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HomeMy WebLinkAboutContractCAG -14 -004 CLAIMS ADMINISTRATION AGREEMENT THIS AGREEMENT is made and entered into between EBERLE VIVIAN INCORPORATED, with its principal place of business at 206 Railroad Ave, N., Kent, Washington, 98032 (hereinafter referred to as "EV "), and CITY OF RENTON, with its principal place of business at 1055 South Grady Way, Renton, WA 98057 (hereinafter referred to as "the Client" or "Renton "). WITNESSETH WHEREAS, the Client maintains an insured plan to cover its Workers' Compensation liabilities in the State of Washington; and EV has agreed to perform certain services in connection therewith, as herein set forth: NOW, THEREFORE, it is agreed as follows: The term of this Agreement shall be for the period of one (1) year commencing March 1, 2014 and ending February 28, 2015. Nonetheless, this Agreement may be terminated by either party at any time by giving not less than sixty (60) days written notice to the other party, and EV may terminate this Agreement on shorter notice in the circumstances described in Sections 3(c) and 5(e). If no notice is given, this contract will be renewed for another twelve (12) month period without further action by either party, upon the same terms and conditions contained herein, and using the previous annual (January to January) U.S. Department of Labor Consumer Price Index percent change for the Seattle Metro area to increase the annual fee, plus an increase of two percent of the current annual fee. 2. During the period of this Agreement, EV shall represent and act for the Client in matters pertaining to the actual or potential liability of the Client for claims based on injuries to the Client's employees which occur during the term of this Agreement that are or should be, in the Client's judgment, handled pursuant to the self - insured provisions of the Industrial Insurance Act of the State of Washington (the "Act "). More specifically, EV shall: a. Receive notice of and create files on each claim reported and maintain these files for the Client. b. Investigate all claims as required to determine their validity and compensability. c. Determine proper benefits due on compensable claims. d. Make timely payment of benefits due, in accord with payment procedures as established from funds provided by the Client. The Client will be wholly responsible for providing such funds as may be required for these payments. e. Prepare documentation and defense of cases considered non - compensable and assist legal counsel selected by the Client in preparation of cases for hearing, appeals, and/or trial. f. Maintain and provide the Client pertinent data on all claim payments g. Provide monthly and/or quarterly computerized loss reports in a tailored format, as mutually agreed at inception of the program, showing descriptive data, details of each month's payments, total payments, reserves and total experience for each claim. h. Provide the Client's excess insurers such reports as they may reasonably require within specific excess coverage reporting requirement. Provide information and assistance as may be reasonably required for preparation and filing of all reports required by the Act and any other applicable law in connection with the Client's approved self - insured status. j. File with the appropriate State of Washington administrative agencies, including but not limited to the Department of Labor and Industries, such information as is required by the Act and any other applicable law with respect to each claim. k. Provide loss control services, defined as loss control, consultations and surveys as mutually agreed. 1. Perform all services to be rendered pursuant to this Agreement in full compliance with the Act and all other applicable law. m. EV RMIS (Risk Management Information System) will electronically interface with the Centers for Medicare and Medicaid Services (CMS) to capture and report data in the format prescribed by the CMS Specifications. n. EV RMIS will report directly to CMS on behalf of Client as an Account Designee (reporting agent), as such term is defined in the CMS User Guide published on March 16, 2009 ( "Account Designee "). o. If Client is the Responsible Reporting Entity ( "RRE ") as that term is defined in MMSEA Section 111 as set forth in 42 U.S.C. 1395Y, EV RMIS will assist client as follows: i. EV RMIS will develop an electronic interface with CMS to forward the information needed to meet Client's MMSEA reporting obligations. ii. As the custodian of the original claims information from which the reports will be compiled, EV RMIS will be authorized Account Designee for Client. As an Account Designee, EV RMIS will prepare and submit test files to CMS in accordance with the applicable regulations and the requirements of the CMS Specifications. iii. EV RMIS will prepare the CMS Medicare beneficiary required data files and submit them to CMS or otherwise forward them as required by applicable regulations instructed by Client. iv. EV RMIS will establish and implement proper safeguards against unauthorized use and disclosure of the data exchanges for the purposes of complying with MMSEA. Proper safeguards shall include, but not be limited to, the adoption of policies and procedures to ensure that the data obtained shall be used solely in accordance with Section 1106 of the Social Security Act [42 U.S.C. 1306], Section 1874(b) of the Social Security Act [42 U.S.0 1395kk (b)], Section 1862(b) of the Social Security Act [42 U.S.0 13958y(b), and the Privacy Act of 1974, as amended [5 U.S.0 552a]. EV RMIS shall establish appropriate administrative, technical, procedures and physical safeguards to protect the confidentiality of the data to prevent unauthorized access to the data provided by CMS. Further EV RMIS agrees to grant an authorized representative of the Center for Medicare and Medicaid Services (CMS) and/or Client access to facilities where the Client's Medicare data is stored or kept for the purpose of inspecting security arrangements at a mutually agreeable date and time. The purpose of any such inspection will be to confirm that EV RMIS is in compliance with all applicable security requirements. Access to the records matched to any records created by the matching process shall be restricted to authorized CMS, EV RMIS and Client employees, agents and/or officials who require access to perform their official duties in accordance with the uses of the information as authorized under Section 111 of the MMSEA of 2007 and this Addendum, Such Personnel shall be advised of (1) the confidential nature of the information; (2) safeguards required to protect the information; and (3) the administrative, civil and criminal penalties for noncompliance contained in applicable Federal laws. p. EV RMIS will be responsible for payment of any and all fines assessed to the Client in regards to compliance with the Medicare beneficiary reporting requirements of Medicare, Medicaid and SCHIP Extension Act of 2007 that relate to the negligent acts or omissions of EV RMIS except to the extent that: i. Such fines or penalties are the direct result of specific direction given by Client and/or its agent or the negligent actions or omissions of Client and /or its agent; ft ii. EV RMIS did not receive information from Client that is essential to the performance of the duties set forth herein in a timely manner so as to be able to comply with the terms of this Addendum; q. EV will perform all work, services, and meet obligations as described in their signed Proposal presented to the Client on or about November 1, 2013, which is attached and fully incorporated into this Agreement by reference with this Agreement as Attachment "A ". Except that in the event of any inconsistencies between EV's Proposal and this Agreement, the Agreement shall prevail. 3. In consideration of the services to be performed by EV hereunder, the Client shall pay to EV: a. A service fee of $77,500.00 per year for all claims administration service performed within the contract period. The service fee may be paid either as a lump sum or in monthly installments of $6458.33, as preferred by the Client, and subject to the annual adjustments. b. Such additional fee as mutually agreed by the parties for any services in addition to those described in Section 2 that are requested by the Client. Interest of 1.5% per month on invoices not paid within 30 days of client's receipt thereof. In the event invoices are not paid within sixty (60) days of client's receipt thereof, EV may terminate this Agreement, at its option, after ten (10) days written notice to the Client. 4. The Parties mutually agree that: a. Client will indemnify, defend and hold harmless EV, its officers, directors, employees, and agents, from all claims, losses, damages, costs, liability or expenses, including attorneys' fees, caused by or resulting from the negligence or willful misconduct of Client, its officers, directors, employees, insureds, or agents, to the extent permitted by law. b. EV will indemnify, defend and hold harmless Client, its officers, directors, employees, and agents, from all claims, losses, damages, costs, liability or expenses, including attorney's fees caused by or resulting solely from the negligence or willful misconduct of EV, its directors, officers or agents, to the extent permitted by law, however the parties agree that EV, its directors, officers, agents or employees, will not be liable to Client or any third party for claims arising from EV's performance under this Agreement in those cases where EV acted at the request of or with the consent of Client. c. Client agrees that it will not hold EV liable for, or reduce the compensation of EV with respect to any failure of EV to deliver any services resulting from any failure of cooperation on the part of Client or the prior administrator, or from any files for takeover claims which have not been properly maintained or are not delivered to EV in good order. d. This section of the Agreement shall survive the termination of the Agreement. 5. The Client agrees: a. To pay EV the fee provided for hereunder and any other fees agreed to by the Client. b. To pay all allocated loss expense, as hereinafter defined, in addition to the fees to be paid to EV. Allocated loss expense is defined as reasonable attorneys' fees, court and/or hearing costs, costs of depositions, documents and exhibits, witness and expert fees, medical and engineering appraisal, surveillance, independent adjusting, photography and other incidental and special costs incurred to evaluate compensability of claims.. To make funds available to EV to be used by EV to pay claims that the Client determines it should pay pursuant to the Act and allocated loss expense. d. To advise EV on a timely basis of all pertinent excess insurance reporting requirements and/or reporting modifications for all annual periods for which claim administration services are provided. e. That this Agreement is entered into with the assumption that existing Federal, State or other jurisdictional regulations will remain in effect for the duration of this Agreement. The Client agrees that should administrative or other costs of service provided hereunder be substantially increased as a result of modifications in existing law, enactment of new legislation, or promulgation of new administrative guidelines, that the Client and EV agree to attempt to negotiate an adjustment to the service fees to equitably reflect the effect of such change. If the parties cannot agree on a revised service fee, EV may terminate this Agreement, at its option, after thirty (30) days written notice to the Client. 6. The Parties acknowledge and agree that: a. Any and all information emanating from either party's business in any form, including compilations of otherwise public information, is confidential and proprietary in nature. Each party will use its best efforts during and after the termination of this Agreement to preclude the duplication, use or disclosure of any such confidential and proprietary information to any third party, unless such duplication or disclosure is specifically authorized under this agreement or by the party claiming ownership or otherwise required by law. In addition, the parties agree that information provided by EV's RMIS or otherwise in the context of this relationship shall be considered confidential and proprietary and may constitute privileged and/or attorney work product protected from discovery by law and/or rules of court. Therefore, neither party will release any such information unless: i. Compelled by an order of a court of competent jurisdiction; ii. Mandated by an insurance code, claim practices act, workers' compensation law, or other applicable law or regulation to provide information to the claimant or other person; iii. Mandated by applicable court discovery rules in the opinion of the claim professional responsible for the adjustment of the claim or defense counsel, if any. b. Any information sought to be produced will be prescreened by EV in consultation with Client, provided such discovery requests comply with applicable rules of court governing discovery litigation. c. If there is an obligation to release part but not all of the information, the part deemed not responsive will be withheld, but nothing in this Agreement is intended to abrogate the duty of either party to comply in good faith with such discovery requests. d. Each party agrees that the information contained within EV's RMIS must be treated in a confidential manner by all users who may gain authorized access to the RMIS. In the event of a third party suit alleging defamation, false light, or other invasion of privacy tort, violation of civil rights, violation of federal or state medical privacy statutes, or violation of fair employment practice laws, arising from either party's use of EV's RMIS under this agreement, the liable party agrees to indemnify and hold harmless the other party for all sums due under the terms of a judgment or reasonable settlement, including interest and attorneys' fees, upon a final judgment or mutual agreement that one of the parties hereto is liable as charged in such allegations. e. EV shall hold the non - public personal information in strict confidence and access it only for explicit business purpose of this agreement. EV's Privacy and Confidentiality Policy, and as applicable, all state and federal laws related to privacy, including, but without limitation, Gramm- Leach - Bliley Act. Upon reasonable request, Client may audit EV's compliance with EV's Privacy and Confidential Policy as well as EV's compliance with state and federal laws related to confidentiality of non - public personal information. EV shall promptly notify Client in writing of any unauthorized use or disclosure of non - public personal information. EV shall endeavor to promptly notify Client of any unauthorized use or disclosure on non- public personal information and it will take immediate steps to remedy the situation and mitigate damage. This section of the Agreement shall survive the termination of the Agreement. 7. All claims and related files generated by EV as a result of its activity under this Agreement shall remain at all times the property of the Client with the exception of any supporting data required by EV to make such accountings to the Client or excess insurers as are required in this Agreement. EV will retain claim files for three (3) years following date of closure. Thereafter, files may be returned, at the Client's direction and expense, to the Client or forwarded to such location as may be designated for continued storage. Upon EV's request, closed claim files will be returned for additional administration as may be required. In the event of termination or non - renewal of EV's services, EV will, at the Client's request and expense, transfer all open and retained closed claim files to the Client or its designee, as of the effective date of termination. EV is retained by the Client only for the purposes and to the extent set forth in this Agreement, and its relationship to the Client shall be that of an independent contractor 9. The Client agrees that during the term of this Agreement and for a period of one (1) year following its termination, it will not employ any person employed by EV during the term of this Agreement without the prior written consent of EV. 10. Any notice required or permitted to be given under this Agreement shall be sufficient if given in writing and sent by registered or certified mail to the Client or to EV at the addresses first set forth above or to any other address of which written notice of change is given. 11. The waiver by EV or the Client of the breach of any provision of this Agreement by the other party shall not operate or be construed as a waiver of any subsequent breach by either party or prevent either party thereafter enforcing any such provision. 12. This Agreement is for the term provided for in Section 1. Upon termination of this Agreement, the Client shall have the option to: a. Assume all open claims pending for the terminated or non - renewal portion of the program as of the effective date of termination or non - renewal, provided, however, that EV shall be entitled to receive its full fee for all quarters beginning prior to the effective date of termination or non - renewal; or b. Upon agreement by both parties to a rate of compensation, require EV to continue administration, to conclusion, of all open claims associated with that portion of the program terminated or non - renewed. Such rate of compensation shall thereafter be reviewed by the parties on an annual basis and shall be the subject of mutual agreement between the parties. Adequate funds shall continue to be made available by the Client for the payment of claims and allocated loss expense until all claims are liquidated. c. In the event the Client requests EV to provide post - termination or non - renewal claims administration, upon agreement by both parties to a rate of compensation, the Client may continue to purchase computer data services. Such rate of compensation shall thereafter be reviewed by the parties on an annual basis and continued on -line services shall be the subject of mutual written agreement between the parties. 13. The obligation of EV to perform its duties hereunder is conditioned upon the Client's cooperation with EV with respect to the activities of EV including, but not limited to, responding to EV's requests for information promptly; providing excess carrier reporting requirements; meeting with EV and/or third parties, as may be needed; making decisions on matters which, in the professional opinion of EV, should be made by the Client; the provision of funds referred to in Section 5; and performance by the Client of all other obligations of this Agreement. 14. This Agreement may not be assigned by either party without the prior written consent of the other party, which consent will not be unreasonably withheld. 15. Any unresolved dispute between the Client and EV that may arise from the obligations of either party as set forth herein, will be resolved by arbitration on the written request of either party. Such arbitration shall be binding upon the Client and EV. The parties shall attempt in good faith to select a single arbitrator within 15 days of the written request for arbitration. If they are unable to select a single arbitrator within said period, then each party shall select an arbitrator who will select a third. If the two arbitrators cannot agree on a third within fifteen (15) days of the notice to the other party of the selection of the first arbitrator, either party may file a petition in court to request that selection be made by a judge of a court having competent jurisdiction. Except as provided herein, the arbitration shall proceed pursuant to RCW 7.04A. The laws of the State of Washington will apply. The prevailing party in any such arbitration shall be entitled to an award by the arbitrators of its reasonable attorneys' fees and costs associated with such arbitration and in any subsequent court enforcement or appeal thereof. 16. This Agreement sets forth all of the terms, conditions, and agreements of the parties relative to the subject matter hereof and supersedes any and all such former agreements which are hereby declared terminated and of no further force and effect upon the execution and delivery hereof. There are no terms, conditions or agreements with respect thereto, except as herein provided and no amendment or modification of this Agreement shall be effective unless reduced to writing and executed by the parties. All terms, conditions, and definitions as set forth in this Agreement will be interpreted under the laws of the State of Washington. 17. Insurance. a. EV shall secure and maintain the following insurance policies, and shall not cancel or suspend the insurance policies identified below, except after twenty (20) calendar day's prior written notice by certified -mail to the City of Renton: i. Commercial General Liability Insurance: Commercial general liability insurance in the minimum amounts of $1,000,000 for each occurrence /$2,000,000 aggregate throughout the duration of this Agreement. ii. Professional Liability Insurance: Professional liability insurance, in the minimum amount of $1,000,000 for each occurrence, shall also be secured for any professional services being provided to Renton that are excluded in the commercial general liability insurance. iii. Workers' Compensation: Workers' compensation coverage, as required by the Industrial Insurance laws of the State of Washington. iv. Fidelity Bond: A fidelity bond, or an alternative form of coverage acceptable to Renton, in the minimum amount of $1,000,000 covering all employees assigned to service Renton's accounts. b. Renton as an Additional Insured: It is agreed that on EV' S commercial general liability policy, the City of Renton will be named as an Additional - Insured on a primary and non - contributory basis. Any coverage maintained by the City of Renton is solely for the coverage and benefit of Renton, and its elected officials, officers, agents, employees, representatives and volunteers. c. Verification of Coverage: Subject to Renton's review and acceptance, a certificate of insurance showing the proper endorsements, shall be delivered to Renton before executing the work of this Agreement. d. Review of Policy: Upon request, EV shall give Renton a full copy of the insurance policy for its records and for the Renton City Attorney's or Risk Manager's review. The policy limits may be reviewed and the value reassessed annually. Termination: Notwithstanding any other provision of this Agreement, the failure of EV to comply with the above provisions of this section shall subject this Agreement to immediate termination without notice to any person in order to protect the public interest. IN WITNESS WHEREOF, the parties hereto have executed this Agreement in duplicate counterparts as of this date written and the persons signing below warrant that they have the authority to execute this Agreement. N INCORPORATED 0 Date: a"�- % 1-3 I Y OF RE 4 N By: Title: Mayor Date: 12130 1 Denis Law Printed Name A ATTACHMENT A SECTION II — SCOPE OF SERVICES The selected TPA is expected to have an office and sufficient personnel assigned to the city account, with access by telephone, fax, and e-mail. The city shall be informed whenever assigned claims personnel are expected to be unavailable for periods longer than 2 business days. The city must be notified with the name and contact information for the alternate claims personnel who will handle business related to claims processing, administration, questions, and issues. Eberle Vivian's office is located at 206 Railroad Avenue North, Kent, Washington, 98032. We will assign an adjuster with extensive experience in handling public entities to the City of Renton's account. This adjuster will be available by telephone, fax, e-mail and with sufficient notice, in person as well. Adjusters always advise all clients when they are to be away from their desk for one day or more. In such an event, Eberle Vivian assigns back -up adjusters with equal experience to cover any issues which may arise. The contact information for the primary and also back -up adjuster will be provided to all necessary City of Renton staff. The selected TPA is expected to be available to meet on -site with City of Renton staff for claims review meetings and /or discussions concerning specific difficult cases up to four times per year. Eberle Vivian's Kent office is located approximately twelve minutes from the City of Renton's Risk Management office. We would be happy to meet with the City for claim reviews four times per year or even more frequent as circumstances warrant. The city reserves the right to select and approve legal representation necessary for the administration of this program. The selected TPA may need to meet, as needed, with the city's legal defense team, hired legal defense contractors, Risk Management personnel and /or other designated employee(s) of the City for discussion and defense planning of legal issues of selected claims. Eberle Vivian agrees to work with the City's chosen defense counsel in any way necessary. In addition, upon request, the City may avail itself of the vast network of legal resources at Eberle Vivian's disposal. TPA's scope of services shall include the following: Claims Administration: Examine all claims reported and determine if the claim is compensable under state statutes and keep Risk Management and the injured employee advised of the claim status. Eberle Vivian will review all claims for compensability and make an appropriate, timely determination. Both Risk Management and the worker will be advised of the claim's status initially and at important intervals as the claim develops. 2. For the purpose of helping to determine claim compensability and for claims administration, the TPA shall do the following: - Establish contact with the designated Risk Management staff, and the injured employee within twenty -four (24) hours of receipt of the reported claim, Eberle Vivian protocols are to make such contact (to include the worker, the employer, and the provider) within 24 hours of receipt of the claim, and to document such contact in the claim notes. - As determined or requested by Risk Management or as may be required by the facts of the claim, the TPA will conduct interviews with the injured employee, co- workers, witnesses or others who might have direct knowledge of the facts and circumstances relating to the claim. Eberle Vivian agrees to perform any such interviews as requested and as may be necessary in order to determine the compensability of the claim. • Conduct any other interviews or investigation deemed appropriate. All forms used to gather information from the injured employee will be preapproved by Risk Management. 2 Eberle Vivian agrees to conduct any such interviews and will seek approval from the City for any forms used in the gathering of such information. • Obtain approval from Risk Management prior to hiring claim specific case managers or claims investigators. Eberle Vivian agrees to this requirement. - Process appeals approved by Risk Management in a timely manner and communicate claim status. Eberle Vivian agrees to process appeals as requested by the City and to always keep the appropriate City personnel advised as to the updated claim status. - Keep all claim diaries and claim correspondence filing current and readily accessible. Documented claim status updates on all open claims shall not exceed 30 days. Eberle Vivian adjusters are required to stay current on their diaries. Claims are generally scheduled for review on a monthly basis but this review may be more frequent depending on the circumstances of the claim. The claim status, which will include the adjuster's plan of action, will be reflected in the client - accessible claim notes via iComp. • Provide a means to promptly correct filing and documentation errors. Filing and documentation errors are extremely rare but when they do occur they are promptly corrected. 3. Provide a medical cost containment program, to include: • Fee schedule review 3 Eberle Vivian adjusts all medical bills in -house at no additional charge to the client. All savings realized in the medical fee reductions are passed on to the client, with no percentage of savings fees and no per -line fees. We have found that this method of fee reduction generally results in a greater savings to the client, and at no additional cost. Further, we do not need to wait for outside vendors to review and return the bills, resulting in much faster turnaround times Appropriate bills are generally paid within 20 days of receipt. The Adjuster also carefully reviews bill data to verify that the treatment corresponds with the injury and to ensure no unrelated conditions are treated under the claim. Bills which require further clarification, or that are for a denied condition, are immediately returned to the provider with an explanation for the denial. A sample savings report will be attached herewith. • Hospital utilization review Prior to admission to a hospital Eberle Vivian will have determined medical necessity. Upon receipt of the bill and the medical reports from the inpatient stay our claims mangers will review the reports for the services provided to match them with billed items to ensure that the providers follow treatment guidelines and acceptable practices. If we feel that they may fall outside of treatment guidelines we will seek approval for review from a nurse case manager or an independent company who performs utilization review. These requests will be made on a case by case basis only. • Hospital bill audit Eberle Vivian audits all bills and services provided. After applying all costs savings that we believe that we can obtain we then determine the possible value of sending the bill out for independent review. If the savings that an independent firm can save our client is more than the savings the Eberle Vivian can save plus the cost of the bill audit, Eberle Vivian will seek approval for bill audit for that individual bill. As this is rarely the case, we have found that this requesting permission on a case by case basis is not burdensome to our clients and at the same time has saved them thousands of bill audit dollars over the years. 4 Hospital /Physician discounts At this time Eberle Vivian does not have any agreements with hospitals or physicians for discounts. There have been numerous penalties issued for payments made for these types of agreements and we have chosen to follow the fee schedule rather than expose our clients to this liability. 4. Provide a quarterly medical cost containment report to the Risk Management Department. Eberle Vivian will provide such a report to the City's Risk Management Department on a quarterly basis or as requested. In addition, Eberle Vivian recommends quarterly stewardship meetings at which time we can discuss not only cost savings, but also review other metrics such as the timeliness of claim reporting and injury trends. 5. Compile and file, on behalf of the city, all notices, reports, and admissions required by state and federal statutes relating to workers' compensation claims. Eberle Vivian performs this service for all clients currently and will happily do so for the City. 6. With the approval of Risk Management, arrange for independent medical examinations, rehabilitation services and activity check -ups, when such procedures may be constructive. Eberle Vivian adjusters regularly employ these claim strategies in order to reduce claim costs. Eberle Vivian will secure the approval of City Risk Management prior to utilizing any of these strategies. 7. As requested by the city, cooperate and coordinate with the city's chosen legal counsel in workers' compensation hearings and proceedings, including stipulations. Eberle Vivian agrees to this requirement. 8. Report claims to the city's excess insurer in accordance with policy requirements and monitor all recoveries due. This shall include providing notice to excess insurers of all claims or potential losses which may exceed the city's per occurrence retention and, if requested, provide such insurers with necessary information on the current status of those claims, including total aggregate loss information for the respective policy year. Eberle Vivian has an excellent working relationship with multiple excess carriers, including but not limited to Midwest Employer's Casualty and Safety National. Eberle Vivian regularly reports electronic claim data directly to these carriers when requested by our clients. Our interaction with the excess carriers also includes fulfilling specific reporting requirements on individual claims and securing funds when the claims have exceeded the retention level. 9. Develop a systematic approach to advise Risk Management concerning the need for managed care, rehabilitation, and /or retraining of injured employees. Eberle Vivian adjusters keep the client apprised of all important claim developments. Any claim which may require managed care, vocational rehabilitation, and /or retraining will immediately be brought to the attention of designated City personnel, and prior to utilizing any of these claim strategies, City approval will be secured. While we believe monthly and /or quarterly claim reviews are helpful, these are by no means the only time we update the client and request approval for these and other strategies. We maintain regular contact via phone and email with our clients in order to limit surprises, and ensure the claims move forward smoothly. We believe client input is extremely important in all aspects of the claim. Moreover, iComp, Eberle Vivian's client interface, allows clients to review adjuster notes, diaries, and claim documents. iComp is just one more tool to help us keep clients "in the loop" on important claim developments. 10. Provide systematic medical bill audits, subject to an agreed threshold bill amount. All medical bills are reduced to Washington Fee Schedule. 11. Provide all data necessary to complete OSHANVISHA reports. Eberle Vivian captures all data necessary for compliance with these reports. 12. Accommodate requests from the city for loss runs within 24 hours of request. Eberle Vivian agrees to this request. 13. Ensure that data platforms and files are secure from cyber- attacks, including all medical records and personally identifiable information. Please see the attached description of Eberle Vivian's security protocols. We have taken extensive measures to protect this valuable and private information. Loss Control and Claims Reporting /RMIS Requirements The selected TPA shall provide a fully integrated risk management information system. In the areas of claim information, loss control information and general financial information, the firm shall have the capability to provide the following: Master loss run printouts by fiscal year (January 1 st through December 31 st) by occupational classification. Each print run must be capable of selecting on the basis of specified range parameters on any or all data fields and must be capable of an ordered print. Eberle Vivian agrees to provide such a loss run to the City. Quarterly loss detail and summary reports. (Please provide samples.) Eberle Vivian agrees to provide these reports. A sample of these reports can be found attached herewith under the tab "Reports ". The "Loss Detail Report" is omitted from the samples as it is an Excel report which is best shared electronically. However, a sample Loss Detail Report can be shared via email should the City wish to see one as part of the vetting process. Quarterly accident analysis detailed reports. (Please provide samples.) Eberle Vivian agrees to provide these reports. A sample can be found attached herewith under the tab "Reports ". Loss development factor /loss payout pattern listing. Eberle Vivian agrees to provide this report. Reserve adequacy analysis, including monthly and annual comparison of total paid on claims closed during the period with the reserve for those claims effective at an initial report, six months, twelve months, eighteen months, twenty -four months and every twelve months thereafter until all claims in a given period are closed. (Please provide samples.) Eberle Vivian can and does provide highly customized reports for our clients to meet their needs. These reports are developed with the client's input and approval. While a sample of this report is not currently available, Eberle Vivian agrees to develop such a report in corroboration with the client after contract inception. An excess carrier report by year. Eberle Vivian agrees to provide this report. Weekly and monthly check register detailing financial activity, including payments issued, payee, amount of check, type of payment, claim number, date of injury and claimant name. (Please provide report samples.) 0 Like most of our reports, check registers can be customized to meet with client demands. A sample of some of our more standard check registers are attached herewith. The data included can be modified to meet with City needs. Capability for on -line access and ad hoc reports by Risk Management utilizing historical loss information. Eberle Vivian provides all customers with online access to claims information via iComp. Through iComp, customers can view information on specific claims including adjuster notes and claim documents. Clients can also run ad hoc reports using iComp. Eberle Vivian would be happy to provide a demonstration of iComp's capabilities to the City. Customized loss reports are preferred. Eberle Vivian will work with the City to develop customized loss reports. SCHIP reporting on behalf of the city and as required by current regulations. Eberle Vivian currently provides this service to all customers and will do so for the City. Provide for complete data migration for past and current claims into the TPA's existing data base. Eberle Vivian agrees to migrate all data for all past and current claims into our claims system. There is no fee for this service. Cooperate fully with the city and any authorized replacement TPA in the event that contract agreement is non - renewed or is cancelled. Eberle Vivian agrees to cooperate fully with the City and any replacement TPA in such an event. Submitted proposals should address ownership of data /loss files. It is the city's intent to maintain ownership of all claim files. Please comment on special ownership of claim file media. All claim files are considered property of the client. Financial and Accounting Services Submitted proposals will require an explanation of the establishment of any fund that may be required for payment of claims. Details should include, but not be limited to: Any monthly requirements after initial establishment of the fund The City would establish and maintain their own workers' compensation account from which Eberle Vivian would write the benefit checks. With this arrangement, the client may determine their own monthly requirement. Procedures under which funds are to be transferred This would be at the client's discretion. Frequency of adjustment to determine accuracy of funding level This would be at the client's discretion. Reconciliation of check issuance This would be at the client's discretion. Maintain accurate and current claim payment records to prevent the issuance of duplicate payments 10 Eberle Vivian's proprietary claims system, iComp, immediately record any payment to vendors and workers in order to prevent any duplicate payments. Please indicate basic funding arrangements available, i.e., daily replenishment (budgeted basis or cleared bank basis), monthly replenishment, etc. Please indicate anticipated amount of initial impress account. As noted above, since this would be a client -owned and maintained account, these matters would be at the client's discretion. The selected TPA will need to maintain constant e-mail capability for communication with the city's Risk Management Department, designated medical providers, and attorneys. This may include making claims data available through secure website access and encrypted e-mail. All Eberle Vivian employees have email access and are expected to respond to emails promptly. In addition to having unfettered access to their adjuster via phone and email, City personnel will also be able to review claim status and claim documents online using iComp, Eberle Vivian's secure client portal. The selected TPA will assign specific personnel to handle all of the city's workers' compensation claims. This claims team will deal with the city's Risk Management Department or other designated employee(s) of the city on the day -to -day claims functions. Eberle Vivian will assign a primary adjuster, a backup adjuster, a clerical person, and a supervisor to work directly with the City of Renton Risk Management Department. The primary adjuster will be the main point of contact, however, should the primary adjuster be away for any length of time, the City will have the contact information of the adjuster's backup and also the supervisor. The selected TPA is expected to return phone calls and /or respond to a -mails from designated city staff and calls from injured city employees within one business day. 11 Eberle Vivian agrees to this requirement. The selected TPA is expected to set an ultimate claim reserve for all lost time cases within 30 days of the receipt of the claim. This reserve would be adjusted as needed to always reflect the ultimate case reserve. The Eberle Vivian adjuster will establish an ultimate claim reserve within 30 days of receipt taking into account all known information about the claim. The adjuster will complete a reserve worksheet which documents their reserve rationale, and which is accessible to the client via iComp. Every 30 days thereafter, the adjuster will review reserves for adequacy, ensuring the reserves always reflect the ultimate potential value of the claim. The selected TPA must have the ability to receive First Reports of Injury by facsimile or email. Eberle Vivian can receive new claims via fax at 253 - 854 -6404 or via email at newclaim(),eberlevivian.com. Both the fax number and the email are checked multiple times daily to ensure prompt entry of new claims. The TPA shall maintain a separation of duties when it comes to check issuance, including the ability to input payees, input checks, print checks, and /or mail checks. A system for maintaining the security and access of check stock shall be established and controlled whenever check stock is kept on the TPA's site or stored under the TPA's direction. Eberle Vivian agrees to maintain the above -noted separation of duties. The TPA shall develop and maintain a workable disaster recovery planning program to allow for continued operations with minimal interruptions. Eberle Vivian's disaster recovery plan allows for the continuance of business operations in the event of a disaster. Our disaster recovery plan is further outlined in answer to question Y, under the Claims Administration Services Questionnaire. 12 SECTION III - PROPOSAL PREPARATION AND SUBMISSION REQUIREMENTS A. Table of Contents to include clear identification of the material provided by section and number. A Table of Contents is included herewith. B. A letter of transmittal indicating the respondent's interest in providing the service and any other information that would assist the city in making a selection. Provide a statement verifying that the submitted proposal is valid for 180 days from date of receipt. This letter must be signed by a person legally authorized to bind the firm to a contract. Such a letter is herewith included. This proposal is valid for 180 days from the date it is received. C. A statement demonstrating understanding and your capability of providing the services of each section of the Scope of Services. Eberle Vivian has reviewed and responded to each individual section of the Scope of Services above. D. A written description of the respondent's qualifications and experience to provide all services requested within this RFP. Eberle Vivian has been providing claim services to self- insured employers since July 1, 1986. We initially provided services to only a small handful of organizations. But by providing excellent claims service and applying our intimate understanding of Washington self- insurance in the overall community, Eberle Vivian has grown to be the largest locally -owned TPA in Washington, and the second largest overall. Eberle Vivian currently provides self- insurance claim services to 18 public entities, including 4 cities, (the Cities of Bellevue, Kent, Bellingham, and Tacoma). 13 Eberle Vivian owns and maintains its own claims system, iComp. By owning and maintaining their own claims program, Eberle Vivian can quickly respond to changing laws and changing customer demands. In addition, when the State of Washington has proposed changes to the state law, such as the recent Provider Network, Eberle Vivian has had a programmer at the table with Labor and Industries personnel in order to ensure the law is instituted in such a way that our excellent service to our customers is not impacted. Although Eberle Vivian does handle some out -of -state claims with iComp, this system was developed with Washington customers in mind. Eberle Vivian adjusters also enjoy the ease and flexibility provided by this system. Eberle Vivian adjusters average 20 years of experience in handling Washington self- insured claims. Along with this experience comes the understanding that each client's culture is unique. We take the time to learn that culture and reflect the client's wishes as closely as possible in our claims handling. Our goal is to develop long -term partners. Our excellent client retention and tenure demonstrates this level of commitment. E. Completion of the Fee Proposal /Questionnaire. A completed Fee Proposal / Questionnaire is herewith attached. F. Evidence of the respondent's insurance as set forth: Workers' Compensation — Statutory Limits, as required by the State of Washington and /or the state where business is being conducted. 2. Commercial General Liability with minimum limits of $1,000,000 per occurrence, $2,000,000 aggregate. Must include Employers Liability Stop Gap - WA coverage when Washington workers' compensation coverage is required. 3. Professional Liability. Minimum limits of $1,000,000, per occurrence. If the policy is on a claims -made basis, the policy shall be continually renewed for two (2) years beyond the date of contract expiration or cancellation. Professional Liability coverage is for all professional services provided to the city that are not covered by the TPA's Commercial General Liability insurance. Eberle Vivian agrees to these requirements. 14 G. An appropriate Certificate of Insurance evidencing all required insurance coverage is to be included at the point of contract award. If the contract for proposed services is awarded, evidence of policy endorsements showing the city as a non - contributing additional insured on the general liability coverage shall be submitted prior to commencement of services under any such awarded contract. Eberle Vivian agrees to this requirement. H. The respondent, on award of the service contract, shall submit evidence of a fidelity bond in the minimum amount of $1,000,000. Such bond shall provide for the fidelity and faithful performance of all employees assigned to service the account and for which accountability of city monies for claim payments is established. Eberle Vivian agrees to provide proof of such a bond at the time of contract award. Indemnification of City by Successful TPA The successful TPA shall indemnify and hold the city harmless from any and all claims, liabilities, losses and causes of action which may arise out of the negligent fulfillment of the TPA's contractual obligations as outlined in this RFP. The TPA shall pay all claims and losses of any nature whatever in connection therewith, and shall defend all suits in the name of the city when applicable, and shall pay all costs and judgments, which may issue thereon. The TPA will also be responsible for penalties assessed by the Washington State L &I Department when the error is the result of the negligence of the TPA. Eberle Vivian will include with this RFP response a copy of our preferred terms and conditions, including indemnification language. If Eberle Vivian is the successful TPA under this RFP, we will seek to incorporate these preferred terms and conditions into the agreement with the City. Eberle Vivian agrees that penalties resulting solely from our negligent handling will be our responsibility. Expected Time of Performance 15 The city would consider a multi -year agreement. Please provide your quote proposals for one, two, and three years commencing March 1, 2014. Please also provide any special conditions for contract renewals. Eberle Vivian will provide pricing for one, two, and three years commencing March 1, 2014. There are no special conditions for contract renewals aside from those already mentioned in our preferred terms and conditions. SECTION IV - CLAIMS ADMINISTRATION SERVICES QUESTIONNAIRE Claim Services Questionnaire A. Name, address and phone number of firm. Eberle Vivian Inc. 206 Railroad Ave N Kent, WA 98032 253 - 854 -6323 B. Branch office(s), address(es), and phone, which would provide service under the proposal. We would provide service from our above -noted Kent office. C. Are "toll free" numbers available? Indicate the proposed personnel (including supervisory and management) who would be assigned to administer the city program, provide details on job title, experience and education, public entity experience, and length of time with firm. Eberle Vivian's toll free number is (800) 927 -9448. Kevin Kincade — Account Manager Kevin Kincade has been in Washington workers' compensation for over twenty years. He was hired at Johnston & Culberson, Inc. in 1992 as a Staff Assistant and was promoted several times, eventually becoming a Supervisor in 16 1997. In 1999, he was hired by Gallagher Bassett to be their Seattle Branch Manager. In 2004, Kevin was hired by Berkley Risk Administrators to be the General Manager of their Seattle office. In January of 2013 Kevin was hired by Eberle Vivian to be a Supervisor and an Account Manager. Kevin has extensive experience in handling claims, overseeing proper claims - handling of others, and working with the Department of Labor and Industries to resolve audits of self- insured clients. Kevin currently supervises the claim - handling for the Cities of Bellevue and Kent. Geri Nelson — Account Executive Geri Nelson has been in Washington workers' compensation since 1981 with the exception of the three years she handled property claims at Cravens, Dargan and Co. She was hired by GAB Business Services in 1981 initially as a receptionist and transcriptionist, later being promoted to working on Metro subrogation claims, workers' compensation Claim Assistant, then Medical -Only Adjuster. She then worked at Cravens, Dargan and Co. handling property claims from 1983 to 1986. From 1986 through 1992, Geri was a workers' compensation Claims Manager for Willis, handling self- insured cities and counties in Washington. Geri was hired in 1992 at Eberle Vivian as an Account Executive and has been handling self- insured Washington claims that entire time. Geri currently handles claims for Kitsap County and is very familiar with the needs of public entities. D. Submit verification that firm is a State - approved third party administrator for self - insured workers' compensation programs. Eberle Vivian is a State - approved third party administrator for self- insured workers' compensation programs. E. Please comment on your firm's professional staff qualifications and related experience for personnel expected to be assigned to the city's account. What is the caseload of open files that would be managed by the claim examiner /adjusters assigned to the city? Break down into incoming claims, outstanding claims, medical -only, and lost -time cases. What is the annual turnover rate of adjusters? How is each adjuster's performance monitored? If your firm is selected for an interview, you will be expected to bring the lead 17 adjuster expected to be assigned to the city's account. This adjuster should be an active participant in the presentation. In addition to the above -noted qualifications of the staff specifically assigned to handle the City of Renton's claims, (see response to "C" above) Eberle Vivian staff is intimately familiar with the needs of public entities and cities. Having 18 current public entity clients, 4 of them cities, our experience with Washington public entities is second to none. Geri Nelson's current caseload is under 50 open claims which allows room for her to absorb the City's open claims without interruption. Her caseload is lower than normal due to the recent purchase of one of her clients by a national organization who uses a national TPA. Normally, caseloads are maintained between 130 -150 open and active claims. The number of incoming claims my vary highly by client and also their industry. However, this caseload differs from our competitors in that our adjusters handle both MO claims and indemnity claims. Most of our competitors will have separate lost -time adjusters and medical -only adjusters, which means that not only is the adjuster's caseload full of more difficult and time - consuming cases, but that the client is inconvenienced by having to work with two separate adjusters. For all practical purposes, our adjuster turnover rate is zero. In addition to providing competitive pay and benefits to our adjusters, Eberle Vivian also creates an excellent work atmosphere for all employees which fosters creativity and togetherness. Adjuster performance is monitored in a number of ways. Every Monday, all supervisors receive a listing of each adjuster's pending diaries to ensure all claims are reviewed in a timely manner. Supervisors are also assigned a secondary diary on litigated claims, claims which exceed $50,000 in paid total, and any other claim which may require additional attention at either the client's or Eberle Vivian's discretion. Supervisors also attend most claim reviews to ensure that not only is the adjuster providing excellent service, but to also help strategize with the client on particularly difficult claims or scenarios. Lastly, we are in the process of developing a file- review checklist for supervisors to use at the time of their claim reviews. Eberle Vivian agrees to bring Geri Nelson to the presentation should we be selected for interview. 18 F. Would an Account Executive be assigned to the city as a primary contact on items not directly related to specific claims? Eberle Vivian empowers adjusters to also assist the client with other issues not directly related to claims. Our experience with public entities allows us to provide this additional service. However, a specific account manager, Kevin Kincade, will be assigned as the claim supervisor and also to assist as the Account Manager / Account Executive for such items. G. Provide at least four (4) references. It is preferred that at least two would be public agencies. Please give names, phone numbers and a brief description of services provided. At least one (1) reference should be from a recently lost client (not from merger or acquisition). Attached herewith is a complete list of all Eberle Vivian clients. Eighteen of the clients are public entities and four of them are cities. Eberle Vivian has not recently lost any clients that weren't due to a merger or acquisition. H. Provide a brief description of your firm's claim handling philosophy. Eberle Vivian is a service- oriented company. Service to us means total commitment to serving the needs of your entire organization. We make it our business to know your operations, your key people, your operational philosophy, and your overall culture. We then work to develop and implement a self- insurance program that is uniquely yours. We reject the notion that one size fits all. The only way to truly serve our clients is by learning everything we can about them. Our well- trained Adjusters are empowered to work closely with the client and arrive at common -sense approaches to claims. We understand that each claim is different. We understand that the majority of workers who have been injured need someone to listen to them and take the time to explain the process. We also understand that some claims may require a more aggressive stance in order to keep the claim from spiraling out of control. In each case, we treat the worker with respect. We find that this overall approach keeps workers' compensation costs low and worker and client satisfaction high, and results in far less costly claim litigation. 19 Our outstanding reputation in the field of claims handling has been achieved only through a continual intense effort to maintain and improve our high standards. Although we work with your dollars and your people, we look upon them as if they are our own. Describe your investigative and reporting procedures. What criteria will be used to determine the extent of an investigation? Eberle Vivian may use a number of investigative techniques. The method and also the extent of the investigation will be driven by client request, adjuster input, and by examining the cost / benefit ratio. Recorded Statements — A recorded statement from the worker and /or witnesses may be taken to confirm the facts behind an accident. Recorded statements are saved in a "wav" file and maintained in the electronic claim file. Accident -Scene Investigation — An Eberle Vivian adjuster may visit the accident -scene with the worker when possible to more accurately verify the facts behind the injury. Photos will be maintained as part of the claim file when necessary. Medical History / Medical Records — Eberle Vivian adjusters will secure a treatment history from the worker and secure any medical records for prior treatment when applicable. Such an investigation may determine that the injury occurred away from the job, or, may help to mitigate costs under the claim if it is allowed. Independent Medical Evaluation (IME) — An IME may be used to determine if an injury or occupational disease is related, on a more probable than not basis, to the claimed incident or exposure. Eberle Vivian ensures only quality, reputable doctors for such exams, and we regularly collaborate with our extensive network of legal consultants to ensure that only quality doctors are used for such exams. Sub Rosa — Eberle Vivian will, with client approval, assign private investigators to determine if the worker's reported disability corresponds with their activities when they are unaware of such observation. As noted above, the extent of any investigation can vary greatly but will heavily depend on client input as well as the cost / benefit ratio. J. What will be the frequency of status reports on any claim involving temporary total disability and /or permanent total disability? 20 The frequency of status reports is driven by the needs of the client and also by the nature of the claims. Eberle Vivian is happy to meet with the client to discuss claims at any frequency. We also provide clients with online access which allows them to check claim status, review adjuster notes, review payments, and view claim documents at any time of their choosing. K. Describe your procedures for making initial and follow -up contact with injured employees, supervisors, and the Risk Management Department. Will you be able to perform this within 24 hours of receiving the claim? What criteria will be used to determine on -site versus telephone investigations? Terms of required field investigations are to be contained within the service agreement. Eberle Vivian adjusters complete an initial contact form for each new claim received. This form requires that the adjuster call the employer, the employee, and the provider, and can be completed within 24 hours of our receipt of the claim. If voice -to -voice contact is not established, follow -up attempts will be made periodically until contact is successfully achieved. At the time each claim is received, Eberle Vivian adjusters will determine, with input from the client, whether or not on -site investigation is necessary. Should an on -site investigation be necessary, it will be promptly scheduled. Eberle Vivian's main office in Kent is only a few minutes away from Renton, which allows us to serve the City particularly well in this regard. L. Describe your approach to claims adjusting and management, including but not limited to: scheduling independent medical evaluations; arranging rehabilitation services; securing medically- approved employment; activity checks, and legal assistance. Independent Medical Evaluations (IME) — We may schedule an IME in order to secure a second opinion on a non - emergent surgical procedure, for a second opinion on causation, for a closing /rating evaluation, or for a multitude of other reasons when there is a medical question on a claim. When possible, Eberle Vivian only uses physicians who are still actively practicing in their field of specialty and who are board certified. Further, we 21 periodically discuss independent doctors with legal counsel to determine which physicians are more respected at the Board of Industrial Insurance Appeals. Lastly, we understand that an IME can be disrupting and stressful for the worker. With that in mind we will accommodate their schedule as much as possible and ensure that the IME doesn't cause any unneeded inconvenience. Rehabilitation Services — Eberle Vivian will choose a vocational counselor, (VRC) who is familiar with the City and their requirements. We will choose a vendor who has extensive experience in working with both self- insured employers and with municipalities. Eberle Vivian will only assign a VRC with the City's approval. Medically- Approved Employment — We believe that early return -to -work is a key element to any successful workers' compensation program. Early return -to- work can cut costs and keep worker satisfaction high. Moreover, workers feel more connected to the workplace when the can contribute in a meaningful way following an injury. Eberle Vivian agrees to help in whatever way needed in order to facilitate early return -to -work. This includes securing completed job analyses, calling the physician to request activity prescription forms, (APFs) and, when needed, assigning a VRC to assist with early return -to -work. Activity Checks — In the event that a worker's subjective complaints seem to outweigh the objective findings, or if we receive a tip that a worker may be more active than they claim to their doctor, Eberle Vivian adjusters will, with client approval, assign an investigator to perform an activity check to verify facts about the worker. Should it appear that the worker may be more active than they claim, we may order sub -rosa with client approval. Legal Assistance — Eberle Vivian works with the worker and client towards litigation avoidance whenever possible. We believe that finding win -win situations between the worker and their employer helps avoid costly legal fees. We do this by treating the worker with respect at all times. Our attempts at litigation avoidance notwithstanding, Eberle Vivian has developed an extensive network of attorneys who are extremely knowledgeable in the area of Washington workers' compensation. If and when a claim does need legal review or representation, Eberle Vivian will assign an attorney who meets with the City's approval. 22 Overall Approach — Our overall approach to claims - handling can best be described with one word — Service. We never forget that we represent our clients and that everything we do reflects on them. With that in mind, we treat workers, providers, vendors, and all other parties with utmost respect at all times. We find that this approach results in win -win situations and helps avoid costly litigation. M. The city is interested in having the ability to maintain a PPO network that provides a broad geographical spread and has a sufficient specialty mix (i.e., orthopedics, physical therapists) and sufficient access to other providers (i.e., radiology, surgical centers, emergency care facilities). Utilizing such a network must be compliant with all state regulations. Describe what your firm has done or is doing to establish a preferred provider network. Please explain how you would propose the city utilize a PPO network on workers' compensation claims. Eberle Vivian has participated in PPO networks in the past and has found that these national networks cannot keep their networks current enough to allow for proper bill payment within the Washington workers' compensation system. Usage of PPO networks has resulted in the largest amount of penalties issued to self - insured employers with regard to bill payment. Proper bill payment has now become the top priority of the Self- Insurance Ombudsman as well as recent legislation. Since we have a very aggressive administrative fee schedule, if properly applied, we have opted out of using a PPO network until such a time that we can assure our clients that usage of such will not result in frustration for their injured employees, to the providers attending to their medical needs, or in penalties to their programs form inaccurate information provided by the PPO network about their participants. N. What type of discounts can the city expect from the firm's choice of PPO? Please provide a sample of a PPO report. We are not participating in any PPO networks at this time. O. Please describe procedures used to assure adherence to State - approved medical fee schedules. 23 While most of our competitors contract out bill review, we help you control your costs with an integrated in -house medical bill review module. Using the state fee schedule, our claims management system reprices medical bills based on standard CPT codes. In addition, our system monitors duplicate billings and new for 2013 will be a module to manage, pay and monitor the requirements of the new L & I Provider Network. Fee transparency is very important to us and our clients. For that reason, we do not charge any additional fees for this service. We will not charge a percentage of savings, per bill, or per line fee. We feel that all savings captured by our bill review process should be realized by the client. P. Describe your mechanism for early warning on short-term cases that are potentially long -term ones? Eberle Vivian will assign all claims to the same adjuster. We have found that this approach helps to maintain continuity of claim - handling for all employees. In addition, our clients appreciate knowing that there is one person to call for all claims. This approach also helps us to identify, early on, those claims that may appear to be straightforward at first but can later become complex. An inexperienced "medical- only" examiner may not be trained to recognize certain red - flags, and use the wrong claim - handling techniques. By using experienced adjusters for all claims, Eberle Vivian avoids the pitfall of mishandling certain claims early in the process. Despite using experienced adjusters for all claims, Eberle Vivian will still assign a supervisor on any medical -only claim open longer than 180 days. The supervisor will establish a secondary diary and will continue to review the claim periodically, with annotated input, until claim closure. This helps to ensure a second set of eyes is reviewing the claims to ensure proper claim - handling at all times. Q Identify any outside firms currently under contract with your firm for investigations, rehabilitation, independent medical exams, and reporting that would likely be used to help administer city claims. Eberle Vivian does not directly contract with any firms for such services. Instead, we work with the employer to find a vendor who meets their requirements. If and 24 when the employer needs help in choosing an appropriate vendor, Eberle Vivian has excellent connections in the industry, and can make recommendations for such services. R. Describe criteria used for providing systematic medical /hospital bill audits. Eberle Vivian audits all bills and services provided. After applying all costs savings that we believe that we can obtain we then evaluate the value of sending the bill out for independent review. If the savings that an independent firm can save our client is more than the savings that Eberle Vivian can save plus the cost of the bill audit, Eberle Vivian will seek approval for bill audit for that individual bill. As this is rarely the case, we have found that this requesting permission on a case by case basis is not burdensome to our clients and at the same time has saved them thousands of bill audit dollars over the years. S. Please describe procedures and frequency for reviewing the adequacy of claim reserves. Eberle Vivian understands the importance of accurate reserving on a claim. We understand that our client's assigned account is impacted by our reserves. Moreover, we realize that our clients need to know at any given time their outstanding financial exposure. Adjusters establish a reserve on the claim file at the time of their initial review. This initial reserve and all future changes must be accompanied by a reserve worksheet which can, upon request, be shared with the client for review and approval. The adjuster takes into account all known information about the claim in order to determine the client's financial exposure. Reserves are then reviewed at each diary for adequacy. If necessary, an adjustment will be made at the time of the review, however, stair - stepping of reserves is strongly discouraged. Adjusters are trained to ensure that the reserve accurately reflects the client's financial exposure at all times. Reserve changes in excess of $50,000 require supervisor review and approval. However, the client is kept apprised of reserve changes at their own pre- determined threshold. T. Are the employer's liability claims to be handled under your proposal? 25 We are not proposing to handle the City's liability claims. U. Explain your capabilities in adhering to the RMIS requirements as outlined under the Scope of Services. Eberle Vivian is capable of delivering the City's RMIS requirements. We hope we have adequately addressed each of these needs by responding individually to each of the loss control and claims reporting /RMIS requirements listed earlier in this RFP. However, we welcome the opportunity to further demonstrate our abilities should this be requested as part of the vetting process. Eberle Vivian believes in working smarter and harder. Our claims management system, iComp, has been designed for and by the claims adjusters and administrators. It is a unique tool, in that it has been created specifically to handle the complexities of managing claims in Washington State. No other software integrates so completely with the reporting requirements of the State. Our programmers have worked closely with various State committees as they have established reporting requirements for both SIEDRS and the new L & I Provider Network. This focus gives our staff the ability to quickly and accurately manage and administer claims. iComp's unique disability history record supports Cockle, calculates time loss rates, LEP worksheets and PPD schedules automatically for you. It also handles COLA and SBI Reimbursements. It has built in support for State Forms including the various SIF5 forms, APF, EC Closure, MO Closure, Denial of Claim, Quarterly and Annual reports. In addition to Washington State's unique requirements, our technology also manages reporting for Section 111 and generates 1099's for the IRS. We also provide our clients with the ability to access their claims information online through our suite of services. Access is provided as view -only and clients can run standard reports. In addition, customized reports and exports can be automated by our staff. V. Explain any aspect of the Scope of Services that your firm cannot perform. Eberle Vivian has reviewed and individually responded to each aspect of the Scope of Services, and there is no aspect of the Scope of Services that we cannot perform. W. It is the desire of the city to retain the right to periodically conduct file audits. Please acknowledge permission to conduct audits of claim files, either by city staff or other duly authorized representatives. Please submit a copy of your firm's established Audit Protocol and your internal standards for file management. Additionally, please verify /acknowledge the city's right to review any /all third party auditor's reports and /or management letters as they may pertain to city claim files. Eberle Vivian will grant the City and their authorized representatives unlimited access to the claims for the purposes of conducting audits. Eberle Vivian curtails its internal file management standards to meet with each client's demands. Such a document will be created with City input and approval. X. All claim files are to remain property of the city. Please state your acknowledgment as to ownership of files. Eberle Vivian agrees that the City of Renton maintains ownership of the claim files. Y. Explain your disaster recovery planning as it relates to data protection and office operations. Eberle Vivian is committed to providing timely service to our clients. We recognize the importance of preparing for various disaster scenarios that could hamper our ability to provide service. Eberle Vivian has taken aggressive steps to provide for business contingency and continuity planning under a variety of potential scenarios. We continue to evaluate our continuity plans and take the necessary action to ensure the proper resources are available to provide for the recovery and timely resumption of critical business operations to our staff, and clients. 27 Eberle Vivian has its headquarters and principle operations staff in Kent, WA. In addition, we maintain two remote offices for data processing (Spokane, WA and Portland, OR) and all of our claims administration staff are able to remotely process claims. We also maintain a remote backup facility in Stanwood, WA. In the event of a disaster that would make the Kent office unserviceable, the Stanwood location would bring remote services online and would act as the data processing center. The Kent, Spokane, and Portland offices serve as primary locations for our mission - critical departments, including: Operations, Claims Administration, and Client Reporting. Each office serves as a backup to the others and claims administration staff are able to process claims remotely. Eberle Vivian's production data center is located in the Kent location. The alternate data center is located in the Stanwood location. The physical location of the backup site and reliance on alternate networking and power sources mitigate potential threats of business disruption to this remote site. If Eberle Vivian loses the ability to perform business at it's primary site (Kent, WA), recovery staff associated with mission - critical functions will begin processing at our alternate processing site (Stanwood, WA). Staff associated with non - mission critical functions will be relocated to alternative sites (ie. hotel, home) in an unaffected area. We have plans in place for this relocation and they are tested periodically. Recovery time objectives vary based on the criticality of the function that is disrupted. Z. Provide a sample of the annual OSHA reporting forms to be provided to the city. Attached herewith is a sample OSHA extract. The data necessary to complete the OSHA logs will be provided in a format similar to the attached example. SECTION V - MEDICAL CASE MANAGEMENT QUESTIONNAIRE A. Please describe your medical case management program with details on who provides the service, components of the service, criteria used in selecting cases, and coordination with employees, employers, medical providers and the city. Please provide a description of the professional experience /qualifications on medical case management personnel who would be assigned to work with the city. 28 We may assign a Nurse Case Manager based on the needs of the needs of the claim or upon client request. Since the assignment of a Nurse Case Manager is an additional allocated claim cost, we choose carefully which files need such an assignment. When possible, adjusters work directly with the doctors and /or their assistants to resolve medical questions. This arrangement avoids unnecessary and costly referrals to a Nurse Case Manager. Since Eberle Vivian uses outside Nurse Case Managers, this allows us the flexibility to select one who works best with the City. Eberle Vivian will be happy to either work with the City's chosen Nurse Case Manager after contract inception, or, we will be happy to help the City select an outside Nurse Case Manager who meets their qualifications. B. How often are reports on managed care cases submitted? Please provide a copy of a "typical" medical case management report. Will the managed care personnel be willing to play an active role in our critical claims management process? If so, In what capacity would they see their role in this process? The Nurse Case Managers assigned to our cases will update us via phone, email, or fax as often as is needed. Formal reporting is done monthly but since updates are immediate, the reports generally are a summary of action taken. Since Eberle Vivian uses a number of different Nurse Case Managers, a typical report is not available. We would work with the City's chosen Nurse Case Manager to develop a case management reporting format that suits the City's needs. The Nurse Case Manager would play a critical role including meeting the worker, meeting the doctor, and attending regular claim reviews if requested. When needed, the Nurse Case Manager will help to direct care to an appropriate provider and assist with scheduling the appointment. SECTION VI - RMIS QUESTIONNAIRE A. Please provide an explanation of the RMIS capabilities of your firm. Eberle Vivian's proprietary claims system, iComp, was developed internally specifically for handling Washington self- insured workers' compensation claims. No other TPA has a system solely developed for this purpose. Where our competitors must rely on technology services from out -of -state specialists who are unaware of Washington's unique demands, Eberle Vivian has an internal team devoted to the development of reports and enhancements. Eberle Vivian works proactively with the Department of Labor and Industries whenever changes in the law may require system enhancements. For instance, 29 when the new provider network was implemented on January 1, 2013, Eberle Vivian had already met with Department professionals on multiple occasions to ensure we were ready for the changes. This allowed for a smooth transition for our clients and their workers. Reports can and will be customized to meet individual client needs. We don't believe the client should ever simply "make do" with what they are given as far as data. We firmly believe you should have exactly what you need, and we make sure you get it. While every company will say this, Eberle Vivian is the only company with professionals in Washington devoted solely to that purpose. B. Please provide samples of all loss reports (summary and detail) that would be under a service agreement. Attached herewith under the section entitled "Reports" you will find such samples. C. With what frequency will reports be provided? Reports are provided to clients at any frequency they desire. The most common requests are either monthly or quarterly. D. What other management reports will be routinely provided as a part of the administrative services? Eberle Vivian looks forward to working with the City to develop customized management reports which allow the Risk Management department to focus on the areas which need the most attention. Such reports can also assist management when reporting to other City personnel. As noted, these reports can and will be developed after inception and with City input. 30 E. Describe what on -line capabilities are available to the city. By accessing iComp online, our customers can view our daily claim management activities. iComp allows the viewer to see adjuster diary dates, claim notes, payment activity, reserves, and claim documents, such as Activity Prescription Forms. iComp activity is real -time, so our clients essentially have a window into our claim - handling. iComp also allows the user to run certain reports on their own. Eberle Vivian will be happy to perform a demonstration of iComp as a part of the vetting process. F. Upon termination of any service agreement, will the city continue to receive periodic loss reports on open and closed claims? If so, what will be the costs for such reports? Will online access to claim information be available after agreement termination? If so, what will be the charge? Eberle Vivian will ensure that all data, including historical data, will be transferred to the new TPA in order that the new TPA would be able to provide the City with such reports. There is no charge for transferring data to the new TPA. Online access to claim information would cease at the time of contract termination unless separate arrangements were made for a pre- determined cutoff date. G. Explain your ability to provide SCHIP reporting, as may be necessary. Eberle Vivian currently provides this service to all current clients, and would be happy to do so for the City as well with no additional charge. H. Explain your expected data migration plan from the previous TPA's database to yours. Eberle Vivian will secure a sample of claim data and record layouts from the previous TPA roughly 60 days prior to contract inception. Eberle Vivian will then review and build the conversion program. At the time of contract inception, Eberle Vivian will verify all claim counts and financial information provided by the previous TPA. We will then migrate the previous TPA claim data into iComp within days of contract inception, usually 31 over a weekend. Eberle Vivian adjusters will then have access to all historical and current claim data. Such claim data will also be readily available in the client's online access portal. SECTION VII — FEE PROPOSAL QUESTIONNAIRE Claims Administration / Adjusting A. Please indicate your proposed fees for administration / adjustment of workers' compensation claims. Explain basis of fee structure (i.e., composite rate, cost per lost time / medical only, etc.) Eberle Vivian proposes one of the following agreements, at the choice of the City: 1 -year - $77,500 per year 2 -year - $81,000 per year 3 -year - $83,500 per year Should the City wish to renew any agreement above, the fee increase after the renewal would be the Seattle /Metro CPI plus 2 %. The fee agreement is easy to explain and understand. Our fees include everything necessary for the administration of the City's workers' compensation program, including the Scope of Services of this RFP. a � Z � We do not impose any additional fees for bill review, data transfer, takeover of run -in claims, online access, or regular and customized reports. Put simply, there are no hidden fees anywhere in our agreement. Any allocated fees which may be billed to the claim file are listed below in response to question H. B. Will the claims service fee for a work - associated injury follow to the final settlement of the claim regardless of time involved? If not, explain. Please provide a quote on a "life of the claim" basis. 32 Eberle Vivian's fee proposal contemplates everything necessary to see the claim to conclusion, regardless of the amount of time involved. Allocated fees may be billed to the claim file but only with client permission and as listed below, in response to question H. Eberle Vivian's agreement is for the life of the contract. Should you wish to have Eberle Vivian continue to administer claims which remain open after the expiration of the contract and any renewal periods, the cost would be a fixed fee agreed upon at that time, reflecting the estimated hours of service needed per quarter at $150 per hour. C. Please note if the above quoted fee is based on a minimum volume level. If so, show fee at different volume levels. Our fee contemplates the most recent full claim year, where the City had 119 claims. We will be happy to annually review claim volumes and provide different fee structures should the claim volume vary significantly from 119 per year. Any request for fee change would need to be within 60 days of the contract's annual renewal. D. In the event of termination of the contract by either party, describe how the runoff of claims will be handled. What are the per claim runoff charges? Is there a service time limit associated with the charges? Should you wish to have Eberle Vivian continue to administer claims which remain open after the expiration of the contract and any renewal periods, the cost would be a fixed fee agreed upon at that time, reflecting the estimated hours of service needed per quarter at $150 per hour. E. Please provide a sample contract. A sample contract is attached herewith. F. Are occupational disease claims included in the service fee? If not, describe. Yes, our fee contemplates the handling of occupational disease claims. 33 G. This item was left blank in the original RFR H. Define "claim" or "claimant" as it applies to your fee structure. Define "allocated" expense as it applies to your fee structure. A claim would be each SIF2 completed by a worker and forwarded to us for handling. Allocated expenses will be charged against the file upon which they are incurred. Allocated expenses include: • Court, trial, formal hearings and defense costs, including fees for attorney. • Expenses and fees of experts. • Cost of photocopies of records from public authorities, medical facilities and state agencies. • Professional photocopy charges. • Activity investigations. • Arbitration filing fees. • Medical or consultant witness fees. • Any assessment, taxes, filing fees, cost of surety bonds, etc., as required by state regulatory authorities. Is there a dollar maximum for a medical -only claim above which the claim is classified as an indemnity for fee purposes? If so, what is that dollar amount? Since Eberle Vivian assigns each claim, regardless of complexity, to an experienced adjuster, we have no different fee level for medical -only claims. This arrangement is beneficial to the client in a number of ways. First, it allows the 34 client to only call one person for claims questions, rather than have to determine who is handling the claim. More importantly the client can rest easy knowing that someone experienced will be looking at every single claim. This experienced adjuster will know how to identify red flags and will be able to apply appropriate handling to all claims from the beginning. J. Under the city's Return to Work /Alternative Duty program, we require assertive claims administration and case medical management since this program has shown significant improvement in claim severity. We have many cases, which are A r medical -only which would be indemnity claims if it weren't for our Return to Work/ Alternative Duty program. This often creates a "hybrid" claim; one that incurs medical costs only, but requires administration and management much like a list time indemnity case. How would your firm price such "hybrid" claims? As noted earlier, our fee structure contemplates all claims of all complexities. Eberle Vivian's claims philosophy, it would seem, is in that manner similar to the City's, since we assign an experienced adjuster to all claims. We would welcome this arrangement since we already apply this additional level of handling to all claims. K. If there are costs / charges for RMIS that are not included in the fee proposed /quoted for claims adjusting and administration, please state what charges will apply. Our fees already contemplate our RMIS services. Note: Please be sure to comment on any additional or recurring fees that may be charged for services requested that may be outside your "basic" services. If there are to be additional charges for your firm's participation in this requested service, be sure to show those charges separate from all other "basic" services. If no separate charges are denoted, the city will assume all requested services are included in base fee quoted. As noted earlier, Eberle Vivian's fee structure is easy to understand and easy to explain. There are simply no hidden fees anywhere. 35 r Medical Case Management A. Please provide fees for the various case management services. Eberle Vivian has no additional fee for case management, however, Nurse Case Manager fees may be charged to the file as an allocated fee. We only assign Nurse Case Mangers with client approval. We only assign Nurse Case Managers when absolutely necessary, recognizing the additional claim cost. B. How and at what frequency are these costs charged? Nurse Case Manager fees are generally billed by our vendors on a monthly basis. RMIS Fees A. fee. We have no additional fee for periodic computer loss runs. B. Provide fee proposal for on -line access, if any, such as set up charge, monthly maintenance, special reports, etc. Eberle Vivian does not charge an additional fee for online access, set up, monthly maintenance, or special reports. 36