Revised 09/20/04
203.11

A. DEFINITION OF COVERAGE    

This policy provides medical coverage for in class/on the job injuries to students who participate in the Workforce Investment Act (WIA).

B. LIMITS AND DEDUCTIBLES PER STUDENT

Limits:

$ 5,000 for Accidental Death;

$ 5,000 for Accidental Dismemberment;

$25,000 for Accident Medical Expense;

$ 2,500 maximum Dental

Deductible: There is no deductible amount.

C.  REPORTING OF STUDENT ROLLS   

1.  Annually, during the month of July, each location should forward a report with the total number of participants in WIA credit and non-credit classes from July 1 of the previous year to June 30 of the current year to the District Risk Management Department. The report should include the total number of students in the program and the total number of weeks for each student. Any part of a week that a student participates in the program, counts as one week.

2.  At the end of the policy term, the District Risk Management will provide an audit report of the total number of participants and weeks, and the dollar value of insurance coverage, to the insurance agency.

3.  The insurance agency will forward an invoice to District Risk Management.

4.  A student record of each student should be kept at the location for auditing purposes but not forwarded to District Risk Management. District Risk Management needs actual numbers of students in the program and weeks of participation.

D.  CLAIMS  

Reference Section 20.2.0 for standard procedure.

E.  CHARGES   

The premium is charged to the WIA grant account 11-11-000000-81206 based upon the actual number of participating students.