00

10.500.000.000.000.00

10.500.000.000.000.000.00

0.000.000.000.000.00


2010103090Medical


Injury Date


Adj. Loc. Recd.


04/13/2010

09/30/2010

04/29/201004/29/2010

Fiscal Year:

Incident Desc: When employee was handling box he dropped it on his left kneeBody Part ContusionNature:Knee Cause: Injury Rep. Motion





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00506.21 506.210.000.00

506.21 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

506.21

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2010099595Medical


Injury Date


Adj. Loc. Recd.


01/20/2010

06/23/2010

01/20/201001/26/2010

Fiscal Year:

Incident Desc: He was running and stepped in pot-holeBody Part ContusionNature:Lower Leg Cause: Slip/Fall - Into Opening




Open

Total

MedicalTDPD

Voc RehabExpenses

485035,951.6536,836.15 72,787.800.002,420.50

6,663.97 33,336.039,584.99 0.00

11,687.14 1,947.860.00 0.00

832.24 667.768,067.81 0.00

40,000.00

0.00

0.000.000.000.000.00

1,340.500.00

1,080.000.000.000.00

9,584.9913,635.00

0.001,500.008,067.81


2010103086Indemnity


Injury Date


Adj. Loc. Recd.


04/22/201004/29/201004/29/2010

Fiscal Year:

Incident Desc: Normal Duties of a sworn officer. There are prior claims for back and shoulder arm neckBody Part All Other Cumulative InjuryNature:Multiple Body Parts Cause: Injury Rep. Motion




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009092468First Aid


Injury Date


Adj. Loc. Recd.


07/21/2009

08/21/2009

07/30/200907/30/2009

Fiscal Year:

Incident Desc: when removing delineators from the back of the flatbed truck ee twisted his wristBody Part SprainNature:Wrist Cause: Injury - Twisting





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00661.49 661.490.000.00

661.49 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

661.49

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2009093619Medical


Injury Date


Adj. Loc. Recd.


08/18/2009

11/06/2009

08/31/200908/27/2009

Fiscal Year:

Incident Desc: while ee was picking up cons and placing back into truck he twisted his right wristBody Part SprainNature:Wrist Cause: Injury - Twisting


Fiscal Year Total:


Net Incurred

32 5,365.972,183.722,029.57

0.003,191.88

0.0012,771.14

480,821.50179,385.88 301,435.62130,995.62115,281.22 15,714.40120,010.0020,129.78 99,880.2214,500.00997.50 13,502.5039,071.3411,390.17 27,681.17

760.10 24,192.7923,432.69809,591.25350,617.24 458,974.01

75.5015,760.07

0.000.000.000.00

15,835.57

809,591.250.00

MedicalTDPD

Voc RehabExpenses

4850




Open

Total

MedicalTDPD

Voc RehabExpenses

485050,584.389,088.31 59,672.690.003,735.12

3,999.48 41,000.524,961.26 6,921.43

0.00 2,640.000.00 0.00

127.57 22.430.00 0.00

45,000.00

0.00

0.000.000.000.000.00

2,047.771,559.78

0.000.00

127.570.00

11,882.692,640.00

0.00150.00

0.00


2010109227Indemnity


Injury Date


Adj. Loc. Recd.


09/27/201010/13/201010/12/2010

Fiscal Year:

Incident Desc: reported left hand up to forearm injury due to repetitive motion over 9 years.Body Part All Other Cumulative InjuryNature:Wrist(s) & Hand(s) Cause: Injury Rep. Motion





04/01/2011 - 04/30/2011


Paidthis Period





Open

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2011115887Indemnity


Injury Date


Adj. Loc. Recd.


04/21/201104/25/201104/25/2011

Fiscal Year:

Incident Desc: Was walking to Parks and Rec to deliver payrolll checks when I slipped on wet concrete landed of left hand and left kneew, and twisted right ankleBody Part StrainNature:Multiple Body Parts Cause: Slip/Fall




Open

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2011116015Pending


Injury Date


Adj. Loc. Recd.


04/25/201105/05/201104/28/2011

Fiscal Year:

Incident Desc: Was walking on sidewalkafter a seal didn t dry or harden. Fell on both knees. Injuring both knees.Body Part StrainNature:Knee Cause: Slip/Fall - Same Level




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00564.89 564.89303.42303.42

444.97 0.0077.38 0.000.00 0.000.00 0.000.00 0.00

42.54 0.00

444.97

0.00

303.420.000.000.000.00

303.420.000.000.000.000.00

77.380.000.000.00

42.54


2010109196Indemnity


Injury Date


Adj. Loc. Recd.


09/05/2010

01/18/2011

10/18/201010/11/2010

Fiscal Year:

Incident Desc: When Officer approached the house he entered the front gate and was attacked by dog.Body Part PunctureNature:Multiple Upper Extremities Cause: Struck - Animal/Insect





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

4850148.4110.50 158.91158.9110.50

10.50 148.410.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

158.91

0.00

158.910.000.000.000.00

10.500.000.000.000.000.00

0.000.000.000.000.00


2010109197First Aid


Injury Date


Adj. Loc. Recd.


07/22/2010

12/22/2010

10/13/201010/11/2010

Fiscal Year:

Incident Desc: When Officer reached into the trunk of his patrol car he struck his middle finger on an unknown object cutting it.Body Part LacerationNature:Elbow Cause: Cut - Object Lift Or Handled




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2010109198Indemnity


Injury Date


Adj. Loc. Recd.


09/09/2010

01/06/2011

10/13/201010/11/2010

Fiscal Year:

Incident Desc: Officer was searching a suspects belongings and was pricked by an exposed hypodermic needle in the left thumb.Body Part All Other Specific InjuriesNature:Thumb Cause: Cut/Punct/Scrap




Open

Total

MedicalTDPD

Voc RehabExpenses

48500.000.00 0.000.000.00

0.00 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

0.00

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2011115114Medical


Injury Date


Adj. Loc. Recd.


03/04/201104/01/201104/01/2011

Fiscal Year:

Incident Desc: Employee was running to assist officers with in progress hot callBody Part StrainNature:Lower Leg Cause: Injury - Jumping





04/01/2011 - 04/30/2011


Paidthis Period





Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00199.39 199.390.000.00

199.39 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

199.39

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2010106043Medical


Injury Date


Adj. Loc. Recd.


07/03/2010

10/22/2010

07/16/201007/16/2010

Fiscal Year:

Incident Desc: while exiting his patrol unit ee felt sharp pain in his lower left backBody Part StrainNature:Lower Back (muscle) Cause: Injury Rep. Motion




Open

Total

MedicalTDPD

Voc RehabExpenses

48502,313.38336.62 2,650.000.0021.00

336.62 2,163.380.00 0.000.00 0.000.00 0.000.00 150.000.00 0.00

2,500.00

0.00

0.000.000.000.000.00

21.000.000.000.000.000.00

0.000.000.00

150.000.00


2010111207Indemnity


Injury Date


Adj. Loc. Recd.


11/18/201012/16/201012/09/2010

Fiscal Year:

Incident Desc: while employee was being served with a pending intternal affairs investigation that was being conducted on him. He felt his blood pressure rise w/rapid heartbeat and chest painsBody Part All Other Specific InjuriesNature:No Phys. Injury/Mental Stress Cause: Misc - Other Than Physical Cause




Closed

Total

MedicalTDPD

Voc RehabExpenses

48500.00383.98 383.980.000.00

383.98 0.000.00 0.000.00 0.000.00 0.000.00 0.000.00 0.00

383.98

0.00

0.000.000.000.000.00

0.000.000.000.000.000.00

0.000.000.000.000.00


2010109629Medical


Injury Date


Adj. Loc. Recd.


10/21/2010

02/28/2011

11/09/201010/22/2010

Fiscal Year:

Incident Desc: while cleaning feeder the filter popped off respirator causing gases to be inhaled by employeeBody Part All Other Specific InjuriesNature:Body Systems & Multi Body Sys Cause: Absorption, Ingestion, Inhalation Noc





04/01/2011 - 04/30/2011


Paidthis Period





Open

Total

MedicalTDPD

Voc RehabExpenses

485021,153.5715,021.67 36,175.24350.001,799.79

4,155.79 20,844.2110,675.24 0.00

0.00 0.000.00 0.00

190.64 309.360.00 0.00

25,000.00

0.00

0.000.000.000.00

350.00

1,609.150.000.000.00

190.640.00

10,675.240.000.00

500.000.00


2010109966Indemnity


Injury Date


Adj. Loc. Recd.


11/01/201011/09/201011/01/2010

Fiscal Year:

Incident Desc: was going down the front stairs when she missed the last step causing her to twist her right ankle/foot.Body Part StrainNature:Ankle Cause: Injury - Twisting





04/01/2011 - 04/30/2011


Paidthis Period





Open

Total

MedicalTDPD

Voc RehabExpenses

485020,588.763,540.42 24,129.180.00267.79

439.93 19,560.072,067.11 826.97

0.00 0.000.00 0.000.00 150.00

1,033.38 51.72

20,000.00

0.00

0.000.000.000.000.00

267.790.000.000.000.000.00

2,894.080.000.00

150.001,085.10


2011111861Indemnity


Injury Date


Adj. Loc. Recd.


01/02/201101/07/201101/05/2011

Fiscal Year:

Incident Desc: was arresting a combative suspect requiring him to use physical force which caused him to hyperextend his right knee.Body Part All Other Specific InjuriesNature:Knee Cause: Injury - Twisting


Fiscal Year Total:


Net Incurred

12 4,259.631,559.78

0.000.00

318.210.00

6,137.62

93,687.259,970.66 83,716.5925,529.3917,780.99 7,748.402,640.000.00 2,640.00

0.000.00 0.00950.00318.21 631.79

51.72 1,127.641,075.92123,934.2829,145.78 94,788.50

462.330.000.000.00

350.000.00

812.33

123,934.280.00

MedicalTDPD

Voc RehabExpenses

4850

Grand Total:79 MedicalTDPD

Voc RehabExpenses

4850Grand Total

11,778.969,342.582,029.57

0.003,746.732,799.36

29,697.20

709,522.50249,445.20 460,077.30206,843.55175,915.95 30,927.60148,689.6841,339.46 107,350.2214,500.00997.50 13,502.5059,115.5725,044.89 34,070.68

8,277.10 52,796.7544,519.651,191,468.05537,262.65 654,205.40

537.8326,957.75

0.000.00

1,365.000.00

28,860.58Recoveries

Net Incurred 1,191,468.050.00


City of RidgecrestOrganizational Chart

City Council

City Manager

Police

Captain

Sergeants

Officers

Dispatchers

Animal Control

Public Works

Wastewater

Streets

Engineering

Public Services

Community Development

Planning

City Clerk

Human Resources

Risk Management

Elections

Council Support

Park & Recreation

Parks Maintenance

Facilities

Swimming Pool

Preschool

Recreation

Finance

Payroll

Accounts Payable

Capital

MIS/IT

rford

Typewritten Text

Administration

rford

Typewritten Text

Date: 6/27/2011

Employee Census

Page 1

Position Title Full/Part Time

Annual Salary Group Code

Workers Compensation

Code

EEO Category

CodeACCOUNT CLERK I F $27,217.00 CO 8810 FACCOUNTANT I - ACCT/TRAINING F $53,118.00 CO 8810 BACCOUNTING MANAGER F $92,020.00 MM 8810 AACCOUNTING TECHNICIAN F $44,112.00 CO 8810 CADMINISTRATIVE ANALYST III F $87,869.00 MM 8810 BADMINISTRATIVE ASSISTANT - FI F $66,180.00 CO 8810 FADMINISTRATIVE ASSISTANT - HR F $60,027.00 CO 8810 FADMINISTRATIVE ASST - HR - P/T P $18,479.00 PT 8810 FADMINISTRATIVE SECRETARY-CONF F $42,886.00 CO 8810 F

F $47,259.00 CO 8810 FF $34,410.00 CO 8810 FF $41,843.00 CO 8810 F

ANIMAL CONTROL OFFICER F $29,779.00 PE 7720 DF $28,355.00 PE 7720 D

ANIMAL SHELTER SUPERVISOR F $47,311.00 PE 7720 DCHIEF OF POLICE F $121,800.00 MG 7720 ACHIEF PLANT OPERATOR F $75,949.00 MM 9420 BCITY CLERK F $88,106.00 MG 8810 ACITY COUNCIL MEMBER P $3,250.00 PT 8810 A

P $3,250.00 PT 8810 AP $3,250.00 PT 8810 AP $3,250.00 PT 8810 AP $3,250.00 PT 8810 A

CITY ENGINEER F $89,937.00 MM 9410 BCITY MANAGER F $166,500.00 MG 9410 ACITY PLANNER F $101,773.00 MM 8810 BCODE ENFORCEMENT OFFICER F $44,987.00 RA 9410 DCOMMUNITY DEVELOPMENT TECH F $47,259.00 RA 8810 F

F $37,942.00 RA 8810 FCULTURAL AFFAIRS COORD II F $45,567.00 CO 8810 FCULTURAL AFFAIRS COORD. I F $31,321.00 RA 8810 E

F $28,267.00 RA 8810 EDIR.COMMUNITY/ECONOMIC DEV. F $130,660.00 MG 9410 ADIR.PUBLIC WORKS/CITY ENGINEER F $130,660.00 MG 8810 BDIRECTOR OF FINANCE F $103,148.00 MG 9410 ADIRECTOR OF PARKS & RECREATION F $123,045.00 MG 9410 A

Date: 6/27/2011

Employee Census

Page 2




Code

EEO Category

CodeDRIVER - TRANSIT F $32,019.00 RA 9422 G

F $25,073.00 RA 9422 GECONOMIC DEVELPMNT PROJECT MGR F $88,106.00 MM 8810 AENGINEERING TECHNICIAN III F $71,651.00 RA 9410 GEXECUTIVE SECRETARY F $72,224.00 CO 8810 FFLEET MECHANIC II F $57,510.00 RA 9422 H

F $46,132.00 RA 9422 HINFORMATION SYSTEMS MANAGER F $92,198.00 MM 9410 EINFORMATION SYSTEMS SPECIALIST F $60,101.00 CO 9420 BINFORMATION SYSTEMS TECHNICIAN F $44,112.00 CO 9420 EKENNEL ATTENDANT F $23,754.00 PE 7720 DMAINTENANCE WORKER I F $34,410.00 RA 9420 H

F $28,325.00 RA 9420 HF $33,602.00 RA 9420 HF $25,698.00 RA 9420 H

MAINTENANCE WORKER II F $38,883.00 RA 9420 HF $39,858.00 RA 9420 HF $37,942.00 RA 9420 HF $40,867.00 RA 9420 HF $40,867.00 RA 9420 HF $38,883.00 RA 9420 HF $34,410.00 RA 9420 HF $34,410.00 RA 9420 HF $36,125.00 RA 9420 HF $36,125.00 RA 9420 H

P.A.C.T. COORDINATOR P/T P $15,975.00 RA 8810 FPARKS MAINTENANCE SUPERVISOR F $53,118.00 MM 9420 HPLANNING COMMISSIONER P $3,250.00 PT 8810 A

P $3,250.00 PT 8810 AP $3,250.00 PT 8810 AP $3,250.00 PT 8810 AP $3,250.00 PT 8810 A

POLICE CAPTAIN F $92,198.00 MM 7720 BPOLICE CLERK I F $25,428.00 RA 8810 FPOLICE CLERK II F $37,029.00 RA 8810 F

F $34,410.00 RA 8810 FF $31,227.00 RA 8810 F

Date: 6/27/2011

Employee Census

Page 3




Code

EEO Category

CodePOLICE DISPATCHER F $50,030.00 PE 8810 F

F $40,101.00 PE 8810 FF $44,215.00 PE 8810 FF $36,368.00 PE 8810 FF $48,810.00 PE 8810 F

POLICE PATROL OFFICER F $59,288.00 PE 7720 DF $56,431.00 PE 7720 DF $59,288.00 PE 7720 DF $59,288.00 PE 7720 DF $59,288.00 PE 9420 EF $59,288.00 PE 7720 DF $59,288.00 PE 7720 DF $53,712.00 PE 7720 DF $59,288.00 PE 7720 DF $59,288.00 PE 7720 DF $56,431.00 PE 7720 DF $51,154.00 PE 7720 DF $53,712.00 PE 7720 DF $51,154.00 PE 7720 DF $48,719.00 PE 7720 DF $48,719.00 PE 7720 DF $48,719.00 PE 7720 DF $46,399.00 PE 7720 DF $48,719.00 PE 7720 DF $46,399.00 PE 7720 DF $53,712.00 PE 7720 DF $46,399.00 PE 7720 D

POLICE PATROL OFFICER - COPS F $46,399.00 PE 7720 DF $46,399.00 PE 7720 D

POLICE SERGEANT F $72,785.00 PE 7720 CF $69,338.00 PE 7720 CF $72,785.00 PE 7720 DF $62,800.00 PE 7720 CF $72,785.00 PE 7720 CF $72,785.00 PE 7720 C

PROPERTY EVIDENCE CLERK F $26,976.00 PE 7720 DPUBLIC WORKS MAINTENANCE COORD F $49,879.00 MM 9422 G

Date: 6/27/2011

Employee Census

Page 4




Code

EEO Category

CodeREC LEADER I P $6,000.00 PT 9410 E

P $8,000.00 PT 9410 EP $8,000.00 PT 9410 EP $7,200.00 PT 9410 EP $7,200.00 PT 9410 EP $8,000.00 PT 9410 EP $8,320.00 PT 9410 EP $8,000.00 PT 9410 EP $8,000.00 PT 9410 EP $8,000.00 PT 9410 EP $2,600.00 PT 9410 EP $8,000.00 PT 9410 EP $3,360.00 PT 9410 F

REC LEADER II P $8,400.00 PT 9420 EP $3,780.00 PT 9420 EP $4,816.00 PT 9420 EP $7,938.00 PT 9420 EP $3,704.00 PT 9420 EP $4,763.00 PT 9420 EP $4,763.00 PT 9420 EP $4,763.00 PT 9420 EP $8,736.00 PT 9420 EP $9,173.00 PT 9420 EP $4,234.00 PT 9420 EP $8,000.00 PT 9420 EP $3,704.00 PT 9420 EP $3,704.00 PT 9420 EP $3,704.00 PT 9420 EP $3,704.00 PT 9420 E

REC LEADER III P $10,650.00 PT 9420 BP $10,650.00 PT 9420 BP $9,660.00 PT 9420 BP $9,660.00 PT 9420 BP $4,637.00 PT 9420 BP $9,660.00 PT 9420 B

RESERVES P $10,440.00 PT 7720 DP $0.00 PT 7720 DP $0.00 PT 7720 D

Date: 6/27/2011

Employee Census

Page 5




Code

EEO Category

CodeRESERVES P $20,881.00 PT 7720 D

P $23,260.00 PT 7720 DP $23,958.00 PT 7720 DP $27,758.00 PT 7720 DP $13,879.00 PT 7720 D

SENIOR BUS DRIVER/DISPATCHER F $37,942.00 CO 8810 FTRANSIT SERVICES COORDINATOR F $72,745.00 MM 9410 GWASTEWATER OPERATOR III F $57,149.00 RA 9420 EWASTEWATER OPERATOR TRAINEE F $25,787.00 RA 9420 G

Medical Vision

1 Party 2 Party FamilyEmployee Dependant

1

Dependant

2

Dependant

3

Dependent

4

Plan A 9.75$ 9.18$ 8.63$ 8.10$ 7.65$ PERSSelect 216.94$ 433.87$ 564.03$

Monthly $433.87 $867.74 $1,128.06 Plan B 7.68$ 7.23$ 6.80$ 6.40$ 6.03$

PERSCare 393.62$ 787.24$ 1,023.41$ Monthly $787.24 $1,574.48 $2,046.82

PERSChoice 248.08$ 496.15$ 645.00$ Monthly $496.15 $992.30 $1,289.99

PORAC 263.50$ 493.50$ 627.00$ Monthly $527.00 $987.00 $1,254.00 Retirement Health Savings Plan

Dental1 Party 2 Party Family

Ogden Benefits (OBA) 13.84$ 25.14$ 34.75$ Misc:Monthly 27.68$ 50.28$ 69.50$

Long Term Care - PERS

AFLAC Supplemental Policies - See Representative for Rates

Accident InsuranceRecovery Plus InsuranceLife Assurance InsuranceHospital Intensive Care Insurance

City of Ridgecrest Benefit Rates Chart Effective 01/01/11

ICMA - VantageCare

Short-Term Disability Insurance

See UNUM Brochure

Valic

ICMA

FLEX ONE Flexible Spending Accounts

Example: Emp. $9.75 + D1 $9.18 + D2 $8.63 + D3 $8.10 = $35.66 ppp

Life-Group

Cancer Insurance

457 Deferred Comp:

Employee Only w/Major

*Mid-Management/Confidential/Management/Local 1036/PEAR receive the Tiered Cafeteria Plan amount per month to purchase benefits within this Cafeteria Plan (IRS code Section 125).

Monthly Tiered Cafeteria Plan

***Employees enrolled in other City sponsored medical plans qualify for tier 2 with no major medical

Additional Employee Benefits

City Paid PERS Retirement Plan 2.7% @ 55Various Incentive Pays as negotiated by Memorandum of Understanding (UFCW; PEAR; MM; CON, MGT)

**Premium Rates are quoted per pay period

UFCW Local 1036/PEAR/MM/CON/MGT $936.00$738.00$575.00$450.00 (0.00 for PEAR)

Tier 3

Employee + 1 w/Major Tier 4

Employee + 2 + w/Major Tier 1

No MedicalTier 2

human resources administrative services

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