Texas Association of School Boards. Request for Information for a Risk Management Information System October 24, 2016

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1 Texas Association of School Boards for a Risk Management Information System October 24, 2016

2 Executive Summary The Texas Association of School Board s goal is to replace its current separate risk management software systems with a single, enterprise-wide risk management software solution and enhance its technological capabilities. TASB seeks a comprehensive Risk Management Information System that incorporates claims management, policy administration, underwriting, reporting, and financial capabilities to support its administration of the TASB Risk Management Fund s programs. This is an initial effort to learn more about current software products available to meet this goal. The Texas Association of Schools Boards (TASB) is a nonprofit, statewide educational association that serves and represents Texas public school districts. The Association is headquartered in Austin, Texas with a staff of over 425 full time employees who work in a variety of complex and diverse service areas, including Risk Management Services. TASB s mission is to promote educational excellence for Texas school children through advocacy, visionary leadership, and high quality services to school districts. TASB administers the TASB Risk Management Fund (Fund) which is a risk-sharing pool serving the risk management and insurance needs of TASB members. The Fund is not an insurance enterprise, but is similar in operation to a non-profit mutual insurance company. Over 1,000 school districts, cooperatives, and community colleges participate in one or more of the Fund s programs. The Fund provides Property, Legal Liability, Auto, Unemployment Compensation and Workers Compensation coverage. The Fund and TASB are separate legal entities. The Fund contracts with TASB to carry out its operations, including underwriting, claims adjudication, accounting, loss prevention, information technology, and general administrative functions. TASB Risk Management Overview The following information provides an overview of Fund membership and size, as well as TASB s operations dedicated to administration of the TASB Risk Management Fund: Fund Program Members Contribution Exposure Measure Workers Compensation 397 $26.0M $13.1B Payroll Auto Liability/Physical Damage 592 $8.7M 37,000/$1.6B Fleet size/value Liability 648 $7.3M 2.3 M Enrollment Property 552 $27.5M $34.3B Total Ins Value Unemployment Compensation 927 $10.2M $20.0B Payroll 2

3 Function Staff Count Function Staff Count Claims Adjusters 47 Loss Prevention/Member Training 15 Claims Managers 9 Technology System Support 8 Claims Process/Support 29 Legal/Regulatory 3 Utilization Management 10 Data Management/Analysis 8 Compliance/Audit 3 Administrative Support 10 Underwriting 8 Executive Leader 1 Marketing 14 Division Directors 8 Accounting/Finance 7 Workers Compensation The Fund provides statutory workers compensation benefits to its members under Texas workers compensation law. The Fund s Workers Compensation program is regulated by the Division of Workers Compensation of the Texas Department of Insurance. Depending on their size and coverage needs, Fund members can choose from three membership options: Fully-Funded: Members pay a fixed annual contribution and the Fund pays all claims incurred in the coverage period. Aggregate Deductible: Members pay a smaller fixed contribution and retain an aggregate amount for all losses in a coverage period. The contribution and size of the aggregate deductible depend on member size and claims experience. Once a member s aggregate deductible has been exhausted, claims liability reverts to the Fund. Administrative Services Only (ASO): Members self-fund their workers compensation claims liability and the Fund serves as a third party administrator, paying claims on the members behalf. TASB s Workers Compensation Claims Division handles all claim functions internally including first report of injury, processing and payment of all bills related to claim files, utilization management, pre-authorization, physician peer reviews and oversight, and all related claims adjudication functions. The Fund receives 15,000 to 16,000 claims per year. The following table shows the typical volume of Workers Compensation claims activities. Workers Compensation Number Average number of new Workers Compensation claims each day 70 claims Average number of medical bills received per month 11,000 medical bills Average number of medical pre-authorizations processed per month 483 Number of claims-related checks issued per year 225,000 3

4 Auto, Liability and Property TASB s Auto, Liability and Property Claims Division handles all claim functions internally including initial report of loss, coverage verification, claim investigation, liability determination, reserve setting, suit notification, salvage, subrogation, valuation, and payment of claims. There are typically 550 open Auto claims, 180 open Liability claims, and 190 open Property claims. The Fund uses the services of independent claims adjusters who work directly with TASB adjusters to inspect and prepare estimates on most property and auto claims. The Fund maintains an attorney panel to defend lawsuits filed against members. TASB staff works closely with assigned counsel to manage litigation and track legal expenses and billing. Unemployment Compensation The Fund s Unemployment Compensation program provides required Texas Workforce Commission (TWC) wage reporting services on members behalf. The program reimburses TWC quarterly for unemployment claim benefits paid on members behalf. Under this program, members can participate as fully-funded, paying a contribution relative to their size and loss history, or as self-insured Administrative Services Only members. In both cases, TASB staff handles all wage and benefit reporting to and from TWC and provides legal assistance with contested claim hearings. The Fund does not make payments directly to claimants in this program. Unemployment benefits are paid by TWC directly to the claimant but TASB receives and stores claims records in its current system. Underwriting and Marketing TASB s Underwriting and Marketing Division underwrites and maintains coverage records for all current and prospective Fund members. The Marketing team, with a staff of eight field-based marketing consultants solicits new business, responds to requests for proposals, secures coverage renewals, and assists members with coverage issues. The division secures and maintains exposure data such as property values and automobile fleet schedules. The Fund contracts with Duff & Phelps for property and auto valuations. Member Solutions TASB s Member Solutions Division provides loss prevention services, resources and training to Fund members. Member Solutions Consultants work directly with members to prevent and reduce losses through regular site visits, consultations and training. 4

5 Risk Management Financial Operations TASB s Risk Management Financial Operations Division (RMFO) conducts all accounting and financial management activities for the Fund s operations. The division works independently of TASB s accounting and finance department and is solely focused on financial management of the Fund, including billing, receivables, audit, financial statements, internal control analysis, and coordination with the Fund s third-party investment advisors. Information Technology Risk Management Systems Support TASB s Information Technology Service area has 39 employees that provide infrastructure services, project management, help desk support and software development. There are an additional nine IT staff members on the Risk Management Systems Support team which is entirely focused on supporting and maintaining TASB s current risk management software platforms and tools. TASB also has a small risk management data team that maintains a SQL data warehouse, develops ETL workflows, and conducts business analysis of the Fund s operations. Current Systems TASB uses a variety of software systems and platforms to administer the Fund s programs. The following is a list of all major systems in place today: RiskMaster Accelerator (CSC): Auto, Liability, Property claims system Legal Solutions Suite (CSC): Legal billing management and tracking software for liability claims CompSuite (StoneRiver): Workers Compensation claims, billing, bill review, preauthorization and utilization management (i-series) NavRisk (David): Underwriting and policy administration for all lines Enterprise One (Oracle): Accounting and financial reporting system OnBase (Hyland): Document management and workflow system Paper Vision Capture / Forms Magic (Digitech): Scanning and optical character recognition (OCR) tool Dynamics CRM (Microsoft): Customer Relationship Management (CRM) system to track member profile informationand key member contacts US4U/UC360 (Unemployment Solutions for You): Unemployment Compensation administration (implementing November 2016) Informatica PowerCenter 9.6 (Informatica): Extract, transform, load (ETL) tool 5

6 Business Objects/BI Suite (SAP): Enterprise business reporting tool TASB is updating its current member portal (mytasb) and website. There are approximately 2,500 registered risk management users today, though not all members use the available tools. Fund members can currently renew coverage, request a quote, view claims and payments reports, submit a claim, and submit required DWC forms (e.g. First Report of Injury, Wage Statement) online. TASB s updated portal will be built in ADXStudio which is designed to interface with Microsoft Dynamics CRM. Business Opportunity TASB is considering replacing several of its current systems with a single, enterprise-wide software solution that incorporates claims management, policy administration, underwriting, reporting, billing and financial capabilities. The ideal solution must provide the following functionality: Claims administration for Auto, Liability, Property, Workers Comp Underwriting and rating Policy administration Billing and payments Compliance reporting for state and federal governments In addition to the required functionality described above, the following functionality is desired, but not essential: Bill review Utilization management/ medical pre-authorization Subrogation / salvage support Reinsurance module Accounting and general ledger Unemployment compensation program administration Litigation support Loss prevention RFI Procedure and Instructions Interested vendors should submit responses to this RFP by 5 p.m. CST on November 11, Please submit an electronic file to Jenny.Shepherd@TASB.org. Vendors interested in bidding should notify us by November 4, 2016 so that we can plan accordingly. Any questions should be directed to Jenny Shepherd at Jenny.Shepherd@TASB.org. 6

7 Response Format and Content Please organize your response into the following categories and provide the following information: 1. Company Profile: Please submit an overview of your company including: Company address; Contact person; Number of years the company has been in business; Number of years the system has been in production; Ownership structure; Statement of financial stability; Annual revenue; Number of employees; Number of customers; Market niche (premium/contributions, coverage types); List of clients including those who are risk pools; List of clients who have implemented your workers compensation claims module and the states in which they are operating. 2. Product Overview: Please provide an overview of your proposed solution that describes the following: Functional Overview: Description of how the system addresses the required and desired functionality listed above. Service Overview: Description of professional services offered to support implementation and ongoing operations and whether these are provided by your staff or through partners. Technology Overview: Description of technical architecture. 3. Price: Please provide estimates of: Product costs and pricing structure Maintenance and support costs 4. Product Literature: Please include literature on each product and service offering. 7

8 Next Steps for Software Search TASB has developed a plan for this software search that is designed to maximize the possibility of arriving at the best solution for the organization. This RFI is the first milestone in the plan. Once responses are received and reviewed, TASB will invite the vendors that best meet the functionality requirements stated in this RFI to provide high-level demonstrations of their product to TASB staff. his will provide vendors with the opportunity to demonstrate their product s functionality and features to a broad range of TASB staff, and for TASB staff to understand the range of options and system features available. Demos will be presented the week of January 9, Vendors must complete their demonstration in four hours and allow up to an additional hour for questions and clarifications. Vendors can choose whether to deliver the demonstrations in person in Austin, Texas or remotely. Once the high-level demos are complete, TASB will assess the options. Depending on the number and fit of potential vendors, we will either issue a detailed RFP and invite the most qualified vendors to respond, or we will begin discussion of detailed requirements and negotiations of contract terms. 8