Renewal Rates for Worker's Compensation Claims Administration Copyright 2014
City of Dubuque Consent Items # 9.
ITEM TITLE: Renewal Rates for Worker's Compensation Claims Administration
SUMMARY: City Manager recommending acceptance of the renewal rates from
Alternative Services Concepts for services related to the administration of
the City's Worker's Compensation Program.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve
ATTACHMENTS:
Description Type
❑ Acceptance of Worker's Compensation Administration Renewal Rates- City Manager Memo
MVM Memo
❑ Memo-Acceptance of ASC Renewal Staff Memo
❑ ASC Renewal Rates Supporting Documentation
THE CITY OF Dubuque
UBE I
erica .i
Masterpiece on the Mississippi 2007-2012-2013
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: August 24, 2015
Personnel Manager Randy Peck recommends City Council acceptance of the renewal
rates from Alternative Services Concepts for services related to the administration of the
City's Worker's Compensation Program. Alternative Services Concepts is proposing no
increase in their fees for the contract period October 1, 2015 to September 30, 2016.
The only change from the existing fee structure is the definition of catastrophic claims.
Currently a catastrophe is any event resulting in ten or more claimants and/or property
losses over $50,000. Catastrophic claims are currently billed as time and expense.
Under the renewal proposal any event resulting in ten or more claimant/suffixes will be
treated as a catastrophe and billed the quoted per claim rate for the first ten
claimants/suffixes and any claim/suffix over ten will be billed at a claim rate of $350 per
claim.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
Micliael C. Van Milligen
MCVM:jh
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Teri Goodmann, Assistant City Manager
Randy Peck, Personnel Manager
THE CITY OF
Dubuque
U .LE Ap Artaca City
Masterpiece on, the. Mississippi 2007•quiz•zun
TO: Michael C. Van Milligen, City Manager(
FROM: Randy Peck, Personnel Manager 1�
SUBJECT: Acceptance of the Renewal Rates for Worker's Compensation Claims
Administration
DATE: August 18, 2015
1 received the renewal rates from Alternative Services Concepts (ASC) for services
related to the administration of the City's Worker's Compensation Program. ASC is
proposing no increase in their fees for the contract period of October 1 , 2015 to
September 30, 2016.
The only change from the existing fee structure is the definition of catastrophic claims.
Currently a catastrophe is any event resulting in ten or more claimants and/or property
losses over $50,000. Catastrophic claims are currently billed as time and expense.
Under the renewal proposal any event resulting in ten or more claimant/suffixes will be
treated as a catastrophe and billed the quoted per claim rate for the first ten
claimants/suffixes and any claim/suffix over ten will be billed at a claim rate of $350 per
claim.
The requested action is for the City Council to pass a motion approving the renewal
rates for our workers compensation claims administration effective October 1, 2015
through September 30, 2016. 1 will send you the Administrative Services Agreement as
soon as it is available.
RP:Imh
Alternative Service Concepts, LLC
City of Dubuque, Iowa
October 1, 2015 -October 1, 2016
Two-Year Claims Handling
New Claims
Service Estimated Number Per-Claimant Estimated
Of Claimants Fee Total Fee
Workers' Compensation
Medical Only 6 $170 $1,020
Indemnity 20 $780 $15,600
Litigation fee TBD $300 + base fee
Run-In Claims
Indemnity TBD $450 ---
Medical Only TBD $50 ---
Incident Reports' TBD $40 ---
Catastrophic Claimsz TBD --- ---
Estimated Minimum Claims Fee $16,620
MMSEA-Annual Transmission
Fees(includes query& submissions) $2,100
Account Administration Fee $3,000
Systems Fee $2,500
Minimum & Deposit Claims Fee $24,220
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
1 Recorded in claifns.tirstein only. ?Llrr.ct he speeifred its "Invident"at time nf'reporting.
'Catastrophic claims—.1 it ?event resulting in 10 or more clainia,rts/suf/ixes will he treated as a catastrophe
and billed the quoted per claim rate for the first 10 claimants1stiff tes and anti,elainilsliff v over 10 will he
billed at it per claim rate of'$350 per claim,
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.
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 Claim 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 Pursuit and Recovery
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 Fees3
Client Data Transmission...................................................................$2500 Per Release
Carrier Data Transmission.................................................................$400 Per Release
State-Mandated EDI ..........................................................................$3 Per Report/Bill
Computer Compatible Checks & Electronic Transfers.....................At Cost
Data Conversion From Prior Administrator........................................At Cost
On-Line Access (One User)...............................................................No Charge
Additional Users ...........................................................................$60 Per User Per
......................................Month
Reports Produced by Client...............................................................No Charge
Reports Produced by ASC.................................................................$50 Per Copy
Systems Training .............................................................................T&E ($85 Per Hour)
Customized Programming .................................................................T&E ($/Hour)
Actuarial Data Requests ....................................................................$50 Per Hour
Travel Over 100 Miles........................................................................T&E ($85 Per Hour)
Outside Investigation ........................................................................T&E ($85 Per Hour)
Medical Cost Management4
Fee Scheduling.......................................................................28% of Savings
PPO Usage.............................................................................30% of Savings
.f As required or requester. Most services are optional.
4 Pricing for additional managed care services is available upon request.
Invoicing and Payment Terms
Fees will be invoiced annually. Fees are payable upon receipt of the invoice. asc
reserves the right to charge 1'/2% 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
• Medical records • Experts' / rehabilitation services
• Index Bureau reporting • Accident reconstruction
• Architects, contractors • Engineers, chemists
• Police, fire, coroner, weather reports • Expert witness statements
• Surveillance • Official documents and transcripts
• Extraordinary travel at client's request • Court reporters
• Independent medical examinations, • Managed care
MRIs, etc.
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.