The ESD 105 Workers' Compensation Cooperative operates in the districts' benefit in lieu of making payments to the state of Washington for workers' compensation insurance.

Member districts are assessed a rate based on: total payroll hours and claims history over a three year period and and the pension rate set by Washington State Department of Labor & Industries. The Co-Op manages and invests these premiums. Claims are managed and paid internally up to reinsurance levels.

Online Forms for ESD 105 Workers' Comp Co-op:
• Accident/Incident/Injury Report
• Supervisor Accident Report Form
• Witness Statement
• Travel Expense Voucher
• Safety Committee Meeting Form
• Safety Committee Guidelines
• Workers' Comp Co-op Bylaws
• Workers' Comp Contribution Transmittal Form
• Doctor's Estimate of Physical Capacities
• Claim Filing Information for Employees
• Worker's Comp Filing Information

Safety & Loss Control Resources:
• Washington State Dept. of Labor and Industries
• OSHA (U.S. Dept. of Labor)
• State & Federal Workplace Posters (Required/Recommended)
• Safety & Health Rules for Washington State Employers
• Preventing Slips and Falls
• ESD 105 Occupational Safety & Health Trainings

ESD 105 Workers' Compensation Co-op Newsletters:
• January 2008
• December 2007
• November 2007
• October 2007
• September 2007

Contact Information:

	Jeanette Lilja Workers' Compensation Coordinator (509) 454-3100 FAX: (509) 575-2018 jeanettel@esd105.wednet.edu
	Orlando Cerrillo Loss Control Consultant (509) 454-3108 orlandoc@esd105.wednet.edu
	Kathy Bailes Workers' Comp Adjudicator/Insurance Accountant (509) 454-5316 kathyb@esd105.wednet.edu
	Marge Stanley Workers' Comp Adjudicator/Insurance Accountant (509) 454-2850 marges@esd105.wednet.edu
	Dave Curry Assistant Superintendent for Fiscal Services (509) 454-5302 davec@esd105.wednet.edu

Workers Compensation Co-op – Executive Committee:

Dave Curry, Assistant Superintendent, ESD 105:
509-454-5302 • davec@esd105.wednet.edu

Chris Scacco, Business Manager., Selah School District:
509-697-0705 • chrisscacco@selah.k12.wa.us

Sandra Pasiero-Davis, Superintendent, Mabton School District
509-894-4852 • pasierodavis@mabton.wednet.edu

Dave Andrews, Business Manager, Toppenish School District:
509-865-8145 • andrewsd@toppenish.wednet.edu

Dean Schlenker, Business Manager, Highland School District
509-678-4173 • dschlenker@highland.wednet.edu

Tom Fleming, Assistant Superintendent of Business & Operations
West Valley School District
509-972-6006 • flemingt@wvsd208.org