Presentation on theme: "Self-Insured Workers’ Compensation Third Party Administration & Related Services PRE-PROPOSAL CONFERENCE: December 11, 2014 Civil Service Conference."— Presentation transcript:
1Self-Insured Workers’ Compensation Third Party Administration & Related Services PRE-PROPOSAL CONFERENCE: December 11, Civil Service Conference Room, 611 Walker, 4th Floor Annex, Houston, TX
2Agenda Introduction Kim Smith Demographics Helaine Rumaner Roles and Responsibilities John QuinleyRFP Review Shannon PleasantContract RequirementsEvaluation CommitteeSelection ProcessEstimated TimelineMWBE and Pay or Play Velma LawsProposal Tec Demo Jeff Spencer
3Demographics The City of Houston (26) twenty-six departments 22,000+ employees,5,300 classified Police employees3,800 classified Fire employees3,600 Public Works/Engineering employees
5WC Summary 1,821 workers’ compensation claims per year 473 involving compensable lost time1,200 claims open at any given time1,854 Pre-authorizations per year25,563 Bill Reviews per year4,274 Prescription submissions per yearTotal of $729, paid prescriptions per year252 Peer Reviews per year175 Required Medical Evaluations per year
6Roles , Responsibilities and Requirements John QuinleySenior Vice President,Marsh Risk Consulting(314)Consultants Role and Responsibilities
7Contract Requirements Listed below are some of the requirements of this contract.Performance Based Contract with Standards, which must be metRequiring a Good Faith Effort the meet the 24% MWBE goalEstablished Monthly, quarterly and annual reporting requirementsMust work City hours and HolidaysAssume full financial responsibility for WC related administrative violationsAgree to measure program improvements and their outcomes
8Contract Requirements Have a full time dedicated on-site account managerAdjusters caseload of no more than one hundred ten (110) active (meaning TIBs have been paid or are being currently paid) Lost Time Claims.Provide a 24/ 7 claims intakeOffice located in Houston TexasAgree to be the official custodian of the workers’ compensation files during contract periods..At this time the City dose not wish to pursue a Network
9RFP Review Shannon Pleasant CTPM City of Houston Senior Procurement Specialist
10Evaluation CommitteeAn evaluation committee will develop a short list of Proposer(s) based upon the initial review of each Proposal received. The short listed Proposer(s) may be scheduled for a structured oral presentation, demonstration and/or interview At the end of the oral presentation, demonstration and/or interview, the evaluation of the short listed Proposer(s) will be completed. However, the evaluation committee reserves the right to visit locations, issue letter(s) of clarity when deemed necessary to any or all Proposer(s).
11Selection ProcessThe award of this contract(s) will be made to the respondent(s) offering the response which best meets the needs of the City. The City may make investigations, as it deems necessary, to determine the capabilities of the Proposer(s). The City reserves the right to reject any offer if the evidence submitted by or the investigation of the Proposer(s) fails to satisfy the City or the Proposer(s) is deemed unqualified to provide the services requested.
12Estimated Timeline December 1, 2014 Date of issue of the RFP Questions to be answered at pre-proposal conference dueDecember 8, 2014Pre-Proposal ConferenceDecember 11, 2014Proposals due from ProposersJanuary 29, 2015Oral presentations and site visitsMarch 2015Notification of intent to award (Estimated)April 2015Council Agenda Date (Tentative)May 2015Contract start date (Estimated)On or Before August 31, 2015
13MWBE Participation and Pay or Play Velma Laws MWBE Participation and the Pay or Play Program