164-22 Exhibits to Agreement for Workers Compensation Third Party Administration - 2022.pdf

Exhibit “A”

Request for Proposals WORKERS COMP THIRD PARTY ADMINISTRATION- REBID RFP Submission Date: April 26, 2022 10:00 AM. Prevailing Time Township of West Orange *66 Main Street* West Orange, NJ 07052 973-325-4056

REQUEST FOR PROPOSALS The Township of West Orange is soliciting proposals through the competitive contracting process in accordance with N.J.S.A. 40A;:11-4.1 et seq., for the following services: WORKERS COMP THIRD PARTY ADMINISTRATION-RE BID The proposal package can be obtained in person at the Township of West Orange, 66 Main Street, Purchasing Room 111, West Orange, NJ 07052, during regular business hours, 8:30 AM to 4:30 PM Monday ~ Friday or by emailing a request to preynolds@westorange.org. Proposals, clearly marked with the title and name and address of party making same, addressed to the Township Council of the Township of West Orange can be mailed, or hand delivered to the Municipal Building, Room 111, 66 Main Street, West Orange, NJ 07052. Proposal due date is Tuesday, April 26, 2022 at £0:00am and will be publicly opened and read at that time in the West Orange Council Chambers located at 66 Main Street, West Orange, NJ 07052 on the same day. No proposals received after that time will be considered. Bidders are required to comply with the Contract Compliance and Equal Employment Opportunities in Public Contracts N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 and have a current New Jersey Business Registration Certificate P.L. 2004, N.IS.A. 52:25-24,2. Paula Reynolds, R.P.P.S, QPA

TOWNSHIP OF WEST ORANGE WORKERS COMP 38” PARTY ADMINISTRATION It is the intent of this Request for Proposal to obtain from interested and qualified insurance consulting firms a proposal to provide services to assist the Township in Workers Compensation 3" Party Administration. 1, SCOPE OF SERVICES Proposals must be made on the basis that it either meets or exceeds the requirements contained herein. All bidders must be capable of performing the services listed: a. Supervise the Township’s obligation to employees who sustain bodily or neurological injury and/or occupational diseases in the Township’s service or employ. Maintain accurate records of all details incident to all Workers’ Compensation cases filed against the Township. Compile and file all notices and reports required under the Workers’ Compensation Law. Provide care and medical supervision, administration and disposition of Workers’ Compensation cases filed by employees against the Township. Provide the Township with a monthly report on all Workers’ Compensation cases, Timely, complete and accurate management of bill repricing, network negotiation, nurse case management and medical review services typically associated with managed care services. Maintain multiple PPO Network agreements to maximize bill penetration and cost savings for the Town. 2. PROPOSAL REQUIREMENTS The Firm shall provide a lump sum cost. Each proposed lump sum cost shall include all fees for Claim Administration and Managed Care. These services will be provided for a period of one year from January 1, 2022 through December 31, 2022. Proposals will be evaluated by the Township on the basis of the most advantageous proposal, price and other factors considered.

Submission: Each proposal must contain: Name, qualifications and experience of principal who will oversee the relationship, Name and qualifications of any other individual who may assist the principal in #1 above. Fee schedule, Statement of Availability to perform work outlined in the Scope of Services. Copy of Business Registration Certificate. Copies of other required disclosure information. AYEYN ES 3. SELECTION CRITERIA The Mayor and Council reserve the right to reject any or all proposals. Selection will be based on the following criteria, in order of rank: Qualifications of the primary principal and support staff. General experience-of the firm. Experience with communities the size and complexity of West Orange. Familiarity with West Orange, Essex County and the State of New Jersey. Fee. vee No 4. HISTORICAL DATA Attached hereto as Attachment “A” are partially redacted reports representing historical data from 2016 through 2021 for Managed Care Payments, Provider Payments and Bill Review Fees. The Claimants names have been removed. Please note that the “check date” provided in the “Provider Payment” Schedule is within sixty (60) days of the processing date by the Third-Party Administrator or its medical bill repricing service and each payment represents a single bill processed and paid. Summary of Number paid: 2016 — 132 2017 — 259 2018 ~- 337 2019 - 572 2020 — 579 2021-318 Total — 2,197 Total 5 years only (2017 — 2021) - 2,065 ne

ADMINISTRATOR ONLY. THIS SOLICITATION IS FOR WORKERS COMPENSATION THIRD PARTY ALL RESPONSES MUST MEET THE ABOVE REQUIREMENTS AND THE REQUIREMENTS CONTAINED IN THE TOWNSHIP’S STANDARDIZED SUBMISSION REQUIREMENTS FOR PROFESSIONAL SERVICES. GENERAL INSTRUCTIONS AND MANDITORY FORMS . The Township of West Orange reserves the right to reject any or all bids, or to waive any informalities in the bids, and unless otherwise specified by the bidder, to accept any item in the bid, should it be deemed in the best interest of the Township of West Orange to do so. In case of default by the bidder or contractor, the Township of West Orange may procure the articles or services from other sources and hold the bidder or contractor responsible for any excess cost occasioned thereby. . The bidder, if awarded a contract, agrees to protect, defend and save harmless the Township of West Orange against any damage for payment for the use of any patented material process, article or devise that may enter into manufacture, construction, or form a part of the work covered by either order or contract, and the bidder further agrees to indemnify and save harmless the Township of West Orange from suits or actions of every nature and description brought against it, for, or on account of any injuries or damages received or sustained by any party or parties by, or from any of the acts of the contractor, his servants or agents. The contractor shall maintain sufficient insurance to protect against all claims under Workers Compensation, General Liability and Automobile and shall be subject to approval for adequacy of protection and certificates of such insurance shall be provided to the Township of West Orange when required. . It is to be understood by the bidder that this bid is submitted on the basis of specifications prepared by the Township of West Orange and the fact that any bidder is not familiar with these specifications or conditions will not be accepted as an excuse. Each bid must be signed in ink by the person authorized to do so. Bidders must use the proposal form furnished by the Township of West Orange when submitting their bid, if applicable. Non-Collusion Affidavit must be completed and included with bid. Insert prices for furnishing all of the material and/or labor described or required. Prices shall be net, including any charges for packing, crating,

ffidavit must be completed and included with bid. Insert prices for furnishing all of the material and/or labor described or required. Prices shall be net, including any charges for packing, crating, containets, etc. and all transportation charges fully prepaid by the contractor. F.O.B. destination and placement at locations specified by the Township of West Orange. No additional charges will be allowed for any transportation costs resulting from partial shipments made at the vendor’s convenience when a single shipment is ordered. a

10. 12. 13. 14. 15. 17. 18, 19. Payments will be made upon the approval of vouchers with the requirements of the Township of West Orange and subject to the Township of West Oranges customary procedures. . Contract will be awarded on a (Line Item) or (Lump Sum) basis, if applicable. Award will be made by Township of West Orange within sixty (60) days after receipt of bids. Prevailing Wage & Labor Laws. The New Jersey prevailing Wage Act (P.D. 1963, Chapter 150) and provisions of the State Labor Laws shall be compiled with by the successful bidder in construction contracts. The Township of West Orange is exempt from any State sales tax or Federal excise tax. The contract, if applicable, shall be in effect for one (1) year from date of award unless otherwise stated. Continuation of the terms of this contract beyond December 31 is contingent on availability of funds in the following year’s Budget and in the event of unavailability of such funds; the Township of West Orange reserves the right to cancel this contract. Bids may be hand delivered or mailed per legal notice to bidders. In case of mailed bids, the ‘Township of West Orange assumes no responsibility for bids after the designated date and time and will return late bids to the bidder unopened. . Mandatory: Bidder shall provide copy of their Business Registration Cettificate. In addition, Contractors providing services for regarding construction or repair of a public building must provide copy of Public Works Contractor Registration Certificate. No interpretation of the meaning of the specifications will be made to any bidder orally. Every request for such interpretations should be in writing to the Purchasing Agent and to be given consideration must be received at least five (5) days prior to the date fixed of the opening bids. Any and all such interpretations and any supplemental instruction will be mailed to all prospective bidders (at the respective addresses furnished for such purpose) not: later than three (3) days prior to the date fixed for the opening of bids. Failure of any bidder to receive any such addenda or interpretations shall not relieve any bidder from any obligation under his bid submitted. All addenda so issued shall become part of the contract document. Mandatory: Bidder shall submit Disclosure of Ownership Form stating the names and addresses of all stockholders in

his bid submitted. All addenda so issued shall become part of the contract document. Mandatory: Bidder shall submit Disclosure of Ownership Form stating the names and addresses of all stockholders in the corporation or partners in the partnership, who own a 10% or more of its stock, or any class, or of all individual partners in the partnership who own a 10% or greater interest therein, as the case may be. In case of default by the bidder or contractor, the Township of West Orange may procure the articles or services from other sources and hold the bidder or contractor responsible for any excess cost occasioned thereby.

20, Pay to Play Requirements Contractors are advised of the responsibility to file an annual disclosure statement on political contributions with the New Jersey Election Enforcement Commission, pursuant to N.J.S.A. 19:44-20.13(P.L. 2005, ¢, 271, s.3), if the contractor receives contracts in excess of $50,000 in the aggregate from public entities during the calendar year. It is the contractor’s responsibility to determine if filing is necessary. Additional information on this requirement is available from ELEC at 888-313-3532 or at www.clec.state.nj.us. In addition, pursuant to Section 2-68.1 of the Revised General Ordinances of the Township of West Orange respondents shall disclose all political contributions of two hundred dollars ($200) or more made within the preceding five (5) years to any elected officials of the Township of West Orange currently in office or any political organization affiliated with an elected official of the Township currently in office