Request for Proposal

Transcription

1 City of Raleigh Request for Proposal RFP # 274-HR WCTPA Third Party Administrator of Workers Compensation Claims Proposal Due Date: February 13, 2018 All inquiries concerning this RFP shall be made in writing to: Eddy Parham, Sr. Human Resources Manager Safety and Compliance. Human Resources Department City of Raleigh Eddy.Parham@raleighnc.gov;

2 Table of Contents 1 REQUEST FOR PROPOSALS INTRODUCTION CITY BACKGROUND REQUEST FOR PROPOSAL INSTRUCTIONS TO PROPOSERS IMPORTANT DATES & DEADLINES RFP QUESTIONS & CLARIFICATIONS RIGHTS TO SUBMITTED MATERIALS PROPOSALS FORMAT REQUIREMENTS CONTENT REQUIREMENTS SUBMITTAL REQUIREMENTS EVALUATION CRITERIA EVALUATION PROCESS FINAL SELECTION SCOPE OF SERVICES CLAIMS ADMINISTRATION LITIGATION MANAGEMENT FINANCIAL ACCOUNTING INFORMATION SYSTEM DATA & ACCESS REPORTING RECORDS RETENTION CONTRACT TERMS NON-DISCRIMINATION MINORITY OR WOMEN OWNED BUSINESSES ASSIGNMENT APPLICABLE LAW INSURANCE INDEMNITY INTELLECTUAL PROPERTY FORCE MAJEURE ADVERTISING CANCELLATION LAWS/SAFETY STANDARDS APPLICABILITY OF NORTH CAROLINA PUBLIC RECORDS LAW MISCELLANEOUS AUDIT E-VERIFY IRAN DIVESTMENT ACT CERTIFICATION APPENDIX A QUESTIONNAIRE APPENDIX B - COST PROPOSAL...23 Page 2 of 23

3 1 REQUEST FOR PROPOSALS 1.1 INTRODUCTION The City of Raleigh ( City ) is seeking proposals from qualified firms interested in serving as the City s Third-Party Administrator (TPA) for Workers Compensation claims. The TPA shall be responsible for providing all services required to supervise, manage, and administer the City of Raleigh s self-insured workers compensation program. Throughout this Request for Proposal ( RFP ) the terms Proposer and/or TPA refer to the qualified firms that submit proposals in response to this RFP. The anticipated contract period for these TPA services is three (3) years, with an option to extend the contract period for two additional one (1) year periods at the City s discretion. 1.2 CITY BACKGROUND The City of Raleigh, the Capital City of North Carolina, remains one of the fastest growing areas in the country. With an estimated population of more than 450,000 residents, the City currently employs approximately 4,000 full time employees and over 3,200 part-time, temporary and seasonal employees. The City s services include the following operating departments: Police, Fire, Parks & Recreation, Solid Waste, Public Utilities and Transportation. The City also has a Police Academy and a Fire Fighter Academy. The Human Resources Department s Safety and Compliance Division manages the City s Safety Program and works closely with the Third-Party Administrator in the management and administration of the City s selffunded workers compensation program. The City s Workers Compensation Program is self-funded at retentions levels of $1.1 million. The City contracts a third party medical provider to provide the initial medical treatment for work related injuries. The following information is a five year history of reported Workers Compensation claims by fiscal year, dated July 1, 2012, to June 30, Fiscal Year Loss Time Medical Only Total Paid Incurred FY $2.75M $3.1M FY $2.2M $2.4M FY $2.4M $2.6M FY $1.5M $2M FY $0.95M $1.8M 1.3 REQUEST FOR PROPOSAL This RFP shall be comprised of this RFP document, including all appendices and addenda released before the Contract is awarded. All appendices and addenda released for this RFP in advance of any Contract award are incorporated herein by reference. 1.4 INSTRUCTIONS TO PROPOSERS The North Carolina General Statutes, City of Raleigh Charter, and City of Raleigh Ordinances, in so far as they apply to purchasing and competitive bidding, are made a part hereof. Page 3 of 23

4 It shall be the Proposer s responsibility to read this RFP in its entirety, including these Instructions, the City s terms and conditions, all relevant attachments, and any other components made a part of this RFP. It shall be the Proposer s responsibility to comply with all requirements and specifications set forth herein. It shall be the Proposer s responsibility to obtain and comply with all Addenda and other changes that may be issued in connection with this RFP. The City reserves the right to reject any or all proposals. It further reserves the right to waive formalities and technicalities in so far as it is authorized to do so where it deems it advisable in protection of the best interest of the City. Oral communication with Evaluation Committee memebers and/or other city staff regarding this RFP is strictly prohibited, and may result in the rejection of the Proposer s submission. 1.5 IMPORTANT DATES & DEADLINES Date / Time Time RFP Posted January 22, :00 a.m. Last Date for Written Questions to City February 2, :00 p.m. City s Responses to Proposer s Questions posted by February 9, :00 p.m. Proposal Due Date February 13, :00 p.m. Finalists Selected February 27, :00 p.m. Finalist Presentations March 12 23, Proposal Selected March 30, :00 p.m. All times shown as Eastern Standard Time (EST). 1.6 RFP QUESTIONS & CLARIFICATIONS All questions related to this RFP shall be directed to Eddy Parham, Sr. Human Resources Manager-Safety & Compliance, via at the following address. Eddy.Parham@raleighnc.gov. Responses to questions will be posted on the City s official website and shall be considered addenda to this RFP. It is the Proposer's responsibility to assure that all addenda have been reviewed and, if need be, signed and returned. The City will not accept any questions and/or inquiries regarding this RFP, including any follow-up questions to responses previously provided by the City, after January 26, 2018, The issuance of a written response is the only official method by which interpretation, clarification, or additional information will be given by the City regarding this RFP. Only requests answered by formal written addenda will be binding on the City. 1.7 RIGHTS TO SUBMITTED MATERIALS All proposals, responses, inquiries, or correspondence relating to or referencing this RFP, and all reports, charts, and other documentation submitted by Proposers (other than materials submitted as and qualifying as trade secrets under North Carolina law) shall become the property of the City when received and the entire proposal shall be subject to the public records laws of the State of North Carolina except where a proper trade secrets exception has been made by the Proposer in accordance with the procedures allowed by North Carolina law. The City reserves the right to retain all proposals submitted and to use any ideas in a proposal regardless of whether that proposal is selected. Submission of a proposal indicates acceptance by the Proposer of the conditions contained in this Request for Proposal. Page 4 of 23

5 2 PROPOSALS 2.1 FORMAT REQUIREMENTS In order for a proposal to be considered by the City, the Proposal must follow the format described in this section. The City may reject as non-responsive at its sole discretion any proposal or any part thereof that is incomplete, inadequate in its response, or departs in any substantive way from the required format. All Proposals shall be 8 1/2" x 11" format with all text no smaller than 11-point font. All submissions should use one-sided copying and be bound with tab dividers corresponding to the content requirements specified below 2.2 CONTENT REQUIREMENTS Proposals shall include the following components and be organized as follows: A. Cover / Transmittal Letter B. Executive Summary C. Qualifications & Experience D. Questionnaire Responses E. Cost Proposal F. References. Instructions relative to each part of the response to this RFP are defined in the remainder of this section. Response information should be limited to pertinent information only. Marketing and sales type information is not to be included. A. Cover/Transmittal Letter: Proposal must include a Cover/Transmittal Letter on the organization s official letterhead signed by an authorized representative of the Proposer who has authority to enter into a contract with the City on behalf of the proposer, such as a President, Vice President, or other corporate officer. The cover/transmittal letter shall provide the name, address, telephone and facsimile numbers of the Service Provider along with the name, title, address, telephone and facsimile numbers of the authorized representative signing on behalf of the proposer. B. Executive Summary: The Proposal shall contain an executive summary, which outlines the proposal and includes, at minimum, the following: Comprehensive narrative statement that clearly illustrates an understanding of the service requirements requested by this RFP; General approach and management plan that Proposer will use to meet the services required under the Scope of Services section of this RFP; and The proposed staffing, deployment and organization of personnel to be assigned to be assigned to accomplish the work called for in this RFP. The Proposer shall include an organizational chart of personnel assigned to the project. C. Qualifications & Experience: Each proposal must provide sufficient information about Proposer so that the City can evaluate the Proposer s stability and ability to support the commitments set forth in response to the RFP. The Proposer shall provide information as to the qualifications and experience of all executive, managerial, legal, claims adjusters, and professional personnel to be assigned to this project, including resumes citing experience with similar projects and the responsibilities to be assigned to each person.the City, at its option, may require a Proposer to provide additional support or clarify requested information. Page 5 of 23

6 D Responses to Questionnaire: Each proposal shall include complete and thorough responses to the Questions set forth in Appendix A to this RFP. Failure to answer any question may result in your submission being deemed as unresponsive and rejected. E. Cost Proposal: Proposers must indicate their proposed pricing for each type of charge listed in the table set forth in Appendix B. Pricing should take into consideration any additional cost the TPA might incur including after-hours and holiday services. Pricing must be all-inclusive and cover every aspect of the Third-Party Administration Services. If there are additional costs associated with the Services not otherwise contemplated in the table in Appendix B, please add those additional costs to the existing table. Your Price Proposal must reflect all costs that the City will be responsible for. F. References. Provide a list all public entities you have contracted with in the past five (5) years for services similar to those requested in this RFP. The failure to list all similar contracts in the specified period may result in the rejection of the Proposer s proposal. The evaluators may check all public sources to determine whether Proposer has listed all contracts for similar work within the designated period. If the evaluators determine that references for other public contracts for similar contracts were not listed, the evaluators may contact the public entities to make inquiry into Proposer s performance of those contracts and the information obtained may be considered in evaluating Proposer s proposal. 2.3 SUBMITTAL REQUIREMENTS Proposals must be delivered and submitted to the City in accordance with this section. Proposals must be received (not just postmarked) by the City no later than 5:00 p.m. EST on the February 13, 2018 (the Due Date ). Proposals received after the Due Date will not be considered and will be returned unopened to the return address on the submission envelope. Proposals received via facsimile or will not be considered by the City. Proposer must submit five (5) hard copies and one (1) electronic copy of the proposal to the City. The electronic version of the Proposal must be in PDF format on either a CD or USB flashdrive attached to the original hard copy proposal. Proposals must be delivered to the City in a sealed envelope or package. The outside of the submittal package and USB Drive must be clearly marked with the applicable RFP number. Proposals may be delivered to the City by (a) hand-delivery, or (b) U.S. mail. (a) In-Person Delivery. If delivered in person, the proposal shall be delivered to the following address: RFP No. 274-HR WCTPA c/o Eddy Parham City of Raleigh 310 W. Martin St. Suite 120 Raleigh NC (b) Delivery by Mail. If delivered by mail, the proposal shall be sent to the following address: RFP No. 274-HR WCTPA c/o Eddy Parham P.O. Box 590 Raleigh, NC Page 6 of 23

7 The City reserves the right to reject any or all proposals for any reason and to waive any informality it deems in its best interest. Any requirements in the RFP that cannot be met must be indicated in the proposal. 2.4 EVALUATION CRITERIA This section provides a description of the evaluation criteria that will be used by the City to evaluate the Proposals. To be deemed responsive, it is important for the TPA to provide appropriate detail to demonstrate satisfaction of each criterion and compliance with the performance provisions outlined in this RFP. The Service Provider s Proposal will be the primary source of information used in the evaluation process. Proposals must contain information specifically related to the proposed services and requested herein. Failure of any Service Provider to submit information requested may result in the elimination of the Proposal from further evaluation. Proposals will be evaluated based on the following criteria: Criteria (a) Weight Cover Letter / Letter of Transmittal 0 Executive Summary 5 Qualifications, Experience, and References 25 Approach to Scope of Services 25 Data Management & Accessibility 25 Proposed Cost 20 Final Score (b) Score (0-3) (a) x (b) Weighted Score Score Points 0- Missing or Does Not Meet Expectation 1- Partially Meets Expectation 2- Meets Expectation 3- Exceeds Expectation 2.5 EVALUATION PROCESS The process by which proposals are evaluated by the City shall be set forth in this section. Evaluation Committee. The City will establish an Evaluation and Selection Committee ( Committee ) to evaluate the Proposals and select a proposal that represents the best value to the City. The Committee will be comprised of City personnel and any other persons as designated by the City. This Committee will determine the responsiveness and acceptability of each proposal. The Committee may request additional information from Proposers. Communication with members of the Committee is subject to 1.4 and 1.6 of this RFP. Proposal Review. Proposals will first be analyzed for overall responsiveness and completeness to this RFP. Each Proposal will then be evaluated based on each of the criteria as outlined in section 2.4 of this RFP. After after which will identified as either reasonably qualified or unqualified. A Proposal will be Page 7 of 23

8 declared unqualified if it clearly fails to demonstrate, in any of the listed areas, a standard that the City believes necessary to meet the requirements set forth in this RFP. Finalists Determined & Notified. Following its review of all properly submitted Proposals, the Committee may select a shortlist of the highest ranked reasonably-qualified proposals. If additional information is required by the City, the City will contact the shortlisted firms at this time. Proposal Presentations. Shortlisted Offerors will be invited to present their Proposal to the Evaluation and Selection Committee. The purpose of the presentations will be to allow Offerors to further present their proposal and allow members of the Committee to ask questions of the proposed project team. 2.6 FINAL SELECTION Subsequent to the presentations to the Evaluation and Selection Committee, the committee will make a recommendation to the City Manager and / or City Council for approval to negotiate a contract with the #1 choice and if unsuccessful to then pursue negotiations with the #2 choice. All proposers will be notified of their standing immediately following City s decision. Price quoted must be held firm for 180 days after the RFP is due. The City reserves the right to make an award without further discussion of the proposal submitted. The City shall not be bound or in any way obligated until both parties have executed a contract. The City also reserves the right to delay the award of a contract or to not award a contract. The RFP may be awarded by individual task or total proposal, whichever is most advantageous to the City of Raleigh. The general conditions and specifications of the RFP and the selected proposal, as amended by agreement between the City and the Contractor including or written correspondence relative to the RFP, may become part of the contract documents. Failure of the awarded Contractor to perform as represented may result in elimination of the Contractor from competition or in contract cancellation or termination. 3 SCOPE OF SERVICES The TPA shall perform all services required to properly and efficiently supervise, manage, and administer the City of Raleigh s self-insured workers compensation program in compliance with all applicable federal, state, and local laws, including the North Carolina Workers Compensation Act and the Workers Compensation Rules of the North Carolina Industrial Commission. The TPA shall perform, at minimum, the following services on behalf of the City of Raleigh: 3.1 CLAIMS ADMINISTRATION Review and investigate all claims and losses reported to it by the City to the extent deemed necessary in the judgment of the TPA, and adjust, settle, contest or otherwise handle all such claims within the authority granted by the City. The TPA shall obtain pre-approval from the City of any claim for benefits that the TPA recommends be disputed or contested Maintain thorough documentation on all claims, including but not limited to notes of all claim activity, correspondence, Industrial Commission forms and filings, investigatory materials, medical records, rehabilitation and vocational reports, records, invoices, memoranda, and other documents. Page 8 of 23

9 The TPA shall provide copies of any claim file document or materials to the City s Human Resources Department, Safety and Compliance Division, upon request Review all existing workers' compensation claim files and identify files that are closable and to continue to perform necessary services to process active claims to conclusion. Perform all administrative tasks required to properly close out the files that have been identified as closable TPA shall assume the complete handling of all prior claims as well as new claims originating from the effective date of the contract TPA shall have a claims Administrator s Supervisor or Manager shall review all notices of injury received from the City prior to assignment of claim file to adjuster Initiate contact with injured worker via telephone or within twenty-four (24) hours of receipt of claim from City. The City shall be copied on all correspondence sent to injured worker and any attorney representing them. The TPA shall maintain contact with the injured worker, or if represented, the injured workers attorney, throughout the duration of the claim. TPA shall respond to inquiries from injured workers and/or their attorneys, and City staff within twenty-four (24) hours The TPA shall provide the injured worker and/or their attorney, responsible customer service. Responsible customer service means to provide the injured worker prompt and accurate information about their claim Timely file all Industrial Commission Forms and documents required by the Workers Compensation Act or Workers Compensation Rules of the North Carolina Industrial Commission. The TPA shall be responsible for the payment of all penalties and fines incurred by the TPA due to untimely filings Comply with all State and Federal requirements including EDI reporting requirements. TPA shall also prepare, for the City s use in filing, any self-insured reports required by the Federal Government or the State of North Carolina for lost time claims greater than seven (7) work days Provide a customer service representative locally in Raleigh, North Carolina throughout the duration of the TPA s contract with the City. The customer service representative will act as a liaison and coordinate services between the City and TPA Assist the City in coordinating all return-to work efforts of the injured employee and notify the City of any changes to the injured employee s medical status including work restrictions Promptly pay all authorized and related medical bills in compliance with the North Carolina Workers Compensation Act and the North Carolina Workers Compensation Medical Fee Schedule Engage a pharmacy benefit manager, private provider network, and fee schedule re-pricing vendor for the use and benefit of the City. The City will be responsible for costs associated with savings achieved under those programs Coordinate medical treatment of all accepted and med-only claims by promptly scheduling appointments and authorizing necessary physician referrals and treatments. The City reserves the right to approve or disapprove any health care provider. The TPA may employ a nurse case manager to assist in managing the medical aspect of a claim; however, such assignment is subject to City approval TPA may assign outside vendors/specialists to claims only if the outside vendor/specialist has been pre-approved by the City and the appropriate service agreement has been executed. Outside vendors/specialists include but are not limited to the following: nurse case managers; vocational rehabilitation specialists; subject matter experts; transportation service providers; and investigation Page 9 of 23

10 specialists. Surveillance authority for worker s compensation claims is limited to $3,500 for each claim. Any associated costs incurred in excess of $3,500 must be pre-approved by the City All claims should be reserved out of respect of the claimed injury or disease. The reserve should reflect the ultimate lifetime settlement value of the claim, considering the liability and defenses available that may influence the ultimate value of the case. The final reserve should be achieved usually within 180 days of the initial creation of the claim file, taking care to avoid frequent increases. A reserve should be adequate for the life of the claim, with reserve increases only based on the development of substantial new information that would impact the value of the case. (i.e. injury worsens, surgery is required, employee does not recover from the injury timely, cannot return to work, etc.) Initial reserves are to be set by the TPA s claim supervisor on new loss-time claims within ten (10) days of receiving new claim from City. TPA shall document reserve changes on a reserve worksheet along with reasons. The TPA s claim supervisor must sign off on a reserve worksheet for all reserves increases that exceed $100, The TPA s shall have the following authority with regards to settlement of claims: TPA shall have authority to settle and close all claims for permanent partial disability compensation benefits; TPA shall have authority to settle claims up to $40,000 above the amount due and payable to the injured worker. Any settlement more than $40,000 the amount due and payable shall require prior approval from the City Attorney s Office. All Compromise Settlement Agreements (Clinchers) required to effect any settlement reached, shall be prepared by the City Attorney s Office; and Any final settlement of indemnity benefits, medical benefits, or both shall be made pursuant to a Compromise Settlement Agreement ( Clincher ) coordinated, drafted, and approved by the City Attorney s Office Determine, at the onset of claim, if subrogation should be pursued and to take all necessary actions to protect the City s lien recovery rights. Third-party liability information shall be documented in the claims data system. Claim files that remain open for subrogation purposes after the closure of underlying workers compensation claim will be assigned to a Subrogation Specialist to continue recovery effort. This will be billed at time and expense. Any waiver or reduction of the City s lawful third-party lien recovery rights shall be subject to City approval The TPA will close files in a timely manner and provide the Safety and Compliance Division of the City s Human Resource Department with a closing letter for each claim outlining at minimum all indemnity and medical expenses paid on claim. 3.2 LITIGATION MANAGEMENT Advise the City when defense attorney assignment is necessary on a claim file. The City Attorney s Office shall approve and designate defense counsel Maintain a litigation management budget for each litigated file and provide litigation status reports for each litigation file on a quarterly basis Upon the defense attorney s assignment of a claim, the TPA shall provide the defense attorney a complete copy of the claim file, which is to include but not be limited to all adjuster notes, Industrial Commission forms and filings, correspondence, medical records, rehabilitation reports, investigatory Page 10 of 23

11 materials and documents, subrogation information, reserve information, and an attorney referral sheet that outlines the reasons for attorney referral The TPA shall provide investigatory assistance to the assigned defense attorney on a time and expense basis Attend any mediation, hearing, or deposition on behalf of the City when requested by defense counsel, or required by the North Carolina Industrial Commission. The adjuster shall bill time and expense for attendance at mediation on an hourly basis. 3.3 FINANCIAL ACCOUNTING At the end of each month, the TPA shall provide the following information to the City: A billing report for services. A billing for reimbursement of claims payment by the tenth (10th) business day of each month A monthly report of all open and closed claims (Loss Run Report) to include the status of each open claim assigned, including details of payment and outstanding reserves for the month and year covered by the report and such report will be provided no later than the fifth (5th) day of the following month. This report will be in the form of an electronic data transfer, which contains a download of cumulative claim information in a format specified by the City. A copy of the check register of all payments The TPA shall cooperate fully with, and provide requested information to, the City s auditor and consultants when needed TPA shall timely submit requests to any excess carrier(s) for all payments made in excess of the claim s Self-Insured Retention to obtain the proper reimbursement for the City. Upon request by the Safety and Compliance Division of the City s Human Resource Department, the TPA shall provide a report of all claims where excess money is currently outstanding at the time of the request. 3.4 INFORMATION SYSTEM DATA & ACCESS Timely transfer all claims data and respective file documentation for all open and closed files into the TPA s claims information system to ensure future City loss runs will contain a complete history of all claim years At no additional cost, the TPA shall provide designated City staff with real-time electronic, internet accessible claim file data, which includes read-only access to the following claim information: Page 11 of 23

12 adjuster notes, all documents, payment and billing records, and reserves, and any additional information requested by the City. 3.5 REPORTING TPA shall comply with the reporting requirements of all City excess insurance carriers TPA shall report immediately to the claims excess carrier any claim that involves the following: (i) fatality; (ii) spinal cord injury; (iii) brain injury; (iv) serious burn injury; (v) loss of consciousness; (vi) amputation; and (vii) accidents involving two or more City employees The TPA shall also provide prompt notice to the applicable excess carrier of any claim where: (i) the injured employee s disability exceeds fifty-two (52) weeks, even if the claim is contested; or (ii) when fifty percent (50%) of Self-Insured Retention (SIR) is reached TPA shall maintain liaison between the excess insurance carriers and the City on matters affecting the adjustment of such claims. TPA shall copy the City s Human Resources Department, Safety and Compliance Division on all excess carrier correspondence The TPA shall be responsible for all fines, penalties, reduction in reimbursements, or any other incurred costs imposed by insurance carriers or the North Carolina Industrial Commission due to failure of the TPA to provide timely reporting to the respective carrier or agency TPA shall provide to the City narrative or analytical reports of claims, upon request Send a reserve worksheet for any claims with medical and indemnity combined over $25,000 to the City s Human Resources Department, Safety and Compliance Division for review Provide a report to the City every 30 days indicating all employees that are not working in a full duty unrestricted capacity. At the end of each fiscal year an overview report of lost work days shall be provided to the City by the Claims Administrator Participate in claim review meetings with the City s Human Resources Department, Safety and Compliance Division on an as-needed basis, and at a minimum, semi-annually. The file review shall include, at a minimum, information on nature of injury, medical treatment history, current status, expenditure, reserves, exposure information, subrogation/sdtf and an action plan. 3.6 RECORDS RETENTION Comply with all federal, state, and local laws including public records laws Loss and claim files shall be stored in their existing state at the time of file closure for a period of up to five (5) years from inception of the original contract. Upon expiration of this contract, the City shall have one of the following three options: (1) Require the TPA to return all stored files to the City at the City s expense; (2) require the TPA to continue storing files at the then prevailing rate; OR (3) require the TPA to transfer all stored files to another TPA. If at the end of the contract period the City has not notified the TPA in writing of its selection of one of the options as set forth above, it is agreed that the TPA will return all stored files to the City at the City s expense. Page 12 of 23

13 4 CONTRACT TERMS The final contract (the Contract ) between the City and the selected vendor will be subject to negotiation of terms acceptable to the City. Those terms shall include the terms within this section, which are mandatory for City of Raleigh contracts. No exceptions may be made to the terms set forth in this section and any attempt by Proposer to make exception to these terms shall be null and void. The City objects to and shall not be required to consider any additional terms and conditions submitted with a vendor s proposal in response to this RFP. 4.1 NON-DISCRIMINATION To the extent permitted by State Law, the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner on the basis of race, color, creed, national origin, sex, age, handicap, or sexual orientation with reference to the subject matter of this Contract. The parties further agree, to the extent permitted by law, to conform to the provisions and intent of City of Raleigh Ordinance , as amended. This provision is hereby incorporated into this Contract for the benefit of the City of Raleigh and its residents, and may be enforced by action for specific performance, injunctive relief, or other remedy as provided by law. This provision shall be binding on the successors and assigns of the parties with reference to the subject matter of this Contract. 4.2 MINORITY OR WOMEN OWNED BUSINESSES Pursuant to General Statues of North Carolina Section and and to City policy, the City of Raleigh encourages and provides equal opportunity for Certified Minority and Woman-Owned Business Enterprise (MWBE) businesses to participate in all aspects of the City's contracting and procurement programs to include - Professional Services; Goods and Other Services; and Construction. The prime contractor will be required to identify participation of MWBE businesses in their proposal, and how that participation will be achieved. Furthermore, the City s goal is to contract or sub-contract fifteen percent (15%) of the contract amount to Certified MWBEs on construction projects over $300,000, or with contracts that include $100,000 or more in state funding. The goal breakdown is 8% for minorities and 7% for non-minority females. 4.3 ASSIGNMENT This Contract may not be assigned without the express written consent of the City. 4.4 APPLICABLE LAW All matters relating to this Contract shall be governed by the laws of the State of North Carolina, without regard to its choice of law provisions, and venue for any action relating to this Contract shall be Wake County Civil Superior Court or the United States District Court for the Eastern District of North Carolina, Western Division. 4.5 INSURANCE Contractor agrees to maintain, on a primary basis and at is sole expense, at all times during the life of this Contract the following coverages and limits. The requirements contained herein, as well as City s review or acceptance of insurance maintained by Contractor is not intended to and shall not in any manner limit or qualify the liabilities or obligations assumed by Contractor under this Contract. Page 13 of 23

14 Commercial General Liability Combined single limit of no less than $1,000,000 each occurrence and $2,000,000 aggregate. Coverage shall not contain any endorsement(s) excluding nor limiting Product/Completed Operations, Contractual Liability or Cross Liability. Automobile Liability Limits of no less than $1,000,000 Combined Single Limit. Coverage shall include liability for Owned, Non-Owned and Hired automobiles. In the event Contractor does not own automobiles, Contractor agrees to maintain coverage for Hired and Non-Owned Auto Liability, which may be satisfied by way of endorsement to the Commercial General Liability policy or separate Auto Liability policy. Automobile coverage is only necessary if vehicles are used in the provision of services under this Contract and/or are brought on a COR site. Worker s Compensation & Employers Liability Contractor agrees to maintain Worker s Compensation Insurance in accordance with North Carolina General Statute Chapter 97 with statutory limits and employees liability of no less than $1,000,000 each accident. Additional Insured Contractor agrees to endorse the City as an Additional insured on the Commercial General Liability, Auto Liability and Umbrella Liability if being used to meet the standard of the General Liability and Automobile Liability. The Additional Insured shall read City of Raleigh is named additional insured as their interest may appear. Certificate of Insurance Contractor agrees to provide COR a Certificate of Insurance evidencing that all coverages, limits and endorsements required herein are maintained and in full force and effect, and Certificates of Insurance shall provide a minimum thirty (30) day endeavor to notify, when available, by Contractor s insurer. If Contractor receives a non-renewal or cancellation notice from an insurance carrier affording coverage required herein, or receives notice that coverage no longer complies with the insurance requirements herein, Contractor agrees to notify the City within five (5) business days with a copy of the nonrenewal or cancellation notice, or written specifics as to which coverage is no longer in compliance. The Certificate Holder address should read: City of Raleigh Post Office Box 590 Raleigh, NC Umbrella or Excess Liability Contractor may satisfy the minimum liability limits required above under an Umbrella or Excess Liability policy. There is no minimum Per Occurrence limit of liability under the Umbrella or Excess Liability, however, the Annual Aggregate limits shall not be less than the highest Each Occurrence limit for required policies. Contractor agrees to endorse City of Raleigh as an Additional Insured on the Umbrella or Excess Liability, unless the Certificate of Insurance states the Umbrella or Excess Liability provides coverage on a Follow-Form basis. Professional Liability Limits of no less than $1,000,000 each claim. All insurance companies must be authorized to do business in North Carolina and be acceptable to the City of Raleigh. 4.6 INDEMNITY Except to the extent caused by the sole negligence or willful misconduct of the City, the Contractor shall indemnify and hold and save the City, its officers, agents and employees, harmless from liability of any kind, including all claims, costs (including defense) and losses accruing or resulting to any other person, firm, or corporation furnishing or supplying work, services, materials, or supplies in connection with the performance of this Contract, and from any and all claims, costs (including defense) and losses accruing or resulting to any person, firm, or corporation that may be injured or damaged by the Contractor in the performance of this Contract. This representation and warranty shall survive the termination or expiration of this Contract. Page 14 of 23

15 The Contractor shall indemnify and hold and save the City, its officers, agents and employees, harmless from liability of any kind, including claims, costs (including defense) and expenses, on account of any copyrighted material, patented or unpatented invention, articles, device or appliance manufactured or used in the performance of this Contract. 4.7 INTELLECTUAL PROPERTY Any information, data, instruments, documents, studies, reports or deliverables given to, exposed to, or prepared or assembled by the Contractor under this Contract shall be kept as confidential proprietary information of the City and not divulged or made available to any individual or organization without the prior written approval of the City. Such information, data, instruments, documents, studies, reports or deliverables will be the sole property of the City and not the Contractor. All intellectual property, including, but not limited to, patentable inventions, patentable plans, copyrightable works, mask works, trademarks, service marks and trade secrets invented, developed, created or discovered in performance of this Contract shall be the property of the City. Copyright in and to any copyrightable work, including, but not limited to, copy, art, negatives, photographs, designs, text, software, or documentation created as part of the Contractor s performance of this project shall vest in the City. Works of authorship and contributions to works of authorship created by the Contractor s performance of this project are hereby agreed to be works made for hire within the meaning of 17 U.S.C FORCE MAJEURE Except as otherwise provided in any environmental laws, rules, regulations or ordinances applicable to the parties and the services performed under this Contract, neither party shall be deemed to be in default of its obligations hereunder if and so long as it is prevented from performing such obligations by an act of war, hostile foreign actions, nuclear explosion, earthquake, hurricane, tornado, or other catastrophic natural event or act of God. Either party to the Contract must take reasonable measures and implement reasonable protections when a weather event otherwise defined as a force majeure event is forecast to be eligible to be excused from the performance otherwise required under this Contract by this provision. 4.9 ADVERTISING The Contractor shall not use the existence of this Contract, or the name of the City of Raleigh, as part of any advertising without the prior written approval of the City CANCELLATION The City may terminate this Contract at any time by providing thirty (30) days written notice to the Contractor. In addition, if Contractor shall fail to fulfill in timely and proper manner the obligations under this Contract for any reason, including the voluntary or involuntary declaration of bankruptcy, the City shall have the right to terminate this Contract by giving written notice to the Contractor and termination will be effective upon receipt. Contractor shall cease performance immediately upon receipt of such notice. In the event of early termination, Contractor shall be entitled to receive just and equitable compensation for costs incurred prior to receipt of notice of termination and for the satisfactory work completed as of the date of termination and delivered to the City. Notwithstanding the foregoing, in no event will the total amount due to Contractor under this section exceed the total amount due Contractor under this Contract. The Contractor shall not be relieved of liability to the City for damages sustained by the City by virtue of any breach of this Page 15 of 23

16 Contract, and the City may withhold any payment due to the Contractor for the purpose of setoff until such time as the City can determine the exact amount of damages due the City because of the breach. Payment of compensation specified in this Contract, its continuation or any renewal thereof, is dependent upon and subject to the allocation or appropriation of funds to the City for the purpose set forth in this Contract LAWS/SAFETY STANDARDS The Contractor shall comply with all laws, ordinances, codes, rules, regulations, safety standards and licensing requirements that are applicable to the conduct of its business, including those of Federal, State, and local agencies having jurisdiction and/or authority. All manufactured items and/or fabricated assemblies subject to operation under pressure, operation by connection to an electric source, or operation involving a connection to a manufactured, natural, or LP gas source shall be constructed and approved in a manner acceptable to the appropriate state inspector which customarily requires the label or re-examination listing or identification marking of the appropriate safety standard organization, such as the American Society of Mechanical Electrical Engineers for pressure vessels; the Underwriters' Laboratories and/or National Electrical Manufacturers' Association for electrically operated assemblies; or the American Gas Association for gas operated assemblies, where such approvals of listings have been established for the type(s) of devices offered and furnished. Further, all items furnished by the Contractor shall meet all requirements of the Occupational Safety and Health Act (OSHA), and state and federal requirements relating to clean air and water pollution. Contractor must comply with North Carolina Occupational Safety and Health Standards for General Industry, 29CFR In addition, Contractor shall comply with all applicable occupational health and safety and environmental rules and regulations. Contractor shall effectively manage their safety and health responsibilities including: A. Accident Prevention - Prevent injuries and illnesses to their employees and others on or near their job site. Contractor managers and supervisors shall ensure personnel safety by strict adherence to established safety rules and procedures. B. Environmental Protection - Protect the environment on, near, and around their work site by compliance with all applicable environmental regulations. C. Employee Education and Training - Provide education and training to all contractors employees before they are exposed to potential workplace or other hazards as required by specific OSHA Standards APPLICABILITY OF NORTH CAROLINA PUBLIC RECORDS LAW This Contract and all materials submitted to the City by the Contractor are subject to the public records laws of the State of North Carolina, and it is the responsibility of the Contractor to properly designate materials that may be protected from disclosure as trade secrets under North Carolina law as such and in the form required by law prior to the submission of such materials to the City. Contractor understands and agrees that the City may take any and all actions necessary to comply with federal, state, and local laws and/or judicial orders and such actions will not constitute a breach of the terms of this Contract. To the extent that any other provisions of this Contract conflict with this paragraph, the provisions of this section shall control. Page 16 of 23

17 4.13 MISCELLANEOUS The Contractor shall be responsible for the proper custody and care of any property furnished or purchased by the City for use in connection with the performance of this Contract, and will reimburse the City for the replacement value of its loss or damage. The Contractor shall be considered to be an Independent Contractor and as such shall be wholly responsible for the work to be performed and for the supervision of its employees. Nothing herein is intended or will be construed to establish any agency, partnership, or joint venture. Contractor represents that it has, or will secure at its own expense, all personnel required in performing the services under this Contract. Such employees shall not be employees of or have any individual contractual relationship with the City. This Contract may be amended only by written agreement of the parties executed by their authorized representatives AUDIT The City may conduct an audit of any services performed and fees paid subject to this Contract. The City, or its designee, may perform such an audit throughout the contract period and for three (3) years after termination thereof or longer if otherwise required by law. The Contractor and its agents shall maintain all books, documents, papers, accounting records, contract records and such other evidence as may be appropriate to substantiate costs incurred under this Contract. The City, or its designee, shall have the right to, including but not limited to: review and copy records; interview current and former employees; conduct such other investigation to verify compliance with contract terms; and conduct such other investigation to substantiate costs incurred by this Contract. Records shall be defined as data of every kind and character, including but not limited to books, documents, papers, accounting records, contract documents, information, and materials that, in the City's sole discretion, relate to matters, rights, duties or obligations of this Contract. Records and employees shall be available during normal business hours upon advanced written notice. Electronic mail shall constitute written notice for purposes of this section. Contractor shall provide the City or its designee reasonable access to facilities and adequate and appropriate workspace for the conduct of audits. The rights established under this section shall survive the termination of the Contract, and shall not be deleted, circumvented, limited, confined, or restricted by contract or any other section, clause, addendum, attachment, or the subsequent amendment of this Contract. The Contractor shall reimburse the City for any overcharges identified by the audit within ninety (90) days of written notice of the City s findings E-VERIFY Contractor shall comply with E-Verify, the federal E-Verify program operated by the United States Department of Homeland Security and other federal agencies, or any successor or equivalent program used to verify the work authorization of newly hired employees pursuant to federal law and as in accordance with N.C.G.S et seq. In addition, to the best of Contractor s knowledge, any subcontractor employed by Contractor as a part of this contract shall be in compliance with the requirements of E-Verify and N.C.G.S et seq IRAN DIVESTMENT ACT CERTIFICATION Contractor certifies that, as of the date listed below, it is not on the Final Divestment List as created by the State Treasurer pursuant to N.C.G.S , et seq. In compliance with the requirements of the Iran Divestment Act and N.C.G.S , Contractor shall not utilize in the performance of the contract any subcontractor that is identified on the Final Divestment List. Page 17 of 23

18 5 APPENDIX A QUESTIONNAIRE A. COMPANY OVERVIEW 1. How long has your Organization been in the business of providing Third-Party Administration services for Workers Compensation claims.? 2. What experience does your Organization have administering claims for other public entities? 3. Provide evidence of a current, valid TPA license. 4. What auditing standards does your organization adhere to (e.g., SAS 70)? 5. Please describe your organization s confidentiality standards. 6. Have any principals or employees ever been accused or convicted of mishandling/misappropriating company funds, or had a lawsuit or Insurance Department complaint brought against them? If yes, what corrective actions have taken place since this event? State whether Service Provider is currently or previously filed a petition in bankruptcy, taken any actions with respect to insolvency, reorganization, receivership, moratorium or assignment for the benefit of creditors, or otherwise sought relief from creditors. 7. Do you have a disaster recovery plan which includes cyber-attacks and theft of Personally Identifiable Information? Describe your firm s disaster recovery plan for workers compensation administration. 8. Please provide the name(s), titles(s), address (es), telephone and address (es) of the individual(s) responsible for responding to the Request for Proposal. B. CLAIM PROCESSING 1. What methods of claim reporting are available to your clients? (internet, , fax, phone numbers,)? 2. Explain your company s procedure for establishing contact with injured workers, third party claimants, and the client? 3. What is your company s policy for returning phone calls and responding to written correspondence (including )? How compliance is tracked? 4. Describe your after-hours claim reporting procedures for an escalating or fatality claim. 5. Will you provide acknowledgments of new losses to the client and the broker upon receipt of a new claim? If so, how are the acknowledgments provided (fax, , regular mail)? Please describe the frequency, content, and method of delivery for any status reports that are generated to the client/broker throughout the life of a claim. 6. Will you be responsible for filing all State loss notices/forms at no additional charge? 7. State your company s procedure for when a Medicare Set Aside is required. 8. How often are loss reports sent to the excess carrier? At what dollar level or time intervals are claims reimbursement requests communicated to the excess carrier? Page 18 of 23