Workers' Compensation Assigned Risk Plan Administrator Services

The vendor required to provide workers’ compensation or occupational disease coverage to each employer who has been denied workers’ compensation or occupational disease coverage by two or more insurers.
- The administrator shall use the system for electronic rate and form filing (“SERFF”) made available by the national association of insurance commissioners (“NAIC”) or its affiliates to submit the plan of operation to the using agency within 30 days of the award of this contract:
•    The method shall enable the administrator to begin selection of the servicing carriers within 14 days after the using agency approves the administrator’s plan of operation.
•    The administrator shall provide a list of at least three (3) proposed servicing carriers to the using agency within 120 days after award, and the evaluation criteria applied and results used in determining those proposed servicing carriers.
•    The criteria the administrator shall apply to determine the number of servicing carriers that are needed to meet the performance standards set forth in the plan of operation, and the method by which the administrator will increase or reduce the number of servicing carriers if it, or the Using agency, identifies a need to do so.
- Perform other duties that are reasonably requested by the agency and that are incidental to the work performed hereunder, including but limited to:
•    Furnishing analysis and research related to services performance. 
•    Testifying as a witness in any administrative or court proceeding commenced against the services or any servicing carrier in its performance of services -related duties.
- The cost of the contractor train employees of the using agency on any policy, procedure or system that the using agency needs to use to competently perform responsibilities related to the services pursuant to this contract.
- Contractor nor any person, firm or organization employed by the contractor in the performance of the contract shall offer or give any gift, money or anything of value or promise for future reward or compensation to any servicing carrier, insurer or to any state employee at any time.
- Provide all resources and bear all expenses required to fulfill contract requirements.
- Provide the methods to be used to maintain documentation for all fees and other charges made to any insurer transacting workers’ compensation insurance in state, and in accordance with generally accepted accounting principles, for services rendered as administrator.
- Subcontract with at least one insurer transacting workers’ compensation insurance coverage in state to act as its servicing carrier(s) unless the contractor is an insurer and acts as its own and sole servicing carrier.
- Administering claims matters, including:
•    Policyholder claims reporting; 
•    Claims investigation; 
•    Insurance fraud reporting to the using agency; 
•    Providing claims cost control measures including, but not limited to, utilization review of medical services, managed care services, disability management and return-to-work programs.
- Administering premium billing, collection and audits, including:
•    Providing premium payment plans, which shall allow an employer insured by the services to pay premiums on a quarterly basis, and may allow an employer option to pay premiums on other periodic bases.
•    Providing notices to the industrial commission in all circumstances that notices would be required to be submitted to the commission by a workers’ compensation insurer under state law, including but not limited to the ineligibility, cancellation or nonrenewal of an applicant or policy.
•    Each insurer’s share of the fee shall be based on the insurer’s share of the preceding calendar year’s total net direct workers’ compensation and occupational disease compensation insurance premiums written in state.