Bid Detail

18-016 - RFP: Injured on Duty Claims 3rd Party Administration and Accidental Disability

The City of Springfield requests proposals from qualified bidders for third-party administration of both current and new injured on duty and accidental disability retirement claims for fire and police personnel subject to M.G.L. Chapter 41, Sections 100 and 111F and Chapter 32 Accidental Disability Retirement. The contract will be for a one (1) year term.

The City reserves the right to renew the contract on a yearly basis for up to two (2) additional years. The City reserves the right to terminate this contract upon a written sixty (60) day notice.


Injured On Duty and Accidental Disability Retirement Claims Administration and Case Management Services


Injured on duty (IOD) third-party administration (TPA) services shall consist of claims administration, claims monitoring, and case management to and through resolution of all active past, current and future claims and cases. The services shall include: receipt, processing, filing and maintenance of all claim-related forms, reports and notices as required by state law for controlling losses; verification of all medical billings and determination of state authorized rate for payments, including public safety personnel granted accidental disability retirement (ADR);
processing of approved payments to medical providers; timely follow-up with doctors and claimants and investigation of cases, when necessary, to reduce exposure and cost; recommendations of appropriate salary status for final decision by the city. Administration may also include incorporation of nursing or other professional medical services to provide advice and assist in case management.

The service provider will maintain frequent personal contact via telephone, fax and meetings with the Human Resources & Labor Relations Director, City Solicitor, and the Police and Fire Commissioners and/or their designees as needed to coordinate all information, actions, and decisions, including weekly site visits with the Commissioners and/or their designees.

Loss reports for Police and Fire Departments will be issued monthly on claims activity or more frequently if required by the city. The loss report will include information such as claimant’s name, and date of injury/illness, type of injury/illness, nature of the incident, determine if an OSHA recordable work-related injury/illness and document accordingly, medical costs to date, and date of next medical appointment and reason for it.

The report will also include actual payments for salary, if such information is so provided by city. The service provider shall conduct analysis of open claims and loss activity, with findings presented to the Human Resources & Labor Relations Director, City Solicitor, and respective Police and Fire Commissioners, and/or their designees at least monthly or more frequently if required by the city, including collecting, recording and maintaining the reporting information for affected departments’ OSHA Forms 300 and 300A and produce them as needed in a format acceptable to the city and U.S. Department of Labor and Massachusetts Department of Labor Standards.

These services shall be provided for all covered public safety employees, as described under “Background Information”.

BACKGROUND INFORMATION

File Maintenance

The service provider will maintain copies of all salient documentation and files resulting from public safety employee injuries the city deems necessary. The service provider will also maintain all medical reports, attorney letters, notice of third party liens, or any other documentation or files the city deems necessary. The service provider will outline the aforementioned in the narrative of its proposal as well as how it will access city IOD and ADR records and documents with no interruption to the city’s office staff.
Ancillary Support Services

The service provider will offer education and training on interpretation and application of related legislation, various procedures, and interpretive case law, (where applicable). The service provider will assist in advising the city with regard to any administrative or legal proceedings relating to injured on duty claims. The service provider will identify claims with subrogation potential, will assist in placing notice of lien and will monitor status of such claims.

Supplementary Services

When determined necessary, independent medical evaluations, private investigations, occupational safety and health consultants, rehabilitation and functional capacity evaluation service firms, or utilization reviewers will be retained within the parameters of discussions between the service provider and the city. Further, the service provider will not schedule the use of the aforementioned supplementary services without the approval of the Human Resources Department. The service provider will also communicate time limits and budget considerations with outside services and will monitor progress through the conclusion of each claim.


Medical Services Bill Review and Payment

The service provider, upon receipt of bills, shall review bills for causation, appropriateness, and medical necessity. Each bill shall be set to the state rate setting standard using the state CMR designated by the city. The service provider shall process payment of all approved bills to the respective medical providers and shall reconcile said payments on a monthly or monthly billing cycle. The service provider shall also respond to all billing inquiries and provide 1099 forms to all vendors.


SUBMISSION REQUIREMENTS

Bid Submission Requirements
Any Proposer submitting a proposal in response to this RFP shall submit one (1) original unbound, Eight (8) bound copies and One (1) electronic copy of the Technical Proposal and the separately sealed Price Proposal no later than 2:00 P.M. on August 22, 2017. To:

City of Springfield Office of Procurement
Attn: Lauren Stabilo, Chief Procurement Officer
36 Court Street – Room 307
Springfield, MA 01103

Proposals must be received at this office no later than 2:00 p.m. EST on Tuesday, August 22, 2017. The deadline will be strictly observed. Proposals delivered to any other office or location will be rejected as non-responsive. If at the time of the scheduled RFP opening, City Hall or the Office of Procurement is closed due to uncontrolled events such as fire, snow, ice, wind, or building evacuation, the RFP opening will be postponed until 2:00 p.m. on the next normal business day. RFP will be accepted until that date and time.

Proposals shall be delivered by U.S. Mail, Federal Express or other such service or by hand. Delivery by facsimile is prohibited. It is the Proposer’s sole responsibility to ensure that its proposal is received at the proper location at or prior to the deadline.

Proposals will be analyzed by a review committee made up of the various members of Human Resources department; supplemental information or the clarification of information submitted may be requested by the City and obtained from Proposers. The highly advantageous Proposal will be recommended to the Chief Procurement Officer for final approval. In connection with the evaluation of Proposals, oral presentations may be requested of all or some of the Proposers.

The City of Springfield supports the goal of twenty percent minority and women participation in all contracts. No questions will be answered unless received by the Chief Procurement Officer at least 7 days prior to the expiration of the time set for submitting bids or proposals. The Chief Procurement Officer reserves the right to waive any informality in and to reject any or all bids if it is in the public interest to do so.

Available Solicitations

As of 10:04 pm Tuesday, April 23, 2024

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