Loading...
Renewal Rates for Worker's Compensation ClaimsMasterpiece on the Mississippi Dubuque hail AB- NneticaCity 2007 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Acceptance of the Renewal Rates for Worker's Compensation Claims Administration DATE: October 26, 2010 Personnel Manager Randy Peck is recommending City Council approval of the renewal rates for Alternative Services Concepts (ASC), the City's Worker's Compensation Claims Administrator effective October 1, 2010 through October 30, 2011. Their fee for medical only claims will increase from $165 per claim to $170 per claim, and indemnity claims will increase from $760 to $770 per claim. The litigation fee will increase from $250 plus the base fee to $300 plus the base fee. Fixed medical case management will increase from $68 per hour to $75 per hour. The minimum deposit and claims fee will increase from $25,520 to $27,760. The only other change has to do with the options that would be available to the City should the City cancel the contract. Should the City cancel the contract with ASC, they would no longer manage claims based on their time and expense. I concur with the recommendation and respectfully request Mayor and City Council approval. MCVM:jh Attachment cc: Barry Lindahl, City Attorney Cindy Steinhauser, Assistant City Manager Randy Peck, Personnel Manager Michael C. Van Milligen Masterpiece on the Mississippi TO: Michael C. Van Milligen, City Manager FROM: Randy Peck, Personnel Manager RP SUBJECT: Acceptance of the Renewal Rates for Worker's Compensation Claims Administration DATE: October 13, 2010 On October 12, 2010 I received the renewal rates from Alternative Services Concepts (ASC) for services related to the administration of the City's Worker's Compensation Program. The effective date of the renewal rates is October 1, 2010. The following is a comparison between the current rates and the renewal rates: - Current Rate Rate Service per Claimant Fee per Claimant Fee Increase/Decrease Workers' Compensation • Medical Only $165 • Indemnity Incident Reports Catastrophic Claims Estimated Claims Fee Account Administration Fee Litigation Fee Subroqation Fee kl: Systems Fee Field Medical Case Management Maintenance Fee for Claims Open after 24 Months Fees i iincluues,cluevirfarmutsups. Minimum and Deposit Claims Fee $760 1 1 - 11 - rtk ' Iii;1,q1/1 $2 500 $25,520 $170 $770 $450 4.1 ip a ti 1 $27,760 $20, 340 $300 Plus Base Fee $2,500 Dubuque heal All-AmedcaCIty hil l ! 2007 +$5 +$10 $0 and Expense +$320 +$50 "ktql; SO Medical only claims will increase from $165 per claim to $170 per claim and indemnity claims will increase from $760 per claim to $770 per claim. The litigation fee will increase from $250 plus the base fee to $300 plus the base fee. Fixed medical case management will increase from $68 per hour to $75 per hour. The minimum deposit and claims fee will increase from $25,520 to $27,760. The only other change has to do with the options that would be available to us should we cancel the contract. Should we cancel our contract with ASC they would no longer manage claims based on their time and expense. The requested action is for the City Council to approve the renewal rates for our workers compensation claims administration effective October 1, 2010 through October 30, 2011. I wU -Year ..iams rtanalin • Service Estimated Number Of Claimants Per - Claimant Fee Estimated Total Fee Workers' Compensation Medical Only 20 $170 $3,400 Indemnity 22 $770 $16,940 Litigation fee TBD $300 + base fee Run -In Claims Indemnity TBD $450 - -- Medical Only TBD $50 - -- Incident Reports TBD $ 40 - -- Catastrophic Claims TBD Time & Expense - -- Estimated Minimum Claims Fee $20,340 MMSEA- AnnualTransmission Fees(includes query & submissions $1,920 Account Administration Fee $3,000 Systems Fee $2500 Minimum & Deposit Claims Fee $27,760 • alternative service concepts, L.L.C. City of Dubuque, Iowa October 1, 2010 - October 1, 2011 Claims will be handled for two years from the date the loss is reported to asc with no additional per claim fee. Any claim remaining open after 24 months will be subject to an annual maintenance fee of $450.00 Notes ASC will handle the number of claims indicated for the minimum claims fee. If the fee for the actual number of claims is more than the minimum claims fee, ASC will invoice the client for the difference. 1 Recorded in claims system only. Must be specified as "Incident" at time of reporting. 2 Any event resulting in 10 or more claimants and/or property losses over $50,000 will be treated as a catastrophe. The account administration fee will be 7.5% of the claims fee or $3,000, whichever is greater. The administration fee includes: • Account Setup • New Claire Setup • Client Meetings (Frequency to be Determined) • Excess Reporting • State Reporting • Storage Fees At the conclusion of the contract, the following options are available for continued handling of open claims: • Negotiated annual fee per claim • Claims returned to client Subrogation All parties will automatically be placed on notice if the potential for subrogation exists. Pursuit of subrogation will be performed at the client's request. Pursuit of recovery fee is 15% of recovery. Additional Services and Fees Client Data Transmission Carrier Data Transmission State - Mandated EDI Computer Compatible Checks & Electronic Data Conversion From Prior Administrator On -Line Access (One User) Additional Users $2500 Per Release $400 Per Release $3 Per Report/Bill Transfers At Cost At Cost No Charge $60 Per User Per Month No Charge $50 Per Copy T &E ($85 Per Hour) T &E ($ /Hour) $6.25 Per Report $50 Per Hour T &E ($85 Per Hour) T &E ($85 Per Hour) Reports Produced by Client Reports Produced by asc Systems Training Customized Programming Index Bureau Reporting Actuarial Data Requests Travel Over 100 Miles Outside Investigation Medical Cost Management Fee Scheduling 28% of Savings PPO Usage 30% of Savings Field Medical Case Management $75 Per Hour Invoicing and Payment Terms Fees will be invoiced annually. Fees are payable upon receipt of the invoice. asc reserves the right to charge 1 per month or the maximum legal rate on unpaid balances after 30 days. Allocated Expenses Allocated expenses will be charged to the claim file and include fees for: • Legal services • Professional photographs 3 As required or requested Most services are optional. 4 Pricing for additional managed care services is available upon request. • Medical records • Index Bureau reporting • Architects, contractors • Police, fire, coroner, weather reports • Surveillance • Extraordinary travel at client's request • Independent medical examinations, MRIs, etc. • Experts' / rehabilitation services • Accident reconstruction • Engineers, chemists • Expert witness statements • Official documents and transcripts • Court reporters • Managed care Workers' Compensation Definitions Medical Only Claims - Work - related claims that require medical treatment only. • Subrogation not required • Investigation sufficient to determine claim type and compensability • Lost days do not exceed statutory waiting period • No loss notices, captioned reports, client meetings, or settlement authority required • Payments do not exceed $2,500 • Two -point contact made Indemnity Claims - Work - related claims that involve disability or payment of medical and other expenses in excess of $2,500. Claims that require investigation for subrogation and settlement negotiations. All claims, regardless of type, will be investigated, evaluated, and adjudicated in accordance with state statutory requirements and corporate guidelines.