TOWN OF CENTREVILLE PROPOSAL PACKAGE INSURANCE BROKERAGE FIRM WORKERS COMPENSATION MAY 2016

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1 TOWN OF CENTREVILLE PROPOSAL PACKAGE INSURANCE BROKERAGE FIRM WORKERS COMPENSATION MAY 2016 CONTACT: Krystel Ebaugh, Human Resources Specialist 101 Lawyers Row Centreville, MD Page 1 of 10

2 TABLE OF CONTENTS I. PURPOSE OF REQUEST II. III. IV. INSTRUCTIONS TO PROPOSERS MINIMUM QUALIFICATIONS TERMS AND CONDITIONS V. SELECTION CRITERIA VI. VII. BACKGROUND INFORMATION SCOPE OF SERVICES DESIRED VIII. PROPOSAL FORMAT Page 2 of 10

3 I. PURPOSE OF REQUEST The Town of Centreville (herein after called the Town ) is soliciting proposals from qualified brokerage firms to assist and service workers compensation claims administration. The Town is currently a self-funded entity with its contract for workers compensation claims administration expiring June 30, II. INSTRUCTIONS TO PROPOSERS a. In order to provide any follow-up or modifications to the RFP, it is requested that each firm with an intention to respond to this RFP provide a non-binding Letter of Interest to propose via e- or delivery to Krystel Ebaugh, Human Resources Specialist, no later than 4:00 p.m. on Friday, June 3, b. All proposals shall be submitted in a sealed envelope to: Krystel Ebaugh Human Resources Specialist Town of Centreville 101 Lawyers Row Centreville, MD To be considered, four (4) copies of proposals must be physically received at the Centreville Town Hall, 101 Lawyers Row, Centreville, Maryland clearly identified as Workers Compensation Claims Administration RFP on the exterior of the envelope by 1:00 p.m., June 13, (Under no circumstances will late delivery be accepted.) Proposals will not be opened publicly. No oral, telephone, fax, or proposals will be considered. All questions regarding the RFP shall be directed to Krystel Ebaugh at kebaugh@townofcentreville.org or (410) ext. 20. Final Proposal Due Date: June 13, 2016 at 1:00 p.m. c. Failure to comply with any section of the RFP may result in rejection of the proposal as non-responsive. III. MINIMUM QUALIFICATIONS The Town encourages proposals from all claims administrators meeting the following minimum qualifications: a. License in the State of Maryland. b. Five years experience as a firm providing claims administration services to municipalities. c. Experience in providing services similar to those outlined in the Request for Proposal. Page 3 of 10

4 d. Demonstrated experience in assisting other municipalities with the development and/or administration of self-insured risk management strategies. IV. TERMS AND CONDITIONS a. The Town reserves the right, at its sole discretion, to terminate this process, at any time, or reject any and all proposals without penalty, prior to the execution of a contract acceptable to the Town. Following the review, the final selection, if any, will be based on the proposal which best meets the requirements set forth in the RFP and is in the best interest of the Town. b. The Town reserves the right to award the contract to the next most qualified firm if the successful firm does not execute the contract within thirty (30) days after the aware of the proposal. c. The Town reserves the right to request clarification of information submitted and to request additional information of one or more applicants. d. Any proposal may be withdrawn up until the date and time set above for the opening of proposals by written request to the Town of Centreville Human Resources Specialist. Any proposals not so withdrawn shall constitute an irrevocable offer, for a period of 180 days, to provide the Town the services set forth in the attached specification, or until one or more of the proposals have been approved by the Town, whichever occurs first. e. Any agreement or contract resulting from the acceptance of a proposal shall be on forms supplied or approved by the Town. The Town reserves the right to reject any agreement that does not conform to the request for proposal and the Town s requirements for agreements and contracts. f. The successful respondent will be required to provide evidence of insurance for General Liability, Employers Liability, and Errors and Omissions Insurance. The firm will also be required to provide workers compensation insurance in accordance with Maryland State Law. g. Proposals submitted are offers only, and the decision to accept or reject is a function of quality, reliability, capability, reputation, and expertise of the firms submitting proposals. Issuance of this RFP does not obligate the Town to pay any costs incurred by a respondent in its submission of a proposal or making any necessary studies or designs for the preparation of that proposal, or for procuring or contracting for the services to be furnished under this RFP. The Town reserves the right to accept the proposal that is, in its judgment, the best and most favorable to the interests of the Town and to the public; to accept any item of any proposal; to reject any and all proposals; and to waive irregularities and informalities in any proposal submitted in the RFP process; provided, however, that the waiver of any prior defect or informality shall not be considered a waiver of any future or similar defect or informality. Firms should not rely upon, or anticipate, such waivers in submitting their proposal. Page 4 of 10

5 V. SELECTION CRITERIA The Town staff will evaluate all properly submitted proposals with respect to the Project Scope set forth in this Request for Proposals, including the total cost of the project and responsiveness of the proposal. The Town will then select the top preferred firm, with whom a contract, on a form to be provided by the Town, will be negotiated. The Town has the ultimate authority to approve any proposal and to authorize execution of the negotiated contract. The Town reserves the right to make clarifications, corrections, or changes in this Request for Proposals at any time prior to the deadline for the submission of proposals. All proposers or prospective proposers will be informed of said clarifications, corrections, or changes. Proposals will be evaluated according to the criteria outlined below: a. Responsiveness: The Town will consider the material submitted by the proposer to determine whether the proposer is in compliance with the RFP. b. Responsibility: The Town will consider the material submitted by the proposer and other evidence it may obtain to determine the firm s demonstrated ability to perform the desired services for the Town of Centreville with similar scope of activities. c. The accuracy of the firm s perception of the Town s needs in the workers compensation area claims administration and the firm s proposal(s) for meeting those needs. d. The qualifications, experience, and familiarity with municipal risk management issues of the service term to be assigned to the Town s account. e. Total cost to the Town for the services to be provided. f. The availability of other support services (i.e. training). g. References VI. BACKGROUND INFORMATION The Town has a Council-Town Manager form of government. The Town is a full service community that provides a variety of services to their populations including police protection, water utility, streets, sewer maintenance, and administration. The employee demographics for the Town include: Municipality Full-Time Employees Part-time FTEs Town of Centreville (4 people) Department Total Employee Count Total Proposed FY17 Salaries Administration 13 $599,581 Dept. of Public Works 14 $616,361 Police Department 12 $693,288 Total Proposed FY17 Salary Budget: $1,909,231 Page 5 of 10

6 VII. SCOPE OF SERVICES DESIRED The Town desires the Broker to provide their expertise in finding one provider for claims administration services. The Town desires prompt, accurate claims handling and reporting. Administrative legal support required in the daily administration of claims is anticipated to be included with the scope of services provided by the Claims Administrator. Legal defense associated with workers compensation lawsuits will be handled by a firm to be designated by the Town. The Town will take into consideration any input provided by the selected Workers Compensation Claims Administrator in selecting this legal counsel. The Claims Administrator will be expected to provide initial training for all designated Town staff on the claims submission process and forms, as well as ongoing training as required. The Broker will be expected to provide the Town with loss control, data, and other cost control services. No assumption of claims from the Town s current Claims Administrator will be required. The Town desires the following minimum claims handling specifications: Broker and Claims Service Coordinator designated to ensure that superior claims service is being performed. Designated claims adjusters and a claims supervisor will be assigned for the Town s account. Claim status reports for all open claims provided to the Town and Broker on 90 day intervals. Quarterly claim review meetings to be conducted with Town staff, Broker and Town s legal counsel for all open files. The Town will designate defense attorneys for all litigated claims. Claims Administrator will contact the Town prior to initiating subrogation action against any third parties. Claims Administrator will contact the Town prior to initiating any surveillance activities. Claims Administrator will be responsible for reporting claims to Workers Compensation and Liability excess carriers in accordance with policy provisions. Claims Administrator will allow the Town or its designee to audit any paper claim file. The amount of paper claims reviewed is unlimited. The Town desires the following minimum reporting capabilities: Monthly loss reports Payment registers available upon request of the Town or Broker Loss run summaries by department quarterly Loss run detail reports by department and division quarterly New claims received (by date received) monthly Monthly and cumulative claim service fees itemization Ability to run claim status reports online Ad hoc reporting capabilities Reports pre-formatted as requested by the Town Triangulation reports as required for financial reporting purposes Online access to the system for five (5) users from the Town Ability to import reports into Excel VIII. PROPOSAL FORMAT All proposals must be prepared in the following format: Page 6 of 10

7 a. Transmittal Letter a signed letter of transmittal briefly stating the proposer s understanding of the work to be done in compliance with the Town s Request for Proposals, a statement why the firm believes itself to be the best qualified firm to perform the services, and a statement that the proposal is a firm and irrevocable offer for 180 days. Any exceptions to requirements listed in the Town s Request for Proposals must be clearly identified in the Transmittal Letter, including exceptions to the desired scope of services outlined in Section VII. The Transmittal Letter must be signed by an authorized representative of the firm. b. Completed Exhibits A and B. c. Information on how clients are kept abreast of market changes. d. An explanation of how the firm can support the special needs of public entities, including support for self-funded programs. e. The cost of services to be provided and an explanation of the basis on which fees are determined. All potential services and associated pricing must be disclosed in this section. Provide pricing for the following: New Claims Administration Fees by Line of Coverage Account for litigated, non-litigated, incident only pricing in 3 and Annual flat fee 2. Life of contract 3. Life of claim 4. Run-out claim fees if contract is terminated Subrogation Fees Annual Claims Administration Fee Medical Management 1. Bill Review 2. Nurse Case Management (telephonic, field, vocational rehab) 3. Utilization Review 4. Pharmacy 5. Physician Review/Consultation Loss Control Services 1. Hourly Rate 2. OSHA 300, 300a and 301 report production Field Investigation Services Data Management Services 1. Online access to notes, financials and reporting 2. Ad hoc report creation requiring programmer support 3. List fees (if any) subsequent to contract termination Claim Indexing Fees Additional Services Offered PLEASE NOTE: FAILURE TO COMPLY WITH ANY PART OF THE RFP MAY RESULT IN REJECTION OF THE PROPOSAL AS NON-RESPONSIVE. Exhibits attached: Exhibit A Exhibit B Claims Administration Questionnaire List of Current Municipal Clients Page 7 of 10

8 EXHIBIT A Claims Administration Questionnaire Name of Firm: Address: City, State, Zip: Phone: Licensed in the State of Maryland: Number of years experience as a business: Do you have experience in providing services similar to those outlined in the RFP? GENERAL 1. Provide a brief description of the firm, including an office which would handle the Town s claims. 2. What type of quality control management methods are used by your firm? Provide a copy of your best practices, if available. 3. What is your company s claim handling and administration philosophy? Describe your approach to litigation management. 4. How are unique claim handling instructions set up and administered to ensure compliance? 5. How are claim audits/reviews conducted with your firm? How many are allowed within the course of a year? 6. Provide the names of the senior executives ultimately responsible for this program. 7. Provide a detailed transition plan assuming an effective date of July 1, Will any services be provided by a third party? If yes, please describe the services provided and submit the name, address and phone number of the third party vendor(s). STAFFING 1. Describe a staffing plan which includes claims handling, field investigations, fraud investigation, claims supervision, clerical and other support personnel. Please include information pertaining to medical management and cost control and vocational rehabilitation. 2. What type of training/continuing education is offered to your technical personnel? 3. Describe the availability of bilingual claims handlers. Page 8 of 10

9 CLAIMS PROCEDURES Describe the procedures and strategies used by your company with respect to the claims handling process. Provide sample letters for claim confirmations and denials. Please note the Town s desired minimum claims handling specifications outlined in Section VII. Include within the section details concerning: Claim reporting options Timely assignment of claims Investigations (including fraud) Processing of catastrophic claims, such as fatalities, paraplegic or quadriplegic type of injuries, severe burns, amputations or permanent loss of use of a major extremity of the body, head/brain injuries, 5 or more claimants in a single occurrence, or any other injury that may require temporary total disability or continued time off of work for an extensive period of time. Describe the availability of claims services during non-business hours for catastrophic claim occurrences. Communication with injured workers and third party claimants Timely payment of benefits to injured workers Determination of compensability Process for client reporting of suspected fraud to Claims Administrator Claim denials Evaluation of liability and damages Reserving criteria, philosophy and supervisory controls (provide sample of reserve calculation worksheets) Diary system Medical management and cost control Vocational rehabilitation Litigation management and cost control Subrogation Settlement authority requests (with and without claimant legal representation) Reporting to file and client Payments to claimants and outside vendors Sample reports DATA MANAGEMENT 1. What types of internal reports are used for tracking timeliness of payments, closing ratios, diary and other supervisory functions? 2. Describe how 1099, Index Bureau Filing, and OSHA reports are completed. FINANCIAL/TRUST ACCOUNT Date: 1. Provide information about the trust account/banking options available, including specific information relating to loss fund amount requirements. 2. Describe the security/audit procedures in place at your company to ensure the fiduciary responsibility required. Signature: Title: Page 9 of 10

10 EXHIBIT B List of Current Municipal Clients Reference Contacts Name of Firm: Municipality Period Handled Contact Name and Phone Number Page 10 of 10

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