HomeMy WebLinkAboutReso 101-25 Declaring City of Dublin’s Assumption of Workers’ Comp Liability Self-Insured EReso. No. 101-25, Item 5.7, Adopted 12/02/2025 Page 1 of 2
RESOLUTION NO. 101 – 25
A RESOLUTION OF THE CITY COUNCIL
OF THE CITY OF DUBLIN
DECLARING THE CITY OF DUBLIN’S ASSUMPTION OF WORKERS’ COMPENSATION LIABILITIES AS A
SELF-INSURED EMPLOYER, AUTHORIZING SELF-FUNDED WORKERS’ COMPENSATION
OPERATIONS, AND DIRECTING RELATED ACTIONS
WHEREAS, since 2005 the City of Dublin (“City”) has participated in the San Mateo County Cities
Insurance Group Joint Powers Authority (“Cities Group”) for the administration and pooling of workers’
compensation liabilities; and
WHEREAS, due to significant structural and financial changes in the Cities Group risk pool, the
Cities Group Board voted to dissolve and cease all workers’ compensation operations effective January 1,
2026; and
WHEREAS, as a result of this dissolution, the City is required to secure an alternative workers’
compensation program structure to comply with the California Workers’ Compensation Act and ensure
continuation of benefits for City employees; and
WHEREAS, on November 18, 2025, the City Council received a Staff Report analyzing workers’
compensation program alternatives and subsequently approved the City’s transition to a self-funded
workers’ compensation model beginning January 1, 2026, supported by a third -party administrator and
excess workers’ compensation insurance, and authorized the City Manager to take all necessary
implementation actions; and
WHEREAS, California Labor Code section 3700 et seq. and Title 8, California Code of Regulations
section 15200 et seq. authorize public entities to self-insure for workers’ compensation liabilities, subject
to the approval of the Director of Industrial Relations; and
WHEREAS, it is necessary and appropriate for the City Council to formally declare the City’s
assumption of liability as a self-insured employer.
NOW, THEREFORE, BE IT RESOLVED that, effective January 1, 2026, the City Council declares that
the City of Dublin shall operate as a self-insured employer for workers’ compensation purposes and shall
assume any and all liabilities arising under the California Workers’ Compensation Act, subject to
applicable excess insurance coverage.
BE IT FURTHER RESOLVED that the City Council affirms its intention to maintain appropriate
excess insurance to cover statutory benefits above the City’s self-insured retention.
BE IT FURTHER RESOLVED that the City Council authorizes the establishment and continued
maintenance of a Workers’ Compensation Trust Fund for the purpose of paying claims and related
expenses and authorizes initial and ongoing deposits consistent with expected obligations.
BE IT FURTHER RESOLVED that the City Manager is authorized and directed to execute all
agreements, filings, certifications (including the Certification Statement attached hereto as EXHIBIT A),
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Reso. No. 101-25, Item 5.7, Adopted 12/02/2025 Page 2 of 2
records transfers, and administrative actions necessary to implement and maintain the City’s status as a
self-insured employer, including required filings with the State of California Office of Self-Insured Plans.
PASSED, APPROVED AND ADOPTED BY the City Council of the City of Dublin, on this 2nd day of
December, 2025 by the following vote:
AYES: Councilmembers Josey, McCorriston, Morada, Qaadri and Mayor Hu
NOES:
ABSENT:
ABSTAIN:
______________________________
Mayor
ATTEST:
_________________________________
City Clerk
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Exhibit A to the Resolution
CITY MANAGER CERTIFICATION STATEMENT
Pursuant to Title 8, California Code of Regulations, Section 15211 et seq. City of
Dublin Application for Public Entity Workers’ Compensation Self-Insurance Authority
I, Colleen Tribby, City Manager for the City of Dublin, hereby certify the following:
1. Authority to Bind the City
I am duly authorized to execute and submit the City of Dublin’s application to the
California Office of Self-Insurance Plans (OSIP) to obtain a Certificate of Consent to
Self-Insure workers’ compensation liabilities pursuant to Labor Code §3700 and
Title 8 California Code of Regulations §15200, et seq.
2. Assumption of Liability
The City of Dublin expressly assumes and accepts full legal responsibility for the
payment of any and all workers’ compensation claims and benefits arising under
the California Workers’ Compensation Act for its employees, as required by Labor
Code §3700, subject to applicable excess insurance coverage.
3. Financial Capacity / Funding Commitment
The City has the financial capacity to administer a self-insured workers’
compensation program and commits to funding all workers’ compensation
liabilities including, but not limited to, temporary disability, permanent disability,
medical benefits, vocational rehabilitation, death benefits, administrative costs,
investigation, legal defense, and claims adjusting costs.
4. Establishment of a Dedicated Fund
The City has established or will establish a dedicated workers’ compensation trust
fund for the payment of claims, costs, and benefits, and will maintain funding levels
consistent with actuarially estimated obligations.
5. Program Administration
The City will administer claims through a third-party administrator duly licensed to
administer workers’ compensation claims in the State of California, and will ensure
compliance with all statutory and regulatory reporting requirements.
6. Compliance Commitment
The City agrees to comply with all rules, regulations, forms, data reporting
requirements, audits, and investigations of OSIP.
7. Accuracy of Information
All information included in the application and supporting documents is true,
accurate, and complete to the best of my knowledge.
Executed this _____ day of _____________________, 2025 in Dublin, California.
_______________________________
Colleen Tribby
City Manager, City of Dublin
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