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HomeMy WebLinkAboutA012 - Resolution approving contract renewal with EMC Claims Solutions, LLC, of Des Moines, IA, to provide third-party administration of the City's Workers' Compensation and Municipal Fire and Police claimsITEM #:13 DATE:07-08-25 DEPT:HR SUBJECT:CONTRACT AWARD FOR WORKERS' COMPENSATION AND MUNICIPAL FIRE AND POLICE SYSTEM MEDICAL CLAIMS ADMINISTRATION COUNCIL ACTION FORM BACKGROUND: The City contracts third-party administration services for workers’ compensation and Municipal Fire and Police “411 System” injury medical claims. The City’s current contract with EMC for these services is set to expire on July 31, 2025. EMC has provided a renewal contract for the same services since at least 2009. Services provided in this contract include workers’ compensation claims administration for all City employees, medical bill review, self-insured loss fund management, and pharmacy and medical expense consultation. Also included under this contract are the performance of regulatory filings and maintenance of an online claims database accessible to City staff. Additionally, the third-party administrator collects for medical bill review and savings identified through that process. The fees, along with actual claims expenses are charged to individual departments. On May 12, 2025, a Request for Proposal (RFP) was posted to Ames Bids, the electronic bidding site. A total of 16 potential bidders viewed the RFP. On June 5, 2025, two proposals were received as follows: Firm Score Rank EMC Claims Solutions, Des Moines, IA 985 1 SFM Risk Solutions, Bloomington, MN 840 2 An evaluation team was formed by staff to review proposals. Proposals were evaluated based on experience, qualifications of personnel, the firms' claim administration process, capability of providing the requested services, and cost. After evaluating the proposals, staff determined that the proposal from EMC Claims Solutions of Des Moines, IA is most acceptable. EMC Claims Solutions has a local presence in the state of Iowa and is the incumbent, making it easy to meet the City's timeline. EMC highlighted a strong team, pinpointing a primary and back-up team along with a claims specialist with expertise in the police and fire (411) claims process. This annual contract has historically run from August 1 to July 31. However, the first term of this contract shall be August 1, 2025 through June 30, 2026, at which time the four (4) optional 1-year extensions will each run on the fiscal year of July 1 through June 30. The actual costs incurred under this contract vary depending on the number and nature of claims. The expenses under the current agreement total $27,820 to date, while the claims under the contract in the prior year totaled $27,810. The FY 2025/26 budget contains $55,000 1 for these services. ALTERNATIVES: 1. Approve the contract with EMC Risk Services, LLC, of Des Moines Iowa, to provide third- party administration of the City’s workers’ compensation and municipal fire and police “411 System” claims for August 1, 2025 through June 30, 2026. 2. Accept the proposal from SFM. 3. Reject all proposals and direct City staff to seek other claims administration alternatives. CITY MANAGER'S RECOMMENDED ACTION: EMC Risk Services, LLC, continues to be an effective provider of professionally administered workers’ compensation claims and associated services. Its staff has been responsive and sensitive to the needs of City employees in managing their injury and disability claims. The online claims system makes cost and other data accessible to City staff and provides a frequently utilized tool for analyzing injury types and safety program effectiveness. While EMC prices per claim are slightly higher, SFM has more ancillary fees that are not subject to their maximum fee cap. (See Attachments). Therefore, it is the recommendation of the City Manager that the City Council adopt Alternative No. 1, as described above. ATTACHMENT(S): EMC Cost Proposal.pdf SFM Cost Proposal.pdf 2025-153 TPA Contract Signed by EMC.pdf 2 717 Mulberry St. | Des Moines, IA 50309 | P.O. Box 9399 | Des Moines, IA 50306-9399 |P 515.345.4532 |P 800.741.5302 | F 866.504.6598 | www.emcins.com Employers Mutual Casualty Company Illinois EMCASCO Insurance Company Union Insurance Company of Providence EMC Underwriters, LLC EMCASCO Insurance Company Dakota Fire Insurance Company Hamilton Mutual Insurance Company EMC National Life Company (affiliate) EMC Reinsurance Company EMC Property & Casualty Company EMC Risk Services, LLC June 4, 2025 SERVICE FEE SCHEDULE 2025 Workers Compensation – City of Ames Claim Fees Claim Fees shall be effective as of the Effective Date, 8-1-25, for 11 months and annually thereafter on 7-1, or upon the agreed established date. PRICING REVISIONS PER RENEWAL City of Ames agrees to pay EMC Claims Solutions the following fees: Workers Compensation Claims: Incident Only $35 per report Medical Only $260.00 Indemnity $1,142.00 Medical Case Management $115.00 /hour $.56 /mile + reasonable expenses Legal Nurse Review $128.00 /hour Medical Bill Review and Pharmacy Benefit Management: PPO Network Utilization and audit of all bills by nurses in our Medical Cost Review Unit for optimal savings and network reductions on every medical bill. Also, the Pharmacy Benefit Management network provides both savings and clinical management of prescription drug costs for your injured workers. Per bill fee 9.50 Bill Review 30% of savings PPO 30% of savings - Capped at $10,000 3 717 Mulberry St. | Des Moines, IA 50309 | P.O. Box 9399 | Des Moines, IA 50306-9399 |P 515.345.4532 |P 800.741.5302 | F 866.504.6598 | www.emcins.com Employers Mutual Casualty Company Illinois EMCASCO Insurance Company Union Insurance Company of Providence EMC Underwriters, LLC EMCASCO Insurance Company Dakota Fire Insurance Company Hamilton Mutual Insurance Company EMC National Life Company (affiliate) EMC Reinsurance Company EMC Property & Casualty Company EMC Risk Services, LLC Miscellaneous Fees: On-line Claim Reporting/Administration (includes banking, accounting and fund management) Annual Administration/Reporting: $5,200.00 Additional users: $ 300.00 Risk Improvement $ 220.00 /hour Subrogation: 18% of recovery OSHA 300 Reporting $2650 Annually Approved on _____________ by: EMC Claims Solutions By: Barbara A. Sullivan, CPCU President and Chief Operating Officer EMC Claims Solutions City of Ames, Iowa By: _____________________________ _____________________________ 4 Costs For SFM Risk Solutions SFM Risk Solutions, Inc. Proposal to City of Ames June 5, 2025 Proposed fees subject to a not to exceed amount of $60,000 SERVICES PY 8/1/2025 – 6/30/2026 PY 7/1/2026 – 6/30/2027 PY 7/1/2027 – 6/30/2028 Incident Only 0 0 0 Medical Only $200 $200 $208 Lost Time $1075 $1075 $1118 Account Management $5000 $5000 $5000 Texting Fees $250 annually $250 annually $250 annually Bill Entry Fee $11 per bill $11 per bill $11 per bill CMS Reporting per claim $16 per submission $16 per submission $16 per submission Claim Regulatory Fees $3.00 per submission $3.00 per submission $3.00 per submission RMIS/Report System Access $500 per user $500 per user $500 per user Additional ancillary Fees not subject to the $60,000 maximum Services Fee Bill Review Re-Pricing 30% of savings PPO & Pharmacy network 30% of savings Non-litigated subrogation by recovery specialist **client approval required** 15% of recovery In-house physician review **client approval required** $150 per review Nurse prescription drug review **client approval required** $100 per hour Telephonic Nurse Case Management client requested services $110 per hour Loss Prevention Services client requested services $150 per hour plus expenses SFM Hotline Reporting client requested services $95 per report IT Programming Fees**/Data Transfer Fees** $400 per hour **Programming time for specialty reports requested by the client that require additional programming time by the Information Services Department and does not include the pre-determined list of reports that SFM Risk Solutions already supplies. Data transfer fees refers to work done to move data to another TPA or entity. Available Reports: (this is not a comprehensive list, but basic reports requested by clients) Loss Runs Paid in Year Loss Spreadsheet Legal Costs Invoices Settlements Escrow invoices Permanent Total Disability Check Registries (daily, weekly, monthly) Trending 5 1 CONTRACT FOR THIRD- AND MUNICIPAL FIRE AND POLICE RETIREMENT SYSTEM PROFESSIONAL SERVICES CONTRACT FOR CITY OF AMES THIS AGREEMENT, made and entered into effective the 1st day of August 2025, by and between the CITY OF AMES, IOWA, a municipal corporation organized and existing pursuant to the laws of the State of Iowa (hereinafter sometimes called "City") and EMC Risk Services, LLC (a Domestic Limited Liability Company, organized and existing pursuant to the laws of the State of Iowa and hereinafter called "Provider"); W I T N E S S E T H T H A T: WHEREAS, the City of Ames has determined that certain services to be provided to the City of Ames and its citizens by Provider, such services and facilities being hereinafter described and set out, should be purchased in accordance with the terms of a written agreement as hereinafter set out; NOW, THEREFORE, the parties hereto have agreed and do agree as follows: I PURPOSE The purpose of this Agreement is to procure for the City of Ames certain services as hereinafter described and set out; to establish the methods, procedures, terms and conditions governing payment by the City of Ames for such services; and, to establish other duties, responsibilities, terms and conditions mutually undertaken and agreed to by the parties hereto in consideration of the services to be performed and monies paid. II SCOPE OF SERVICES Provider shall provide the services set out in the City of Ames, Iowa, Scope of Services from Request for Proposal #2025-153, and response Third-Compensation and Municipal Fire and Police Retirement System, attached hereto as Exhibit A. The City, without invalidating the Agreement, may direct changes in the services within the general scope of the Agreement, with the authorized payment maximum being adjusted accordingly. Any change in the scope of service by the provider shall be done by written agreement signed by both parties. The added cost or cost reduction to the City resulting from a change in the Agreement shall be determined by mutual acceptance of a lump sum properly itemized and supported by sufficient data to permit evaluation, or by unit prices stated in the Agreement or subsequently agreed upon. It shall be the responsibility of the provider, before proceeding with any change in scope, to verify that the change has been properly authorized on behalf of the City. No additional charges or any other change in the Agreement will be allowed unless previously authorized in writing by the City, with the applicable compensation method and maximum authorized additional sum stated. 6 2 III METHOD OF PAYMENT A.Payments shall be made by the City of Ames in accordance with Exhibit B Service Fee Schedule, as applicable, attached hereto and incorporated herein. B.The maximum total amount payable by the City of Ames under this Agreement is $55,000 and no greater amount shall be paid without written amendment. C.Payment will be made upon completion of the services and acceptance by the City of Ames. Provider shall submit an invoice upon completion of the services. The invoice shall include an itemization of the services for which payment is claimed. Invoices referencing the assigned purchase order number shall be emailed to accountspayables@cityofames.og. D.In the event that this Agreement is terminated for any reason other than a breach by the City, Provider shall refund to the City any unused pre-paid Administration fees, pro-rated through the date of termination. IV FINANCIAL ACCOUNTING AND ADMINISTRATION A.All claims for payment shall be supported by properly executed payrolls, time records, invoices, contracts, vouchers, or other documentation, evidencing in proper detail the nature and propriety of the charges. All checks, payrolls, invoices, contracts, vouchers, orders, or other accounting documents pertaining in whole or in part to this Agreement shall be clearly identified as such and readily accessible for examination and audit by the City or its authorized representative. B.All records shall be maintained in accordance with procedures and requirements established by the City Finance Director, and the City Finance Director may, prior to any payment under this Agreement, conduct a pre- audit of record keeping and financial accounting procedures of the Provider for the purpose of determining changes and modifications necessary with respect to accounting for charges made hereunder. All records and documents required by this Agreement shall be maintained for a period of three (3) years following final payment by the City. C.At such time and in such form as the City may require, there shall be furnished to the City such statements, records, reports, data, and information as the City may require with respect to the payments made or claimed under this Agreement. D.At any time during normal business hours, and as often as the City may deem necessary, there shall be made available to the City for examination all records with respect to all matters covered by this Agreement and Provider will permit the City to audit, examine, and make excerpts or transcripts from such records, and to make audits of all contracts, invoices, materials, payrolls, records of personnel, conditions of employment, and other data relating to all matters covered by this Agreement. 7 3 V INSURANCE A.The provider shall maintain insurance coverage in scope and amounts acceptable to the Risk Manager. B.Any failure to comply with reporting provisions of the policies shall not affect coverage provided to the City of Ames, its officials, employees, or volunteers. C.Provider shall furnish the City with certificates of insurance and with original endorsements effecting coverage required by this clause. The certificates and endorsements for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf. The certificates and endorsements are to be on standard insurance company forms or forms provided by the City and are to be received and approved by the City before services commences. The City reserves the right to require complete, certified copies of all required insurance policies, at any time. D.Provider shall include all sub-Firms as insured under its policies. All coverages for sub- Firms shall be subject to all of the requirements stated herein. E.To the fullest extent permitted by law the Provider shall indemnify and hold harmless the City of Ames, their agents, and employees from and against all claims, damages, losses, and expenses, including, but not limited to fees arising out of or resulting from the performance of the services, provided that any such claim, damage, loss, or expense (1) is attributable to bodily injury, sickness, disease, or death, or to injury to or destruction of tangible property (other than the services itself) including the loss of use resulting therefrom; and (2) is caused in whole or in part by any negligent act or omission of the Provider, any Sub-Firm, anyone directly or indirectly employed by any of them or any one for whose acts, any of them may be liable. F. negligence alleged to be caused by the sole negligence of employees of the City of Ames. VI PROPRIETARY RIGHTS AND CONFIDENTIAL INFORMATION Provider agrees to hold in trust and confidence any confidential and/or proprietary information or data relating to City business and shall not disseminate or disclose such confidential information to any individual or employees or sub-Firms performing services hereunder (who shall be under a duty of confidentiality), and any other individuals specifically permitted in each instance by the City. VII TERMINATION The City of Ames may terminate this Agreement without penalty to the City at any time by giving written notice to the Provider at least fifteen (15) days before the effective date of such termination. In any case where the Provider fails in whole or in part to substantially perform its obligations or has delivered nonconforming services, the City shall provide a Cure notice. If after notice the Provider continues to be in default, the City may terminate this agreement immediately. The City shall only be obligated to compensate the Provider for compliant services performed prior to notice of termination. 8 4 VIII INDEPENDENT CONTRACTOR STATUS Provider agrees that the relationship between Provider and the City is that of an independent contractor for employment tax purposes. The Provider shall be solely responsible for all taxes relating to payments under this agreement, including those of employees. IX LAWS This contract is governed by the law of the State of Iowa with venue in the appropriate state and/or federal courts for Story County, Iowa X ASSIGNMENT This Agreement may not be assigned or transferred by the Provider without the prior written consent of the City. XI AFFIRMATIVE ACTION Provider shall place on file with the City a statement of nondiscrimination policy in the form of a completed Assurance of Compliance with the City of Ames, Iowa, Affirmative Action Program satisfactory to the Affirmative Action Officer of the City XII NOTICE All notices under this Agreement shall be in writing. Notices shall be deemed to have been given: (i) upon hand delivery or (ii) if sent by Regular Mail, within seventy-two (72) hours after the notice has been deposited in the United States Post Office, postage paid. Notices shall be sent to the other party at the addresses set forth below. Either party may change its address by giving notice in writing thereof to the other parties. City of Ames: Provider: Bill Walton, Risk Manager Human Resources 515 Clark Avenue, PO Box 811 Ames, IA 50010 9 5 XIII DURATION This Agreement shall be in full force and effect from and after August 1, 2025 until June 30, 2026, or, until terminated by the City of Ames, Iowa. IN WITNESS WHEREOF the parties hereto have, by their authorized representatives, set their hand and seal as of the date first above written. CITY OF AMES, IOWA By: By: John Haila, Mayor Attest By: _______ Renee Hall, City Clerk Printed Name and Title 10 Technical Response and Scope of Services Overview EMC Claims Solutions (ECS) is a multiline third party administer (TPA) equipped to handle claims for the City of Ames. We would like to meet and discuss our best practices for claims handling, audit standards, team members and our philosophy to provide the best service, management and results. We are driven to be unsurpassed in the industry at cutting claim costs and managing losses. As soon as awarded the contract we will establish expectations and begin our work. We will establish a tier structure in our system according to your financial reporting needs and develop your structure of authorization and funding. Training on our claims system will be provided. We will establish and document claims handling expectations during the transition and implementation phase. Communication on an ongoing basis is key to ensure we are providing the level of service that meets the needs of City of Ames. We know a dedicated client manager is critical to the success of a great relationship. Lori McMurray Enger will be assigned to the City of Ames. We will work to make the transition as smooth as possible. Specific tasks include, but are not limited to: Bring our team to meet the City of Ames team o Discuss expectations and document in claims handling instructions o Discuss operations and review the types of claims received by the City of Ames Integration of historic claim data Tier structure and specific coding requirement setup Medicare reporting TPA transfer of RRE submission agent Contact current open claims parties alerting of TPA change Setup and initial contact of open claims Coordination between ECS and the City of Ames financial staff to setup billing and reconciliation processes For the City of Ames, we would propose a three-member team to handle the claims for w compensation. A primary adjuster who would handle a majority of the claims, as well as a back- up adjuster to assist with overflow and out of office situations and a chapter 411 claims specialist. There would be one claims supervisor for each line of business for the City of Ames. All claims are handled from the Des Moines, Iowa office. All team members, including the client manager, reside in the Des Moines office and are available for on-site visits and phone conferences. The yearly average claim volume of both adjusters referenced will average from 100-125 open claims at any one time. 11 Executive Summary Our Mission Deliver quality financial protection and effective claim management to the clients and agents we serve. Our Business laims handling General Liability and Auto claims handling Coordinating Risk Improvement Services Medical Bill Review and Medical Case Management Difference Maker What sets EMC Claims Solutions by our team members. We believe each client is unique and we treat them that way, which is why our services are built around our clients. Our Delivery Client dedicated claims handlers Prompt response to questions and an action plan for each loss Customized billing and reporting Strong relationships with Business Partners to mitigate losses Commitment to service based on Client expectations and culture Our Guiding Beliefs Service Honesty and Integrity Teamwork Continuous Improvement How Will We Accomplish our Goals Respond to customers in a positive manner Provide the right products and services Take initiative to deliver successful outcomes Make financially responsible decisions We Stand in our Clients Shoes Develop lasting relationships Offer new products and services Continuously fine tune the process Deliver excellent products and services Adapt to your specific business needs and culture Empathetic and creative suggestions to resolve difficult claims 12 Exceeding Your Expectations Quarterly, Biannually or Annual File Reviews o These provide an opportunity for us to receive direct feedback from our customers on how we are doing and how we can improve o This face to face or virtual meeting allows us to be on a close business relationship with our clients Facility Tours o Together with our clients, adjusters would like to participate in facility tours o T Attending seminars with clients offers additional education opportunities. This creates a collaborative effort to ensure we understand the most up-to-date information in a constantly changing industry. The Right Products and Services Clients have direct access to the claims file system and are directly involved with claims Developing loss analysis tools which meet individual client needs. Our claims system allows for specific detailed loss runs Providing a link between clients and EMC Claims Solutions 13 The ECS Team The ECS team consists of four workers compensation teams and one general liability/auto team. Each team consists of 4-5 experienced adjusters and a supervisor knowledgeable in their respective lines of business. Workers Compensation Team (4) Assistant Managers (3) Claims Specialist (5) Senior Claims Adjusters (8) Claims Adjusters (4) Claims Representatives (1) Claims Assistant General Liability/Auto Team (1) Assistant Manager (3) Claims Specialists (2) Claims Adjusters Support and Finance Team (1) Assistant Manager (4) Claim Support Associates Leadership (4) President, Claims Director, Client Services Management Consultant and Financials Services and Systems Operations Manager We are fully equipped and highly experienced in providing claims management services. We will provide fully trained and experienced claim handlers who are well versed in Iowa workers compensation laws. The caseload for the senior adjuster staff is approximately 100 claims. The caseload for those with fewer indemnity claims and more medical only claims will be approximately 125 claims per handler. Assistant Managers do not carry a caseload. We handled approximately 2,215 claims over the last two years for other municipalities. ECS average turnover rate is 7% over the past three years. Licensing is not required for adjusters in Iowa; however, we support continuing education and participation in any available legal and administrative training by the State of Iowa Compensation Division. ECS conducts quarterly claim file audits of every team member to identify by claim type any areas for the supervisor to coach the team member. The results of these audits are tied to each score at the end of each year. Our most recent quarterly audit yielded a team average score of 94.7%. The 12-month team average score is 94.6%. Our adjusting staff has access to internal legal counsel and private defense counsel. We will work with the City of Ames legal staff to collaborate and achieve results. 14 Administrative Services We utilize the Filehandler Claims System designed by JW Software. It is a software system specifically designed for claims handling in the TPA environment. ECS can store all your s records, photos, videos, etc. and create reports to address any specific need. The City will receive a sign-on and password to be able to access all files in 24/7 real time from any internet connected computer. Our system is easy to use and operate. Our goal is to be flexible and responsive. Training on the Filehandler system will be provided within 30 days of the program inception. Claim handlers and the client manager will be available for risk management meetings, as needed. All new claims and correspondence may be emailed to ECS at ClaimsSolutions@EMCIns.com. We will set up the claims in a tier structure to reflect your organization and generate reports in the way best suited to provide the data requested. All data is stored on a secure network and is backed up daily to a separate secure server location. All federal, state and local filing requirements are managed by either the adjuster or claims administrative team. The Filehandler claims system allows for Electronic Data Interchange as well as Medicare RRE reporting capabilities. The City of Ames will have access to notes and all claim information, including financial summaries and payment detail. The City will be able to request the design of any ad hoc reports. Data points in the system can be translated into reporting capabilities tailored to the Reports from Filehandler are available in PDF, Word and Excel formats. The files will be retained in a manner agreeable to the established protocol of the City. All files are owned by the City, and the City shall have the right to copy any and all claim files, or any documents related to any claim. ECS shall retain and store closed claim files for such period as required by the record retention policies or such other time as the City and ECS may mutually agree. Until the obligation to retain and store claim files ends, ECS shall either return or destroy closed claim files as directed by the City. 15 Claims Administration Work Compensation At ECS we understand Iowa e specialize in claims for police officers and firefighters who are entitled to pension fund benefits created by the Iowa Code chapters 410 and 411. We will verify the injury meets the requirements for acceptance under the chapter and the bill has not been processed under another medical payer plan. We will contact the injured worker to determine the extent of the injury and the relatedness to the work activity so we can anticipate the extent of the cost to the City. We will maintain contact and investigate medical treatment as necessary throughout the life of the claim. Claims handling services include a three-point contact within 24 hours of receipt. ECS will determine the cause and compensability of the incident and explain benefits or liability to the injured worker or party. We handle the gathering of all information and advice our clients of the best path to resolution in each specific case. Our handling includes all the required filings, including Medicare Section 111 reporting, if needed. We will create Special Handling Instructions with the City of Ames which would outline the required actions for varying types of claims with ongoing communication and direction as requested by the City of Ames and/or as situations change on the claim. Claims handling services include contact within 24 hours of receipt. We will investigate the cause of the incident and deny or pursue a settlement. We will handle the gathering of all information and advise the City of Ames of the best path to resolution in each specific case. We will contact a lost time injured worker a minimum of one contact weekly until they have returned to work. We will assist the City of Ames by providing suggestions on the process for computing indemnity payments for lost time claims as required by City of Ames policy and labor contracts and how best to coordinate timely payments with the City of Ames risk manager. We pride ourselves on our flexibility to meet the needs required to best serve the internal processes within the City of Ames. All authorized medical bills associated with an approved claim comply with the medical fee schedule (UCR) and/or discounted fee arrangements negotiated by or on behalf of the City of Ames. EMC Claims Solutions utilizes the Medical Care Review department of the parent EMC Insurance Companies to process bills through the Mitchell International Medical Bill Review platform. Savings are passed along to the client. We are considered an approved vendor by many excess carriers and shall provide timely notification to the City of Ames excess insurers and the City of Ames risk manager of all claims or losses meeting the excess carrier reporting criteria with all necessary information about the status of such claims or losses as determined or required by such insurers. Excess carrier reimbursement requests are managed by our financial staff and are completed quarterly. We report to the excess carrier when called for by the policy and in conjunction with requirements. Typically, this is when the incurred amount hits 50% of the retention, or when certain types of injury occur. Focus would be on open communication with the excess carrier. Our claims best practices dictate our processes of investigation, file assignments and three- point contacts. Recorded statements are required of complex claims or when needed, and transcription needs are completed in house. 16 Claims Best Practices Guidelines These guidelines shall serve to provide positive recommendations for the timely investigation of losses and evaluation of fact patterns, as well as careful attention to statutory and regulatory regulations. The material is by no means exhaustive and shall not be replaced by the initiative, ingenuity or imagination of the handler or client. Each claim is unique and must be dealt with on an individual basis within the confines of its merit. The guidelines are intended to provide consistency and reduce variation in the claims service provided to our clients and customers. The guidelines will be included in the auditing function and will serve to provide a superior claim product that includes flexibility, attention to detail and aggressive management for cost control. Our intent is to continuously measure return to work outcomes and analyze results to provide our client the benefit of proactive management in claim handling by our experienced staff of claims adjusters. Coverage Coverage is provided by ______________ for $__________ Self Insured Retention Confirm coverage for the date of loss and policy contract period Identify State and be advised of proper statutory filings and jurisdictional conditions Identify coverage discrepancies and conduct additional investigation as relevant Review Coverage/Jurisdictional issues with Supervisor/Manager and/or Client Investigation The prompt and complete collection of the facts and circumstances surrounding each injury with a goal to construct the best possible basis for closure and settlement of the claim, using sound judgment and experience as to what each investigation might require. ECS will complete compensability investigation within one week of the initial claim assignment. We will contact the City of Ames with additional time requests or if any suspicion of fraud and report any potential findings. We will work with you to determine which claims you would like indexed. Costs for indexing are passed through without a mark-up. EMC Claims Solutions will partner with investigators and surveillance companies when warranted on a claim. We will work directly with you prior to requesting services from a partner. ECS will also work with EMC SIV unit depending on the level of severity of fraud, misrepresentation or abuse. Three Point Contact Contact with the Supervisor, Employee and Medical provider is required within 24 hours of receipt of the claim. All contacts and attempts to contact are to be documented in the claim handling file with meaningful comments to include verification of the facts, dates and witnesses along with whether or not the injury was preventable. 17 Contact Point One Supervisor - Employer Interview Obtain information about cause of injury (preventable or not) Obtain internal records where available Discuss and identify modified or light duty work opportunities Identify potential witnesses and obtain statements as needed Identify Subrogation Potential Identify Medicare Potential and report accordingly Contact Point Two Injured Employee - Employee Interview Obtain recorded statement if a back or shoulder injury Obtain recorded statement if: o Controverted facts o Cumulative/Repetitive Trauma o Pre-existing conditions or Impairments o Subrogation Potential o Lost time not accommodated by light duty Obtain list of past medical providers and secure medical authorizations as necessary Explain benefits and answer questions as needed Follow-up contact as needed after medical appointments and to discuss RTW Contact Point Three Medical Provider - Health Care Provider Request medical records as per jurisdiction Establish injury, diagnosis, treatment plan, next scheduled appointment, physical restrictions and verify lost time if any Confirm causal connection Research pre-existing conditions Follow-up after each appointment to obtain records and monitor treatment plan Send requests for medical opinions and clarification to physician as needed Subrogation Develop theory of liability based on first contacts Contact responsible parties to protect liens Continue investigation and settle or recover losses paid EDI Reporting Identify the waiting period has been exceed for jurisdiction and benefits are owed Approach appropriate EDI filing system and update as necessary Evaluation Consistency and quality in claim handling is imperative to determine if sufficient information exists and has been collected to document the loss and create an action strategy. This includes consistent documentation of the investigation, the reserving process, vendor choices, and ongoing evaluation of the information at hand. 18 Documentation Maintain diaries on each file for follow-up and action planning Document all conversations and interpretation of medical records Document payment of related, reasonable medical expense Document factors upon with the reserves are based along with a settlement strategy and action plans which may include timelines, negotiations, verification of benefits paid, and evaluation of exposure Document reserve changes and Special Funds Request Reserving Use online reserve worksheet to be updated as necessary with new information collected Set reserves per category of anticipated medical treatment and diagnostics Evaluate for extent of lost time and potential permanent impairment and set reserves accordingly Use best reasonable judgment as to the total cost of the claim, reflecting the quantity and quality of the information currently available Notify Client of any new reserve set or increased over $10,000 Notify Client of significant changes in the course of medical treatment Diary for ongoing reporting to excess carrier when incurred reaches 50% of SIR Supervision ECS assistant managers are responsible for the staff oversight of the team members and their claims. They oversee the handling of all aspects of the claims assigned to the unit including reserving, communication, documentation, evaluation, negotiation and settlement. They will ensure all claims are eligible or ineligible for payment, conform to quality and production standards. The assistant manager will confirm the claim processing is consistent with policies, procedures and claim handling guidelines. They will analyze and assign claims. They complete regular quality audits of their work, records results and counsels team members to bring work to or above standards. They will review reports and monitor the Filehandler system to ensure adherence to corporate and regulatory standards. Besides reviews of the claim files quarterly audits are conducts on five files for each adjuster. These proprietary audits are reviewed with the team member and used for annual performance appraisals. Assistant managers also, review and analyze processes, procedures, and workflows to identify opportunities for process improvement and efficiency. They also manage personnel administration including employee evaluations and salary administration. Vendors Use only client approved vendors Manage and monitor Medical Case Management to ensure effective results outside vendors Use MCR for medical bill review 19 Litigation/Resolution EMC Claims Solutions will expect to work with the firm and the client to achieve the best result for the client in an efficient and cost effective manner. A sound legal defense shall be developed in a timely matter and with a strategic plan for resolution. Alternate dispute resolution is encouraged where applicable and is to be discussed with client and claim handler prior to scheduling. A settlement range discussion will be documented in the report from defense counsel and updated as developments occur and facts are revealed. Adjuster Expectations in Litigation Claims brief and Supervisor Review upon receipt of Petition Notify Client and refer to appropriate Defense counsel Change file status to Litigated and forward file copies to counsel Offers, demands and negotiations clearly documented and communicated to Client. Request settlement and/or reserve authority after coordination with Client and defense counsel Determine if additional reporting to Excess Carrier is needed and diary accordingly Monitor litigation process and strategy Reporting Submit Large Loss Report when incurred reaches 50% of SIR Maintain client requirements for reporting o All ratings and PPD payments o Any Industrial Disability o All Settlement Discussions o All Denials o Hearings or Mediations Maintain and update EDI reporting as required by the Jurisdiction Report Medicare Eligibility as applicable Ongoing reporting to Medicare as mandated Maintain other statutory or regulatory reporting as needed Prepare monthly, quarterly, annual and subrogation reports as requested by the City of Ames Attend claim review discussions as requested by the City of Ames Provide assistance in preparation of the annual self-insurance renewal filings as requested by the City of Ames Meet with the City of Ames Human Resource Department quarterly and provide an executive summary reviewing the program and its cost Medical Management It is our practice to monitor the treatment programs recommended by physicians or specialists by reviewing all reports prepared by treating or examining physicians and by maintaining such contact as may be appropriate or at the request of the City of Ames to monitor any change of a injured worker 20 Our adjusters shall also recommend any courses of medical management which will expedite recovery and return to work of employees and will implement recommendations as approved by the City of Ames. Medical treatment is coordinated by our adjuster and monitored by the Claims Supervisor for all claims by setting appointments and authorizing necessary physician referrals and treatments. Our adjusters complete a review of all medical restrictions placed on the employee and will consult with the risk manager regarding transitional duty capability if the City of Ames has identified appropriate transitional work. We will review return-to-work documentation from the treating physician and notify the risk manager of the date of return. Any concerns regarding the ability of the employee to perform the essential functions of their job based on the City of Ames job description should be communicated immediately to the risk manager. ECS offers the following services to our clients in addition to our claims handling services. Services can be provided by the Medical Management Department within our parent, EMC Insurance Companies (EMC). ECS also utilizes outside vendors to obtain the most cost effective pricing. Medical Claims Review (MCR) MCR provides medical bill review services for ECS. EMC bill review services comply with all state mandates. EMC has received the necessary certifications from the appropriate states. State fee schedule pricing procedure codes are compared to state fee schedules and reduced accordingly. Many providers bill more than required for treatment of occupational injuries Usual and customary pricing Correct CPT coding Unbundling of charges Providers many times will separate procedures into smaller units to maximize their billing. - provide a lower cost than individual procedures Duplicate services The system tracks procedures and dates of service and automatically removes duplicate billings Up coding Provides often use a code for a treatment which will pay them more for the service. MCR is capable of re-coding and reducing the fee Turnaround time on our bill review system is monitored, not only from the date MCR receives a bill, but also from the date a branch receives a bill to be certain ERS is in compliance with state regulations with specific timelines for payment of medical bills. System links exist between EC payments are for compensable claims All medical provider payment disputes are handled by the MCR Unit. Key submissions include, w compensation State reporting, NCCI/URE reporting, Medicare & Medicaid reporting, and Excess Carrier reporting. Our claims handling instructions 21 developed for City of Ames would address quality control measures, review, cost control, City of Ames staff involvement and the general resource management. Pharmacy Benefit Management (PBM) Program injured workers within 3-5 days of notification When the injured worker uses the card, the pharmacy will bill the PBM The PBM pays the pharmacy The PBM bills ECS and provides a record for each claim file To initiate the program, the referral must be made through the PBM directly, either by ECS or the employer Advantages to using the program o Savings are contracted between PBM and pharmacies o The injured worker does not pay up front to fill prescriptions o ECS and the PBM have designated staff to handle questions or problems Medical Review Medical review with a chronological timeline includes a brief summary as described above but will also include a chronological summary of the medical records. When a file is lengthy or has complex medical issues, we will do a chronology of the pertinent medical records. This gives us a clear picture of the treatment, testing, statement of complaints, the consistency of the injured worker and the ongoing status of the medical condition. By documenting the information included on the bills in the chronological summary we can confirm documentation of a service provided, we can also determine if there are pertinent medical records not available in the file and we can determine if services unrelated to the claimed injury are included on the bill. Medical and Legal Report This report is very similar to the above medical review with chronological summary. The records with page numbers added will be organized and place in notebooks. The chronological summary will include notations of these corresponding page numbers. This review can be forwarded to our defense attorney. The medical/legal review not only decreases legal costs but also provides the attorney with access to a medical resource person. In addition to the medical records and bills, we ask the specific demands are provided and/or issues of the case. This will assist us in providing a more concise report directed towards the specific needs of our defense counsel. Depending on the needs of the defense counsel we will: Compile a notebook with records sorted by providers Provide a summary of medical costs by provider Create a timeline (chronology) of the medical records Provide a summary which includes a list of medical records not available which may be pertinent, point out discrepancies or questionable review findings Provide medical research related to the claimed injury/illness 22 List prescribed medications with a brief description The Medical Claims Consulting Staff are available to discuss the file medical issues with the defense attorney, to answer any questions, to discuss medical issues found in the medical research provided and/or to assist with compiling questions for deposition, etc. Utilization Management Utilization Management ensures appropriate, effective, quality health care services. Reviewers screen criteria to each case to assist in the evaluation of setting and the quality of care for the injured person. Medical Case Managers Medical Case Managers covering the State of Iowa all have received the Certified Case They are experienced in case management, nursing, and managed care. For case management outside of Iowa, ECS utilizes approved case management vendors. A Rehab Case Coordinator is available for Vocation Case Management and Life Care Planning. National Durable Medical Equipment National durable medical equipment providers supply equipment for injured workers. Through these vendors ECS will obtain prompt service and cost containment for all types of equipment and other services: Medical Equipment and supplies Electrotherapy Equipment Specialty Items Orthotics and Prosthetics Health Care Services and Ancillary Services Transportation Translation & Interpretation Medical Diagnostic Imaging and Physical Therapy Medical diagnostic imaging and physical therapy companies provide scheduling diagnostic tests and physical therapy for adjusters with the following benefits: Nationwide networks of imaging facilities and physical therapy providers Guaranteed scheduling time for injured workers is within 1-5 days of the referral Guaranteed written results to the adjuster in 1-2 days after the procedure Reduced administrative costs on claims Preferred Physician Program A designated preferred physician program is - claims. The Designated Physician Program shows an employer how to organize their response to an initial work injury/illness situation, as well as how to efficiently and quickly communicate needed information to ECS. The employer procedures prepare the claim for ECS handling based on immediate action and accurate information. 23 to do when an injury occurs. hours after the work injury by: Providing initial employee reporting procedures for a work injury or illness Collecting accurate information regarding the injury/illness Providing employees with prompt organized medical care Getting employers to report the initial injury to ECS Claims Adjusters in a timely and well-documented manner It is important to designate medical facilities based on quality and convenience to the employer and the employees. Controlling costs of medical claims is prefaced by good documentation and organized procedures at the first report of injury The Designated Physician program is one of the many ways in which ECS is helping Medical Claims Consulting The medical claims consulting team consists of nurses possessing degrees and the Licensed Nurse Consultant (LNCC) designation with the ability to help with w compensation claims. On Call Nurse An injured employee or their immediate supervisor can contact a nurse any time day or night. The employee speaks directly with a specially trained nurse who assesses the injury and recommends the best course of action for the injured worker. This proven process resolves many cases simply with first aid, avoiding unnecessary costs and time away from work. Medical Review A medical review includes a brief summary of the medical reports, answers to specific questions, it may include recommendations, an explanation of the medical problem and it may point out discrepancies in the file, prior conditions and their relationship to the claimed injury. The contents of the review will vary according to specific needs for the claim file and according to the findings on review. Loss Fund We can set up a payment system in several ways, but we suggest we analyze the payment frequency to determine the amount of an imprest fund. An escrow imprest amount is determined based on historical payment information for the City. The escrow imprest is pre- funded and reimbursed on a weekly or monthly basis, whichever fits your business needs best. Escrow imprest amount is recalculated bi-annually to ensure funds held are sufficient based on claim activity. Large payments are prefunded outside of the monthly escrow cash flow. Escrow balances are held in a checking account specifically held for TPA escrow funds. Your account would be reconciled on a monthly basis and all 1099 reporting and unclaimed property reporting 24 is managed by ECS. We can monitor and maintain the fund, which would be replenished at a pre-agreed upon schedule as payments are made. ECS may also access a bank account, if requested by the City of Ames, maintained by your organization to withdraw funds on a weekly or monthly basis to make benefit payments or settlement payments. We first provide a payment register statement to the authorized party showing the exact dollar amount to be requested from the account on the weekday of their preference and what amount is needed to replenish the account. Supporting documentation including, but not limited to, a payment register and financial register, Additional reports outside our standard system generated reports can be requested as needed. Loss allocation is developed into the tier structure so that all claim payments can be allocated back to the designated fund. Monthly reconciliations are completed and sent to the City of Ames and include, but are not limited to, beginning and ending balances, check register and a fund review summary. Any loss allocation reporting can be discussed and tailored to meet the reporting needs of the City of Ames and your internal accounting practices. Balance billing is not practiced at EMC Claims Solutions and is not allowed in Iowa. Loss Reports ECS offers a large selection of reports tailored to your business needs which are available for you to run, scheduled to you at prescribed times, or upon demand. Our goal is to be flexible and responsive; we will set up the claims software in a tier system to reflect the structure of your organization and report in the fashion best suited to provide whatever data you request. All data is stored on a secure network and is backed up daily to a separate server location. Any claim entered into the Filehandler system is available to query with either a Filehandler report either via our standard Filehandler reports or via Ad Hoc reporting. reporting capability, which means determine financial picture as of that day or any timeframe. The City of Ames tier structure will be setup to allow for separation of w compensation losses and Municipal Fire Police Retirement System losses. Furthermore, the tier structure will allow for allocation to department and loss fund coding. EC This custom dashboard is an effective tool to be used when analyzing risk and the costs associated with each injury within each department or tier level. This customized dashboard is delivered when signing on to the Filehandler system. 25 1 REQUEST FOR PROPOSAL NO. 2025-153 THIRD- AND MUNICIPAL FIRE AND POLICE RETIREMENT SYSTEM SCOPE OF SERVICES 1. OBJECTIVE The City of Ames (City), Iowa, is requesting proposals to provide Compensation Third- Compensation Program and the Municipal Fire and Police Disability and Injury Program. The Firm will provide all specified adjusting services for claims as well as all other required services, such as administrative, managed care, web-based claims/loss statistical information (RMIS) and banking/loss fund reconciliation. 2. BACKGROUND & OVERVIEW 2.1 The City is a full-service City employing approximately 600 full-time equivalent employees. These employees provide a varied range of services to the residents and visitors of the City. Employees range in classifications including professional, technical, administrative support, maintenance/repair, and public safety services. The City presently has a contract with a local clinic to provide occupational medical services for initial and follow-up care, including physical therapy. Exhibit A includes a historical May 1, 2015 until May 8, 2025. 2.2 -Party Administration 2.2.1 On-the-job injuries are an inherent injuries do occur, the Third-Party Administrator (TPA) will treat City employees with respect and professionalism when providing the required services. The TPA representatives will introduce themselves to the City employees during the initial communication after a claim has been received and shall provide clear information concerning the content, purpose, and schedule of future contacts to be made with that employee. The TPA representatives must make every reasonable effort to explain pertinent rights, regulations, and responsibilities to ultimate goal is to return the injured employee to work as soon as possible. 26 2 2.2.2 The City has been self-more than 20 years and has been utilizing a TPA since at least 2010. 2.3 Municipal Fire and Police Retirement System of Iowa (411) 2.3.1 The disability benefit program includes both non-job related and job-related disabilities. The program does not provide for partial disability or for a rated disability. 2.3.2 The provisions also provide for Temporary Disability Assistance. If a firefighter or a police officer has a medical condition which has, or is anticipated to last, for longer than sixty days (Temporary Disability), the retirement System is to be notified. Members receive full pay and allowances for a job-related temporary disability and will be paid for the City outside of the self-insured workers compensation program. The City is responsible for lifetime medical payments for injuries that result in permanent disability under the program. 3. GENERAL The basic scope of services is summarized as follows. The Firm will: 3.1 Provide Third-ensation and Municipal Fire and Police Retirement System, including but not limited to claims administration, medical management, loss fund management, temporary disability Compensation costs, and related services. 3.2 Be responsible for complying with all State and Federal rules, regulations, and laws relating to and required for compliance as a Third-Party Administrator for Self-Insured Plans/Employers such as the City of Ames, Iowa. This includes, but is not limited to: 3.2.1 Iowa Code 85 3.2.2 Iowa Code 86.11 and 86.12 3.2.3 Iowa Code 86.13 3.2.4 Iowa Code 87.11 27 3 3.2.5 Iowa Administrative Rule 879 sub-rules 3.1(1) and 3.1(2) 3.2.6 Federal Privacy Acts (HIPPA) 3.2.7 Iowa Code 411.15 3.3 The Firm shall have a web-based claims administration system and shall provide the City with access to said system for file review, email communications, or other purposes at no additional cost to the City. 3.4 Term of Contract 3.4.1 The current contract is in place through July 31, 2025. Services resulting from this Request for Proposal shall commence on August 1, 2025, and shall continue for eleven (11) months, through June 30, 2026, the end of the fiscal year. 3.4.2 The contract may be renewed for up to four subsequent one-year periods, from July 1-June 30, provided all of the following occur: 3.4.2.1 The Firm will provide the City with written notice of any proposed price adjustment for the subsequent year at least ninety (90) days prior to the anniversary date of the contract 3.4.2.2 The City will provide the Firm with a written agreement to renew the contract, with prices adjusted as mutually agreed, at least thirty (30) days prior to the anniversary date of the contract. 3.4.2.3 The City will provide the Firm with a written agreement for the renewal of the contract, at least thirty (30) days prior to the anniversary date of the contract. 3.5 Owner 3.5.1 The Owner is identified as the City of Ames, Iowa. 3.5.2 Manager. 3.6 All reports currently provided to the City are required from the Firm; refer to Section 6. The cost of reports shall be included in the fee structure and not considered an additional cost; the City of Ames will not pay any additional charges for reports. 28 4 3.7 All files shall remain the property of the City during and subsequent to the expiration of any contract or agreement and shall be returned to the City. Failure to comply shall constitute a breach of contract and be subject to damages and reimbursement for the cost of reconstruction of information. 3.8 Documents and furnished reports shall be provided in format acceptable to the City. 4. QUALITY REQUIREMENTS 4.1 personnel and management providing services under this contract shall be knowledgeable, trained, and certified or credentialed in their respective areas of expertise. The City reserves the right to conduct investigations as may be deemed necessary to ensure that competent personnel will be utilized in the performance of the work. 4.2 -effective -insured loss payments is to ensure the claims administrator hires and retains the appropriately qualified staff and assigns caseloads to ensure that all requests are handled in a timely and efficient manner. 4.3 The claims administrator shall have a full-service claims operation. The claims administrator shall be familiar with City of Ames policies and procedures and area medical providers to ensure efficient claims handling and to demonstrate value and respect for City employees. 5. GENERAL REQUIREMENTS 5.1 The City expects its Third-Party Administration Firm to treat City employees with respect and consideration when providing the required services. The TPA will introduce themselves and provide clear information concerning the content, purpose and schedule of future contracts to be made with the employees. The Firm must make every reasonable effort to explain pertinent rights, regulations, and responsibilities to the 5.2 Other than the filing of applications for self-insurance, the successful firm, at the option of the City, shall be required to: 29 5 5.2.1 Provide services on all claims occurring during the contract period and until six months after the termination of the contract, including renewals, extensions, or replacements thereof. 5.2.2 Provide all legally required reports for the contract period rendered and assist in assigning ratings to City job groups. 5.3 All claims data is the property of the City, and any data and media will be provided to the City upon request or upon termination of this agreement. 6. CLAIMS ADMINISTRATION The Firm shall be responsible for the following tasks: 6.1 6.1.1 Perform all of the administrative services required and shall control the disposition of all claims in accordance with applicable statutory and administrative notification requirements of the Iowa Code and the Iowa and procedures. 6.1.2 Review all notices of injury received from the City prior to the assignment to an adjuster approved by the City. 6.1.3 with applicable Workers' Compensation Law. The decision to deny a claim must first be discussed with and approved by the City. 6.1.4 Investigate each reported claim to the extent deemed necessary or at the request of the City. 6.1.5 Contact the injured worker within 24 hours of notice of injury. There shall also be periodic contact thereafter as deemed necessary for the type of claim filed. For example, a lost time claim would require a minimum of one contact weekly until the claimant has returned to work. 30 6 6.1.6 Subject to prior approval from the City of subcontractor selection, the Firm shall arrange for independent investigators, experts or other professionals when such action is necessary to properly process cases, assist in determining the status of disabled claimants, assist in preparation of litigated cases, or at the request of the City. 6.1.7 Payment will be made by the claims administrator from the loss fund as an allocated expense. 6.1.8 Assure, prior to payment, that all authorized medical bills associated with an approved claim comply with the medical fee schedule and/or discounted fee arrangements negotiated by or on behalf of the City. 6.1.9 Assist and support legal counsel selected or retained by the City in the preparation and defense of litigated cases and negotiations of settlements and provide periodic analytical or narrative reports of litigated cases to the City. Under no condition will a claim be settled without the express approval of the City. 6.1.10 Assist in arranging for rehabilitation or retraining of claimants in appropriate cases, as requested by the City. 6.1.11 Manager of all claims or losses meeting the excess carrier reporting criteria with all necessary information about the status of such claims or losses as determined or required by such insurers. 6.1.12 Pursue all possibilities of subrogation. 6.2 Claims Administration for Municipal Fire and Police Retirement System 6.2.1 Record the injury, review the incident, and provide recommendations regarding whether the injury is work-related. 6.2.2 Make medical payments. The City is responsible for lifetime medical costs for claimants that receive a medical disability. 6.2.3 Track medical payments. 31 7 6.2.4 Record the specific cause of the disability and monitor payment for the appropriate treatment. 6.3 Administrative Services The Firm shall perform the following administrative services: 6.3.1 Prepare all required Federal, State, and local filings. 6.3.2 Submit all required Federal, State, and local filings. 6.3.3 Perform loss management including but not limited to monitoring and reporting fund balance used to pay claims 6.3.4 Prepare and provide loss runs and other management reports as required herein. 6.3.5 Prepare and file, on behalf of the City, with the appropriate State agency, all -insurer. 6.3.6 Prepare, maintain, and file all records and reports as may be required by all legal authorities including, but not limited to, Federal, State, and local. 6.3.7 Prepare, maintain, and file statistical data, records, or reports as required by 6.3.8 compensation rating bureaus, including all data required for promulgation of the 6.3.9 Prepare and file any other reports as required by the City and State relating to claims experience and payments. 6.3.10 Submit quarterly requests to the excess carrier for all payments above each checks will be forwarded to the City and the amount recovered will be entered information system. 6.3.11 Maintain a file for each claim or loss including but not limited to medical reports, legal reports, cost data, and estimates of future liability on an individual claim basis which shall be available for review by the City or its authorized agents. 32 8 6.3.12 City. 6.4 Medical Management 6.4.1 Monitor treatment programs recommended by physicians or specialists by reviewing all reports prepared by treating or examining physicians, and by maintaining such contact as may be appropriate or at the request of the City to monitor any change of a claima their ability to work. 6.4.2 Recommend any courses of medical management which will expedite recovery and return to work of employees, and implement recommendations as approved by the City. 6.4.3 Assign City approved/selected nurse case managers on a case-by-case basis after Provider has the authorization to assign a nurse case manager for the initial visit pending contact and approval for continued use of a nurse case manager. 6.4.4 Coordinate the medical treatment of all claims by setting appointments and authorizing necessary physician referrals and treatments. 6.4.4.1 Review all medical restrictions placed on the employee and consult with Transitional Duty Team has identified appropriate transitional work. 6.4.4.2 Review return-to-work documentation from the treating physician and notify the Risk Manager of the date of return. Any concerns regarding the ability of the employee to perform the essential functions of their job based on the City of Ames job description should be communicated immediately to the Risk Manager. 6.5 Loss Fund Management 6.5.1 All claims, expenses and legal payments will be made by the Firm on checks drawn on a separate account set up by the City and funded monthly by the City in a manner agreed to by both parties. It is understood that all funds in this account are City funds and are to be returned to the City upon request or at termination of this contract. 33 9 6.5.2 The Firm is responsible for the monthly reconciliation of this account and shall provide bank statements to the City monthly. 6.5.3 The monthly reconciliation statement submitted by the Firm to the City will include the following: 6.5.3.1 Balance at inception of statement period. 6.5.3.2 Total disbursements which cleared, by date and claimant/payee. 6.5.3.3 Balance at close of statement period. 6.5.3.4 A list of all payments issued and outstanding. 6.5.4 Penalties required due to late payments or adjuster mishandling are to be paid by the Firm unless caused by late reporting from the City. 6.5.5 The Firm will reimburse the City for any penalties or fees generated due to the errors of the Firm, including but not limited to interest and penalties assessed for late benefit payments, overpayments, and bad faith claims. 6.6 Loss Data 6.6.1 The City will provide the Firm with historical claims data. This data shall not be purged and shall be returned to the City upon termination or expiration of the contract. 6.6.2 The Firm, at its expense, will ensure all claims and payment data is included in their loss run by the 10th day of the month following the claim. 6.6.3 Claims data for all open and closed claims shall be transferred from the database to the City database upon termination or expiration of the contract. 6.6.4 All notes recorded by the Firm will be included transfer to a successive claims administrator. 6.7 Loss Reports All loss reports are to be provided in electronic format by the Firm Representative. Reports shall include data for all claims active during the current fiscal year. 34 10 6.7.1 Reports shall be separated for Workers Compensation losses and Municipal Fire Police Retirement System losses. 6.7.2 Weekly Reports the date the claim was submitted to the carrier. 6.7.3 Monthly Reports 6.7.3.1 A report of claims, alphabetically by last name shall include Representative: 6.7.3.1.1. Claimant name. 6.7.3.1.2. Date of injury. 6.7.3.1.3. Status of claim. 6.7.3.1.4. Type of injury. 6.7.3.1.5. Type of claim. 6.7.3.1.6. Reserves (an estimate of future cost and total expected costs. 6.7.3.1.7. The amount and type of each payment made during the current period. 6.7.3.1.8. Total paid during the period for the claimant. 6.7.3.1.9. Grand total of all claims paid during the period. 6.7.3.2 A report of claims by City department number shall include the Representative and including the above information plus a total amount paid during the period for each department. 6.7.3.3 A monthly cumulative report by claimant by department shall include Representative: 6.7.3.3.1. Claimant name. 6.7.3.3.2. Date of injury. 6.7.3.3.3. Status of injury. 6.7.3.3.4. Type of injury. 6.7.3.3.5. Type of claim. 6.7.3.3.6. Reserves. 6.7.3.3.7. Amount paid fiscal year-to-date for each claim. 6.7.3.3.8. Amount paid claim-to-date. 6.7.3.3.9. Total amount paid fiscal year-to-date by department. 6.7.3.3.10. Grand total amount paid fiscal year-to-date. 35 11 6.7.3.4 Monthly check register indicating the date, amount, associated claim reference, and payee. 6.7.3.5 attorney paid, description of work performed, reserves recommended, and settlement date (if applicable). 6.7.3.6 OSHA 300 log. 6.7.3.7 Compensation claims that involve no payment or no medical treatment. This data shall be reported and included in the database as reporting purpose only (RPO), or first aid or no pay cases and should be identified in the system in that way. Information is recorded in the same manner as an active claim with the date of the incident, claimant name, department, and type of injury. 6.7.3.8 Report on large loss claims ($20,000 plus). 6.8 Quarterly Loss Reports Every 90 days, on a schedule as agreed, the Provider shall submit a full summary report to the City on all claims of the following types: 6.8.1 Any claim in which an employee is not working full duty. 6.8.2 Claims in which settlement (washout) is recommended. 6.8.3 Annual Reports: 6.8.3.1 Cumulative report by type of claim (medical only, lost time) of coverage for each fiscal year. 6.8.3.2 Summary report of claims paid by medical only, lost time, open claims, reserves for each fiscal year. 6.8.3.3 For each fiscal year period and for each calendar year: 6.8.3.3.1. The total number of claims or losses by department and city wide. 6.8.3.3.2. A summary of medical and indemnity payments by department and city wide. 6.8.3.3.3. Estimated future costs and total costs by department and city wide. 6.8.3.3.4. Number of open and closed claims by department and city wide. 6.8.3.3.5. Detail of medical bill savings and charges. 36 12 6.8.3.3.6. Any other data deemed necessary by the City to comply Commission requirements. 6.9 Subrogation Reports 6.9.1 On a semi-annual basis, or as specifically requested by the City, a report shall be provided of all claims for which the claims administrator has pursued (whether successfully or not) subrogation, contribution or indemnity or recovery from special or second injury funds on behalf of the insured. In addition to the data specified in the Basic Report, as applicable, the report should include the following: 6.9.1.1 Name of claimant. 6.9.1.2 Date of injury. 6.9.1.3 Type of injury. 6.9.1.4 Amount paid claim-to-date. 6.9.1.5 Name of party from whom recovery is sought. 6.9.1.6 Basis for recovery. 6.9.1.7 Amount recovered to date. 6.9.1.8 Estimated amount yet to be recovered. 7. COST OPTIONS AND METHODS 7.1 The successful fee shall include full consideration for such continuing obligations and, except for as noted herein, no additional consideration shall be due for such obligations which extend beyond the contract period. 7.1.1 Medical review bill shall be shown as a percentage of savings with a cap of $10,000 per medical bill. 7.2 All charges related to the Work are to be included in the annual claims administration fee. 7.3 Any costs associated with programming changes that are necessary to create a report required by the City are the responsibility of the TPA. 37 717 Mulberry St. | Des Moines, IA 50309 | P.O. Box 9399 | Des Moines, IA 50306-9399 |P 515.345.4532 |P 800.741.5302 | F 866.504.6598 | www.emcins.com Employers Mutual Casualty Company Illinois EMCASCO Insurance Company Union Insurance Company of Providence EMC Underwriters, LLC EMCASCO Insurance Company Dakota Fire Insurance Company Hamilton Mutual Insurance Company EMC National Life Company (affiliate) EMC Reinsurance Company EMC Property & Casualty Company EMC Risk Services, LLC June 4, 2025 SERVICE FEE SCHEDULE 2025 Workers Compensation – City of Ames Claim Fees Claim Fees shall be effective as of the Effective Date, 8-1-25, for 11 months and annually thereafter on 7-1, or upon the agreed established date. PRICING REVISIONS PER RENEWAL City of Ames agrees to pay EMC Claims Solutions the following fees: Workers Compensation Claims: Incident Only $35 per report Medical Only $260.00 Indemnity $1,142.00 Medical Case Management $115.00 /hour $.56 /mile + reasonable expenses Legal Nurse Review $128.00 /hour Medical Bill Review and Pharmacy Benefit Management: PPO Network Utilization and audit of all bills by nurses in our Medical Cost Review Unit for optimal savings and network reductions on every medical bill. Also, the Pharmacy Benefit Management network provides both savings and clinical management of prescription drug costs for your injured workers. Per bill fee 9.50 Bill Review 30% of savings PPO 30% of savings - Capped at $10,000 38 717 Mulberry St. | Des Moines, IA 50309 | P.O. Box 9399 | Des Moines, IA 50306-9399 |P 515.345.4532 |P 800.741.5302 | F 866.504.6598 | www.emcins.com Employers Mutual Casualty Company Illinois EMCASCO Insurance Company Union Insurance Company of Providence EMC Underwriters, LLC EMCASCO Insurance Company Dakota Fire Insurance Company Hamilton Mutual Insurance Company EMC National Life Company (affiliate) EMC Reinsurance Company EMC Property & Casualty Company EMC Risk Services, LLC Miscellaneous Fees: On-line Claim Reporting/Administration (includes banking, accounting and fund management) Annual Administration/Reporting: $5,200.00 Additional users: $ 300.00 Risk Improvement $ 220.00 /hour Subrogation: 18% of recovery OSHA 300 Reporting $2650 Annually Approved on _____________ by: EMC Claims Solutions By: Barbara A. Sullivan, CPCU President and Chief Operating Officer EMC Claims Solutions City of Ames, Iowa By: _____________________________ _____________________________ 39