RFP 26-805 Workers' Compensation Claims Administration Services

City of Shreveport
REQUEST FOR PROPOSALS RFP 26-805
WORKERS' COMPENSATION CLAIMS ADMINISTRATION SERVICES
INDEX
Page
Numbers
Proposal Invitation 2
General Information - Part I 3-4
Introduction - Part II 5-6
Scope of Work - Part III 7-15
Evaluation Criteria - Part IV 16
Submission Requirements - Part V 17-19
NOTE: All items listed in Part V must be submitted with your proposal
Index of reference items not included herein that is incorporated by reference with the same force and effect as if set forth
in full text. Should any of these be in conflict with those listed herein, the more stringent will apply.
The General Contract Clauses (Section 20), the Standard Instructions/Conditions for Request for Proposals (Section 30)
will no longer be incorporated in solicitations but will be incorporated by reference in the City of Shreveport (hereinafter the
City) book of Standard Solicitation Instructions / Provisions and General Contract Clauses; which are available at
www.shreveportla.gov (click on Business, then on Bids & RFPs). If you do not have a computer, you can use one of the
public use computers that are available at the Shreve Memorial Library or at most library branches.
EXHIBITS
NARRATIVE ON THE APPROACH TO THE SCOPE OF WORK A-20
SCHEDULE OF EVENTS B-21
OFFERORS EXPERIENCE C-22
PERSONNEL STAFFING D-23
*COST PROPOSAL E-24-26
UNDERWRITER INFORMATION F-27
FORMAT FOR THE RETURN ENVELOPE G-28
*Required for all RFPs
APPENDIX
#1- FAIR SHARE FORMS (Forms 1-4 should be furnished with your proposal) 29-40
#2- ADJUDICATED OR LIEN PROPERTY AFFIDAVIT (do not furnish with your proposal) 41
#3- FELONY CONVICTION / E-VERIFY AFFIDAVIT (must be furnished with your proposal) 42
#4 - RESOLUTION OF BOARD OF DIRECTORS 43
#5- INSURANCE 44-48
The Felony Conviction/E-Verify (Appendix 3) must be submitted with your proposal. Revised 12-05-17
Page 1 of 48

CITY OF SHREVEPORT-PURCHASING DIVISION
P.O. BOX 31109 SHREVEPORT, LOUISIANA 71130-1109 Suite 610, 505 TRAVIS SHREVEPORT, LA 71101-3042
Phone 318/673-5450 web site: www.shreveportla.gov Fax 318/673-5408
April 29, 2026
RFP 26-805
MUST BE RECEIVED NOT LATER THAN 3:00 P.M. (CST) ON: June 4, 2026
PROPOSAL TITLE: WORKERS' COMPENSATION CLAIMS ADMINISTRATOR SERVICES
You are invited to submit proposals in accordance with the requirements of this solicitation which are contained herein.
In order for your proposal to be considered, it must be received in the Purchasing office not later than the date and time
as listed above. Solicitation documents are posted on BidNetDirect. To view the general RFP information and receive
notices by email, register with BidNetDirect. Registration is free. Solicitation documents are also available at
www.shreveportla.gov/Solicitations. BidNetDirect shall be the official source of solicitation documents.
It shall be the responder's responsibility to make inquiry as to the addenda issued. All inquiries pertaining to this RFP shall
reference RFP number as shown above. Paper proposals received by the Purchasing Office after the time specified will be
documented and then returned to the Offeror unopened. Due to the possibility of negotiation with all Offerors, the identity
of any Offeror or the contents of any proposal will not be public information until after the contract award is made. Paper
proposals and modifications received in response to this Request for Proposals shall be time stamped upon receipt and
secured in the Purchasing Division until the established due date. Attendance by the submitter on the established due date
is unnecessary, because submittals will be opened at a later time in the presence of a procurement employee or selection
committee member.
The proposals must be signed in ink by an official authorized to bind the Offeror, and it shall contain a statement to the
effect that the proposal is firm for a period of at least 120 days from the closing date for submission of proposals. Paper
proposals must be submitted using the envelope format as provided in this solicitation document in a sealed
opaque envelope/container showing the above proposal title, number, opening date, time of opening and
appropriate license number(s) on the outside of the envelope or if a sealed container is used, then all this
information shall be shown on the top of the container. The City does not accept faxed or emailed responses for
formal solicitations.
All submittals (see Part V, Submission Requirements) received in response to this Request for Proposals will be rated by
the City's Selection Committee, based upon the Evaluation Criteria as listed in Part IV. If the best Offeror is clearly identified
from the point summary, there will not be a need for oral presentations. If not, then an oral presentation from a minimum of
two (the highest rated) firms shall be required. This solicitation does not commit the City to award a contract, to pay any
costs incurred in the preparation of a proposal, or to procure or contract for the articles of goods or services. The City
reserves the right to accept or reject any or all proposals received as a result of this request, to waive informalities, to
negotiate with all qualified Offerors, or to cancel in part or in its entirety this proposal, if it is in the best interest of the City to
do so.
City of Shreveport
Renee Anderson, MBA, CPPO, CPPB, NIGP-CPP
Purchasing Agent
Important- If you consider the specifications as restrictive or have a problem with this document please contact the Purchasing Agent at least
five days before the proposal opening at (318) 673-5450.
Page 2 of 48

PART I
GENERAL INFORMATION
1.0 Proposals will be considered as specified herein or attached hereto under the terms and conditions of this
proposal.
2.0 Proposals must be made in the official name of the firm or individual under which business is conducted (showing
an official business address) and must be signed in ink by a person duly authorized to legally bind the person,
partnership, company, or corporation submitting the proposal.
3.0 Offerors are to include all applicable requested information and are encouraged to include any additional
information they wish to be considered.
4.0 It is up to you to make sure that all the information requested is returned to us by using the envelope format shown
in this package.
5.0 Each Proposer shall submit one (1) signed original response. Five (5) additional copies of the proposal.
5.1 Proposals should be sent to:
5.1.1 City of Shreveport
5.1.2 Office of The Purchasing Agent
5.1.3 Government Plaza-Suite 610
5.1.4 505 Travis Street
5.1.5 Shreveport, LA 71101-3042
6.0 QUESTIONS
6.1 Offerors requiring additional information may email or fax their questions so that they will be received at least five
(5) working days prior to proposal opening to:
6.2 Email angela.mcnicoll@shreveportla.gov or fax Angela McNicoll at 318-673-5408.
6.3 Answers to questions received that should change and/or clarify this solicitation will be provided in writing to all
Offerors via an amendment.
7.0 PROPOSAL WITHDRAWAL
7.1 Any proposal may be withdrawn until the date and time set above for the submission of the proposals. Any
proposal not so withdrawn shall constitute an irrevocable offer, to sell to the City the services set forth in these
specifications until one or more of these proposals have been awarded.
7.2 Withdrawals may be directed to the buyer, Angela McNicoll at angela.mcnicoll@shreveportla.gov.
8.0 EXPENDITURE
8.1 Estimated Expenditure: $250,000.
9.0 CONFIDENTIAL INFORMATION, TRADE SECRETS, AND PROPRIETARY INFORMATION
9.1 The designation of certain information as trade secrets and/or privileged or confidential proprietary information
shall only apply to the technical portion of the proposal. The financial proposal will not be considered
confidential under any circumstance. Any proposal copyrighted or marked as confidential or proprietary in its
entirety may be rejected without further consideration or recourse.
9.2 For the purposes of this procurement, the provisions of the Louisiana Public Records Act (La. R.S. 44.1 et. seq.)
shall be in effect. Pursuant to this Act, all proceedings, records, contracts, and other public documents relating to
this procurement shall be open to public inspection. Proposers are reminded that while trade secrets and other
proprietary information they submit in conjunction with this procurement may not be subject to public disclosure,
protections must be claimed by the Proposer at the time of submission of its Technical Proposal. Proposers
should refer to the Louisiana Public Records Act for further clarification.
9.3 The Proposer shall clearly designate the part of the proposal that contains a trade secret and/or privileged or
confidential proprietary information as "confidential" in order to claim protection, if any, from disclosure. The
Proposer shall mark the cover sheet of the proposal with the following legend, specifying the specific section(s)
of the proposal sought to be restricted in accordance with the conditions of the legend:
9.4 "The data contained in pages _____ of the proposal have been submitted in confidence and contain trade secrets
and/or privileged or confidential information and such data shall only be disclosed for evaluation purposes,
Page 3 of 48

provided that if a contract is awarded to this Proposer as a result of or in connection with the submission of this
proposal, the City of Shreveport shall have the right to use or disclose the data therein to the extent provided in
the contract. This restriction does not limit the City of Shreveport's right to use or disclose data obtained from any
source, including the Proposer, without restrictions."
9.5 Further, to protect such data, each page containing such data shall be specifically identified and marked
"CONFIDENTIAL".
9.6 If the Proposer's response contains confidential information, the Proposer should also submit a redacted copy of
their proposal along with their original proposal. When submitting the redacted copy, the Proposer should clearly
mark the cover as such - "REDACTED COPY" - to avoid having this copy reviewed by an evaluation committee
member. The redacted copy should also state which sections or information has been removed. The proposer
should also submit one (1) electronic redacted copy of its proposal on a USB flash drive. The redacted copy of
the proposal will be the copy produced by the City if a competing proposer or other person seeks review or copies
of the Proposer's confidential data.
9.7 If the Proposer does not submit the redacted copy, it will be assumed that any claim to keep information
confidential is waived.
9.8 Proposers must be prepared to defend the reasons why the material should be held confidential. By submitting a
proposal with data, information, or material designated as containing trade secrets and/or privileged or
confidential proprietary information, or otherwise designated as "confidential", the Proposer agrees to indemnify
and defend (including attorney's fees) the City and hold the City harmless against all actions or court proceedings
that may ensue which seek to order the City to disclose the information.
9.9 The City reserves the right to make any proposal, including proprietary information contained therein, available
to other agencies or organizations for the sole purpose of assisting the City in its evaluation of the proposal. The
City shall require said individuals to protect the confidentiality of any specifically identified proprietary information
or privileged business information obtained as a result of their participation in these evaluations.
10.0 Additionally, any proposal that fails to follow this section and/or La. R.S. 44:3.2.(D)(1) shall have failed to
properly assert the designation of trade secrets and/or privileged or confidential proprietary information and the
information may be considered public records.
Page 4 of 48

Part II
INTRODUCTION
1.0 PROJECT BACKGROUND
1.1 The City of Shreveport is the third-most populous city in Louisiana with approximately 2,500 municipal
employees.
1.2 The City of Shreveport is self-insured for workers' compensation and liability coverage within our retention.
1.2.1 The City utilizes the services of a third-party claim administer to assist in the delivery of services for this program
and to ensure that it complies with all applicable state statues.
1.3 The City's Risk Manager oversees the self-insured workers' compensation/liability program and TPA.
2.0 INTENT
2.1 The City of Shreveport (hereinafter referred to as "City") is soliciting proposals for Workers' Compensation
Claims Administration Services and Complex Liability claims processing (hereinafter referred to as "TPA").
2.2 The City is seeking a quality claims service provider who is technically proficient, automated, flexible and
effective with competitive pricing.
3.0 MINIMUM QUALIFICATIONS
3.1 Offerors for Workers' Compensation Claims Administration/Liability Services must:
3.1.1 Be authorized as an administrator in the State of Louisiana with required adjuster licensing;
3.1.2 Demonstrate experience administering a Workers' Compensation/Liability program since 2019 for two
Louisiana public entity clients in Louisiana; and
3.1.3 Demonstrate experience administering a Workers' Compensation/Liability program since 2019 for one
Louisiana public entity client with more than 2,000 employees.
4.0 TERM OF CONTRACT
4.1 The term of any contract resulting from this solicitation shall be for three years from the date of award, unless
terminated or extended in accordance with the provisions listed herein. The City of Shreveport reserves the
right to renew any resultant contract(s), if mutually agreeable with the consultant, for two additional years in
one-year increments with price changes limited to Price Changes paragraph below, unless prices are requested
for a longer period in this RFP.
5.0 PRICE CHANGES
5.1 Prices will be firm for the contract term as specified in paragraph 2 above. After the term of the contract, the
TPA may request price increases that are limited to the increase in the TPA's actual documented cost of doing
business or the appropriate CPI or PPI, whichever is lower. Written requests for price increases must be sent
by Certified Mail-Return Receipt Requested. The City reserves the right to accept or reject the price increase
within fifteen days after receipt of the request. Should the City reject the price increase, the City reserves the
right to cancel the contract and award to the next best Offeror or to solicit new proposals. No increase will be
effective until approved in writing by the Purchasing Agent. Any decrease in the cost of the contract items shall
be forwarded to the Purchasing Office with immediate inception into the contract. Any decrease in pricing shall
not be less than the appropriate CPI or PPI.
6.0 AWARDS
6.1 An award resulting from this request shall be awarded to the responsive and responsible Offeror whose
proposal is determined to be most advantageous to the City, taking into consideration price and the evaluation
factors set forth in the RFP; however, the right is reserved to reject any and all proposals received, to waive
any informalities, and in all cases the City will be the sole judge as to whether an Offerors proposal has or has
not satisfactorily met the requirements of this RFP.
7.0 EVALUATION OF PROPOSALS FOR MULTIPLE AWARDS
7.1 In addition to other factors, proposals will be evaluated on the basis of advantages to the City that might result
from making more than one award (multiple awards). For the purpose of making this evaluation, administrative
costs to the City for issuing and administering each contract awarded under this invitation will
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Part II (cont.)
7.2 be considered, and individual awards will be for the items and combinations of items which result in the lowest
aggregate price to the City, including such administrative costs.
8.0 PURCHASE ORDER REQUIREMENT
8.1 The City of Shreveport shall not be responsible for invoices exceeding $5,000 that do not have a written
purchase order covering them.
9.0 PUBLIC ACCESS TO PROCUREMENT INFORMATION
9.1 Proposals will be available for public inspection at the time and date approved by the Purchasing Agent.
10.0 PAYMENTS DUE THE CITY
10.1 Section 26-211 of the City's Code of Ordinances requires the following:
10.1.1 On every contract to which the City is a party and for which written specifications are prepared, the specification
shall include the requirement that before the contract is awarded the contractor shall pay all taxes, licenses,
fees, and other charges which are outstanding and due to the City.
10.1.2 No contract to which the city is a party shall be awarded to any person who:
10.1.3 Has not paid all taxes, licenses, fees and other charges which are outstanding and due the city, or owns any
property which is adjudicated to the city, or which has demolition liens, grass cutting liens, or any other property
standards liens on it, or owns more than 25% of a legal entity that owns any property which is adjudicated
to the city, or which has demolition liens, grass cutting liens, or any other property standards liens on it.
10.1.4 For purposes of this section, Own shall mean to be the last record owner of property prior to a tax sale or
adjudication.
10.1.5 Bids/proposals will not be accepted from, or contract awarded to any person, firm, or corporations which have
at any time failed to execute a contract that has been awarded to them by the City, or which is in arrears to the
City upon debt or contract, or which is a defaulter as surety or otherwise upon any obligation to the City.
11.0 ASSIGNMENT
11.1 This contract shall not be assigned without the prior written consent of the city through its Mayor.
12.0 UNSATISFACTORY WORK
12.1 The City shall not be obligated to pay for unsatisfactory work.
13.0 COMPLIANCE WITH CIVIL RIGHTS LAWS
13.1 By submitting and signing this bid, bidder agrees to abide by the requirements of the following as applicable:
Title VI and VII of the Civil Rights Act of 1964, as amended by the Equal Opportunity Act of 1972, Federal
Executive Order 11246, Federal Rehabilitation Act of 1973, as amended, the Veterans Readjustment
Assistance Act of 1974, Title IX of The Education Amendments of 1972, the Age Act of 1975, and bidder agrees
to abide by the requirements of the Americans with Disabilities Act of 1990. Bidder agrees not to discriminate
in its employment practices and will render services under any contract entered into as a result of this solicitation
without regard to race, color, religion, sexual orientation, national origin, veteran status, political affiliation, or
disabilities. Any act of discrimination committed by the bidder, or failure to comply with these statutory
obligations when applicable, shall be grounds for termination of any contract entered into as a result of this
solicitation.
14.0 JOINT VENTURE
14.1 If the Proposer is a joint venture, provide the following information:
14.1.1 Date of formation
14.1.2 Name and address of each venture partner
14.1.3 Principals of each venture partner
14.1.4 Venture partner holding the majority interest in the venture and its percentage of interest
14.1.5 Proposer shall include a copy of the Joint Venture agreement as an attachment to proposal. Such attachment
shall not count in the page limit.
Page 6 of 48

PART III
SCOPE OF SERVICES
1.0 ADMINISTRATIVE REQUIREMENTS AND OPERATIONS
1.0.1 Location, Facilities, and Basic Operating Requirements
1.0.1.1 At all times during the term of the Contract, TPA must hold all required licenses, including but not limited
to the licensing required for a Third-Party Administrator (TPA) in the State of Louisiana per R.S. 22:1651
et seq.
1.0.1.1.1 The City may request proof of licensure for the Contractor and any staff members at any time during the
term of the Contract.
1.0.1.2 TPA shall have an office located within Shreveport to service this Contract.
1.0.1.2.1 TPA may request, and the City may approve, an alternate location.
1.0.1.2.2 TPA should identify the key and support personnel that will be housed at this location.
1.0.1.2.3 TPA's facilities must be adequate to accommodate its staff who are not housed at this location to attend
meetings or work onsite temporarily as the need arises.
1.0.1.2.4 The cost of the office space shall be borne by the TPA.
1.0.1.3 TPA shall provide a toll-free telephone for claims reporting.
1.0.1.3.1 TPA shall provide a secure electronic method or methods for agencies and claimants to report incidents
and claims.
1.0.1.3.2 Claims may also be received by mail, fax, and email.
1.0.1.3.3 The TPA shall have procedures to handle all types of claims submittals.
1.0.1.3.4 Also, the TPA should provide continual and monitored telephone coverage, 24-hours-a-day, to include
weekends and holidays, for the purpose of receiving incident reports and messages. This may be
accomplished by voicemail, an answering service, or other alternative means.
1.0.1.4 Contractor will provide the City with an Annual Stewardship Report, outlining the business the TPA
conducted on behalf of the City and highlighting initiatives and projects started or completed in the most
recent fiscal year ending December 31.
1.0.1.4.1 Statistics compiled on a fiscal year basis include but are not limited to total number of:
1.0.1.4.1.1 open claims (including claim type),
1.0.1.4.1.2 closed claims (including claim type),
1.0.1.4.1.3 closing ratio
1.0.1.4.1.4 outstanding reserves on open claims
1.0.1.4.1.5 total payments made on both open and closed claims and
1.0.1.4.1.6 medical cost savings.
1.0.1.4.2 This report will be delivered within the last 60 days of each calendar year.
1.0.2 Staffing Requirements
1.0.2.1 For the term of the Contract, the TPA shall staff a full time, dedicated Account Manager who shall possess
the technical and functional skills and knowledge to direct all aspects of the Contract.
1.0.2.2 The Account Manager will have the primary responsibility for interacting with the City on all contract, policy
and procedure issues.
1.0.2.3 The Account Manager shall be responsible for contract management activities that will occur continuously
throughout the contract term that will include but are not limited to the following:
1.0.2.3.1 Manage day-to-day activities of the TPA personnel to meet all Contract service requirements;
1.0.2.3.2 Develop and maintain communication with City Risk Manager and City Attorney;
1.0.2.3.3 Resolve contract-related questions and service standards;
1.0.2.3.4 Resolve any issues concerning TPA performance;
1.0.2.3.5 Make decisions on behalf of the TPA and effect change that will be upheld by TPA's staff without incurring
delays;
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PART III (cont.)
1.0.2.3.6 Review key deliverables and other formal work products prepared by TPA's staff prior to submission to
the City;
1.0.2.3.7 Monitor turnaround times and accuracy rates;
1.0.2.3.8 Assist City Risk Management staff with IT and reporting needs, including data field research, trouble-
shooting, and creation of custom loss runs and other types of reports;
1.0.2.3.9 Assist in the production of data and electronic documents relating to public records requests, specialized
City report requests, and auditor requests.
1.0.2.3.10 Include all other duties as reasonably required to assure the successful completion of the TPA's
responsibilities.
1.0.2.4 TPA shall assign full-time adjusting staff members.
1.0.2.4.1 A dedicated lost time adjuster and supervisor is preferred.
1.0.2.4.2 TPA staff must possess the knowledge, skills, and abilities to successfully perform the assigned tasks.
1.0.2.4.3 Any TPA staff member whose work performance is continually substandard or who conduct themselves
in a consistently negligent manner as deemed inappropriate by the City shall be removed from the account
at the City's request.
1.0.2.5 Each claims adjuster assigned to the City shall be licensed under the laws of the State of Louisiana.
1.0.2.5.1 TPA shall furnish verification of the appropriate licensing for each adjuster handling City claims as
requested throughout the life of the contract.
1.0.2.6 TPA shall apply insurance industry standard caseloads/claim counts.
1.0.2.6.1 Additionally, please provide details regarding any adjuster case-load maximums which will be applied.
1.0.2.6.2 TPA's staffing model must be able to fully meet the expectations and timelines.
1.0.2.7 All medical case managers shall be registered nurses or nurse practitioners licensed in the state of
Louisiana.
1.0.2.8 All vocational rehabilitation counselors shall be licensed to perform services in the State of Louisiana.
1.0.2.8.1 Proof of licensure shall be provided at any time upon request.
1.0.3 Access to Claim Files
1.0.3.1 The offeror agrees that the City shall have real-time access to all claim files, including all:
1.0.3.1.1 adjuster notes,
1.0.3.1.2 supervisor notes,
1.0.3.1.3 field case management notes,
1.0.3.1.4 diary items,
1.0.3.1.5 payment records,
1.0.3.1.6 medical bills, and
1.0.3.1.7 expense bills
1.0.3.1.8 in an electronic manner with internet-based access available.
1.0.3.2 Proposals should detail how this access to claim files will be provided.
1.0.3.3 The proposal evaluation process may include review of the adequacy of proposed systems.
1.0.4 Ownership of Claim Files
1.0.4.1 The City shall have all rights, title, interest, and ownership to all loss statistics and claim files created as a
result of the services to be provided by the offeror.
1.0.4.1.1 Further, at the sole option of the City and upon ten (10) days written notice, the offeror shall return such
files to the City.
1.0.4.2 At the termination of the contract, at the sole expense of the offeror, the offeror shall provide the City with
computer tapes or other computer media containing all of the claim data.
1.0.4.2.1 Such data shall be made available in a format generally importable into a commonly recognized database
for claims administration services.
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PART III (cont.)
1.0.5 Public Records Requests and Records Management
1.0.5.1 TPA will assist the City in preparing responses to Public Records Requests (PRR) by:
1.0.5.1.1 Researching,
1.0.5.1.2 Providing responsive data and records, and/or
1.0.5.1.3 Providing requested reports to assist the City in identifying responsive data and records
1.0.5.1.4 Within the period designated by the City.
1.0.5.1.5 TPA shall provide the documents in the form required by the City.
1.0.5.2 TPA shall file the Annual Report of Worker's Compensation Costs (LWC-WC-1000) if they have the
capability.
1.0.5.2.1 If not the TPA shall provide an annual calendar year workers' compensation data report to assist the City
in the preparation of the Annual Report of Workers' Compensation Costs (LWC-WC-1000).
1.0.5.2.1.1 This report is due each year on March 30th.
1.0.5.3 TPA shall maintain City records in accordance with the City's records retention schedule.
1.0.5.4 The City shall have access to all of TPA's hard files and all computer files relating to the City's claims,
including drafts and working documents, at all times and without prior notice to Contractor.
1.0.5.4.1 Whenever possible, the City shall give TPA a reasonable time to produce the file or locate the electronic
data.
1.0.5.4.2 TPA shall also provide such documents, files, and information to the City's for purposes of compliance
with the service requirements of their contract with the City.
1.0.6 Training and Education
1.0.6.1 TPA shall provide training, online or in person, during the initial transition period under the Contract, and
on request thereafter, on its Internet Information System for:
1.0.6.1.1 The City's Risk Management staff,
1.0.6.1.2 Auditors,
1.0.6.1.3 Actuaries,
1.0.6.1.4 Attorneys, and
1.0.6.1.5 Other contractors who require access to the City's data in performing services on behalf of the City.
1.0.7 Financial Management Processes
1.0.7.1 TPA shall maintain financial policies and procedures including but not limited to:
1.0.7.1.1 Financial reporting,
1.0.7.1.2 Bank reconciliations,
1.0.7.1.3 Segregation of duties, and
1.0.7.1.4 Check processing.
1.0.7.2 TPA shall ensure that its internal operating procedures establish and maintain internal controls that will
ensure the integrity of financial information, prevent fraud, and safeguard City assets.
1.0.7.3 Notwithstanding any state law directing TPA's records retention, all financial records (including all paid
bills and invoices) shall be maintained in a secured environment and retained for the entire contract period.
1.0.7.3.1 Cancelled checks, check copies, or document images shall be securely stored, placed in numeric (check
number) order, and are deemed to be the property of the City.
1.0.7.3.2 All records, images, and documents shall be made available to the City.
1.0.7.3.3 Access to such records shall be within 24 hours upon request.
1.0.7.4 TPA shall be responsible for complying with 1099 regulations issued by the Internal Revenue Service
(IRS).
1.0.7.4.1 TPA shall be liable for any penalties assessed on 1099 processing as established by the IRS.
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PART III (cont.)
1.0.7.4.2 TPA shall research and resolve any errors identified by the IRS.
1.0.7.5 For payment of claims and authorized claim expenses, TPA shall provide a dedicated checking account
on behalf of the City, maintained under best banking fraud practices.
1.0.7.5.1 The City will fund the dedicated checking account.
1.0.7.6 Uncashed checks for claim payments shall be considered stale-dated after six (6) months.
1.0.7.6.1 Any unclaimed checks held in the City's Self-Insurance Fund which could be claimed by any claimant shall
not be presumed abandoned at any time.
1.0.7.6.2 TPA shall ensure the time researching of all stale-dated checks to determine if the payment is still owed.
1.0.7.6.3 If the payment is not owed, the check shall be voided.
1.0.7.6.4 If the payment is still owed, the check shall be voided and reissued.
1.0.7.7 Bank account reconciliations, the monthly bank statement for the dedicated checking account, and
documentation sufficient to substantiate all charges must be submitted to the City by the end of the
subsequent month.
1.0.8 Financial Reports and Audit Requirements
1.0.8.1 The City shall have full access to and the right to examine all financial records and documentation relating
to the program.
1.0.8.2 On or before December 1st of each year, TPA shall submit its annual SOC1, Type 2 report resulting from
an (Statement of Standards for Attestation Engagement) SSAE 18 review, either by internet link or in hard
copy.
1.0.8.2.1 The review shall be completed at TPA's expense and submitted to the City immediately upon completion.
1.0.8.3 The City requires the TPA's cooperation with any audits performed.
1.0.9 Claim Management System Requirements
1.0.9.1 Real time City access to claim files that includes all required software, at no additional cost. Access would
include but not limited to:
1.0.9.1.1 Claim status,
1.0.9.1.2 Payments,
1.0.9.1.3 Reserves,
1.0.9.1.4 Claim notes, and
1.0.9.1.5 Documentation;
1.0.9.2 Easy-to-navigate interface;
1.0.9.3 Ability to generate custom loss runs and other reports;
1.0.9.4 Dashboards and analytics for real-time insights into claim trends and performance;
1.0.9.5 Customizable data fields;
1.0.9.6 Efficient claim submission process with support for multiple channels (online forms, email, phone);
1.0.9.7 Streamlined processes for claim routing, approvals, and notifications;
1.0.9.8 Support data integration for various data formats;
1.0.9.9 Secure storage and retrieval of claim-related documents and images;
1.0.9.10 Adherence to industry regulations (e.g., HIPAA, GDPR);
1.0.9.11 Frequent updates to keep the system current with technological advancements and regulatory changes;
1.0.9.12 Robust security measures including encryption, access controls, and regular audits;
1.0.9.13 Detailed logs of all system activities for accountability and compliance;
1.0.9.14 Detailed tracking of claim-related payments and reserves;
1.0.9.15 Comprehensive training programs for the City users;
1.0.9.16 24/7 support for system issues and user queries;
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