AR 071806 Tristar Risk Management

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EXHIBIT "A" SCOPE OF SERVICES The services provided by the Consultant will meet all Federal, State and local requirements as well as the requirements of the business needs of the City. Assignment to outside providep including medical exams, investigators, vocational rehabilitation services, and defense coutisel are to be controlled by the claims staff with approval from the City to assure delivery of a quality r regulations oriented product by individuals knowledgeable of claims admmistratiart„ Litigated claims will be closely coordinated with the City with emphasis on commutticaflon with: applicants and defense attorneys to resolve issues and avoid unnecessary appearances, 1. General- The Consultant will: eat claims staff assigned to this account mill attend local and state-wide vstty meetings and coursi es, in CarJcr' to stay abreast with procedural applying changes in case law to active files, and delivering a state -of - 1.1 Ensure that its workers' compensation changes in handling cla the -art service. 1.2 Provide effective, courteous and cost efficient claims handling. 1.3 Be able to report new claims and review case files via remote access. 1.4 Prepare the Public Entities Self -Insurer's Annual Report as required by the Department of Industrial Relations, Self -Insurance Plans; to be submitted to the City no later than 30 days prior to the due date. 1.5 Provide all printed workers' compensation forms which the City may require, printed checks for checking account, and stamped window envelopes for mailing of all workers' compensation checks and correspondences. 1.6 Provide a monthly summary of the workers' compensation checking account, listing all checks, vouchers, voided checks, in numerical sequence; stating date issued, claim number, claimant name, payee, amount, type of benefit paid, and benefit period. 1.7 Provide two copies of a monthly computer -produced claims report and management summary no later than the tenth day of the following month. 1.8 Provide a quarterly summary (loss analysis) of all pending claims; report of all claims by fiscal year; current month new claims, closed claims; all claims by date of injury by fiscal year, all claims by payment type; all active claims, alpha order; all claims with payment in current month with payment detail n alpha order; all litigated claims referenced by defense firm. Formats other than described above will be considered in negotiation on the contract. 1.9 Establish and administer a Medical Provider Network. RvvuewGs\529334 A -I (BBK revised July 2, 2001)