The vendor is required to provide district with workers’ compensation claims administration services.
- include for services:
• Complete a prompt and thorough investigation of all incidents, accidents, work-related illnesses (including infectious disease exposures) and/or claims assigned, including but not limited to:
o Contact the HR designee and the employee within twenty-four (24) hours of receipt of the reported claim.
o Conducted interviews with the injured employee, coworkers, supervisor, witnesses or others who might have direct knowledge of the facts and circumstances relating to the claim.
o Conduct any other interviews or investigation deem appropriate.
o Determine if the claim is compensable under state statues and advise the school district and injured employee of the determination.
• Provide a medical cost containment program, to include:
o Fee schedule
o Hospital utilization review
o Hospital bill audit
o Hospital and physician discounts
• Provide a quarterly medical cost containment report to the HR designee.
• Compile and file, on behalf of the school district, all notices, reports and admissions required by state statues relating to workers’ compensation claims.
• The selected workers’ compensation claims administrator will have specific personnel assigned to handle all school district claims.
• The expectation is the assigned personnel will have offices and will be equipped with access available by telephone, fax and email and on-site meetings with designated school district staff, as required.
• This claims team will handle claims with the HR designee on the day-to-day basis
with the approval of the HR designee, arrange for independent medical examinations, rehabilitation services and other medical care, when such procedures may constructive.
• This shall include providing notice to excess insurers of all claims or potential losses which may exceed the school district’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 policy year.
• The selected workers’ compensation claim administrator will need to have electronic capability for communication with school district staff, designated medical providers and attorneys.
• The selected workers’ compensation claims administrator is expected to return phone calls and/or respond to emails from designed school district staff and calls from injured school district employees within 24 hours.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: May 10, 2025