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Agenda 09/13/2022 Item #16E 1 (Awarding RFP #22-7971 to Johns Eastern Company, Inc.)09/13/2022 EXECUTIVE SUMMARY Recommendation to award Request for Proposal (“RFP”) No. 22-7971, “Property, Casualty and Workers’ Compensation Third Party Administration Services,” to Johns Eastern Company, Inc., and authorize the Chairman to sign the attached agreement. OBJECTIVE: To procure claims adjusting services for the County’s Property, Casualty and Workers’ Compensation insurance program. CONSIDERATION: Florida Statutes Section 768.28(16)(a) authorizes Counties to enter into risk management programs and to purchase insurance as they determine necessary. The procurement of coverage also requires the engagement of a professional third party administration (adjusting) company to adjudicate claims on behalf of the program. The existing County contract with Johns Eastern Company, Inc. is set to terminate on December 31, 2022. On February 15, 2022, the Procurement Services Division advertised RFP No. 22-7971, “Property, Casualty and Workers’ Compensation Third Party Administration Services,” with a response deadline of March 17, 2022. The evaluation criteria included cover letter/management summary; certified minority business enterprise; proposal requirements; costs of services to the County; experience and capacity of the firm; specialized expertise of team members, business implementation plan, and local vendor preference. The RFP was bifurcated between Property, Casualty and Workers’ Compensation adjusting services, permitting proposers to propose for both or separately. A selection committee met on April 19, 2022, and scored and ranked the proposals in the following order: Firm Name Final Ranking Johns Eastern Company, Inc. 1 Underwriters Safety & Claims, LLC 2 Hawkeye Claims, LLC 3 Johns Eastern Company, Inc. is a Lakewood Ranch, Florida based Claims Adjusters and Third Party Administration firm with over seventy five years of experience. Johns Eastern Company, Inc. is currently providing Property, Casualty and Workers’ Compensation Third Party Administration Services for the County under Agreement No. 17-7112; and the proposed attached agreement will supplant Agreement No. 17-7112, which expires December 31, 2022. The attached agreement has an effective date of January 1, 2023. FISCAL IMPACT: The estimated base cost of services for calendar year 2023 is $168,000. Sufficient funds are budgeted in Fund 516, Property and Casualty Insurance, and Fund 518, Workers’ Compensation Insurance, for this purpose. GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this item. LEGAL CONSIDERATIONS: This item is approved as to form and legality, and requires majority vote for Board approval.-SRT RECOMMENDATION: That the Board approves the award of a contract for RFP No. 22-7971 to Johns Eastern Company, Inc., and authorize the Chairman to sign the attached agreement. Prepared by: Jeff Walker, CPCU, ARM, Director, Risk Management 16.E.1 Packet Pg. 2671 09/13/2022 ATTACHMENT(S) 1. 22-7971_Executive Summary (5-11-22) (DOCX) 2. 22-7971 NORA Signed (PDF) 3. 22-7971 Request for Proposals (PDF) 4. 22-7971 Final Ranking (PDF) 5. 22-7971 JohnEastern_Contract_VendorSigned (PDF) 6. 22-7971 JohnEastern_COI (PDF) 7. 22-7971 JohnEastern_COI-Cyber (PDF) 16.E.1 Packet Pg. 2672 09/13/2022 COLLIER COUNTY Board of County Commissioners Item Number: 16.E.1 Doc ID: 22467 Item Summary: Recommendation to award Request for Proposal (“RFP”) No. 22-7971, “Property, Casualty and Workers’ Compensation Third Party Administration Services,” to Johns Eastern Company, Inc., and authorize the Chairman to sign the attached agreement. Meeting Date: 09/13/2022 Prepared by: Title: Operations Coordinator – Risk Management Name: Greily Gonzalez 06/06/2022 11:28 AM Submitted by: Title: Division Director - Risk Management – Risk Management Name: Jeff Walker 06/06/2022 11:28 AM Approved By: Review: Procurement Services Ana Reynoso Level 1 Purchasing Gatekeeper Completed 06/06/2022 12:53 PM Procurement Services Kristofer Lopez Additional Reviewer Completed 06/06/2022 12:59 PM Risk Management Jeff Walker Director Review Completed 06/06/2022 4:51 PM Procurement Services Sue Zimmerman Additional Reviewer Completed 07/31/2022 8:56 PM County Attorney's Office Scott Teach Level 2 Attorney Review Completed 08/01/2022 10:31 AM Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 08/01/2022 10:36 AM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 08/01/2022 4:12 PM Office of Management and Budget Susan Usher Additional Reviewer Completed 08/22/2022 3:11 PM County Manager's Office Dan Rodriguez Level 4 County Manager Review Completed 08/30/2022 10:01 AM Board of County Commissioners Geoffrey Willig Meeting Pending 09/13/2022 9:00 AM 16.E.1 Packet Pg. 2673 [16-PRC-03172/1286736/1] EXECUTIVE SUMMARY Recommendation to award Request for Proposal (“RFP”) No. 22-7971, “Property, Casualty and Workers’ Compensation Third Party Administration Services,” to Johns Eastern Company, Inc., and authorize the Chairman to sign the attached agreement. OBJECTIVE: To procure claims adjusting services for the County’s Property, Casualty and Workers’ Compensation insurance program. CONSIDERATION: Florida Statutes Section 768.28(16)(a) authorizes Counties to enter into risk management programs and to purchase insurance as they determine necessary. The procurement of coverage also requires the engagement of a professional third party administration (adjusting) company to adjudicate claims on behalf of the program. The existing County contract with Johns Eastern Company, Inc. is set to terminate on December 31, 2022. On February 15, 2022, the Procurement Services Division advertised RFP No. 22-7971, “Property, Casualty and Workers’ Compensation Third Party Administration Services,” with a response deadline of March 17, 2022. The evaluation criteria included cover letter/management summary; certified minority business enterprise; proposal requirements; costs of services to the County; experience and capacity of the firm; specialized expertise of team members, business implementation plan, and local vendor preference. The RFP was bifurcated between Property, Casualty and Workers’ Compensation adjusting services, permitting proposers to propose for both or separately. A selection committee met on April 19, 2022, and scored and ranked the proposals in the following order: Firm Name Final Ranking Johns Eastern Company, Inc. 1 Underwriters Safety & Claims, LLC 2 Hawkeye Claims, LLC 3 Johns Eastern Company, Inc. is a Lakewood Ranch, Florida based Claims Adjusters and Third Party Administration firm with over seventy five years of experience. Johns Eastern Company, Inc. is currently providing Property, Casualty and Workers’ Compensation Third Party Administration Services for the County under Agreement No. 17-7112; and the proposed attached agreement will supplant Agreement No. 17-7112, which expires December 31, 2022. The attached agreement has an effective date of January 1, 2023. FISCAL IMPACT: The estimated base cost of services for calendar year 2023 is $168,000. Sufficient funds are budgeted in Fund 516, Property and Casualty Insurance, and Fund 518, Workers’ Compensation Insurance, for this purpose. GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this item. LEGAL CONSIDERATIONS: This item is approved as to form and legality, and requires majority vote for Board approval.—SRT RECOMMENDATION: That the Board approves the award of a contract for RFP No. 22-7971 to Johns Eastern Company, Inc., and authorize the Chairman to sign the attached agreement. Prepared by: Jeff Walker, CPCU, ARM, Director, Risk Management 16.E.1.a Packet Pg. 2674 Attachment: 22-7971_Executive Summary (5-11-22) (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party Notice of Recommended Award Solicitation: 22-7971 Title: Property & Casualty and Workers’ Compensation Third Party Admin Services Due Date and Time: March 17, 2022 @ 3:00 PM Respondents: Company Name City County State Final Ranking Responsive/Responsible Johns Eastern Company, Inc. Lakewood Ranch Sarasota FL 1 Yes/Yes Underwriters Safety & Claims, LLC Louisville Louisville- Jefferson KY 2 Yes/Yes Hawkeye Claims, LLC Hollywood Broward FL 3 Yes/Yes Utilized Local Vendor Preference: Yes No Recommended Vendor(s) For Award: On February 15, 2022, the Procurement Services Division released notices of Request for Proposal No. 22-7971 for Property & Casualty and Workers’ Compensation Third Party Administrative Services. 8,621 firms were notified, 47 firms viewed the solicitation information, and three (3) responsive and responsible proposals were received by the March 17, 2022 deadline. The Selection Committee met on April 19, 2022 and after review of the proposals and deliberation, the Committee scored the proposals and ranked the firms as shown above. The committee determined that oral presentations were not required. Staff is recommending award to the top-ranked firm, Johns Eastern Company, Inc. Contract Driven Purchase Order Driven Required Signatures Project Manager: Procurement Strategist: Procurement Services Director: __________________________________ _________________ Sandra Herrera Date DocuSign Envelope ID: 43E32D55-C59D-441A-B96A-1850BC2F25EB 4/27/2022 4/27/2022 4/27/2022 16.E.1.b Packet Pg. 2675 Attachment: 22-7971 NORA Signed (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party Administration COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS REQUEST FOR PROPOSAL (RFP) FOR Property & Casualty and Workers’ Compensation Third Party Administrator Services SOLICITATION NO.: 22-7971 KRISTOFER LOPEZ, PROCUREMENT STRATEGIST PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST, BLDG C-2 NAPLES, FLORIDA 34112 TELEPHONE: (239) 252-8375 Kristofer.lopez@colliercountyfl.gov (Email) This solicitation document is prepared in a Microsoft Word format (Rev 8/7/2017). Any alterations to this document made by the Vendor may be grounds for rejection of proposal, cancellation of any subsequent award, or any other legal remedies available to the Collier County Government. 16.E.1.c Packet Pg. 2676 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 2 SOLICITATION PUBLIC NOTICE REQUEST FOR PROPOSAL (RFP) NUMBER: 22-7971 PROJECT TITLE: Property & Casualty and Workers’ Compensation Third Party Administrator Services PRE-PROPOSAL CONFERENCE: N/A LOCATION: N/A DUE DATE: March 17, 2022 @ 3:00 PM PLACE OF RFP OPENING: PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST, BLDG C-2 NAPLES, FL 34112 All proposals shall be submitted online via the Collier County Procurement Services Division Online Bidding System: https://www.bidsync.com/bidsync-cas/ INTRODUCTION As requested by the Risk Management Division (hereinafter, the “Division or Department”), the Collier County Board of County Commissioners Procurement Services Division (hereinafter, “County”) has issued this Request for Proposal (hereinafter, “RFP”) with the intent of obtaining proposals from interested and qualified consultants in accordance with the terms, conditions and specifications stated or attached. The consultant, at a minimum, must achieve the requirements of the Specifications or Scope of Work stated. The results of this solicitation may be used by other County departments once awarded according to the Board of County Commissioners Procurement Ordinance. Historically, County departments have spent approximately $100,000; however, this may not be indicative of future buying patterns. BACKGROUND Collier County Government operates two self-insurance funds to finance its Property, Casualty, Automobile and Workers’ Compensation programs. Collier County has been self-funded since 1989. Participants in the program include the County of Commissioners, the Clerk of Courts, the Supervisor of Elections, the Property Appraiser, and the Tax Collector. The Department of Risk Management is responsible for the overall management of these programs. The County utilizes the services of a third-party administrator (TPA) to adjudicate and pay claims on its behalf. The County maintains an active role in the management of claims. The County also utilizes the services of a broker/consultant, Brown & Brown (PRIA) to provide assistance in the evaluation and selection of carriers and vendors who service these programs. Brown & Brown (PRIA) is not permitted to accept remuneration of any kind from current or potential vendors of the County. Proposers may choose to submit proposals for Workers’ Compensation and/or Property & Casualty adjusting separately. Property losses covered by insurance will be handled separately by an insurer-approved adjusting firm. Third Party Administrator is requested to handle small Property claims below the deductible under this contract. The County prefers to utilize one administrator for both programs. The County will review all proposals; however, the County reserves the right to accept or reject any and all proposals. The County reserves the option to award either service to different firms. Exhibit A provides claims data for Fiscal Years 17-21 to assist you in the preparation of the proposal. The reports provide All Claims by Coverage Line and Fiscal Year as well as Open Claims by Coverage Line and Fiscal Year. Data is as of January 19, 2022. TERM OF CONTRACT The contract term, if an award(s) is/are made is intended to be for five (5) years with two (2) one (1) year renewal options. Prices shall remain firm for the initial term of this contract. Surcharges will not be accepted in conjunction with this contract, and such charges should be incorporated into the pricing structure. The County Manager, or designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in 16.E.1.c Packet Pg. 2677 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 3 this Agreement for up to one hundred eighty (180) days. The County Manager, or designee, shall give the Contractor written notice of the County's intention to extend the Agreement term not less than ten (10) days prior to the end of the Agreement term then in effect. All goods are FOB destination and must be suitably packed and prepared to secure the lowest transportation rates and to comply with all carrier regulations. Risk of loss of any goods sold hereunder shall transfer to the COUNTY at the time and place of delivery; provided that risk of loss prior to actual receipt of the goods by the COUNTY nonetheless remain with VENDOR. DETAILED SCOPE OF WORK SECTION 1. WORKERS COMPENSATION PROGRAM The program is focused on achieving the best medical outcomes for injured workers at the most reasonable cost. To accomplish this, efforts have been initiated and are on-going to partner with the best medical providers in the local community. The program partners with Community Health Partners (CHP) for case management services. CHP works with the TPA to assure that injured employees receive timely, appropriate care and to assure compliance with the County’s Return to Work Practice. Collier County has established a local network of medicals providers to deliver care according to the appropriate need. SECTION 2. SCOPE OF SERVICES Proposers must agree to provide the following Scope of Services:  administrative services,  claims services,  first notice of injury services,  loss statistic services,  network access and development services,  medical bill review and audit services,  pharmaceutical benefit management services, and  communicable disease management program services. The County requires full and total transparency in its vendor relationships. Therefore, any commission, service fee or other form of remuneration paid to any agent, broker, lobbyist or third party must be identified in the proposal and throughout the term of the contract. SECTION 3. ADMINISTRATIVE SERVICES Proposers are requested to provide the following administrative services: 1. In accordance with state mandated time frames, prepare (with the County's assistance) and file with the appropriate state agencies all applications, bonds, documentation, and data required (if any) for implementation and continuance of the program. 2. In accordance with state mandated time frames, prepare, maintain, and file all records and reports as may be required by legal authorities (state, local, and federal). The vendor shall be responsible for any penalties that result from their failure to provide reports to authorities on a timely basis. 3. Prepare, maintain, and file statistical or other records and reports as required by the County’s excess insurers. Report claims to the County’s excess insurer(s) in accordance with the requirements of the excess insurer(s). Provide a copy of the reports to the County. Follow specific written investigation procedures for any case for which the Excess Workers’ Compensation Insurer requires specific notification or investigation. 4. In accordance with state mandated time frames, prepare, maintain, and file statistical information required by Workers' Compensation Rating Bureaus or appropriate state agencies, including Electronic Data Interface (EDI) and data necessary for the promulgation of experience modifications. 5. Comply fully with all rules, regulations, guidelines or procedures established by the County and the State of Florida, including EDI. Prepare and submit all state required reports on behalf of the County in a timely manner. 6. Recognize that the County will be continuing a Workers’ Compensation program which focuses on respecting the injured worker and the medical providers providing care. Proposers must be committed to work collaboratively with the County to effect program changes and enhancements as requested by the County. 16.E.1.c Packet Pg. 2678 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 4 7. Annually, provide the County with a SAS-70 or similar audit, by whatever name called as required by the County’s financial auditors. The report with a bridge letter, if necessary, must be submitted to the Risk Management Division during the month of October of each year for the period October 1st through September 30th. 8. Prepare and follow provisions for ensuring that in the event of an emergency, e.g., hurricane preparedness, including how proposer’s services will continue, how the County’s employees will be paid indemnity in advance, and how they will be instructed on obtaining medical care. 9. Coordinate and cooperate with any audits associated with the Workers’ Compensation program. 10. Assist the County with its Return to Work program, including identifying return to work opportunities and appropriate use of outside vendors. 11. Attend on-site quarterly claims file review meetings with County staff at no additional cost to the County. 12. Be approved by the County’s excess carrier(s) as an approved TPA. 13. Coordinate data reporting requirements to the County’s actuarial firm to prepare annual actuarial evaluations. SECTION 4. CLAIMS SERVICES Proposers are requested to provide the following claims services: 1. Establish reporting procedures which are compatible with the needs and organizational structure of the County. 2. Provide necessary forms and instructions for use, as needed. Such forms are to include appropriate First Reports of Injury with mailing address of primary recipients preprinted thereon. 3. Provide toll free customer service telephone lines. 4. Develop specific service instructions with the County for the handling of the County’s claims. Develop specific service instructions with the County for the handling of the County’s catastrophic claims. 5. Conduct such investigation into the specifics of each individual report of employee injury as in the exercise of professional judgment would seem necessary. Enhanced efforts shall be taken to identify possible fraudulent claims including recorded statements from claimants and discussions with the claimant’s supervisors. 6. Recommend settlements or denials subject to the exercise of professional judgment and in accordance with County Resolution 2004-15 as may be amended from time to and in accordance with the applicable Workers' Compensation Law or law of damages. The proposer shall work in cooperation with the County’s appointed attorney in the development of recommendations, the preparation and actuation of all necessary stipulations, compromise, and release agreements. 7. The proposer will recommend outside professionals such as surveillance personnel, expert witnesses, accident reconstruction experts and others to assist in the investigation, adjustment, and defense of claims. The approval of experts is subject to the provisions of Resolution 2004-15. The County shall select all outside counsel. (a) The proposer must be able to review all bills for such services for reasonableness and conformity to any pre- established rates or fees and have the ability to adhere to any set pricing schedules. (b) Other firms with whom the County contracts must agree to work collaboratively with these outside professionals, including data sharing, portals and other methods for sharing information. 8. Review all medical bills and bills for other services for which a claim is being made for reasonableness and conformity to rules, regulations, and legally imposed medical and surgical fee schedules. 9. Prepare and maintain files necessary for legal defense of claims and/or other litigation (such as actions for subrogation, contribution, or indemnity) or other proceedings. 10. Where appropriate, attend hearings, depositions, mediations, and other proceedings. The adjuster handling the claim file will provide an updated written file note within 48 hours after the hearing, deposition, mediation or other proceeding. 11. At the request of the County, provide a complete copy of all files involving litigation, potential or actual subrogation, or 16.E.1.c Packet Pg. 2679 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 5 potential or actual recovery from special or second injury funds to the Director, Risk Management, or their designee. 12. Aggressively pursue all possibilities of subrogation, excess insurance reimbursement, third party liens, contribution, or indemnity and/or recovery from special or second injury funds on behalf of the County. 13. Periodically as appropriate, but at least every quarter, review all open cases and complete a strategic action plan in order to assist in the settlement of the cases. Such written reviews shall include a review and verification of outstanding reserves. Participate in quarterly reviews of field case management progress and legal progress. A written summary of the review shall be documented in the open case file. 14. Provide rehabilitative services for injured employees including consultation for retraining or reassignment of employees with limited physical performance arising from covered injuries. 15. Aid in communications/coordination with the County’s safety and accident prevention program staff as necessary including providing claims data needed to target safety and prevention initiatives. 16. Conduct adequate, timely and complete 24-hour contact investigation of claims regardless of exposure (24 hours from first notice to WC management organization, not 24 hours from when adjuster received). 17. Pay vendor bills (attorneys, surveillance, etc.), within 20 days. 18. Develop and follow appropriate written policies when (i) the injured employee requests a second opinion, (ii) medical evaluation is questioned, or (iii) grievance report is filed. 19. Assist, as appropriate, in the scheduling of independent medical examinations 20. Follow all provisions of Florida Statutes in regard to medical benefit entitlement and administration. SECTION 5. ACCESS TO CLAIMS SYSTEM The proposer shall provide the County access to comprehensive on-line real-time electronic claim information data, including reporting capabilities, at no additional cost. If requested, the proposer shall provide the County with monthly reports, as agreed upon by the parties, in such a format as is acceptable to the County. The proposer agrees that the County shall have real-time access to all claim files, including all adjuster notes, supervisory notes, field case management notes, diary items, payment records, medical bills and expense bills in an electronic manner with internet- based access available to the County. The system must also permit the County to add notes to the file as needed. Proposals should detail how this access to claim files will be provided. The proposal evaluation process may include review of the adequacy of proposed systems. The County utilizes the Riskonnect, Risk Management Information System, for its internal use. The TPA shall be able to provide and upload financial data to the system on a monthly basis. SECTION 6. NETWORK ACCESS & DEVELOPMENT SERVICES Proposers are requested to provide the following network access and development services: 1. Provide the County access to a provider network that contains appropriate providers outside Collier County. The County is interested in working with the proposer to assure that high quality providers, particularly in key specialties, are encouraged to participate in the network and who contractually agree to preferred appointment setting criteria, reporting and standards to best address the medical and rehabilitative needs of the County injured employees. Key specialties include internists, orthopedics, neurology, neurosurgery, occupational medicine specialties, pulmonology, infectious disease specialists, ear/nose/throat specialists, allergists, psychiatry and psychology. 2. Assist the County in the development of a client specific network of key providers, as needed, particularly in key specialties. Provide contracting and credentialing services required to develop this client specific network. Provide a local provider relations staff member. Develop and maintain combined directory of customized and traditional providers. 3. Provide peer review and utilization review services, as appropriate. 4. Provide reporting regarding network access, provider costs and outcomes. 16.E.1.c Packet Pg. 2680 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 6 SECTION 7. MEDICAL BILL REVIEW AND AUDIT SERVICES Proposers are requested to provide the following medical bill review and audit services: 1. For Medical Bill Review: (a) Promptly review medical/surgical bills (in and out of network) for accuracy including, but not limited to, as they relate to the following: (i) Duplicate billings (ii) Unbundling of charges (iii) Up coding of charges (iv) Approval and appropriate precertification. (b) Review all medical bills that: (i) Are not subject to fee schedule coding (ii) Are for services not specifically addressed in the fee schedule (iii) Need an in-depth medical interpretation of the rules and regulations (iv) In the exercise of professional judgment, specifically warrant review. (c) Process, pay, and mail bills within 20 days of receipt. 2. Reimburse the County for any overpayments made in the bill review process, within 30 days of identification of overpayment. Reimburse the County for any penalties and/or interest associated with inaccurate payments. 3. For Medical Auditing Services: (a) Audit in-network and out-network hospital/provider bills (i) Exceeding $5,000 (ii) Where a departmental charge exceeds 10% of the total bill, excluding room and County charges (iii) Others at the proposer's discretion or specific request by the County for accuracy and appropriateness (b) Develop and follow written policies on how late charges, no show charges and special payment arrangements are to be handled. 4. Develop and provide communication materials to explain the policies and procedures of the Medical Bill Review and Audit Services to: (a) The County (b) Medical providers 5. Develop and follow written grievance procedures for provider concerns. SECTION 8. PHARMACEUTICAL MANAGEMENT SERVICES The proposer shall recommend a prescription benefit management (PBM) vendor. It is anticipated that the successful proposer will sub-contract these services. Details regarding the PBM’s services should be provided, including access, utilization review services, coordination of claims data and reporting. Fees for pharmaceuticals or pharmaceutical services shall be reimbursable at the applicable fee schedule amount (F.S. 440.13(12)(c)), except where the employer/carrier has contracted for a lower amount. Where the employer/carrier has contracted for such services and the employee elects to obtain them through a provider not a party to the contract, the reimbursement shall be at the schedule, negotiated, or contract price, whichever is lower. Proposers are requested to address the issue of physician dispensing and the high cost of repackaged drugs. Proposers should describe how their other Florida based clients have handled this issue. SECTION 9. CONTAGIOUS DISEASE MANAGEMENT SERVICES The proposer must assist the County in the investigation of and management of the contagious disease management program. When an employee contracts a contagious disease for which there is a likelihood that the disease exposure occurred on the job, the County policy is to treat the illness as a workers’ compensation claim. The administrator will be expected to assist in the investigation of these situations, provide quarterly (or more often, at the request of the County) reporting regarding these situations, as appropriate provide disease management services and manage these claims as workers’ compensation claims. 16.E.1.c Packet Pg. 2681 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 7 SECTION 10. STAFFING REQUIREMENTS Proposers must agree to an average open case load, per adjuster, of no more than 170 cases per licensed adjuster. Proposals should clearly outline the dedicated staffing which will be provided, assigned titles and duties and the hierarchy of staffing. Additionally, proposals shall provide details regarding any adjuster case-load maximums which will be applied. SECTION 11. COST PROPOSAL REQUIREMENTS Cost proposals shall be based upon a flat, annual fee for the scope of services (normal adjusting services) as described above. The fee will be payable in equal monthly installments with payment due on the first day of each month. Fees must include the taking over of all open claims. Annual pricing shall include up to 10 field file investigations per year at no additional cost. Field file investigation costs above this figure shall be priced separately. Medical bill review and audit services shall be priced separately, shall be billed monthly, and shall be paid to the vendor by the County upon review and approval of a separate invoice from the vendor. In no instance, shall the vendor be permitted to issue payment to themselves from the claim fund for services provided. The vendor shall also be fully transparent with regard to all fees received for work performed on behalf of the County from whatever source. SECTION 12. PROPERTY AND CASUALTY PROGRAM The program includes property, crime, general liability, automobile liability and physical damage including subrogation, EMS medical malpractice and public officials’ errors and omissions. SECTION 13. SCOPE OF SERVICES Proposers must agree to provide all of the following services:  administrative services,  claims services, and  access to claims system The County requires full and total transparency in its vendor relationships. Therefore, any commission, service fee or other form of remuneration paid to any agent, broker, lobbyist or third party must be identified in the proposal and throughout the term of the contract. Proposers must identify all sub-contractors who will be used to provide the services outlined in this RFP. The flat fee paid by the County must be the only remuneration to the proposer for services provided to the County and proposers must receive no revenue for these services from sub-contractors. SECTION 14. ADMINISTRATIVE SERVICES Proposers are requested to provide the following administrative services: 1. Prepare (with the County's assistance) and file with the appropriate state agencies all applications, bonds, documentation, and data required (if any) for implementation and continuance of the program. 2. Prepare, maintain, and file all records and reports as may be required by legal authorities (state, local, and federal) including Form 1099 and all reporting required for Medicare set aside provisions. 3. Prepare, maintain, and file statistical or other records and reports as required by the County’s excess insurers. 4. Prepare, maintain, and file statistical information required by Rating Bureaus or appropriate state agencies. 5. Comply fully with all rules, regulations, guidelines or procedures established by the County and the State of Florida. SECTION 15. CLAIMS SERVICES Proposers are requested to provide the following claims services: 1. Establish reporting procedures which are compatible with the needs and organizational structure of the County. 2. Provide necessary forms and instructions for use, as needed. Such forms are to include appropriate accident reports with 16.E.1.c Packet Pg. 2682 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 8 mailing address of primary recipients preprinted thereon. 3. Be available on a 24-hour basis and provide immediate response to claims investigation requests through use of email or cellular telephones. 4. Provide toll free customer service telephone lines. 5. Prepare a work plan that has been approved by Risk Management in the handling of the County’s claims to include catastrophe claims. 6. Receive and examine on behalf of the County all reports of third-party claims including claims by an employee of one Insured against another Insured. 7. Report claims to the County’s excess insurer(s) in accordance with the requirements of the excess insurer(s); request coverage opinions as needed; and secure settlement authority as needed. Follow specific written investigation procedures for any case for which the excess insurer requires specific notification. 8. Within 24 hours after notification of a serious (one requiring more than first aid) third party bodily injury claim, contact the claimant by telephone or in person. Within two working days after notification of any other third-party claim, contact the claimant by telephone or in person. 9. Recommend settlements or denials subject to the exercise of professional judgment and in accordance with County Resolution 2004-15 as may be amended from time to and in accordance with the applicable Law or law of damages. The proposer shall work in cooperation with the County Attorney or the County’s appointed attorney in the development of recommendations, the preparation and actuation of all necessary stipulations, compromise, and release agreements. 10. Conduct such investigation as in the exercise of professional judgment would seem necessary. Follow specific written investigation procedures for any case for which the excess insurer requires specific notification. 11. The proposer will recommend outside professionals such as surveillance personnel, expert witnesses, accident reconstruction experts and others to assist in the investigation, adjustment, and defense of claims. The approval of experts is subject to the provisions of Resolution 2004-15. The County shall select all outside counsel. (a) The proposer must be able to review all bills for such services for reasonableness and conformity to any pre-established rates or fees and have the ability to adhere to any set pricing schedules. (b) Other firms with whom the County contracts must agree to work collaboratively with these outside professionals, including data sharing, portals and other methods for sharing information. 12. Prepare and maintain files necessary for legal defense of claims and/or other litigation (such as actions for subrogation, contribution, or indemnity) or other proceedings. 13. Where appropriate, attend hearings, depositions, mediations, and other proceedings. The adjuster handling the claim file will provide an updated written file note within 48 hours after the hearing, deposition, mediation, or other proceeding. 14. Pay in a timely fashion all claims and expenses pertaining to the County’s claims. 15. Assist in the collection of subrogation, excess insurance reimbursement, third party liens, contribution or indemnity on behalf of the County. 16. Periodically as appropriate, but at least every quarter, review all open cases and complete a strategic action plan in order to assist in the settlement of the cases. Such written reviews shall include a review and verification of outstanding reserves. Participate in quarterly reviews of field case management progress and legal progress. A written summary of the review shall be documented in the open case file. 17. The proposer shall include a per claim fee in their proposal for claims requiring only the issuance of a check (data capture and check issuance claims). Examples include minor automobile and property losses that do not include the full services of an adjuster but do require the issuance of a check. SECTION 16. ACCESS TO CLAIMS SYSTEM The proposer shall provide the County with the ability to access comprehensive on-line real-time electronic claim information data, including reporting capabilities, at no additional cost to the County. If requested, the proposer shall provide the County with 16.E.1.c Packet Pg. 2683 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 9 monthly reports, as agreed upon by the parties, in such a format as is acceptable to the County. The proposer agrees that the County shall have real-time access to all claim files, including all adjuster notes, supervisory notes, field case management notes, diary items, payment records, medical bills and expense bills in an electronic manner with internet based access available to the County. Proposals should detail how this access to claim files will be provided. The proposal evaluation process may include review of the adequacy of proposed systems. The County utilizes the Riskonnect, Risk Management Information System. The TPA is tasked with providing updated financial data to the system at a minimum, on a monthly basis. SECTION 17. STAFFING REQUIREMENTS Proposers must agree to an average open case load, per adjuster, of no more than 170 cases per licensed adjuster. Proposals should clearly outline the dedicated staffing which will be provided, assigned titles and duties and the hierarchy of staffing. Additionally, proposals shall provide details regarding any adjuster case-load maximums which will be applied. SECTION 18. COST PROPOSAL REQUIREMENTS Normal Claims Services. Cost proposals shall be based upon a flat, annual fee for the scope of services (normal adjusting services) as described above. The fee will be payable in equal monthly installments with payment due on the first day of each month. The fee proposal shall include the cost of all adjusting services which are usual and customary to prepare a claim for settlement or closure, whether provided in house or through a subcontractor. The firm shall be responsible for retaining subcontracted adjusting services at no additional charge to the County. Examples of these services include automobile damage appraisal or property damage appraisal services. Exceptions must clearly be delineated in the proposal. Annual pricing shall include up to 10 field file investigations per year at no additional cost. Field file investigation costs above this figure shall be priced separately. *Fees must include the taking over of all old claims. Specialized Services. Specialized services not normally provided by an adjusting company and paid to outside vendors shall be excluded from the annual fee (normal adjusting services) and billed directly to the file. Specialized services include the hiring of experts, accident reconstruction specialists, private investigators, engineers, attorneys, economists, process servers or other such services necessary to support a claim or litigated file. Catastrophe Claims Services. Catastrophe adjusting services, to include named storm property adjusting services, shall be priced separately. The payor of these services may be determined by the County’s reinsurance carrier(s) and is subject to their final approval. The firm shall clearly delineate the cost of these services in their proposal. Data Capture and Check Issuance Services. The proposer shall include a per claim fee in their proposal for claims requiring only the issuance of a check (data capture and check issuance claims). This fee shall be separate from the annual fee. Examples include minor automobile and property losses that do not include the full services of an adjuster but do require the issuance of a check. The vendor shall bill the cost of this service on a monthly basis including backup claims reference information to justify payment. In no instance, shall the vendor be permitted to issue a payment to themselves from the claim fund for services they provide. The vendor shall also be fully transparent with regard to all fees received for work performed on behalf of the County from whatever source. The vendor also agrees to provide annually, a statement of all remuneration received as a result of services provided to the County, if requested. SECTION 19. GENERAL REQUIREMENTS COMPLIANCE. It shall be the responsibility of the proposer to comply with all rules and regulations promulgated by the various state agencies prescribing the practices and procedures of self-insurer service companies. Proposer will be responsible for all required (EDI), Division of Workers Compensation (DWC) reporting. OWNERSHIP OF RECORDS AND DATA. The County shall have all right, title, interest, and ownership to all loss statistics and claim files created as a result of the services to be provided by the proposer. Further, at the sole option of the County and upon ten (10) days written notice, the proposer shall return such files to the County. At the termination of the contract, at the sole expense of the proposer, the proposer shall provide the County with computer media containing all of the claim data. Such data shall be made available in a format generally importable into a commonly recognized database for claims administration services. AUDIT. At the sole option of Collier County, Third-Party Administrator (TPA) shall agree, at no additional cost to cooperate with any audits conducted by Collier County or Collier County’s designee (hereinafter, “Auditor”) of TPA’s claim files and procedures as they relate to the services under this Agreement. Collier County shall have the right to audit during the contract period and for 16.E.1.c Packet Pg. 2684 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 10 five years following the termination of the Agreement. RECORDS DEFINED. The term “Records,” shall mean all documentary and electronic records of TPA and TPA’s subcontractors that are related to the services performed under this Agreement including, but not be limited to:  Financial records (including accounting records, payroll records, timesheets, audited and unaudited financial statements)  Contracts (including contracts with subcontractors and contracts between subcontractors and others)  Contractor performance data  Network and provider agreements  Cost data PROPRIETARY DOCUMENTS. To the extent TPA or TPA’s subcontractor designates any “Records” requested for audit as “Proprietary Records” (i.e., containing confidential information, trade secrets, or private information), TPA shall be allowed to limit the access of Auditor such that Auditor will only be permitted to review such Proprietary Records in controlled conditions at a TPA chosen location. With respect to such Proprietary Records, Auditor’s rights will be limited to on-premises review of such Records and Auditor will not be permitted to retain copies or make reproductions of such Records. Such designation of Records as proprietary by TPA or TPA’s subcontractor shall only be made to the extent reasonable grounds exist for TPA or TPA’s subcontractor to protect the information contained in such Records. INTERNAL AUDIT. The proposer must demonstrate that they maintain an ongoing internal audit practice that is commensurate with generally accepted accounting principles. They must also show that they maintain an ongoing internal claims audit practice to assure that claims are processed in accordance with generally accepted claims practices. MINIMUM QUALIFICATIONS Interested proposers must meet the following minimum qualifications:  Be authorized as an administrator in the State of Florida.  Possess appropriate licensure as required by the State of Florida.  Demonstrate experience administering a program of similar size and scope in Florida.  Meet substantial compliance with the Scope of Services in the RFP.  The proposer must be approved by the excess carriers. Questions regarding pre-approval shall be submitted online via the Collier County Procurement Services Division Online Bidding System: https://www.bidsync.com/bidsync-cas/ REQUEST FOR PROPOSAL (RFP) PROCESS 1.1 The Proposers will submit a qualifications proposal which will be scored based on the criteria in Evaluation Criteria for Development of Shortlist, which will be the basis for short-listing firms. The Proposers will need to meet the minimum requirements outlined herein in order for their proposal to be evaluated and scored by the COUNTY. The COUNTY will then score and rank the firms and enter into negotiations with the top ranked firm to establish cost for the services needed. The COUNTY reserves the right to issue an invitation for oral presentations to obtain additional information after scoring and before the final ranking. With successful negotiations, a contract will be developed with the selected firm, based on the negotiated price and scope of services and submitted for approval by the Board of County Commissioners. 1.2 The COUNTY will use a Selection Committee in the Request for Proposal selection process. 1.3 The intent of the scoring of the proposal is for respondents to indicate their interest, relevant experience, financial capability, staffing and organizational structure. 1.4 The intent of the oral presentations, if deemed necessary, is to provide the vendors with a venue where they can conduct discussions with the Selection Committee to clarify questions and concerns before providing a final rank. 1.5 Based upon a review of these proposals, the COUNTY will rank the Proposers based on the discussion and clarifying questions on their approach and related criteria, and then negotiate in good faith an Agreement with the top ranked Proposer. 1.6 If, in the sole judgment of the COUNTY, a contract cannot be successfully negotiated with the top-ranked firm, negotiations with that firm will be formally terminated and negotiations shall begin with the firm ranked second. If a contract cannot be successfully negotiated with the firm ranked second, negotiations with that firm will be formally terminated and negotiations shall begin with the third ranked firm, and so on. The COUNTY reserves the right to negotiate any element of the proposals in the best interest of the COUNTY. 16.E.1.c Packet Pg. 2685 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 11 RESPONSE FORMAT AND EVALUATION CRITERIA FOR DEVELOPMENT OF SHORTLIST: 1.7 For the development of a shortlist, this evaluation criterion will be utilized by the COUNTY’S Selection Committee to score each proposal. Proposers are encouraged to keep their submittals concise and to include a minimum of marketing materials. Proposals must address the following criteria: Evaluation Criteria Maximum Points 1. Cover Letter / Management Summary 5 Points 2. Certified Woman and/or Minority Business Enterprise 5 Points 3. Proposal Requirements 20 Points 4. Cost of Services to the County 20 Points 5. Experience and Staffing Plans 20 Points 6. Business Implementation Plan 20 Points 7. Local Vendor Preference 10 Points TOTAL POSSIBLE POINTS 100 Points Tie Breaker: In the event of a tie at final ranking, award shall be made to the proposer with the lower volume of work previously awarded. Volume of work shall be calculated based upon total dollars paid to the proposer in the twenty-four (24) months prior to the RFP submittal deadline. Payment information will be retrieved from the County’s financial system of record. The tie breaking procedure is only applied in the final ranking step of the selection process and is invoked by the Procurement Services Division Director or designee. In the event a tie still exists, selection will be determined based on random selection by the Procurement Services Director before at least three (3) witnesses. ---------------------------------------------------------------------------------------------------------------------------------------------------------- Each criterion and methodology for scoring is further described below. ***Proposals must be assembled, at minimum, in the order of the Evaluation Criteria listed or your proposal may be deemed non-responsive*** EVALUATION CRITERIA NO. 1: COVER LETTER/MANAGEMENT SUMMARY (5 Total Points Available) Provide a cover letter, signed by an authorized officer of the firm, indicating the underlying philosophy of the firm in providing the services stated herein. Include the name(s), telephone number(s) and email(s) of the authorized contact person(s) concerning proposal. Submission of a signed Proposal is proposer’s certification that the proposer will accept any awards as a result of this RFP. Property Casualty Claims _____ Interested in this service _____ Not Interested in this service Workers Compensation Claims _____ Interested in this service _____ Not Interested in this service a. Provide the state where all claims will be managed. Property Casualty Claims State of: _____________________ Workers Compensation Claims State of: _____________________ 16.E.1.c Packet Pg. 2686 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 12 Minimum Qualifications- Please respond to the questions below and provide a detailed explanation of any deviation separately. Failure to comply with minimum qualifications will deem you non-responsive. Minimum Qualifications Will Comply Will Not Comply Be authorized as an administrator in the State of Florida and possess appropriate licensure as required by the State of Florida. Provide a copy of your license. Demonstrate experience administering a program of similar size and scope in Florida. Complete at least 3 Reference Questionnaires using Attachment 9. Meet substantial compliance with the Scope of Services in the RFP With the exception of the property insurance, the proposer shall be approved by the excess carriers. EVALUATION CRITERIA NO. 2: CERTIFIED WOMAN AND/OR MINORITY BUSINESS ENTERPRISE (5 Total Points Available) Submit certification with the Florida Department of Management Service, Office of Supplier Diversity as a Certified Woman and/or Minority Business Enterprise. EVALUATION CRITERIA NO. 3: PROPOSAL REQUIREMENTS (20 Total Points Available) In this criteria, include but not limited to: Workers’ Compensation Scope of Services- Please respond to the compliance questions below and provide a detailed explanation of any deviation from the scope of services. Failure to comply with proposal requirements will deem you non- responsive. Scope of Services- Workers’ Compensation Administration Services Will Comply Will Not Comply In accordance with state mandated time frames, prepare (with the County's assistance) and file with the appropriate state agencies all applications, bonds, documentation, and data required (if any) for implementation and continuance of the program. Prepare, maintain, and file statistical or other records and reports as required by the County’s excess insurers. Report claims to the County’s excess insurer(s) in accordance with the requirements of the excess insurer(s). Provide a copy of the reports to the County. Follow specific written investigation procedures for any case for which the Excess Workers’ Compensation Insurer requires specific notification or investigation. In accordance with state mandated time frames, prepare, maintain, and file statistical information required by Workers' Compensation Rating Bureaus or appropriate state agencies, including EDI and data necessary for the promulgation of experience modifications. 16.E.1.c Packet Pg. 2687 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 13 Comply fully with all rules, regulations, guidelines, or procedures established by the County and the State of Florida, including EDI. Recognize that the County will be continuing a Workers’ Compensation program which focuses on respecting the injured worker and the medical providers providing care. Proposers must be committed to work collaboratively with the County to effect program changes and enhancements as requested by the County. Annually, provide the County with a SAS-70 or similar audit, by whatever name called as required by the County’s financial auditors. Prepare and follow provisions for ensuring that in the event of an emergency, e.g., hurricane preparedness, including how proposer’s services will continue, how the County’s employees will be paid indemnity in advance, and how they will be instructed on obtaining medical care. Coordinate and cooperate with any audits associated with the Workers’ Compensation program. Assist the County with its Return-to-Work program, including identifying return to work opportunities and appropriate use of outside vendors. Attend quarterly claims file review meetings in person or via remote means. Be approved by the County’s excess carrier(s) as an approved Third Party Administrator. Coordinate timely data reporting requirements to the County’s actuarial firm to prepare annual actuarial evaluations. Claims Services Establish reporting procedures which are compatible with the needs and organizational structure of the County. Provide necessary forms and instructions for use, as needed. Such forms are to include appropriate First Reports of Injury with mailing address of primary recipients preprinted thereon. Provide toll free customer service telephone lines. Develop specific service instructions with the County for the handling of the County’s claims. Develop specific service instructions with the County for the handling of the County’s catastrophic claims. 16.E.1.c Packet Pg. 2688 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 14 Conduct such investigation into the specifics of each individual report of employee injury as in the exercise of professional judgment would seem necessary. Enhanced efforts shall be taken to identify possible fraudulent claims including recorded statements from claimants and discussions with the claimant’s supervisors. Recommend settlements or denials subject to the exercise of professional judgment and in accordance with County Resolution 2004-15 as may be amended from time to and in accordance with the applicable Workers' Compensation Law or law of damages. The proposer shall work in cooperation with the County’s appointed attorney in the development of recommendations, the preparation and actuation of all necessary stipulations, compromise, and release agreements. The proposer will recommend outside professionals such as surveillance personnel, expert witnesses, accident reconstruction experts and others to assist in the investigation, adjustment, and defense of claims. The approval of experts is subject to the provisions of Resolution 2004-15. The County shall select all outside counsel. Review all medical bills and bills for other services for which a claim is being made for reasonableness and conformity to rules, regulations, and legally imposed medical and surgical fee schedules. Prepare and maintain files necessary for legal defense of claims and/or other litigation (such as actions for subrogation, contribution, or indemnity) or other proceedings. Where appropriate, attend hearings, depositions, mediations, and other proceedings. The adjuster handling the claim file will provide an updated written file note within 48 hours after the hearing, deposition, mediation, or other proceeding. At the request of the County, provide a complete copy of all files involving litigation, potential or actual subrogation, or potential or actual recovery from special or second injury funds to the Director, Risk Management, or their designee. Aggressively pursue all possibilities of subrogation, excess insurance reimbursement, third party liens, contribution, or indemnity, and/or recovery from special or second injury funds on behalf of the County. 16.E.1.c Packet Pg. 2689 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 15 Periodically as appropriate, but at least every quarter, review all open cases and complete a strategic action plan in order to assist in the settlement of the cases. Such written reviews shall include a review and verification of outstanding reserves. Participate in quarterly reviews of field case management progress and legal progress. A written summary of the review shall be documented in the open case file. Provide rehabilitative services for injured employees including consultation for retraining or reassignment of employees with limited physical performance arising from covered injuries. Aid in communications/coordination with the County’s safety and accident prevention program staff as necessary including providing claims data needed to target safety and prevention initiatives. Conduct adequate, timely and complete 24-hour contact investigation of claims regardless of exposure (24 hours from first notice to WC management organization, not 24 hours from when adjuster received). Pay vendor bills (attorneys, surveillance, etc.), within 20 days. Develop and follow appropriate written policies when (i) the injured employee requests a second opinion, (ii) medical evaluation is questioned, or (iii) grievance report is filed. Assist, as appropriate, in the scheduling of independent medical examinations. Follow all provisions of Florida Statutes in regard to medical benefit entitlement and administration. Access to Claims System The proposer shall provide the County access to comprehensive on-line real-time electronic claim information data, including reporting capabilities, at no additional cost. If requested, the proposer shall provide the County with monthly reports, as agreed upon by the parties, in such a format as is acceptable to the County. The proposer agrees that the County shall have real- time access to all claim files, including all adjuster notes, supervisory notes, field case management notes, diary items, payment records, medical bills and expense bills in an electronic manner with internet-based access available to the County. The system must also permit the County to add notes to the file as needed. Proposals should detail how this access to claim files will be provided. The proposal evaluation process may include review of the adequacy of proposed systems. 16.E.1.c Packet Pg. 2690 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 16 The County utilizes Riskonnect, Risk Management Information System. The TPA shall be able to provide and upload financial data to the system on a monthly basis. Network Access and Development Services Provide the County access to a provider network that contains appropriate providers outside Collier County. Key specialties include internists, orthopedics, neurology, neurosurgery, occupational medicine specialties, pulmonology, infectious disease specialists, ear/nose/throat specialists, allergists, psychiatry, and psychology. Assist the County in the development of a client specific network of key providers as needed, particularly in key specialties. Provide contracting and credentialing services required to develop this client specific network. Provide a local provider relations staff member. Develop and maintain combined directory of customized and traditional providers. Provide peer review and utilization review services, as appropriate. Provide reporting regarding network access, provider costs and outcomes. Medical Bill Review and Audit Services Promptly review medical/surgical bills (in and out of network) for accuracy including, but not limited to, as they relate to the following: (i) Duplicate billings (ii) Unbundling of charges (iii) Up coding of charges (iv) Approval and appropriate precertification. (v) Process, pay and submit bills to providers within 20 days of receipt. Review all medical bills that: (i) Are not subject to fee schedule coding (ii) Are for services not specifically addressed in the fee schedule (iii) Need an in-depth medical interpretation of the rules and regulations (iv) In the exercise of professional judgment, specifically warrant review. Reimburse the County for any overpayments made in the bill review process, within 30 days of identification of overpayment. Reimburse the County for any penalties and/or interest associated with inaccurate payments. 16.E.1.c Packet Pg. 2691 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 17 Audit in-network and out-network hospital/provider bills (i) Exceeding $5,000 (ii) Where a departmental charge exceeds 10% of the total bill, excluding room and County charges (iii) Others at the proposer's discretion or specific request by the County for accuracy and appropriateness Develop and follow written policies on how late charges, no show charges and special payment arrangements are to be handled. Develop and provide communication materials to explain the policies and procedures of the Medical Bill Review and Audit Services to: (a) The County (b) Medical providers Develop and follow written grievance procedures for provider concerns. Pharmaceutical Management Services The proposer shall recommend a prescription benefit management (PBM) vendor. It is anticipated that the successful proposer will sub- contract these services. Details regarding the PBM’s services should be provided, including access, utilization review services, coordination of claims data and reporting. Fees for pharmaceuticals or pharmaceutical services shall be reimbursable at the applicable fee schedule amount (F.S. 440.13(12)(c)), except where the employer/carrier has contracted for a lower amount. Where the employer/carrier has contracted for such services and the employee elects to obtain them through a provider not a party to the contract, the reimbursement shall be at the schedule, negotiated, or contract price, whichever is lower. Proposers are requested to address the issue of physician dispensing and the high cost of repackaged drugs. Contagious Disease Management Services The proposer must assist the County in the investigation of and management of the contagious disease management program. When an employee contracts a contagious disease for which there is a likelihood that the disease exposure occurred on the job, the County policy is to treat the illness as a workers’ compensation claim. The administrator will be expected to assist in the investigation of these situations, provide quarterly (or more often, at the request of the County) reporting regarding these situations, as appropriate provide disease management services and manage these claims as workers’ compensation claims. 16.E.1.c Packet Pg. 2692 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 18 Proposers must agree to an average open case load, per adjuster, of no more than 170 cases per licensed adjuster. Proposals should clearly outline the dedicated staffing which will be provided, assigned titles and duties and the hierarchy of staffing. Additionally, proposals shall provide details regarding any adjuster case-load maximums which will be applied. Property Casualty Scope of Services- Please respond to the compliance questions below and provide a detailed explanation of any deviation from the scope of services separately. Administrative Services: Develop & Adhere to Special Handling Instructions Prepare (with the County's assistance) and file with the appropriate state agencies all applications, bonds, documentation, and data required (if any) for implementation and continuance of the program. Prepare, maintain, and file all records and reports as may be required by legal authorities (state, local, and federal) including Form 1099 and all reporting required for Medicare set aside provisions. Prepare, maintain, and file statistical or other records and reports as required by the County’s excess insurers. Prepare, maintain, and file statistical information required by Rating Bureaus or appropriate state agencies. Comply fully with all rules, regulations, guidelines or procedures established by the County, FEMA, the State of Florida, or other regulatory authority. Claims Services Establish reporting procedures which are compatible with the needs and organizational structure of the County. Provide necessary forms and instructions for use, as needed. Such forms are to include appropriate accident reports with mailing address of primary recipients preprinted thereon. Be available on a 24-hour basis and provide immediate response to claims investigation requests through use of email or cellular telephones. Provide toll free customer service telephone lines. Prepare a work plan that has been approved by Risk Management in the handling of the County’s claims to include catastrophe claims. Receive and examine on behalf of the County all reports of third party claims including claims by an employee of one Insured against another Insured. 16.E.1.c Packet Pg. 2693 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 19 Report claims to the County’s excess insurer(s) in accordance with the requirements of the excess insurer(s); request coverage opinions as needed; and secure settlement authority as needed. Follow specific written investigation procedures for any case for which the excess insurer requires specific notification. Within 24 hours after notification of a serious (one requiring more than first aid) third party bodily injury claim, contact the claimant by telephone or in person. Within two working days after notification of any other third-party claim, contact the claimant by telephone or in person. Recommend settlements or denials subject to the exercise of professional judgment and in accordance with County Resolution 2004-15 as may be amended from time to and in accordance with the applicable Law or law of damages. The proposer shall work in cooperation with the County Attorney or the County’s appointed attorney in the development of recommendations, the preparation and actuation of all necessary stipulations, compromise, and release agreements. Conduct such investigation as in the exercise of professional judgment would seem necessary. Follow specific written investigation procedures for any case for which the excess insurer requires specific notification. The proposer will recommend outside professionals such as surveillance personnel, expert witnesses, accident reconstruction experts and others to assist in the investigation, adjustment, and defense of claims. The approval of experts is subject to the provisions of Resolution 2004-15. The County shall select all outside counsel. (a) The proposer must be able to review all bills for such services for reasonableness and conformity to any pre-established rates or fees and have the ability to adhere to any set pricing schedules. (b) Other firms with whom the County contracts must agree to work collaboratively with these outside professionals, including data sharing, portals and other methods for sharing information. Prepare and maintain files necessary for legal defense of claims and/or other litigation (such as actions for subrogation, contribution, or indemnity) or other proceedings. Where appropriate, attend hearings, depositions, mediations, and other proceedings. The adjuster handling the claim file will provide an updated written file note within 48 hours after the hearing, deposition, mediation or other proceeding. Pay in a timely fashion all claims and expenses pertaining to the County’s claims. Assist in the collection of subrogation, excess insurance reimbursement, third party liens, contribution or indemnity on behalf of the County. 16.E.1.c Packet Pg. 2694 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 20 Periodically as appropriate, but at least every quarter, review all open cases and complete a strategic action plan in order to assist in the settlement of the cases. Such written reviews shall include a review and verification of outstanding reserves. Participate in quarterly reviews of field case management progress and legal progress. A written summary of the review shall be documented in the open case file. The proposer shall include a per claim fee in their proposal for the takeover of old claims and for claims requiring only the issuance of a check (data capture and check issuance claims). Examples include minor automobile and property losses that do not include the full services of an adjuster but do require the issuance of a check. Access to Claim System The proposer shall provide the County with the ability to access comprehensive on-line real-time electronic claim information data, including reporting capabilities, at no additional cost to the County. If requested, the proposer shall provide the County with monthly reports, as agreed upon by the parties, in such a format as is acceptable to the County. The proposer shall provide the County with the ability to access comprehensive on-line real-time electronic claim information data, including reporting capabilities, at no additional cost to the County. If requested, the proposer shall provide the County with monthly reports, as agreed upon by the parties, in such a format as is acceptable to the County. The County utilizes the Riskonnect Risk Management Information System. The TPA is tasked with providing updated financial data to the system on a monthly basis. EVALUATION CRITERIA NO. 4: COST OF SERVICES TO THE COUNTY (20 Total Points Available) Cost Proposal- Workers’ Compensation *Ensure fees adhere to the Cost Proposal Requirements Initial Contract Period Fee January 1, 2023 through December 31, 2027 $ /per yr. Does the Annual Fee include the takeover of all runoff claims? Yes_____ No ______ If deviating, please describe below: Field Investigation Fees (if investigations exceed 10 per year) Describe all Charges per Investigation: Medical Review and Bill Audit Services Charge $ /per bill audited and % of savings over Fee Schedule Savings Please provide a Medical Review and Audit Services Description as needed: Fee Transparency Do you agree to comply with the fee transparency requirements in the RFP, including the agreement to disclose 16.E.1.c Packet Pg. 2695 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 21 all sources of compensation? Yes No If deviating, please describe below: Do you agree that under no circumstances shall the selected firm remit payment to themselves via draft from the claim fund? Yes No If deviating, please describe below: Cost Proposal- Property Casualty Normal Claims Services: Initial Contract Period Fee January 1, 2023 through December 31, 2027 $ _ /per yr. Does the Annual Fee include the takeover of all runoff claims? Yes_____ No ______ If deviating, please describe below: Which services are not included in the Normal Claims Fee? Field Investigation Fees (if investigations exceed 10 per year) Describe all Charges per Investigation: Fee Transparency Do you agree to comply with the fee transparency requirements in the RFP, including the agreement to disclose all sources of compensation? Yes No If deviating, please describe below: Do you agree that under no circumstances shall the selected firm remit payment to themselves via draft from the claim fund? Yes No If deviating, please describe below: Catastrophe Property Claims Services. Catastrophe adjusting services, to include named storm property adjusting services, shall be priced separately. The payor of these services may be determined by the County’s reinsurance carrier(s) and is subject to their final approval. Please describe how you propose to price these services: Data Capture and Check Issuance Services. The proposer shall include a per claim fee in their proposal for claims requiring only the issuance of a check (data capture and check issuance claims). This fee shall be separate from the annual fee. Examples include minor automobile and property losses that do not include the full services of an adjuster but do require the issuance of a check. The vendor shall bill the cost of this service on a monthly basis. Fee per Data Capture and Check Issuance $ _______/Issuance If deviating, please describe below: Implementation, Data Transfer/Conversion, and Other Related Cost. 16.E.1.c Packet Pg. 2696 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 22 Charge $___________/onetime fee. Describe how this fee is calculated. EVALUATION CRITERIA NO. 5: EXPERIENCE & STAFFING PLAN (20 Total Points Available) Workers’ Compensation Staffing Will Comply Will Not Comply Proposers must agree to an average open case load, per adjuster, of no more than 170 cases per licensed adjuster. Staffing Please describe your staffing plan, include the following information: • Outline the dedicated staffing which will be provided, assigned titles and duties and the hierarchy of staffing. Additionally, proposals shall provide details regarding any adjuster case-load maximums which will be applied. Provide an organizational chart. • Provide a list all proposed subcontractors who will participate on the team. • Describe the firm’s internal audit procedures. • Describe the firm’s claims system and whether the County will have access to this system, including access to notes and the ability to add notes. • Please state the location where claims will be managed. Property Casualty Will Comply Will Not Comply Proposers must agree to an average open case load, per adjuster, of no more than 170 cases per licensed adjuster. Staffing Please describe your staffing plan, include the following information: • Outline the dedicated staffing which will be provided, assigned titles and duties and the hierarchy of staffing. Additionally, proposals shall provide details regarding any adjuster case-load maximums which will be applied. Provide an organizational chart. • Provide a list all proposed subcontractors who will participate on the team. • Describe the firm’s internal audit procedures. 16.E.1.c Packet Pg. 2697 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party 23 • Describe the firm’s claims system and whether the County will have access to this system, including access to notes and the ability to add notes. • Please state the location where claims will be managed. The County requests that the vendor submits no fewer than three (3) and no more than ten (10) completed reference forms from clients during a period of the last 5 years whose projects are of a similar nature to this solicitation as a part of their proposal. Provide information on the projects completed by the Proposer that best represent projects of similar size, scope and complexity of this project using form provided in Form 5. Proposers may include two (2) additional pages for each project to illustrate aspects of the completed project that provides the information to assess the experience of the Proposer on relevant project work. EVALUATION CRITERIA NO. 6: BUSINESS IMPLEMENTATION PLAN (20 Total Points Available) In this criteria, include but not limited to: • Provide your implementation plan to the transition if you awarded a contract, include a timeline from award date to implementation start date with major milestones identified. Base your plan on a January 1, 2023, start date. EVALUATION CRITERIA NO. 7: LOCAL VENDOR PREFERENCE (10 Total Points Available) Local business is defined as the vendor having a current Business Tax Receipt issued by the Collier or Lee County Tax Collector prior to proposal submission to do business within Collier County, and that identifies the business with a permanent physical business address located within the limits of Collier or Lee County from which the vendor’s staff operates and performs business in an area zoned for the conduct of such business. VENDOR CHECKLIST ***Vendor should check off each of the following items as the necessary action is completed (please see, Vendor Check List)*** 16.E.1.c Packet Pg. 2698 Attachment: 22-7971 Request for Proposals (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party Selection Committee Scoring Sheet Final Ranking RPS #: 22-7971 Title: Property & Casualty and Workers' Compensation Third Party Admin Services Name of Firm Jeff Walker Greily Gonzalez Romona Martinez Michael Stark Heidi Dareus Roosevelt Leonard Total Scores Johns Eastern Company, Inc.81 85 85 76 85 80 492.00 Underwriters Safety & Claims, LLC 64 76 60 74 83 75 432.00 Hawkeye Claims, LLC 45 38 44 51 76 65 319.00 Procurement Professional Kristofer Lopez Page 1 of 1 16.E.1.d Packet Pg. 2699 Attachment: 22-7971 Final Ranking (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, 16.E.1.ePacket Pg. 2700Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2701Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2702Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2703Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2704Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2705Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2706Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2707Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2708Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2709Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2710Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2711Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2712Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.e Packet Pg. 2713 Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2714Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2715Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2716Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2717Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2718Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2719Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2720Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2721Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2722Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2723Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2724Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2725Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2726Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2727Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2728Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2729Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 16.E.1.ePacket Pg. 2730Attachment: 22-7971 JohnEastern_Contract_VendorSigned (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third 04/22/2022 Al Purmort Insurance 3340 Bee Ridge Road Sarasota FL 34239 Margi Furey (941) 924-3808 (941) 924-8799 mfurey@shepherdins.com Johns Eastern Company Inc P.O. Box 110259 Lakewood Ranch FL 34211-0004 Cincinnati Insurance 10677 Zenith Insurance Company 13269 Federal Insurance (Chubb & Son Inc.)002084 22/23 Master w/Crime A Y ENP 0601136 02/01/2022 02/01/2023 1,000,000 500,000 10,000 1,000,000 2,000,000 2,000,000 A Y ENP 0601136 02/01/2022 02/01/2023 100,000 300,000 100,000 A 10,000 ENP 0601136 02/01/2022 02/01/2023 5,000,000 5,000,000 B Y M1099011 01/01/2022 01/01/2023 500,000 500,000 500,000 C Crime 82117112 05/01/2022 05/01/2023 Limit $5,000,000 Retention $25,000 Collier County Board of County Commissioners, OR Board of County Commissioners in Collier County, OR Collier County Government, OR Collier County are included as additional insured on a primary and non-Contributory basis in regards to the General Liability & Commercial Automobile Liability, when required per written contract, but only in accordance with policy terms, provisions and exclusions. Collier County Board of County Commissioners 3295 Tamiami Trail East Bldg. C-2 Naples FL 34112 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER LIMITS(MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) POLICY EFF POLICY NUMBERTYPE OF INSURANCELTR INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 16.E.1.f Packet Pg. 2731 Attachment: 22-7971 JohnEastern_COI (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party Administration Certificate of Liability Insurance Coverage provided by Claim Professionals Liabililty Insurance Company, RRG.This certificate is issued for information purposes only and confers no rights to or upon the Certificate Holder. It does not extend nor alter PO Box 346, Myrtle, MS 38650 the coverage under the policies itemized in this Certificate of Insurance. Telephone: 714.731.7860 Fax: 714.731.4605 Certificate Holder Additional Insured?No Named Insured Collier County Board of County Commissioners Johns Eastern Company, Inc. Purchasing Department PO Box 110259 Procurement Services Lakewood Ranch, FL 34211-0004 3295 Tamiami Trail East Naples, FL 34112-4901 dlederer@JohnsEastern.com This is to certify that the policies of insurance described below have been issued to the insured named above for the policy period indicated below. The insurance afforded by the policies described by this certificate is subject to all the terms, conditions, and exclusions of such policies. Limits shown below may have been reduced by paid claims. Policy Policy Policy Type of Insurance Number Effective Date Expiration Date Limits Errors and Omissions,CP 40116-18 5/15/2022 5/15/2023 Each Occurrence $5,000,000.00 a Claims Made Policy General Aggregate $5,000,000.00 Deductible $25,000.00 General Liability,CP 40116-18 5/15/2022 5/15/2023 Each Occurrence $1,000,000.00 a Claims Made Policy General Aggregate $2,000,000.00 Deductible $25,000.00 Description of Insured's Operations Adjusting, investigation,surveying and damage appraisal of claims or losses for insurance companies,self-insured entities, TPA services, and JECO Excess Agency, Inc. Cancellation Should any of the above policies be cancelled before the expiration date thereof, Claim Professionals Liability Insurance Company will endeavor to mail 30 days written notice to the certificate holder named herein, but failure to mail such notice shall impose no obligation or liability of any kind upon the company or its agents or representatives. 4/21/2022 Authorized Signature: ___________________________________________ Changes to this document are expressly forbidden unless specifically authorized by the Company. 16.E.1.f Packet Pg. 2732 Attachment: 22-7971 JohnEastern_COI (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party Administration INSR ADDLSUBR LTR INSR WVD DATE (MM/DD/YYYY) PRODUCER CONTACTNAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED $PREMISES (Ea occurrence)CLAIMS-MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ PRO- OTHER: LOCJECT COMBINED SINGLE LIMIT $(Ea accident) BODILY INJURY (Per person) $ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS AUTOS ONLY HIRED PROPERTY DAMAGE $AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below POLICY NON-OWNED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) ACORDTM CERTIFICATE OF LIABILITY INSURANCE ACE American Insurance Company 02/04/2022 USI Insurance Services LLC 2502 N Rocky Point Dr. Suite 400 Tampa, FL 33607 855 874-1270 TracyLynn Blaisdell 855 874-0777 selectcommercial@usi.com Johns Eastern Company, Inc. P.O. Box 110259 Bradenton, FL 34211 22667 A Cyber Liability D9510065A 02/09/2022 02/09/2023 $5,000,000 $25,000 Retention Collier County Board of County Commissioners 3295 Tamiami Trail East Naples, FL 34112 1 of 1 #S34873760/M34873750 JOHNSEAS1Client#: 1432613 TLBEW 1 of 1 #S34873760/M34873750 16.E.1.g Packet Pg. 2733 Attachment: 22-7971 JohnEastern_COI-Cyber (22467 : Recommendation to Award RFP 22-7971 "Property, Casualty, & WC Third Party