JI COMPANIES. Contact Person MICHELLE VILLARREAL CASEY COOK / DAN CAMPBELL DAVID MURRAY

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Doreen Carpenter
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1 Senior Buyer: REBECCA S Company Number / USE VENDOR # HERNANDEZ Bd No: Company Name CLAIMS, INC. CAS-CLAIMS ADMINISTRATIVE SERVICES, INC. JI SPECIALTY SERVICES, INC. Title WORKERS DBA COMPENSATION THIRD PARTY ADMINISTRATOR - REBID JI COMPANIES Contact Person MICHELLE VILLARREAL CASEY COOK / DAN CAMPBELL DAVID MURRAY Address BANDERA RD. #7 501 SHELLEY DRIVE BOYER BLVD., SUITE 100 City, State HELOTES, TX TYLER, TX AUSTIN, TX Zip Code Phone Number / / Fax Number Address mvillarreal@121claims.com casey.cook@cas-services.com / dan.campbell@cas-services.com sales.proposals@jicompanies.co m PRICES WILL BE HELD FOR 12 MONTHS FROM AWARD DATE? IF NO, PLEASE COMMENT IS A MINIMUM PRICE REQUIRED? IF YES, PLEASE COMMENT IS A MINIMUM QUANTITY REQUIRED? IF YES, PLEASE COMMENT MEET THE PAYMENT TERMS NET30? IF NO, PLEASE COMMENT PROMPT PAYMENT DISCOUNT OFFERED? IF YES, PLEASE COMMENT Adheres to Net 30 CAS guarantees the price for the life of the contract. CAS has quoted a flat fee of $178,862. Quantities are not applicable to this contract. CAS payment terms are net 30. CAS payment terms are net 30. CATALOG WITH PRICE IS PROVIDED? INDUSTRY RECOGNIZED PRICE LIST PROVIDED? (YES/NO) PLEASE COMMENT HARDCOPY FORMAT PROVIDED? CD/DVD FORMAT PROVIDED? (YES/NO) PLEASE COMMENT FLASH DRIVE FORMAT PROVIDED? ONLINE OR WEBSITE FORMAT PROVIDED? (YES/NO) PLEASE COMMENT CAN VENDOR MEET 3 DAY STOCK ARO? IF NO, PLEASE COMMENT n/a n/a Catalog is not applicable for this bid. Not applicable. Industry recognized price list Not applicable. is not applicable for TPA services. n/a CAS elected to provide an e- JI is submitting an electronic not requested CAS elected to provide an e- JI is submitting an electronic not requested CAS elected to provide an e- JI is submitting an electronic CAS is submitting this bid online. n/a Not Applicable Not applicable.

2 CAN VENDOR MEET 5 DAY NON STOCK n/a Not Applicable Not applicable. ARO? IF NO, PLEASE COMMENT IS THERE A WARRANTY PERIOD? AS AN ENTITY, IF NOT SUBJECT TO TEXAS FRANCHISE TAX, ADVISE WHY n/a Not Applicable Not applicable. CAS is subject to Texas franchise tax. We are subject to the Texas Franchise Tax. NAME OF FIRM Claims, Inc. CAS-Claims Administrative Services, Inc. PRIMARY CONTACT FOR THIS SUBMITTAL Michelle Villarreal, President Dan Campbell Dan.campbell@cas-services.com Phone: Fax: JI Specialty Services, Inc. David P. Murray, CLU, CIC; Vice President, Sales & Account Management STREET AND MAILING ADDRESS Bandera Rd. #7, Helotes, Texas TELEPHONE AND FACSIMILE NUMBER fax AND WEB PAGE ADDRESS (IF APPLICABLE) mvillarreal@121claims.com Shelley Drive Tyler, TX Phone: Fax: Dan.Campbell@casservices.com Boyer Boulevard, Suite 100 Austin, TX Phone: Fax: david.murray@jicompanies.com Website: YEAR ORGANIZATION FOUNDED 2006 CAS was founded in NUMBER OF YEARS ORGANIZATION 7 years CAS has always done 27+ years UNDER WHAT OTHER OR FORMER NAMES HAS YOUR ORGANIZATION OPERATED LIST COMPANY LOCATIONS AND NUMBER OF EMPLOYEES none 2 locations Claims, Inc. - Home office- 11 employees Bandera Rd #7, Helotes, Texas Claims, Inc. 3 employees 444 Executive Center Blvd Ste 125 El Paso, Texas CAS has a division called Health-E-Innovations that provide cost containment services. Home Office-Tyler, TX 501 Shelley Drive 45 employees El Paso, TX 1200 Golden Key Circle Suite employees Dallas, TX 6750 Hillcrest 2 CAS Employees Miscellaneous Locations: 15 locations across the state of Texas Not applicable Headquartered in Austin, TX, JI has 99 employees and offices in Houston, Dallas, San Antonio, Tyler, and Corpus Christi. NAME AND CONTACT INFORMATION OF 1ST REFERENCE FOR El Paso ISD Contact Kyle Jeglum Murchison El Paso, Texas Frisco ISD 5515 Ohio Dr Frisco TX Tim Sanz-Risk Manager Carrollton-Farmers Branch ISD Contact: Faye Saenz, Employee Benefits / Risk Manager 972/ saenzf@cfbisd.edu

3 NAME AND CONTACT INFORMATION OF 2ND REFERENCE FOR La Joya ISD Tyler ISD Contact ElI Rodriguez PO Box Tyler, TX North Leo Ave, La Joya Tex Bruce Ballard-Risk Manager Alief ISD Contact: Raymond Brantley, Director of Human Resources 281/ NAME AND CONTACT INFORMATION OF 3RD REFERENCE FOR HAS YOUR ORGANIZATION EVER FAILED TO COMPLETE AWARDED WORK? PROVIDE DETAILS Lubbock ISD Contact Bill Tarro th Street Lubbock Tx No we have never failed to complete awarded work ANY No there are no JUDGEMENT/CLAIM/ARBITRATION/SUIT claims/judgements/arbitrations or S PENDING AGAINST suits pending against our ORGANIZATION/OFFICERS organizations or officers Azle ISD 300 Roe St Azle, TX Monica Miller CAS has never failed to complete awarded work. There are no pending judgments against CAS. Spring ISD Contact: John Brownlow, Executive Director of Human Resources 281/ jbrownlo@springisd.org There is one lawsuit pending that is anticipated will be dismissed since the injured worker did not exhaust the Administrative Hearings process with TDI-DWC. In addition, JI was improperly named as a party to the lawsuit, which will be included in th HAS YOUR ORGANIZATION FILED LAWSUITS IN REGARDS TO CONTRACTS HAS YOUR FIRM REQUESTED ARBITRATION IN REGARDS TO CONTRACTS LIST YOUR EXPERIENCE WITH YSLETA ISD No we have not filed any lawsuits in regards to contracts No we have not requested any arbitration in regards to contracts We are familiar with Ysleta ISD through our assocation with EPISD and the claims association. We look forward to the opportunity to work with you to substantially reduce the district's budget for workers compensation claims. CAS has never filed a lawsuit in regards to contracts. CAS has never made a request for arbitration in regards to contracts. CAS has extensive history with Ysleta ISD. CAS has been providing TPA services to Ysleta ISD since CAS safety representative has done numerous trainings and inspections to help control their losses for many years. JI has not had the opportunity to provide any services to the District. LIST 1ST RELATED/SIMILAR PROJECT. El Paso ISD- El Paso Texas. We took over this project in This year there program came in $100,000 under budget. Frisco ISD 5515 Ohio Dr Frisco TX Frisco ISD has been with CAS since for a number of years. They started out on our partially self funded program. Since they were growing significantly CAS and Frisco ISD thought it would better for them t Tarrant County located in Fort Worth, Texas. JI has provided workers compensation administrative services, including all cost containment services, since September The current contract is valued at $377,868. The professional service provid

4 LIST 2ND RELATED/SIMILAR PROJECT. La Joya ISD- La Joya Texas. We took over this program in 2010 and we have been able to save the program over 20% over their prior TPA, CAS. City of El Paso 300 N. Campbell 1st Floor El Paso, TX The City of El Paso has over 6,000 employees. They came on board with us in CAS set up an implementation team that spent two weeks in our El Paso office to hire experience claims Harris Health System located in Houston, Texas. JI has provided workers compensation services to the System since The contract is currently valued at $214,394. The professional service provider is JI Specialty Services, Inc., and the servic LIST 3RD RELATED/SIMILAR PROJECT. University Health Systems- Baptist Health San Antonio, Texas. We took 9601 I Exit 7 over this program in 2009 and Little Rock, AR within the first year we were able to collect over $360,000 in excess recovery overlooked by the prior TPA. Baptist Health is a large private entity client. They are the largest hospital program in the state of Arkansas. Mr. Rick Fisher, EVP, Ms. Tiffany Black, claims adjuster and our customer Alief ISD located in Houston, Texas and has 6,188 fulltime employees. Alief ISD offers workers' compensation through self-insurance and has been managed out of the JI Houston office since The contract is currently valued at $139,949. The pro PROVIDE INFORMATION ON YOUR CURRENT CAPACITY/WORKLOAD Currently we are looking to expand our El Paso office. We have capacity and limit our adjuster to less than 125 claims per adjuster. Ysleta ISD is currently assigned three adjusters. The average caseload for the a loss time adjusters is 128 and the average caseload for the medical only adjuster is 175. Our Indemnity Adjusters handle caseloads of up to 125 and our Medical Only Adjusters handle caseloads of up to 250. All adjusters are required to have either a type 03 or 08 adjuster license certified by the Texas Department of Insurance. REVIEW CONTRACT (IF APPLICABLE) AND ADVISE OF CHANGES ON DEVIATION FORM No changes noted. CAS has reviewed the contract and there are no deviations to the contract. The following changes are also noted on the Deviation Form JI recommends 90 days of notice of cancellation and that the terms are reciprocal This provision should not apply to JI as we are not providing goods or supplies Indemn BREAKDOWN OF EXPENSES & PRICE FOR SERVICE Based on the numbers in the original RFP, the incumbent was providing services at $363,000 per year. In our original submission we were able to reduce that to $198,000. We have come off that price by 9%. This is all inclusive except cost containme CAS is quoting a flat fee for claims administration of $178,862 which also includes safety services. Some allocated cost are: Case Management $88 per hour, Pharmacy Network 9% of savings, Medical Necessity Review average fee range of $250 to $650, JI is proposing a claims administration flat fee of $241,504 for years one (1) and two (2) of the contract period, with a 3.5% increase in year three (3). Bill review would be charged on a per bill basis at $8.95 per bill. Additional services and f INTERESTED IN PARTICIPATING IN ESCHOOLMALL? (YES/NO) COMMENT Yes CAS is currently not participating in ESchool Mall. Not applicable. Solicitation Signed...> Yes Yes Yes Principal State of Business...> Texas Texas Texas 500+ employees in the State of Texas > No No No Franchise Tax Certification of Account Status & date checked > Active, 7/29/2013 Business not found, 7/29/2013 Active, 7/29/2013

5 Addendum received/signed(when N/A N/A N/A applicable)...> Insurance certificates received (when None submitted Submitted None submitted applicable).> Vendor Issues (Yes or No) > No No No VENDORS REF# FOR P.O.S, S&H, EXCLUSIONS/ *RESTOCKING FEE % N/A N/A N/A Original invoice must be sent to accounts payable. No pre-invoicing or statements will be accepted; invoices only. *Restocking fee - It is the responsibility of the District to pay restocking fee when the District is in error Line Item Description Quantity CLAIMS, INC CAS-CLAIMS ADMINISTRATIVE SERVICES, INC YEARLY PREMIUM FOR WORKERS COMPENSATION PLAN ADMINISTRATION AS LISTED ON SECTION 4 SPECIFICATIONS JI SPECIALTY SERVICES, INC. Bid Price $ $ $ Handling Shipping Disc % Actual Unit Price $ $ $

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