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HomeMy WebLinkAbout4413 Contract Number: 4413 Vendor: COMPREHENSIVE RISK MANAGEMENT INC Subject: Claims Management - Workers Compensation Department: Legal File Class: LEG 12-1 Begin Date: 02/O1/2004 End Date: 02/28/2011 Review Date: O1/O1/2011 Vault Date: Comments: Hold Harmless CPI at Anniversary Date Automatic Renewal unless 30 days notice Termination w/60 days notice Comprehensive Risk Management, Inc. SELF-INSURED SERVICE AGREEMENT THIS AGREEMENT is made between Comprehensive Risk Management, ~nc., (CRM) and City of Bremerton, hereinafter referred to as the (Client) on thiso~c~c{ day of t~.}r/r~l lt~ r'~) , 2004. WHEREAS, CRM operates a business at 1520 Broadway, Suite 201, Everett, Washington 98201-1700 and whereas Client operates at 239 4th St., Bremerton, Washington 98337 and; WHEREAS, the Client wishes to engage CRM to manage its self-insured workers' compensation program and assist in its loss prevention efforts. NOW, THEREFORE, the Client and CRM mutually agree to the following: I. Claims Management Services: A. The basic service program includes: 1. Management of all workers' compensation claims with a date of injury during the service period as long as this or subsequent Service Agreements remain in force. This includes management of claims filed prior to the inception of this agreement. 2. Maintenance of all original claims files for the prescribed statutory period. It is understood that the files remain the Client's property. 3. Investigation by CRM claims administrator to determine claim validity and compensability. This investigation will include personal contact with the claimant, employer and medical providers. 4. Written notification to the Client's excess carrier when claim reserves reach 50% of the self-insured retention levels. 5. The following reports: Open claims run, all claims run for current and most recent past fiscal year, OSHA Log, Loss Run Summaries and Check Log, will be provided monthly. Billed/Paid Comparison reports and Loss analysis reports will be provided quarterly. Reports will be mailed within five working days of the end of each calendar month. Additional reports are available at rates to be agreed to by the parties. Self Insured Service Agreement 1 of 4 6. Identification and follow through on potential third-party subrogation. 7. Paying on the client's behalf temporary and permanent disability benefits and other claims related expenses if supported by appropriate medical certification. 8. Establishment and maintenance of realistic claims reserves for all anticipated benefits and related cost exposures on each claim. 9. Paying on the client's behalf authorized medical expenses in compliance with current State medical fee schedule. 10. Paying on the client's behalf all other pre-approved claims related expenses, including those for investigations, vocational services, legal services, expert witness fees and other similar expenses. 11. Preparation of Federal 1099 forms. 12. Compilation of all notices and reports required under the Industrial Insurance Statute of the State of Washington or by the City of Bremerton's excess insurance carrier. 13. Requesting supplemental insurance reimbursement requests. 14. Obtaining prior approval from the client prior to utilization of outside medical resources or advisory bodies. B. At the client's request, a quarterly claims review with the client's assigned Claims Administrator is included in the basic service program. C. All miscellaneous administrative support costs, including administrative costs, data information and analysis are included in the basic service fee program. However, the costs of checks and all bank service charges are not included in the service fee and will be billed to the client as incurred. II. Service Fees A. CRM agrees to manage up to 45 claims with a date of injury during the service agreement year, for an annual fee of $17,275.00. This fee will be prorated and billed at the monthly rate of $1439.58. At the anniversary date of this agreement an adjustment to the fee will be made for inflation. The increase will be based upon the consumer price index (CPI-U) change from the prior year for the Seattle, Washington area. Self Insured Service Agreement 2 of 4 An excess claims charge of $430.00 per medical and or indemnity claim will be charged for claims filed in excess of 45 during the term of the service agreement. B. Assumption Fee: There will be no assumption fee for any claims that are open at the inception of the service agreement. C. Fees will be billed on or before the first day of each month, and fees will be due and payable on the 10th day of each month. It is agreed that accounts will be considered past due after thirty days from the billing date and that interest will accrue at the rate of 1.5% per month on the outstanding balance. IlL Administrative Provisions A. This agreement will be in effect for one year, beginning February 1, 2004, and will be automatically renewed for additional successive one year terms, unless CRM or the Client give at least 30 days written notice to the other party, prior to anniversary date, that the agreement will not be renewed or that the party giving notice desires to renegotiate the terms of the agreement. At all other times, the term of the service agreement may be terminated at any time upon sixty (60) days written notice by either party. B. Hold Harmless 1. The Client agrees to defend any legal action commenced against CRM caused directly or indirectly by the wrongful or negligent acts of the Client's employees, officers, agents, or others engaged by the Client and indemnify and hold harmless CRM against any liability, loss, cost of damage, including attorney's fees resulting therefrom. 2. CRM agrees to defend any legal action commenced against the Client caused directly or indirectly by the wrongful or negligent acts of CRM's employees, agents or others engaged by CRM in the performance of this service agreement, and to indemnify the Client against any liability, loss, costs or damage including attomey's fees resulting therefrom. 3. The Client and CRM agree that in the event that both parties are at fault, the parties will agree on reasonable contribution one to the other, or failing to agree, will submit the question for binding arbitration. The prevailing party will be awarded reasonable attorney fees and costs. C. Any optional services that may be available to the client will be negotiated independently of this service agreement. Self Insured Service Agreement 3 of 4 D. The parties agree that this service agreement sets forth the complete understanding of the parties and that it may not be amended, modified or changed in any way unless the parties' duly authorized representatives mutually agree in writing to a modification of the terms of the service agreement. IN WITNESS WHEREOF, CRM and the Client have executed this agreement by their authorized representatives. ! Signed this c:,Q ~ fl~ day of ~,-JOa~ I./O~ ~, \ ,2004. CITY OF BREMERTON COMPREHENSIVE RISK MANAGEMENT, INC. A Washington Corporation Cary Terry E~. Peterson Mayor President Attest: ~~ _~(l~.~Za~22::~ praul~t-J~ol~sto~l~.-~-- . . Interim City Clerk Self Insured Service Agreement 4 of 4