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HomeMy WebLinkAboutContract 54879-A1CSC No. 54879-A1 FIRST AMENDMENT TO FORT WORTH CITY SECRETARY CONTRACT NO. 54879 This Amendment is made between the City of Fort Worth ("Fort Worth") and Sedgwick Claims Management Services, Inc. ("Vendor"). WHEREAS, Fort Worth and Vendor entered into an Agreement for Vendor to provide Workers' Compensation administration and related services (the "Agreement"); and WHEREAS, it is the collective desire of both Fort Worth and Vendor to amend the Agreement to incorporate spending authority for additional services not covered under the annual flat fee, in particular fees related to RMIS access. NOW THEREFORE, Fort Worth and Vendor, acting herein by and through their duly authorized representatives, agree to the following terms, which amend the Agreement as follows: 1. The first page of Exhibit B of the Agreement, Service Fee, is hereby deleted in its entirety and replaced with the attached, revised first page. 2. All other terms, provisions, conditions, covenants and recitals of the Agreement not expressly amended herein shall remain in full force and effect. [Signature Page Follows] OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX 35853 Amendment 1 to Fort Worth City Secretary Contract No. 54879 Pagel of 3 Executed effective as of the date signed by the Assistant City Manager below. 10[s) 4lUx"Ll) 71_Y_ IF City of Fort Worth By: Name: Jesica McEachern Title: Assistant City Manager Date: Dec 2, 2024 Approval Recommended: By: 9'—/"'w Name: Joanne Hinton Title: Interim HRAsst Dir Attest: By: Name: Jannette Goodall Title: City Secretary VENDOR: 0494�Ub 4 T d �o9dd �o Pvo o=°o Caa*00000000 0 *� aII� nEXA?a4a Sedgwick Claims Management Services, Inc. By: �� Name:JEdward Peel Title: Vice President Contract Compliance Manager: By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. By:�. Name: Danielle Caster Title: FIR - Manager- Workers' Compensation Approved as to Form and Legality: uJ- By: Name: Jessika J. Williams Title: Assistant City Attorney Contract Authorization: M& C : 20-0648 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX 35853 Amendment 1 to Fort Worth City Secretary Contract No. 54879 Page 2 of 3 EXHIBIT B SERVICE FEES Client shall pay the following fees on a life of contract basis for services provided during the term of this Agreement: Annual flat fee Client shall pay the following fees for claims received by Sedgwick during the period beginning November 1, 2020 and ending October 31, 2021: $725,967. This fee is based on the estimated claim volumes and the dedicated staff to service those claims. Our proposed staffing model will continue to provide the City with exceptional claims services deliver results that reduce the City's overall cost of risk. Under this option, Sedgwick reserves the right to modify the annual flat fee if acquisitions, divestitures, changes in program requirements, or an increase in claim volume that impacts the staffing requirements of the unit. Since Sedgwick is presenting a dedicated staff our pricing model is fixed annual as stated above and we are not presenting variable option at a fee per claim. Claims open at contract termination will either be transferred to the new administrator or handled by Sedgwick for an additional annual fee. RMIS The following items are included at no charge in the RMIS line item in the table above. RMIS access: viaOne for six users, which provides a platform -independent, web -based tool for viewing and analyzing claims data. Access provides secure, near real-time information from Sedgwick's proprietary claims information systems RMIS data outgoing feed: Monthly data file to a single source o RMIS data outgoing feed: Monthly feed to Integer Health for claims and bill review files. o RMIS data incoming feed biweekly feed from the city's payroll. Items included in the quoted fees include: Customer service intake (call center or web reporting only) Semi-annual telephonic claim reviews with electronic status reports In addition to the annual flat fee, City may purchase additional services in an annual amount up to Fifty Thousand Dollars ($50,000.00). Services available for an additional fee include: Subrogation services will be charged 20% of recoveries when referred to a specialist (with client approval) o RMIS access: Additional viaOne user access is $933 per user per year. o RMIS data feeds: Additional interface files are $249 per month for monthly file, $605 per month for weekly file or $1,895 per month for daily file 35853 Amendment 1 to Fort Worth City Secretary Contract No. 54879 Page 3 of 3 11 /21 /24, 10:39 AM M&C Review ACITY COUNCIL AGEND Create New From This M&C DATE: 9/15/2020 REFERENCE **M&C 20- NO.: 0648 LOG NAME CODE: P TYPE: CONSENT PUBLIC HEARING: Official site of the City of Fort Worth, Texas FoRTWoRn 13P 20-0148 WORKERS' COMPENSATION ADMINISTRATION HRD JPB IN SUBJECT: (ALL) Authorize Execution of an Agreement with Sedgwick Claims Management Services, Inc. for Workers' Compensation Administration and Related Services for a Flat Fee Up to $725,967.00 for the First Year and about a 2.5% Increase in the Subsequent Years (Year 2 - $744,116.00, Year 3 - $762,719.00, Year 4 - $781,878.00, and Year 5 - $801,332.00), for a Five -Year Initial Term with Option to Renew Up to Two Additional One - Year Terms at the City's Sole Discretion RECOMMENDATION: It is recommended that the City Council authorize the execution of an agreement with Sedgwick Claims Management Services, Inc. for workers' compensation administration and related services for a flat fee up to $725,967.00 for the first year and about a 2.5\% increase in the subsequent years (year 2 - $744,116.00, year 3 - $762,719.00, year 4 - $781,878.00, and year 5 - $801,332.00), for a five-year initial term with option to renew up to two additional one-year terms at the City's sole discretion, and authorize claims and associated costs to be paid for estimated claims expenses in the initial one-year period up to $9,400,000.00 and an estimated 5 percent increase in future years (year 2 - $9,870,000.00, year 3 - $10,380,000.00, year 4 - $10,890,000.00, and year 5 - $11,430,000.00). DISCUSSION: The Human Resources Department (HRD) approached the Purchasing Division to secure an agreement for workers' compensation administration and related services. The services includes: (1) third party claims administration services for a self -funded workers' compensation program to include claims adjusting, claims investigations, claims payments, establishing reserves, and claims management reports; (2) medical case management to include field and telephonic case management and vocational case management; (3) medical cost containment to include field and telephonic case management, early intervention, medical bill auditing, preauthorization and reconsideration determinations, utilization review, and durable medical equipment management; (4) pharmacy benefits management to include developing and maintaining a drug formulary, contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, processing and paying prescription drug claims, and working with the City and the vendor to maintain or reduce pharmacy expenditures and improving health care outcomes of City employees; (5) 504 medical provider program — administration of the City's "BlackStone Provider Panel" to include provider credentialing, website maintenance, and maintenance of claimant and healthcare provider policies and procedures; (6) related services, such as Department of Workers' Compensation Austin Representatives, actuarial services, claims auditing, private investigations, legal representation at hearings; and (7) other such services. The York Risk Services Group, Inc. has been providing these services since November 1, 2015 under its previous Agreement (City Secretary Contract (CSC) No. 47186; Mayor and Council communication (M&C) C-27435) with the City. This agreement will expire on October 31, 2020. Staff issued a Request for Proposals (RFP) that consisted of detailed scope of services. The RFP was advertised in the Fort Worth Star -Telegram every Wednesday from May 13, 2020 through June 24, 2020. Seventeen vendors were solicited from the purchasing database; eleven responses were received. An evaluation team consisting of staff from the HRD, the Police Department, the Fire Department, the Law Department and the Diversity and Inclusions Department evaluated proposals received. The apps.cfwnet.org/council_packet/mc_review.asp? I D=28217&cou ncildate=9/15/2020 1 /3 11 /21 /24, 10:39 AM M&C Review evaluation team ranked the proposals based on pre -defined factors. Three finalists were selected for presentations. Following the presentations, the evaluation team determined Sedgwick Claims Management Services, Inc. provides the best overall services and recommended that the City Council authorize the execution of agreement for an initial five-year term with options to renew up to two additional one-year terms at the City's sole discretion. The flat fee for the initial one-year period is up to $725,967.00 and anticipated to trend at about a 2.5 percent increase in subsequent years (year 2 - $744,116.00, year 3 - $762,719.00, year 4 - $781,878.00, year 5 - $801,332.00, year 6 - $821,365.00, and year 7 - $841,899.00). In addition, claims and associated cost will be budgeted for in the respective fiscal years and paid. The estimated claims expenses for the initial one-year period is up to $9,400,000.00 and anticipated to trend at about a 5 percent increase in future years (year 2 - $9,870,000.00, year 3 - $10,380,000.00, year 4 - $10,890,000.00, year 5 - $11,430,000.00, year 6 - $12,000,000.00, and year 7 - $12,600,000.00). An administrative change order or increase may be made by the City Manager up to the amount allowed by relevant law and the Fort Worth City Code and does not require specific City Council approval as long as sufficient funds have been appropriated. Sedgwick Claims Management Services, Inc. is in compliance with the City's BDE Ordinance by committing to 10 percent MBE -AA (Minority Business Enterprises -African American) participation on this project. The City's goal on this project is 10 percent MBE -AA. Upon City Council approval, the five-year term of this contracts shall begin on November 1, 2020 and expire on October 31, 2025. The contract may be renewed for up to two successive one-year term at the City's option. This action does not require specific City Council approval, provided that the City has appropriated sufficient funds to satisfy the City's obligations during the renewal term. The contract will include a standard fiscal funding out clause that would comply with state law requirements by allowing the City to terminate the Agreement without penalty, if in the future, the Council elects not to appropriate funds for contracted services. FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that upon approval of the above recommendations funds are available upon adoption of the Fiscal Year 2021 Budget by the City Council, funds will be available in the Fiscal Year 2021 Operating Budget, as appropriated, in the Risk Financing Fund. Prior to an expenditure being incurred, the Human Resources Department has the responsibility to validate the availability of funds. BQN\\ TO Fund Department I Account Project ID ID FROM Fund Department Account Project ID ID Submitted for City Manager's Office by_ Originating Department Head: Additional Information Contact: Program Activity Budget Reference # I Amount Year (Chartfield 2) Program Activity Budget Reference # Amount Year (Chartfield 2) Jay Chapa (5804) Reginald Zeno (8517) Cynthia Garcia (8525) John Padinjaravila Baby (2279) ATTACHMENTS apps.cfwnet.org/council_packet/mc_review.asp?ID=28217&councildate=9/15/2020 2/3 11 /21 /24, 10:39 AM M&C Review 1295 sianed Sedwick.pdf (CFW Internal) 20-0148 Workers Comp FID.XLSX (CFW Internal) 200825 20-0148 Sedawick Comp Memo rev.pdf (CFW Internal) SAMs Report 8-21-2020 Sedwick.pdf (CFW Internal) apps.cfwnet.org/council_packet/mc_review.asp?ID=28217&councildate=9/15/2020 3/3