Workers Compensation 3rd Party Administrator Services

The Vendor is required to provide third party administration of the county's self-funded worker's compensation claims.
- Comprehensive Workers' Compensation Services
•    Advise the county in all matters pertaining to any and all obligations and requirements as imposed by the state workers' compensation act.
•    Compile and file notices, reports and any forms required under the state workers' compensation act.
•    Supervise all county employee workers' compensation claims to determine their validity and compensability.
•    Determine all benefits due on all compensable cases.
•    Make payments of all benefits due through use of county funds via a specially established account with the approval of designated county employee.
•    Recommend medical providers for a compensable claim (if appropriate).
•    Process compensable claims using established medical fee schedule when possible or necessary.
•    Maintain records of all details regarding payments made to fulfill the obligations of the county under the state workers' compensation act.
•    Conduct investigations to determine obligations of all county employee workers' compensation accidents and injuries and negotiate the settlement of and/or affect the compromise of any claims or suits arising out of such obligations.
•    Attend with and represent the employer at all workers compensation informal conferences and
•    Hearings.
•    Arrange for the defense of such claims, suits, or other proceedings arising from obligations under the
•    State workers' compensation act, with the cost of any such defense being paid by the county and with the selection of attorney, whenever necessary, being made after consultation with the county.
•    Furnish and provide the employer with monthly records of all compensable claims detailing:
o    All payments made on behalf of the county.
o    Estimates of all reserves for actual, anticipated or potential benefits or expenses.
o    All other pertinent data regarding claims and claim payments.
- Comprehensive safety management for the county and all county employees to include:
•    Provide access to an accident prevention and safety plan.
•    Make recommendations for comprehensive incentive and motivational programs used in conjunction with incumbent developed/endorsed accident prevention, safety and claims management programs.
•    Prepare a quarterly accident prevention report detailing: county-wide workers' compensation accident levels, all designated supervisor's accident incident levels and other relevant accident prevention information to be provided to the county no later than thirty (30) days following conclusion of each designated calendar quarter.
•    Provide the detailed quarterly claims report at our discretion specifically listing activities and/or future strategies on all workers' compensation claims with costs (including reserves) in excess of $50,000.00.
•    Assist in interpreting workers' compensation claims reports to consider the circumstance under which an injured employee could return to work in the shortest period of time, as well as assist in arranging for rehabilitation or retraining of employees on appropriate cases.
•    Investigate, recognize unsafe and unhealthy working trends or potential hazards.
•    Establish and maintain all necessary safety records to facilitate incumbent programs and comprehensive services.
•    Monitor compliance with the county's safety rules and regulations and written reports and recommendations by incumbent loss control personnel to evaluate and reduce accidents and potential loss situations; the incumbent TPA will continue to provide current services through the end of JUNE date.
•    Consult with appropriate management personnel employees on loss prevention matters and provide the guidance necessary to assure effective administration of the program.
•    Ensure thorough investigation of accidents that result in lost time, hospitalization, death, or extensive property damage.
•    Provide department and division safety meetings upon request.
•    Represent the employer during investigations conducted by the occupational safety and health administration (OSHA), by law or by the organization's insurance carrier relating to recordkeeping and retention of records.
•    Maintain required OSHA 300, 300a, and 301 reports, as well as provide information in a timely manner to complete the annual OSHA report.
•    Monitor compliance with the various requirements of any law or by the organization's insurance administrator relating to recordkeeping and retention of records.
•    Conduct special inspections as requested by human resources.
•    Comply with any mandatory OSHA reporting requirements, including work-related fatalities.
•    Perform subrogation against third parties, if applicable.
•    Perform other duties as required in relation to safety and risk management.
- Fees & billing
•    Confirm that your firm is willing to be compensated on a quarterly retainer to be determined at the beginning of each plan year.
•    Assuming no change in the services outlined in this proposal, please express your willingness to offer a 3-year fee guarantee or a maximum fee increase in the second or third year, as well as the maximum fee increase should the contract be renewed annually up to a total of five years.
•    Please provide the annual and/or quarterly fee required.