MEMORANDUM


TO: Members of the Georgia Self-Insurers Guaranty Trust Fund

FROM: John P. Reale, Administrator

DATE: December 1, 2011

RE: Important Changes, Notifications, and Reminders


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2011 will be an important year regarding changes for members of the Fund. Due to new legislative changes, a new fee structure will be implemented on January 1, 2011, which will include minimum assessments increasing from $1,000 to $2,000, and maximum assessments increasing from $4,000 to $8,000.


Also, please note the following changes to the 2012 Member Information Update Form:

1. Regarding Question #2c for Active & Canceled Members:

If both the self-insurer and the claims office are located outside the State of Georgia, please designate a GEORGIA AGENT located in the State of Georgia who shall be authorized to execute instruments for the payment of compensation.

2. Regarding Question #16 for Active Members & Question #11 for Canceled Members:

Additionally for those claims excluded, please identify, by name, those claims excluded and attach confirmation from SITF or Excess of 100% acceptance of the claim.

3. Regarding Question #17 for Active Members & Question #12 for Canceled Members:

Additionally for those claims excluded, please identify, by name, those claims excluded and attach confirmation from SITF or Excess of 100% acceptance of the claim.

4. Regarding Question #17 for Active Members & Question #13 for Canceled Members

Please submit a loss run of all OPEN claims as of 12/31/2011. All other requirements remain the same.

5. Regarding Question #18 for Active Members & Question #14 for Canceled Members

Please attach a written explanation of any variance of 20% (only if the variance is equal to $20,000 or more) or more in the total medical, indemnity, and/or reserve data that you reported on last year’s Update Form, when compared to what you are reporting on this year’s Update Form.

6. Regarding Question #21 for Active Members & Question #19 for Canceled Members

Please note, the captive endorsement and the bankruptcy/cancellation endorsement for excess are two separate endorsements.

Captive insurance endorsement. Added language per the terms of our insurance policy issued to the employer.

7. Regarding Question #32 for Active Members & Question #29 for Canceled Members

Please note, this item is a two part question with part a and b.

a. Please advise when your most recent fiscal year will be completed.

b. If your most recent audited financial statements are not available, please state the date of their availability.

Should you have any questions, please do not hesitate to contact us at the number listed above.

Thank you in advance for your cooperation.

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0708-16211