Workers Compensation Administrator Services

The vendor is required to provide workers compensation administrator services for include:
•    Provide internet and 800 toll-free access to designated employees of city, in order for employees to report workers’ compensation injuries. 
•    Administer all workers' compensation claims in accordance with all applicable laws, codes, statutes, regulations and rules. 
•    Provide customary and appropriate workers' compensation claims handling services for all qualified claims or losses, including takeover claims. 
•    Claims handling services include but are not limited to the investigation of each qualified claim or loss to the extent deemed necessary, or according to special handling procedures provided by city; adjusting, settling or litigating of all qualified claims subject to the discretionary authority limit or with city’s approval if outside the discretionary authority limit; investigation and pursuit of subrogation on behalf of city; setting appropriate claim reserves; and necessary and customary administrative tasks. 
•    Complete all forms required to be used in the adjustment of workers' compensation claims by the applicable state statutes and regulations. 
•    Comply with all reporting requirements under state children’s health insurance program (SCHIP) for all claims that are legally required to do so.
•    Prepare and issue medical or indemnity payments to city’s injured employees. 
•    Make recommendation as to the compensability or denial of any claim to city prior to notification. 
•    The city will make the final decision. 
•    Provide required reports to the city’s actuary or make reports available for city staff. 
•    Report to city’s excess insurance carrier all qualified or takeover claims which meet excess insurance reporting requirements. 
•    Notify city at any time an initial reserve or a reserve change of $20,000 or more occurs.

- Contract Period/Term: 5 years