Agenda Item # 2
Columbus Consolidated Government
Council Meeting
02/14/2017
Agenda Report # 87
TO: Mayor and Council
SUBJECT: Workers? Compensation Annuity Agreement
INITIATED BY: Risk Management
Recommendation: Approval is requested for funding of a Medicare Set Aside
annuity in the amount of $69,804.48 in the matter of Samuel Turner?s Workers?
Compensation settlement previously presented to Council in executive session on
January 31, 2017.
Background: Mr. Turner sustained a work-related injury in the year 2000.
Mediation of that claim was concluded in January, 2017 with reimbursement of
funds paid by CCG to be made by the Subsequent Injury Trust Fund (SITF),
excepting only approximately $8,700 of the total settlement amount.
Analysis: This is a one-time only annuity funding payment, reimbursable by the
SITF. The annuity agreement must be signed by CCG as the self-insured employer.
Financial Considerations: Monies for settlement of this claim are budgeted in
Human Resources ? Risk Management ? Workers Compensation ? Workers
Compensation: 220-0860-3820-0252.
Projected Annual Fiscal Impact Statement: None.
Legal Considerations: The City Attorney's office has approved the language of
this Resolution.
Recommendations/ Actions: Approval is requested for a Medicare Set Aside
annuity agreement in the amount of $69,804.48.
A RESOLUTION
NO._____
WHEREAS, Claimant Samuel Turner has agreed to a settlement of his Workers?
Compensation claim to include the funding of an annuity to cover anticipated
medical expenses incurred by Medicare; and,
WHEREAS, the annuity will be funded by a one-time only payment of $69,804.48,
such funds to be reimbursed by the Subsequent Injury Trust Fund; and,
WHEREAS, the annuity agreement must be signed by the Columbus Consolidated
Government, as a self-insured employer.
NOW, THEREFORE, THE COUNCIL OF COLUMBUS, GEORGIA, HEREBY RESOLVES AS FOLLOWS:
We hereby authorize the City Manager or his designee to execute all appropriate
settlement documents to this effect.
_________
Introduced at a regular meeting of the Council of Columbus, Georgia, held the
_________ day of _____________, and adopted at said meeting by the affirmative
vote of
_____________ members of said Council.
Councilor Allen voting __________.
Councilor Baker voting __________.
Councilor Barnes voting __________.
Councilor Davis voting __________.
Councilor Garrett voting __________.
Councilor Henderson voting __________.
Councilor Huff voting __________.
Councilor Thomas voting __________.
Councilor Turner Pugh voting __________.
Councilor Woodson voting __________.
______________________________ ________________________
Tiny B. Washington, Clerk of Council Teresa Pike Tomlinson,
Mayor
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