2020 Rural Volunteer Fire Department Insurance Program (HB 3667) - The Rural Volunteer Fire Department Insurance Program (HB 3667) is a grant program designed to reimburse eligible volunteer fire departments for the purchase of insurance from private insurance companies. Eligible coverage includes any combination of compensation insurance for firefighters (workers’ compensation, accidental death and dismemberment, group term life, accident and sickness, and/or cancer-related insurance) purchased from Texas insurance companies. The program will reimburse 100% of the actual cost of eligible insurance coverage up to a maximum of $175 per fire department member. Recognized, non-profit volunteer fire departments operated by its members are eligible. Any part-paid/part-volunteer department is also eligible, provided the number of paid members is 20 or less. Departments may enter into agreements with cities or counties in order to qualify for coverage and/or special premiums. All eligible departments must participate in a firefighter certification program administered under Section 419.071 of the Texas Government Code (Texas Commission on Fire Protection), or by the State Firemen’s and Fire Marshal’s Association of Texas (SFFMA), or by the National Wildfire Coordinating Group (NWCG). TO APPLY, PLEASE COMPLETE AND SUBMIT BEFORE JULY 31, 2020: 1) Rural Volunteer Fire Department Application for Grant Assistance (Form TFS-FO-408) 2) Request for Taxpayer Identification Number and Certification (IRS Form W-9) 3) Roster of active fire department members. 4) Copy of a Payroll Classification Schedule Page 1 and 2, or a copy of the current paid insurance policy which provides insurance coverage during the calendar year 2020, or payment receipt for a workers’ compensation, accidental death and dismemberment, group term life, accident and sickness, or cancer-related insurance policy. IMPORTANT NOTES: • The policy or payment documents must show the policy number, the cost or premium amount and the coverage period. • All required reimbursement documents must accompany the 2020 grant application form. • Applications, either complete or incomplete, arriving after July 31, 2020 are not eligible for reimbursement. • ONLY ONE application per department will be reimbursed for the enrollment period of November 2019 thru July 2020. All forms can be found at texasfd.com/RuralVFDInsuranceProgram or by contacting the Capacity Building Department. SUBMIT VIA FAX, EMAIL OR MAIL FAX TO: Texas A&M Forest Service 200 Technology Way, Suite 1162 College Station, Texas 77845-3424 P: 979-458-6505 F: 979-845-6160 Email: [email protected] Website: TexasFD.com
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