HomeMy WebLinkAboutAgenda Report - October 31, 1993r
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i
CITY OF LODI
AGENDA TITLE:
MEETING DATE:
PREPARED BY:
COUNCIL COMMUNICATION
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Renewal of Workers Compensation Claim Administration
Service Agreement
ebtuk.aty 3, t9.93
Assistant City Manager
RECOMMENDED ACTION:
That City Council review the attached service
agreement and authorize its acceptance.
BACKGROUND INFORMATION: The City of Lodi renews its service agreement with
its workers compensation third party administrator
on an annual basis, every November 1st.
In November 1990, the City first began using Greenfield -Thompson Associates,
Inc. (now known as Associated Claims Management, Inc.) as its third party
administrator, the service fee was established at $4,400 per month. Council
approved an increase to $4 ^50 per month for the year beginning November 1,
1991. This firm has now agreed to a $4,916.25 fee per month for the 92-93
year, which represents a 3.5% increase relative to last year's fee.
It should be noted that when staff originally began negotiations with this
administrator, the administrator had requested a fee of $5.250 per month (an
increase of 10.52%).
This firm justifies its request on the basis that its staff, and employees in
this industry in general, are still expecting salary increases in the 5V to 7%
range. This has dropped somewhat from a period thre' years ago when salary
increases were generally around 10%. Burnout and turn dr amongst third party
administrator staff is very high. The philosophy of this firm is to hir'
sufficient staff to cover the workload, invest in employee training and provide
competitive salaries in order to prevent turnover. C1•rical support staff at
the Pleasanton office were recently increased from a ratio of 1.0 per examiner
to 1.5 per examiner. Ultimately, Associated Claims Management, Inc. feels the
cost of mai-.caining a stable, quality staff are lower than those of employee
turnover and regular disruptions in the processing of client's claims.
APPROVED :L
yd -y.
THOMAS A PETERSON
City Mpr-,gel
'e'.,CI OiDe,
CC•i
1•
l
r
04
Renewal of Workers Compensation Claim Administration Service Agreement.
Page 2 of 2
February 3, 1991
Included in this contract renewal is a managed care/medical cost-containment
program. Roberta Penarelli, Executive Vice President has stated that through
this program of medical billing reviews, the City could realize a savings of
roughly $25,000 per year, assuming our medical billings fall around $100,000
per year. For this, a fee of 15t of all savings through the bill review system
would be charged, and 30t for savings through negotiated reduced fees with
designated medical providers.
FUNDING: Operating budget.
Respectfully Submitted,
,AA -7
Jerry L. Glenn
Assistant City Manager
JLG:KJE:L
Attachment
Prepared by Kirk J Evans
Administrative Assistant to the City Manager
CCCOM001/TXTA.TLP/WKRSCOMP
J44 26 '93 17:11 ACM:/WC-415-933-72680
SCHEDULE A
to
WORKERS' COMPENSATION SERVICE AGREEMENT
between
CITY OF LODI
and
ASSOCIATED CLAIMS MANAGEMENT, INC. OF CALIFORNIA
ACMI Su idard Management Information Services Package includes:
,RISK AM F N C1AL . AGEME,NLR PORTS
- Policy Period Analysis - monthly or quarterly
- Management Summary Report - monthly or quarterly
- Claim Inquiry Sumrnaiy - monthly or quarterly
- Check Register - weekly or monthly
- Payment Analysis - semi-ann.,ally or annually
- IRS Ft -m 1099 - annually
CLAIM MANAGEMENT REL'ORTS
P.9
- Cost Analysis Report - monthly, quarterly, semi-annually or annually
- Claims Listings - monthly or quarterly
- Stratification Listing - quarterly
- Social Security, Employee Multiple Claim List - quarterly, semi-annually, annually
- Self -Insurer's Annual Report (if self-insured) - annually
LOSS PREVENTION REPORTS
- OSHA logs - monthly
Histograms annually
JAN -26-1993 16:16
41593072680
P. E19
4
JAN 26 '93 17:06 ACMi/tz-41S-93o-72680 P,
WORKERS? COMPENSATION
SERVICE AGREEMENT
This Agreement is entered into by and between City of Lodi, hereinafter referred to as
"Client," and Associated Claims Management, Inc. of California, a California
Corporation, hereinafter referred to as "Associated!
Recitals
1. Whereas, Client has elected to self-Insure/Insure its Workers' Compensation program
in the State of. California.
2. Whereas, Associated provides Bairn administration and management information
services to self-insured and insured employers.
3. Whereas, Client and Associated have agreed to enter into a Service Agreement
effective November 1, 1992.
4. The foregoing recitals are agreed to by the parties.
In consideration of the mutual promises, covenants and conditions contained herein, and
for other good and valuable consideration, the parties hereto agree as follows:
'Terms andSAnditions
1. lerns_ofjignentmt
This Agreement is effective November 1, 1992 and shall be continuous and renewing
on an annual basis unless otherwise terminated as stated in Section 6.
2. Consideratio• t
a. Associated's service fee for the period November 1, 1992 through October 31,
1993 shall be 54,916.25 per month for up to 125 new claim submissions; over 125
claims at $400 per claim; no additional fee for on-going open claim inventory.
JAN -26-1993 16:11
Page 1 of 7
.11 5. P. 02
JAN 26 '93 17:35 ACM:- W_-41`-930-72680 P.2
b. The charge for field and investigative services and outside services such as
mandatory conference, hearing or trial attendance is 565.00 per hour, plus
expenses.
c. It is recognized that the service fee as ncgotated each year represems the expense
of administering and adjusting workers' compensation claims submitted during the
current contract period, and the fee does not cover the expense involved in
processing claims to their ultimate conclusion upon termination of the Agreement.
". In the event that legislative changes are made to the Labor Code and/or Self -
Insurance Plans requirements Aida materially effect caseloads and/or change
servicing requirements, Associated and Client agree to negotiate a reasonable
revision in the fee structure and account staffing levels.
e. The service fee is payable by Client upon the receipt of Associated's invoice, due
and payable by the fifth (5th) day of the month of service.
f. ACMI has developed a comprehensive managed care/medical cost-containment
program designed to significantly reduce the cost of occupational injuries and
illnesses by (1) negotiating reduced medical provider fees with designated
participating medical providers ("PPO') for medical services rendered at amounts
less than their usual and customary charges or the Official Medical Fees for
Covered Medical Services rendered, (2) inpatient utilization management, and (3)
reviewing medical Billings against the Official Medical Fee schedule.
Client desires to take advantage of the ACMI Managed Care Program in the
State of California.
Client agrees to pay an amount equal to 15% of the savings generated b' the
Bill Review System and 30% of the savings for PPO reductions. Savings shall
equal the sum of reductions to the official Medical Fee Schedule and contract
reductions, if any, for all billings.
If client directs ACMI not to review billings of certain Providers, client shall
provide a list of the said Providers in advance.
Utilization Management Services shall be provided as agreed by Client and ACMI
at $35 - 50 per hour, in accordance with the specific assignment.
Page 2 of 7
JA4-26-1993 16: 40 41593072E80
P . 02
JAN 26 '93 1;:08 ACM:AIX-415-930-72680
3. Re_sponsibijities of Assocjp1cd
a. Claims Administration
P.4
(1) Associated agrees to provide claims service for Client's Workers' Compensation
exposure in the State of ealifornia as required by the regulatory bodies of said
State and st a level acceptable to Client
b. ManagemmaInfor tion.Systcm
(1) Asssoaated agrees to maintain claims and cost data as well as estimates of
future claims liability on an individual claim basis.
(2) Associated will provide management information services to Client as agreed
upon by the parties, in accordance with Schedule A of this Agreement.
(3) Associated retains sole right of ownership to its programs. However, the
Client has a right to the data. In the event of a cancellation of Associated's
service, the Client is entitled to a complete history file (tape) of all claims,
as well as a record layout describing the format of the tape.
4. Responsibllldesof Client
a. Client shall report to Associated all Workers' Compensation claims in a timely
manner and shalt cooperate with Associated in all aspects of investigation,
communication, the providing of recorded material and any otber areas pertinent
to Associated being able to protide the agreed service to Client Associated shall
not be responsible, nor be decreed liable for damages, real or otherwise, resulting
from Associated's lack of knowledge of information in the possession of Client,
but withheld from Associated.
S. agEtlaszmail.buri
a. The parties agree Associated will pay claims expenses from a checking account
established by Cliem and funded by Mut. The checking account will be
maintained by Client at an amount sufficient to cover at least 60 days of the
Workers' Compensation claim expense. Associated agrees to make records
pertinent to the client's account available to Client for audit purposes at ail
reasonable times with at least 24 hours notice.
b. Claims expenses are defined as medical expense. temporary or permanent
disability, allocated claims expense, rehabilitation expense. and all other Workers'
Compensation benefits payable to the injured employees or dependents of Client.
Page 3 of 7
JAN -26•-1993 16:17 41593072680
..=•••••••••
P.04
JAM '93 17:08 3 M:: u: -41 93e-72690
P.5
c. Allocated claims expense includes such costs as legal fees, court costs, court
reporters, expert witnesses, fees to undercover operatives, depositions, and certain
special investigations as may be required.
6. Terminating;
a. After the first 10 months, this Agreement may be terminated by either party by
providing to the other written notice sixty (60) days in advance.. In the event of
termination. Associated will be obligated to make available all summary data,
records and information developed with respect to Client's business including all
loss records to Client or its designated agent on the date established by Client.
It is recognized that Associated will provide the records in good condition and will
cooperate In the transition on behalf of Client.
b. In the event termination should occur prior to calendar year-end (12/31).
Associated will provide Client a IRS Form 1099 hard copy report of all vendor
payments made as of termination date; but Associated will not assume
Tonsibility for year-end IRS reporting (including tape production) and vendor
notifications for that calendar year.
c. After the termination date of this Agreement, Client may, at its option, designate
Associated to continue to manage all claim files with injury dates prior to the
termination date of this Agreement, for a fee of 17.5* of paid claims, or on a
time and charges basis at a rate agreed to by the parties.
d. Any notice required by this Agreement of the parties hereto shall be sent by first
class mail, postage prepaid to the parties' addresses fust set forth below.
7. Comnliance with Applicable Law
a. Associated and Client hereto acknowledge the various penalties and administrative
fines that are contained in the California Workers' Compensation Reform Act of
1989 (effective as of January 1. 1990 and January 1, 1991) that may be iznposod
on both employers and claim administrators. Penalties arising from the failure of
Client to provide timely notice of claim or such other Client obligations shall be
and remain the sole responsibility of Client and the Client hereby agrees to
indemnify, defend and bold Associated htnnless for all claims arising from the
imposition of such penalties.
Associated shall have no responsibility or liability whatsoever to defend, pay or
otherwise be responsible for, any administrative Bairn, fine or penalty imposed
at any time after commencement of the effective term of this Agreement, if such
administrative claim, fine or penalty (regardless of when assessed) arises from the
facts, errors or omissions of the claim administrator or any other party acting on
behalf of Client prior to Associated becoming, Client's claims administrator unless
Page 4 of 7
J N-26-1993 16: 1 7 4159307 26E
P . Ei5
JAN 26 '93 17:09 ACM:u:-415-930-72680
P
.ssociated shall have acknowledged the existence of such administrative claim,
fine et penalty in writing and agree to assume liability therefore.
Client shall defend, indemnify and hold Associated harmless from any and all
such undiscovered penalties that may have accrued prior to Associated's becoming
responsible for the administration of Client's Workers' Compensation self-
insurance program. Administrative penalties arising solely from the failure of
Associated to comply in a timely and proper manner with its duties as a claim
administrator shall be and remain the sole responsibility of Associated; provided
however, effective upon the cancellation, discharge or termination of this
Agreement for any reason whatsoever, Associated shall no longer be liable or
otherwise responsible for payment or reimbursement of any administrative fine,
claim or penalty arising from facts occurring during the term of this Agreement
(including facts involving administrative procedures conducted by Associated), but
not assessed until after termination of this Agreement. unless Associated is
notified of the scheduled audit within 48 hours of commencement of the audit and
is allowed to participate in the daily audit proce«, having access to all files in
questions, and is allowed to participate in the ex., interview process to include
negotiation and/or defense of any alleged administrative fines or penalties, and
otherwise Client shall defend, indemnify and hold Associated harmless from any
and all such fines, claims or penalties.
b. The parties acknowledge that. the California Workers' Compensation Reform Act
of 1989 requires first payment of Temporary Disability Indemnity within 14 days
of the Client's knowtedge of the Injury and generally imposes an automatic penalty
of 10% of the amount delayed for late indemnity payments which shall be payable
directly to the injured employee without application. ninth rmore, the parties
agree that, unless Associated is provided with written notice of the claim in the
form of the completed Employer's Report of Occupational llness or Injury, Form
5020. within 7 days of the Client's lmowledge of the injury, the above -referenced
automatic penalty of 109''0 shall be and remain the sole responsibility of the Client.
c. Additionally, ACMI shall not be responsible for such penalties and/or
administrative fines in the event client requires open indemnity caseloads in
excess of the State of California, Self -Insurance Plans Office's recommendation.
8. ,General Condition
a. Associated shall assume legal liability to u,:.!-mnify, hold free and harmless and
defend Client, its agents, servants. employees, officers and directors against any
and ail loss, damage. fines, liability, costs and expenses (including. but not limited
to, attorney fees, court coats and reasonable investigative and delivery costs) and
other such sums which Client, its agents, servants, employees, officers and/or
directors may reasonably pay or become obligated to pay on account of the acts
of negligence of Associated, its agents or employees, officers or directors. Client
Page 5 of 7
JF;ha 26 --1997. L r : t •t :1 `..47.C173E.P0
•
F . El5
JAN 26 '93 tri tB f.:M:-u -415-93o-725ee
P.7
agrees to notify Associated promptly in writing in the event such claim. demand,
assertion of liability or action is brought to Client's attention.
b. Associated agrees to perform the services of adjustment of the Workers'
Compensation claims and at all times, control the disposition of such claims
including those in litigation subject to the direction of the Client. The services
to be rendered are to be within the standards acceptable in the field of Workers'
Compensation including Longshore and Harbor Workers' plans.
in the event Client directs Associated to follow a specific request of Client in
the handling of any claim adjustment, Client agrees to bold Associated harmless
for any loss, cost, or expense should a claim or lawsuit thereafter be filed involving
Associated. This Agreement is not intended to hold Associated harmless for any
independent negligence of Associated in my matter arising from this Agreement.
c. Client shall not be liable to Associated for personal injury of Associated
employees or property damage sustained by Associated in the performance of
the services specified in this Agreement.
d. Because of the comprehensive data Associated provides to Client and the timely
manner in w*ich it is provided, Client has sufficient information to provide to
other parties that Client may have legal, contractual or other obligations for said
reporting, and it is deemed Client's responsibility to perform such reporting.
Unless otherwise stated, Client is responsible to report any claim or event within
the reporting criteria to Client's appropriate insurance broker, insurance carrier,
or to any other interested party.
e. The parties each agree and acknowledge that their respective employees, officers,
and directors are valuable elements of their respective organizations and that
therefore it would be of substantial detriment to the welfare of each such
organization if either party solicited. enticed or otberwlse initiated discussions
leading to the employment of the other party's employees, officers or directors.
Accordinz'v, during the effective term hereof and for a period of eighteen (18)
months after expiration of this Agreement, each party agrees not to directly or
indirectly engage in any solicitation, invitation or discussion with any employee,
officer or director of the other with a view toward engagement of such individuai
as an employee, consultant, representative, officer or director.
Any controversy arising out of, or relating to this Agreement or any document
or other agreement referenced in this Agreement. or any modification or extension
hereof or thereof, including any claim for damages or rescission, shall be settled
by arbitration before three (3) neutral arbitrators in accordance with the rules
then obtaining of the American Arbitration Association. Any such arbitration
shall be conducted and determined in Contra Costa County, California. The
decision of the arbitrators shall be binding on the parties. The award rendered
by the arbitrators shall be final and judgment, subject to any right of appeal
permitted by law, may be entered upon it in any court having jurisdiction thereof.
f.
JAN -26-1933 16:1`.
Page 6 of 7
41!::.9!.0;".2L47:0
P.07
JAN 26 '93 17:11 ACM:'u:-415-930-72680 F.6
The prevailing parry shall be entitled as part of the award, to all reasonable fees
and expenses incurred in connection with the arbitration, including tbe fees and
expenses of the arbitrators, and including reasonable attorneys' fees.
g. While performing the specified services, Associated is an independent contractor
and not an agent or employee of Client.
h. Changes and modifications to this Agreement may be made by tbe mutual written
consent of the parties.
Accepted By:
Ow of Lodi
Accepted By:
Associated Claims Management, Inc.
of Calitbralu
$Y: Bv�
Authorized Signature Au fixed Signature
Name t'Tjrpe or Print)
Title
Street
City, State, Zip
Roberta Phi
Name (Type or Print)
amain Vice Precidknt
Title
390 North Wiget Lane
Street
Walnut Creek , 498
City. State. Zip
January 28. 1993
Date
Page 7 of 7
JAN -26-1993 16:15 415q3C172660
P.26
WORKERS' COMPENSATION
SERVICE AGREEMENT
Tnis Agreement is entered into by and between City of Lodi, hereinafter referred to as
"Client," and Associated Claims Management, Inc. of California, a California
Corporation, hereinafter referred to as "Associated."
Recitab
1. Whereas, Client has elected to self-insure/insure its Workers' Compensation program
in the State of California.
2. Whereas. Associated provides claim administration and management information
services to self-insured and ensured employers.
3. Whereas, Client and Associated have agreed to enter into a Service Agreement
effective November 1. 1992.
4. The foregoing recitals are agreed to by the parties.
In consideration of the mutual promises, covenants and conditions contained herein, d,tid
far tithe. good and valuable consideration. the parties hereto agree as follows:
Terms and Condition.;
1. Ti:rm of Agreement
This Agreement is effective November 1, 1992 and shall be continuous and renewing
on an annual basis unless otherwise terminated as stated in Srraon 6.
2. Cnnsideration
a. Associated's ser.'ice fee for the period November I, 1992 through October 31,
1993 shall be $4,916.25 per month for up to 12.5 new claim submissions; over 125
claims at $400 per claim; no additional fee for on-going open claim inventory.
Pate 1 of 7
b. The charge for field and investigative services and outside services such as
mandatory conference, hearing or trial attendance is $65.00 per hour, plus
expenses.
c. It is recognized that the service fee as negotiated each year represents the expense
of administering and adjusting workers' compensation claims submitted during the
current contract period, and the fee does not cover the expense involved in
processing claims to their ultimate conclusion upon termination of the Agreement.
d. In the event that legislative changes are made to the Labor Code and/or Self -
Insurance Plans requirements which materially effect caseloads and/or change
servicing requirements, t.ssociated and Client agree to negotiate a reasonable
revision in the fee structure and account staffing levels.
e. The service fee is payable by Client upon the receipt of Associated's invoice, due
and payable by the fifth (5th) day of the month of service.
f. ACMI hzs developed a comprehensive managed care/medical cost-containment
program designed to significantly reduce the cost of occupational injuries and
illnesses by (1) negotiating reduced medical provider fees with designated
participating medical providers ("PPO") for medical services rendered at amounts
less than their usual and customary charges or the Official Medical Fees for
Covered Medical Services rendered, (2) inpatient utilization management, and (3)
reviewing medical Billings against the Official Medical Fee schedule.
Client desires to take advantage of the ACMI Managed Care Program in the
State of California.
Client agrees to pay an amount equal to 15% of the savings generated by the
Bill Review System and 30% of the savings for PPO reductions. Savings shall
equal the sum of reductions to the official Medical Fee Schedule and contract
reductions, if any, for all billings.
If client directs ACMI not to review billings of certain Providers, client shall
provide a list of the said Providers in advance.
Utilization Management Services shall he provided as agreed by Client and ACMI
at $35 - 50 per hour, in accordance with the specific assignment.
Page 2 of 7
3. Resnonsibilities of Associated
a. Claims Administration
(1) Associated agrees to provide claims service for Client's Workers' Compensation
exposure in the State of California as required by the regulatory bodies of said
State and at a level ace;.ptable to Client.
b. Management Information System
(1) Associated agrees to maintain claims and cost data as well as estimates of
future claims liability on an individual claim basis.
(2) Associated will provide management information services to Client as agreed
upon by the parties, in accordance with Schedule A of this Agreement.
(3) Associated retains sole right of ownership to its programs. However, the
Client has a right to the data. In the event of a cancellation of Associated's
service, the Client is entitled to a complete history file (tape) of all claims,
as well as a record layout describing the format of the tape.
4. Responsibilities of Client
a. Client shall report to Associated all Workers' Compensation claims in a timely
manner and shall cooperate with Associated in all aspects of investigation,
communication, the providing of recorded material and any other areas pertinent
tc Associated being able to provide the agreed service to Client. Associated shall
not be responsible, nor be deemed liable for damages, real or otherwise, resulting
from Associated's lack of knowledge of information in the possession of Client,
but withheld from Associated.
5. Claim Payment Fund
a. The parties agree Associated will pay claims expenses from a checking account
established by Client and funded by Client. The checking account will be
maintained by Client at an amount sufficient to cover at least 60 days of the
Workers' Compensation claim expense. Associated agrees to make records
pertinent to the client's account available to Client for audit purposes at all
reasonable times with at least 24 hours notice.
b. Claims expenses are defined as medical expense, temporary or permanent
disability, allocated claims expense, rehabilitation expense, and all other Workers'
Compensation benefits payable to the injured employees or dependents of Client.
Page 3 of 7
c. Allocated claims expense includes such costs as legal fees, court costs, court
reporters, expert witnesses, fees to undercover operatives, depositions, and certain
special investigations as may be required.
6. Termination
a. After the first 10 months, this Agreement may be terminated by either party by
providing to the other written notice sixty (60) days in advance. In the event of
termination, Associated will be obligated to make available all summary data,
records and information developed with respect to Client's business including all
loss records to Client or its designated agent on the date established by Client.
It is recognized that Associated will provide the records in goo•; . ondition and will
cooperate in the transition on behalf of Client.
b. In the event termination should occur prior to calendar year-end (12/31),
Associated will provide Client a IRS Form 1099 hard copy report of all vendor
payments made as of termination date; but Associated will not assume
responsibility for year-end IRS reporting (including tape production) and vendor
notifications for that calendar year.
c. After the termination date of this Agreement, Client may, at its option, designate
Associated to continue to manage all claim files with injury dates prior to the
termination date of this Agreement, for a fee of 17.5% of paid claims, or on a
time and charges basis at a rate agreed to by the parties.
d. Any notice required by this Agreement of the parties hereto shall be sent by first
class mail, postage prepaid to the parties' addresses first set forth below.
7. Compliance with Applicable Law
a. Associated and Client hereto acknowledge the various penalties and administrative
fines that are contained in the California Workers' Compensation Reform Act of
1989 (effective as of January 1, 1990 and January 1, 1991) that may be imposed
on both employers and claim administrators. Penalties arising from the failure of
Client to provide timely notice of claim or such other Client obligations shall be
and remain the sole responsibility of Client and the Client hereby agrees to
indemnify, defend and hold Associated harmless for all claims arising from the
imposition of such penalties
Associated shall have no responsibility or liability whatsoever to defend, pay or
otherwise be responsible for, any administrative claim, fine or penalty imposed
at any time after commencement of the effective term of this Agreement, if such
administrative claim, fine. or penalty (regardless of when assessed) arises from the
facts, errors or omissions of the claim administrator or any other party acting on
behalf of Client prior to Associated becoming Client's claims administrator unless
Page 4 of 7
Associated shall have acknowledged the existence of such administrative claim,
fine or penalty in writing and agree to assume liability therefore.
Client shall defend, indemnify and hold Associated harmless from any and all
such undiscovered penalties that may have accrued prior to Associated's becoming
responsible for the administration of Client's Workers' Compensation self-
insurance program. Administrative penalties arising Solely from the failure of
Associated to comply in a timely and proper manner with its duties as a claim
administrator shall be and remain the sole responsibility of Associated; provided
however, effective upon the cancellation, discharge or termination of this
Agreement for any reason whatsoever, Associated shall no longer be liable or
otherwise responsible for payment or reimbursement of any administrative fine,
claim or penalty arising from facts occurring during the term of this Agreement
(including facts involving administrative procedures conducted by Associated), but
not assessed until after termination of this Agreement, unless Associated is
notified of the scheduled audit within 48 hours of commencement of the audit and
is allowed to participate in the daily audit process, having access to all files in
questions, and is allowed to participate in the exit interview process to include
negotiation and/or defense of any alleged administrative fines or penalties, and
otherwise Client shall defend, indemnify and held Associated harmless from any
and all such fines, claims or penalties.
b. The parties acknowledge that the California Workers' Compensation Reform Act
of 1989 requires first payment of Temporary Disability Indemnity within 14 days
of the Client's knowledge of the injury and generally imposes an automntic penalty
of 10% of the amount delayed for late indemnity payments which shall be payable
directly to the injured employee without application. Furthermore, the parties
agree that, unless Associated is provided with written notice of the claim in the
form of the completed Employer's Report of Occupational Illness or Injury, Form
5020, within 7 days of the Client's knowledge of the injury, the above -referenced
automatic penalty of 10% shall be and remain the sole responsibility of the Client.
c. Additionally, ACMI shall not be responsible for such penalties and/or
administrative fines in the event client requires open indemnity caseloads in
excess of the State of California, Self -Insurance Plans Office's recommendation.
8. General Condition
a. Associated shall assume legal liability to indemnify, hold free and harmless and
defend Client, its agents, servants, employees, officers and directors against any
and all loss, damage, fines, liability, costs and expenses (including, but not limited
to, attorney fees, court costs and reasonable investigative and delivery costs) and
other such sums which Client, its agents, servants, employees, officers and/or
directors may reasonably pay or become obligated to pay on account of the acts
of negligence of Associated, its agents or employees, officers or directors. Client
Page 5 of 7
agrees to notify Associated promptly in writing in the event such claim, demand,
assertion of liability or action is brought to Client's attention.
b. Associated agrees to perform the services of adjustment of the Workers'
Compensation claims an,at all times, control the disposition of such claims
including those in litigation subject to the direction of the Client. The services
to be rendered are to be within the standards acceptable in the field of Workers'
Compensation including Longshore and Harbor Workers' plans.
In the event Client directs Associated to follow a specific request of Client in
the handling of any claim adjustment, Client agrees to hold Associated hartnt"ss
for any loss, cost, or expense should a claim or lawsuit thereafter be filed involving
Associated. This Agreement is not intended to hold Associated harmless for any
independent negligence of Associated in any matter arising from this Agreement.
c. Client shall not be liable to Associated for personal injury of Associated
employees or property damage sustained by Associated in the performance of
the services specified in this Agreement.
d. Because of the comprehensive data Associated provides to Client and the timely
manner in which it is provided, Client has sufficient information to provide to
other parties that Client may have legal, contractual or other obligations for said
reporting, and it is deemed Client's responsibility to perform such reporting.
Un11:—., otherwise stated, Client is responsible to report any claim or event within
the reporting criteria to Client's appropriate insurance broker, insurance carrier,
or to any other interested party.
e. The parties each agree and acknowledge that their respective employees, officers,
and directors are valuable elements of their respective organizations and that
therefore it would be of substantial detriment to the welfare of each such
organization if either party solicited, enticed or otherwise initiated discussions
leading to the employment of the other party's employees, officers or directors.
Accordingly, during the effective term hereof and for a period of eighteen (18)
months after expiration of this Agreement, each party agrees not to directly or
indirectly engage in any solicitation, invitation or discussion with any employee,
officer or director of the other with a view toward engagement of such individual
as an employee, consultant, representative, officer or director.
f. Any controversy arising out of, or relating to this Agreement or any document
or other agreement referenced in this Agreement, or any modification or extension
hereof or thereof, including any claim for damages or rescission, shall be settled
by arbitration before three (3) neutral arbitrators in accordance with the rules
then obtaining of the American Arbitration Association. Any such arbitration
shall be conducted and determined in Contra Costa County, California. The
decision of the arbitrators shall b:. binding on the parties. The award rendered
by the arbitrators shall be final and judgment, subject to any right of appeal
permitted by law, may be e;'tered upon it in any court having jurisdiction thereof.
Page 6 of
g.
The prevailing party shall be entitled as part of the award, to all reasonable fees
and expenses incurred in connection with the arbitration, including the fees and
expenses of the arbitrators, and including reasonable attorneys' fees.
While performing the specified services, Associated is an independent contractor
and not an agent or employee of Client.
h. Changes and modifications to this Agreement may be made by the mutual written
consent of the parties.
Accepted By:
Citv of Lodi
Authorized Signature
Thomas A. Peterson
Name (Type or Print)
City Managpr
Title
221 W. Ping. SF,-
Street
trStreet
Lodi. CA 95240
City, State, Zip
February 3. 1993
Date
Attest
t
hpPl (NOG 80 .o lui h it
Date: Z - 5-1-5
e:br.1,:; at
City ,inorney
Accepted By:
Associated Claims Management, Inc.
of California
Authorized Signature
Roberta Penarelli
Name (Type or Print)
Executive Vice President
Title
390 North Wieet Lane
Street
Walnut Creek. CA Q4598
City, State, Zip
January 28. 1993
Date
l'�l_; 7 of 7
-N
SCHEDULE A
to
WORKERS' COMPENSATION SERVICE AGREEMENT
between
CITY OF LODI
and
ASSOCIATED CLAIMS MANAGEMENT. INC. OF CALIFORNIA
ACMI Standard Management Information Services Package includes:
RISK AND FINANCIAL MANAGEMENT REPORTS
- Policy Period Analysis monthly or quarterly
- Management Summary Report - monthly or quarterly
- Claim Inquiry Summary - monthly or quarterly
- Check Register - weekly or monthly
- Payment Analysis - semi-annually or annually
- IRS Form 1099 - annually
CLAIM MANA CEMENT REPORTS
- Cost Analysis Report - monthly, quarterly, semi-annually or annually
- Claims Listings - monthly or quarterly
- Stratification Listing - quarterly
- Social Security, Employee 'Multiple Claim List - quarterly, semi-annually, annually
- Self -Insurer's Annual Report (if self-insured) - annually
LASS PREVENTION REPORT$
- OSHA iogs - monthly
- Histograms - annually