HomeMy WebLinkAboutCC Resolution 8255 (Workers Compensation)RESOLUTION NO. 8255
A RESOLUTION AUTHORIZING THE SIGNING OF A
CONTRACT, LEASE OR AGREEMENT
THE CITY COUNCIL OF THE CITY OF SAN RAFAEL RESOLVES as follows:
The VICE -MAYOR and CITY CLERK are authorized to execute, on
behalf of the City of San Rafael, a contract, lease or agreement
with ComCo Management, Inc., as the City's Workers' Compensation
Administrator from November 1, 1990 to October 31, 1992.
I, JEANNE M. LEONCINI, Clerk of the City of San Rafael, hereby
certify that the foregoing resolution was duly and regularly
introduced and adopted at a regular meeting of the City Council of
said City held on MONDAY , the 15th day of
OCTOBER , 1990, by the following vote to wit:
AYES: COUNCILMEMBERS: BORO, SHIPPEY, THAYER & VICE -MAYOR BREINER
NOES: COUNCILMEMBERS: NONE
ABSENT: COUNCILMEMBERS: MAYOR MULRYAN
JEAUEN,M. LEONCIN , City Clerk
AGREEMENT
This agreement is entered into this 1st day of November 1990,
between ComCo Management, Inc., hereinafter called "ComCo" and the
City of San Rafael, hereinafter called the "Client".
Whereas Comco represents itself as being capable and qualified to
provide Workers' Compensation claims administration services in a
manner commensurate with the Division of Industrial Accidents, the
parties agree as follows:
I. ComCo shall perform the following services on behalf of the
Client:
A. Program Development
1. Consult with the Client's personnel and assist in
developing the necessary procedures, procedures
manual, practices, and coordination to implement
the Client's Workers' Compensation Program and to
meet legal requirements of the State.
B. Claims Administration
1. Review and process all claims for Workers'
Compensation benefits in accordance with the
requirements of the Department of Industrial
Relations for reporting and notification.
2. Determine compensability of claimed injuries and
illnesses in accordance with the State's Workers'
Compensation laws.
3. Monitor treatment programs for injured employees,
including the review of all "Doctor's First Report
of Work Injury" to assure that treatment is related
to a compensatory injury or illness.
4. Schedule medical appointments as needed and
maintain case liaison with treating and/or
evaluating physicians or other medical providers to
ensure that employees receive proper care and to
avoid over -treatment situations.
5. Review and make recommendations to the Client in
its utilization of a medical expert panel.
6. Consult with the Client's personnel and provide
guidance and evaluation of the physical
capabilities of injured employees to return to
work.
7. Determine eligibility for and authorize payments of
medical benefits, and authorize examinations to
determine the nature and extent of disability when
appropriate.
8. Determine eligibility for and authorize payment of
temporary disability compensation in coordination
with medical advice and rehabilitation efforts.
9. Determine the degree of permanent disability, if
any, of injured workers --utilizing, as necessary
and advisable --advisory rating of the Disability
Evaluation Bureau.
10. Authorize the payment of permanent disability
compensation and death benefits in accordance with
advisory ratings, Orders of the Workers'
Compensation Appeals Board, or Compromise and
Release Agreements.
11. With prior Client approval of attorney assignment,
refer litigated cases, negotiations of Compromise
and Release Agreements and subrogation actions.
12. Maintain current estimates of costs of all
anticipated benefits and related expenses on each
case.
13. Investigate or arrange for investigation of, as
necessary and appropriate, questionable cases, and
the status of disabled employees, in order to
adjust all cases and to assist in the trial or
settlement of litigated cases.
14. Participate in an initial orientation and
subsequent Workers' Compensation.
C. Employee Services
1. Provide information and guidance to the Client's
employees regarding Workers' Compensation benefits,
injuries, and permanent disability ratings, in
accordance with the Client's policies.
2. Assist in resolving employee problems relating to
an injury in non -litigated cases.
3. When medically appropriate, develop rehabilitation
programs for injured employees for approval by the
Client, the employee, and other agencies, in order
to provide rehabilitation, retraining, or
reassignment for employees with physical or
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II.
performance limitations resulting from industrial
injuries. The Client shall be consulted prior to
assignment to a specific vocational rehabilitation
vendor.
4. Consult with employee associations and unions on
problem cases in accordance with the Clients
policies and approval, within a reasonable scope.
5. Develop and recommend policies and procedures to
ensure that the employee's ability to work is
consistent with the findings of the Workers'
Compensation Appeals Board.
D. Fiscal and Claims Analysis
1. Provide the Client's administration with continuing
information on the progress of individual claims,
including periodic meetings and reporting.
2. Submit monthly statistical summaries and narrative
reports to assist in the evaluation of the Client's
progress.
Fee to $46,800.00 per year for the Administration of Workers'
Compensation.
Fee Terms of Agreement: Twelve equal installments of
$3,900.00 for a total of $46,800.00
This fee covers all services included in Item I of this
agreement and the following services:
A. All monthly Loss Analysis Reports, as agreed to by the
Client, as well as the Loss Control Summaries.
B. Internal management of all aspects of your Program in
compliance with the legal requirements of the State of
California.
The monthly fee quoted excludes all allocated claim services
which are defined as the costs incurred outside of the scope
of normal administrative adjustment services, such as:
1. Attorney fees and records.
2. Court depositions.
3. Costs and materials for expert witnesses.
4. Subrosa or other outside professional investigation
services.
5. Outside professional assistance in matters of
mandatory vocational rehabilitation.
6. Any special charges for work which may result from
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a State audit of the prior administrator's errors.
7. Costs for printed checks, and printing charges of
specialized forms not elsewhere used by ComCo.
III. Renewal of Agreement
This Agreement is for a period of two (2) years, commencing on
November 1, 1990, and ending on October 31, 1992.
After the initial contract period, this Agreement may be
renewed from year to year by mutual consent and fee as agreed
upon, provided however, that any proposed revisions to the
Agreement by either party be submitted in writing no later
than sixty (60) days preceding the expiration of the contract.
Any proposed fee increase for the second year of this
agreement shall not exceed ten percent (10%) of the first year
fee.
IV. Additional Conditions
A. While performing service
independent contractor and
employee of the Client.
hereunder, ComCo is an
not an officer, agent or
B. Neither party shall assign this Agreement or any part
hereof without the written consent of the other party.
C. The services to be performed by ComCo shall specifically
exclude any which now or in the future are deemed to be
the practice of law.
All claim file records, reports and other documents and material
pertaining to the Client's claims shall be the property of the
Client and shall be delivered to the Client or its designee by
ComCo upon termination of this Agreement.
Client agrees to cooperate with Administrator with respect to its
duties hereunder including, but not limited to, responding to
Administrator's requests for information promptly; meeting with
Administrator and/or third parties, as may be needed; making
decisions on matters which, in the professional opinion of the
Administrator, should be made by Client; performance by Client of
all other obligations of this Agreement.
Administrator and Client hereby mutually agree to indemnify and
hold free and harmless each other for their acts or failure of
pursuant to Labor Code 129.5 from any and all losses, liability,
damages, costs or expense to which Client may be subjected as a
result of failure to pay benefits as required by Labor Code 129.5
enacted and effective 1-1-90. Administrator hereby agrees to
indemnify and hold free and harmless Client from any and all loss
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costs, expense, damages and liability arising from willful
misconduct, negligent acts or any error or omission of
Administrator, its officers, agents and employees in connection
with fulfilling its obligations under this Agreement, except
liability arising out of the sole negligence, willful misconduct or
specific instructions by Client, and its representatives in direct
violation of any Workers' Compensation law or regulation under Self
Insurance Plans, State of California.
Client and ComCo hereby expressly understand and agree that ComCo
is not, and will not be, liable or responsible for any losses,
liability, or damages to Client which are proximately caused by the
performance or non-performance of the predecessor third party
administrator from whom ComCo receives the claim files which are
the subject of this contract.
This contract for service is predicated upon our company's usual
and customary business procedures in administrating the claims of
a permissibly self-insured employer. This includes responsibility
for staffing and the assignment of appropriate staff for the
administration and adjusting of the employer's claims. In the
event that there is a change in the Claims Examiner assigned to the
City of San Rafael's account, the Client shall have the right to
approve such staff changes prior to implementation, if desired.
This also includes, where necessary, the assignment of outside
services including, but not limited to, legal counsel, vocational
rehabilitation specialists, and investigators, with prior Client
approval.
If the employer, or the agents of the employer, wish to designate
the number of personnel required to staff for the administration of
the employer's claims, then the employer must share the
responsibility for the manner in which the employer's claims are
administered and will be responsible for the actions of such
designated administrative and claims personnel. It is also
acknowledged that any designation of outside services provider to
be utilized by the administrator in the adjustment of claims will
render the employer and/or the employer's agents responsible for
the actions of such designated service providers in all regards.
Such service providers will include legal counsel, rehabilitation
specialists, investigators, medical facilities and physicians.
The above policy is the policy of this administrator who will be
responsible for the administration of claims consistent with the
authority extended by the employer. Any alteration in the
authority of the administrator to perform its duties and discharge
its obligations under this agreement must result in a corresponding
retention of responsibility by the employer for such changes in the
administrator's usual business practices. It is acknowledged that
this is obviously a fair and equitable policy, allowing for an
employer's coordination for the administration of such employer's
claims, but clearly delineating the responsibility assumed by such
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coordination.
This agreement and all exhibits shall constitute the entire
Agreement of the parties. No modification or amendment of this
Agreement shall be valid unless it is in writing and executed by
both parties.
ComCo and Client agree to submit any claims arising under this
Agreement, or any disputes concerning the terms and provisions of
this Agreement, to binding arbitration pursuant to the current
provisions of the California Code of Civil Procedure and any
successor statutes.
V. OBAE Penalty Assessments
Any penalties or assessments incurred as a result of an OBAE audit
will be the responsibility and paid by the party at fault, as
determined by Addendum A.
VI. Termination of Agreement
Either ComCo or Client shall have the right to terminate this
Agreement by notifying their intent to cancel, in writing and
delivered via registered mail, 60 days prior to such requested
cancellation, without penalty.
Witness the parties hereto the day and year first above written
COMCO MANAGEMENT, INC.
By
J
TITLE—�/, 7/,- : ; -
-
L
CITY OF SAN RAFAEL
By Af GY SA,6G V
DOROTHY L A REINER
TITLE VICE -MAYOR
ATTEST:
JEAEANNE M. LEONCINI, City Clerk
ADDENDUM A
Under the guidelines of the new legislation regarding Workers'
Compensation in the State of California effective January 1, 1990
there are procedures for the assessment of penalties in varying
amounts for specific violations of either claim practices or the
timely, accurate, and effective provision of benefits to the
injured employees as determined through the audit process of the
Office of Benefit Assistance and Enforcement (OBAE).
It has been clearly stated by OBAE that in the case of a self-
insured employer whose claims are administered by a third party
administrator (TPA) that "the penalty imposed shall be joint and
several, and shall be served upon both the self-insured and third
party administrator." This is to say that both parties will have
the obligation to resolve the payment of the assessment, pay the
penalty assessed or to lodge the appropriate defense against such
payment if the penalty is felt to be either inappropriate or
unreasonable under the specific circumstances that have given rise
to the assessment of the penalty in question.
In the event that the penalty assessed is for work done or not done
properly by a prior administrator, where there has been a
subsequent change in third party administrators the penalty again
will be issued as a joint and several document with notice being
served upon both the self-insured and the prior administrator.
The schedule of penalties has once again been refined and it is
possible that it will be further refined as OBAE continues to draft
its procedure manual for the conduction of an audit and the deter-
mination of penalty assessment. Attached is a copy of the current
schedule of penalties as presented in the draft of procedures
issued May 1990. This draft is not expected to be in final format
and content until late July, 1990 or early August, 1990.
In order to determine in an orderly manner who should be
responsible for the payment of any penalties assessed the
following guidelines will be utilized by ComCo Management, Inc.
NATURE OF VIOLATION RESPONSIBLE PARTY
Failure to pay full 10% As this would appear to be a
self-imposed penalty calculation error, and there-
fore the responsibility of the
claims examiner the penalty
would be paid by the TPA.
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Self-imposed penalty not paid
Failure to advance permanent
disability when due
No employer date received
on employee claim form
8
However, in the event that the
calculation error was based on
incorrect information provided
by the employer, the penalty
would appear appropriate for
payment by the employer.
If the penalty was not paid
because the employer had not
notified the TPA of the return
of the claim form from the
employee then this penalty
would be paid by the employer.
Where the failure to pay the
self-imposed penalty is a
calculation error by the claims
examiner and all information
has been timely provided the
examiner the payment of the
assessment would be the
responsibility of the TPA.
Where the file is clearly
documented and the failure to
pay is an examiner error then
the penalty assessed is the TPA
responsibility.
If the knowledge of permanent
disability is withheld from the
examiner by either the employer
or a doctor specifically se-
lected by the employer the
penalty is the employer
responsibility.
It should be noted that for this
assessment to apply the claim
form must have been returned to
the employer and the employer
in sending the Carrier/TPA copy
of the form will have neglected
to complete the appropriate
information required. This
penalty would be appropriate
for employer payment.
Failure to respond to written
employee request for treatment
within 20 days
Failure to pay requested and
uncontested medical mileage
E
Additionally, it should be
noted that .from time to time
the TPA may receive a claim
form from sources other than
the employer (i.e. Doctors or
Applicant's Attorney).
Where that happens the TPA will
document the file that the
claim form was originally re-
ceived from a source other than
the employer, forward a copy of
the claim form completed by the
employee to the employer for
completion of the appropriated
information for return to the
TPA. If the form is not
returned to the TPA with the
required information the em-
ployer will be responsible for
payment of the assessment.
If the written request is re-
ceived by the TPA the payment
of this penalty will be paid by
the TPA. However, if the writ-
ten request is received by the
employer and is not communi-
cated and sent to the TPA on
the date of employer receipt
the penalty should be paid by
the employer.
If the mileage request is sent
by the employee directly to the
TPA rather than to any other
party the TPA will pay the pe-
nalty assessment. If the mile-
age request is sent first to
the employer and that employer
does not communicate and send
the mileage request to the TPA
on the date of the employer re-
ceipt of the mileage the
penalty should be paid by the
employer.
Payment at less than maximum
T.D. rate without
documentation in addition to
the employer's report
Failure to pay first T.D.
payment within 14 days of
date of knowledge of injury
and disability
Failure to comply with any
rule or regulation of the A.D.
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This penalty assumes that there
is not ample documentation to
support such a payment. It is
ComCo Management, Inc. 's proce-
dure to pay all temporary dis-
ability benefits at maximum
unless an adequate wage state-
ment has been provided and in
our possession at the time that
any indemnity benefit is paid.
In light of this policy the
payment of the penalty assessed
is the responsibility of the
TPA unless the wage information
provided by the employer is in-
accurate and in that case the
employer would be responsible
for the payment of the
assessment.
This date of knowledge is deter-
mined to be the employer's date
of knowledge. Where the infor-
mation has been provided the
TPA by the fifth day following
the employer date of knowledge
the penalty assessed by OBAE
will be paid by the TPA. Where
the TPA is not provided notice
and sufficient information
within five days of the em-
ployer's date of knowledge, or
where it is determined after
investigation or discovery that
the employer's date of know-
ledge was actually earlier than
stated this penalty will be the
responsibility of the employer.
This is the catch-all penalty.
It is certain to be the area of
most discussion in any penalty
assessment. Often the TPA's
ability to control the receipt
of much of the information
identified is difficult if not
impossible. In light of the
ambiguous nature of this penal-
ty often the determination of
who is responsible for payment
will have to be determined on a
No employee Claim Form, or
document is given to employee
by employer, or sent by claims
administrator.
Untimely provision of the
Claim Form to the employee
by the employer
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case by case basis. The fol-
lowing guidelines on specific
areas identified on the at-
tached will be the starting
point for determining
responsibility.
The legal obligation to provide
the Claim Form to the injured
employee has been placed on the
employer. ComCo Management,
Inc. has provided guidelines
for the documentation of
provision of the Claim Form by
use of both the Claim Form Log
and the six part Claim Form.
It will not be ComCo Manage-
ment, Inc.'s policy to provide
the Claim Form except on spe-
cific request by the employee
or the employee representative
and even then it is felt that
the appropriate procedure would
be for the claims examiner to
advise the requesting party to
notify the employer while at
the same time the claims
examiner will call the employer
identifying the request so that
documentation of provision of
the Claim Form can be main-
tained at the employer
premises.
If trie employer utilizes the
suggested procedures then all
files should have appropriate
documentation of provision of
the Claim Form and no penalty
should arise. If the employer
is not following the suggested
procedures or has not provided
the TPA with any proof that the
Claim Form has been provided
for the claim file this penalty
will be paid by the employer.
Penalty assessment will be the
employer's responsibility.
No employer report
No, or missing, medical
reports
Penalty assessment will be the
employer's responsibility.
This will be a difficult penalty
for which to determine
responsibility. In many cases
obtaining medical reports from
doctors can only be achieved
after it is made absolutely
clear that there will be no
payment for medical services
unless the appropriate reports
are provided. Even then some
doctors resist the obligation.
Where the offending medical
facility is one selected by the
employer, if a penalty is
assessed, the responsibility
for payment will be the
employer's. If the medical
provider has been selected by
the TPA, the TPA will be
responsible.
Incomplete or no record of This function is the responsi-
payment (includes missing bility of the TPA and, except
bills) where the employer has main-
tained the responsibility for
production of the checks and
disbursement of payments, the
TPA will provide payment of the
assessment. Where the employer
has maintained control over the
issuance of checks the penalty
will be paid by the employer.
No copy of W.C.A.B. Order
and Award
No copy of Application for
Adjudication of Claim
No DIA (DWC) 500 sent
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If there is proof that service
of the W.C.A.B. Order and Award
was provided the TPA payment of
the penalty will be the TPA
responsibility.
Where there is proof that
service of the application was
provided the TPA or where
employer is served a copy and a
copy of that application
received by the employer is
provided the TPA, TPA will pay
the penalty.
TPA responsibility.
DIA (DWC) 500 sent, but
inaccurate DON, DOK, BNU#,
periods rates, etc.
No DIA (DWC) 510 sent
Failure to pay or object to
medical/legal expense within
60 days of receipt of billing
(must be reasonable objection)
Failure to pay or object to
medical expenses within 60
days (must be reasonable)
Each payment due. Failure
to pay within 10 days any
indemnity due, which is not
specified above. Includes
Maintenance Allowance,
Interest on Awards, subse-
quent to first T.D. payments.
No claim log provided within
5 days of request
Each denied claim not desig-
nated on claim log
Each other omission or mis-
designation on claim log
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Where the TPA has access to
accurate information and pro-
vides inaccurate information
TPA will be responsible for
penalty. Where date of notice
and date of knowledge are not
accurately provided the TPA by
employer or their representa-
tive employer will pay the
assessment.
Employer responsibility.
If first receipt is TPA
receipt the TPA will bear the
responsibility. If the employer
has first receipt and does not
immediately provide TPA with
the billing employer bears the
responsibility for the
assessment.
See above for medical/legal
expense.
If all available and accurate
information has been provided
the TPA then this assessment
would be the responsibility
of the TPA. Where the required
information is within the know-
ledge of the employer but has
not been provided the TPA the
employer will bear the respon-
sibility of the assessment.
TPA responsibility
TPA responsibility
TPA responsibility
Failure to comply with
Rehab time and notice re-
quirements. Each occurrence
Failure to pay or appeal
Notice of Assessment within
15 days of the issue date
Failure to comply with or
appeal any final order of
the W.C.A.B. within 30 days
of service
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TPA responsibility where all re-
quired information is available.
Where TPA does not have infor-
mation that is available to the
employer and that information
has not been provided to the
TPA, employer will bear the
responsibility for this
assessment.
As any penalties that may be
assessed will have to be evalu-
ated on an individual basis and
determination will have to be
made both as to appropriateness
of the penalty and identifica-
tion of the party responsible
the need to act promptly is
imperative. Any party that
delays participation in such
determination of liability and
need to appeal any notice of
assessment will bear the re-
sponsibility of this penalty.
If liability for the penalty
assessment is agreed upon and
payment is appropriate the par-
ty responsible for the payment
of the assessment will pay the
penalty for the late payment of
the assessment should such
payment be made late. If the
party that would be responsible
for the assessment should it
ultimately be upheld after
appeal is late with filing of
the appeal that party will be
responsible for the assessment
for late filing of the appeal.
If the issue is simply the late
payment of an uncontested
W.C.A.B. Order or Award this
penalty would be the responsi-
bility of the TPA if the TPA
had the Order within the time
frame allowed for payment or
compliance of same. If the TPA
did not have service of the
Failure to produce, on a
second request, a legible
paper copy of open claims
files within 5 days of
written notice. Each Claim
File
Insufficient documentation
to support denial of liability
for a claim
No documentation indicating
service of denial on the
injured worker or his/her agent
Failure to comply with or appeal
any lawful written request
of the A.D. regarding a claim
filed within 30 days
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Order but the employer did have
service of the Order but did
not make such Order available
to the TPA within the time
frame allowed such penalty
would be the responsibility of
the employer.
TPA responsibility if the TPA
was provided the file at the
time that responsibility for
administration of the open
claims. If the file was not
sent to current TPA then the
responsibility for this should
be either the employer or the
prior TPA.
The determination to deny a
claim is generally the result of
both TPA and employer
involvement. Where the TPA act
unilaterally in the denial of a
claim this penalty would be the
TPA's responsibility. Where
the employer has participated
in the decision the penalty
would be a shared
responsibility. In the event
that the employer insists upon
denial of a claim against
recommendation of the TPA then
the entire penalty would be the
employer responsibility.
TPA responsibility
TPA responsibility provided that
the TPA has access to the infor-
mation requested. If the in-
formation or action requested
requires information within the
control of the employer and
that information is not provi-
ded to the TPA in a timely
manner so that the written
request can be complied with in
the time allowed this penalty
assessment will be the
responsibility of the employer.
Failure by a claims admini- TPA responsibility
strator, to provide a Claim Form
within 24 hours upon request of
an injured worker or his/her
agent
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