COUNTY OF ALAMEDA
REQUEST FOR PROPOSAL No. 900518
SPECIFICATIONS, TERMS & CONDITIONS
For
GENERAL LIABILITY THIRD PARTY ADMINISTRATOR (TPA) SERVICES
NETWORKING/BIDDERS CONFERENCES
at
10 a.m.on
January 28, 2009
at
General Services Agency
Room 1107, 11th Floor
1401 Lakeside Drive
Oakland, Ca 94612 / 2 p.m.
on
January 29, 2009
at
County of Alameda – Public Works Agency
Conference Room
4825 Gleason Drive
Dublin, CA 94568
For complete information regarding this project see RFP posted at http://www.acgov.org/gsa_app/gsa/purchasing/bid_content/contractopportunities.jsp or contact the person listed below. Thank you for your interest!
Contact Person: Stefanie Taylor, Contracts Specialist II
Phone Number: (510) 208-9610
E-mail Address:
RESPONSE DUE
By
2:00 p.m.
On
March 12, 2009
at
Alameda County, GSA-Purchasing
1401 Lakeside Drive, Suite 907
Oakland, CA 94612
COUNTY OF ALAMEDA
REQUEST FOR PROPOSAL No. 900518
SPECIFICATIONS, TERMS & CONDITIONS
For
General Liability Third Party Administrator (TPA) Services
TABLE OF CONTENTS
Page 1 of 2
Page
I. ACRONYM AND TERM GLOSSARY 4
II. STATEMENT OF WORK
A. Intent 4
B. Scope 5
C. Loss & Claims History 6
D. Vendor Minimum Qualifications / Specific Requirements 6
E. Debarment and Suspension 12
III. INSTRUCTIONS TO BIDDERS
F. County Contacts 13
G. Calendar of Events 13
H. Networking/Bidders Conference 14
I. Submittal of Bids 15
J. Response Format 17
K. Evaluation Criteria / Selection Committee 17
L. Contract Evaluation and Assessment 22
M. Notice of Award 22
N. Bid Protest / Appeals Process 23
IV. TERMS AND CONDITIONS
O. Term / Termination / Renewal 24
P. Quantities 24
Q. Pricing 24
R. Award 25
S. Method of Ordering 26
T. Invoicing 26
U. County Provisions 27
V. Online Contract Compliance System 29
W. Compliance Information and Records 30
X. Account Manager/Support Staff 31
Y. General Requirements 31
COUNTY OF ALAMEDA
REQUEST FOR PROPOSAL No. 900518
SPECIFICATIONS, TERMS & CONDITIONS
For
General Liability Third Party Administrator (TPA) Services
TABLE OF CONTENTS
Page 2 of 2
ATTACHMENTS
Exhibit A – Acknowledgement
Exhibit B – Bid Form (Parts 1, 2, and 3)
Exhibit C – Insurance Requirements
Exhibits D-1 and D-2 – Current and Former References
Exhibit E – SLEB Certification Application Package
Exhibit F – Small and Local Business Subcontracting Information
Exhibit G – Request for Small and Local or Emerging Preference
Exhibit H – First Source Agreement
Exhibit I – Exceptions, Clarifications, Amendments
Exhibit J – Standard Agreement Contract Draft
Exhibit K – Environmental Certification “Intentionally Omitted”
Exhibit L – RFP Vendor Bid List
Exhibit M – Response/Content Submittal; Completeness Check List
Exhibit N – Debarment and Suspension Certification
Specifications, Terms & Conditions
for General Liability Third Party Administrator (TPA) Services
I. ACRONYM AND TERM GLOSSARY
Unless otherwise noted, the terms below may be upper or lower case. Acronyms will always be uppercase.
ADA / American Disabilities ActARM-P / Associate in Risk Management for Public Entities
Bid / Shall mean the bidders’/contractors’ response to this Request
Bidder / Shall mean the specific person or entity responding to this RFP
Board / Shall refer to the County of Alameda Board of Supervisors
CAO / County Administrator’s Office
CSAC-EIA / California State Association of Counties-Excess Insurance Authority
CSC / Shall refer to County Selection Committee
Contractor / When capitalized, shall refer to selected bidder that is awarded a contract
County / When capitalized, shall refer to the County of Alameda
County Counsel / Office of the County Counsel
Federal / Refers to United States Federal Government, its departments and/or agencies
Labor Code / Refers to California Labor Code
MIS / Management Information System
OCC / Office of the County Counsel
Proposal / Shall mean bidder/contractor response to this RFP
PO / Shall refer to Purchase Order(s)
Request for Proposal / Shall mean this document, which is the County of Alameda’s request for contractors’/bidders’ proposal to provide the services being solicited herein. Also referred herein as RFP.
Response / Shall refer to bidder’s proposal submitted in reply to RFP
RFP / Request for Proposal
RMU / Risk Management Unit
SLEB / Small Local Emerging Business
STARS / Risk Management Information System provided by CS STARS
State / Refers to State of California, its departments and/or agencies
TPA / Third Party Administrator
II. STATEMENT OF WORK
A. INTENT
It is the goal of the Alameda County, County Administrator’s Office - Risk Management Unit to contract with a Third Party Administrator (TPA) who is responsive to County needs, goal oriented, dedicated to high standards of administration, and capable of developing a cost effective and proactive liability and medical malpractice administration program. It is the intent of these specifications, terms and conditions to describe the minimum vendor requirements and qualifications.
The County intends to award a three-year contract with two one-year options to renew to the bidder(s) selected as most capable of meeting the County’s requirements.
B. SCOPE
In the County Administrator's Office (CAO), the Risk Management Unit (RMU) is responsible for employee health and wellness services, the workers' compensation program, the disability management return-to-work program, occupational health and safety programs, property and casualty insurance, and the County's self insurance programs for medical malpractice and general liability.
The County currently maintains a self-insured retention level of $1 million for general liability and $100,000 for medical malpractice coverage, with excess insurance limits above the self-insured retention level. The County administers its claims (tort, civil rights, employment practices, medical malpractice, property damage, etc.) through a TPA. These claims are funded through the County’s risk reserves (self-insurance) and participation in various California State Association of Counties-Excess Insurance Authority (CSAC-EIA) programs.
The TPA, RMU, and the Office of County Counsel (OCC) work closely with departments to educate, train, and revise business procedures in order to minimize the risk of exposure to liability. Management of the liability claims program is provided by the liability claims administrator, under the auspices of the RMU. The TPA works closely with the RMU with respect to specific case direction and execution. The TPA serves the County as a central component of an integrated, multi-disciplinary, liability claims program in a manner intended to minimize duplication and staff/resource impacts and maximize program flexibility.
The TPA is responsible for providing guidance and direction to outside counsel and an interface between outside counsel and the RMU. In addition, the TPA acts as a client representative on behalf of the County during formal settlement conferences, in whatever form they take, and provides litigation support, as feasible, including investigative services to both outside counsel and the OCC. The TPA is expected to attend settlement and mediation hearings of County cases and provide direction based upon past experience in resolving litigation.
The Alameda County Director of Risk Management and/or Liability Claims Administrator shall administer any TPA contract which may be awarded through this competitive bid process. Interested and qualified Contractors with the capability of performing the above noted tasks, who meet the minimum requirements identified below and have demonstrated the ability to successfully administer liability claims, are invited to submit proposals.
C. LOSS & CLAIMS HISTORY
The County has approximately three hundred (300) to four hundred (400) open claims at any one time. The average number of claims filed per year is four hundred fifty (450), based upon the last five (5) years of experience. The County uses a state-of-the-art claims management information system to produce a variety of reports to assist in managing claims, meet various reporting requirements and provide information to the Board of Supervisors (Board), its agencies and departments. The County currently uses CS STARS Risk Management Information System (STARS). The TPA is required to use the STARS system or a similar system approved by RMU when handling County claims. Information on the STARS system can be accessed through www.starsinfo.com. The County will supply the required STARS licenses for the TPA. The TPA may suggest other claims management information systems for consideration by the County.
D. VENDOR MINIMUM QUALIFICATIONS / SPECIFIC REQUIREMENTS
1. Vendor Minimum Qualifications
a. A minimum of ten (10) years of experience administering claims as a TPA for a California public agency, a California county or a public entity that has claims of a similar number and nature, including law enforcement.
b. Bidder must possess all permits, licenses, and professional credentials necessary to perform services specified in this RFP.
2. Specific Requirements
- County requirements for its TPA include but are not limited to the following:
i. Bidder must provide a detailed strategy to reduce the amount paid out in claims as part of their response.
ii. Bidder must provide a demonstrated history of effective use of computerized claims management systems as part of their response.
iii. Bidder will provide the name of the individual designated to maintain and handle litigated claims deemed significant by the County (i.e. section 1983, ADA, civil rights, and employment practices claims). This individual must be experienced in the foregoing areas and will assist the TPA in oversight of all litigated claims and will have significant input within the area of litigation management. This individual will have a minimum of ten (10) years of experience adjusting and/or administering litigated claims for a California county. Individuals holding designations such as Associate in Risk Management for Public Entities (ARM-P) are preferred.
Bidder must maintain an individual with the specified experience mentioned above on the team supporting any TPA contract that may be awarded as a result of this competitive bid process. In the event of employee turnover, Bidder must show a good faith effort to replace this individual with someone who also meets the specified experience requirements mentioned above. Bidder must submit proof of replacement efforts (i.e. recruiter’s contract, newspaper/ online advertisements, etc.). When a replacement has been selected, Bidder must submit a copy of the successful candidate’s resume to GSA-Purchasing for review.
iv. Bidder must state the number of claims adjusters that will be assigned to this contract and outline their experience. Additionally, the total maximum number of County claims assigned per examiner must be provided. If the claims adjuster handles multiple clients, the total maximum number and types of cases assigned for all clients must also be provided.
v. TPA must create a review system to ensure accurate data will be entered into the claims management system. All claims must be reviewed on a periodic basis to be determined by RMU. The review system will include a check on all the financial documentation entered into the claims management system to ensure the financial integrity of the system. In addition, the review system must include appropriate claims handling and reserving procedures, and timely file closures.
vi. TPA must comply with all reporting requirements of the CSAC-EIA. Requirements include notifying, on a timely basis, RMU and CSAC-EIA of any claims that may exceed the County’s self-insured retention. Such notification shall be by telephone, followed in writing to the County and a first report notice shall be submitted to the CSAC-EIA.
vii. On a monthly basis, TPA will review selected County claims with RMU and designated Office of County Counsel (OCC) personnel or other County officials to discuss the status of ongoing claims and litigation and make case strategy recommendations.
viii. TPA will cooperate, assist, and meet with auditors and actuaries reviewing the County’s and the TPA’s system and records. TPA will provide documents to auditors and actuaries upon request. To ensure a high quality work product, TPA will also cooperate, assist and meet with RMU on TPA audits conducted by RMU.
ix. TPA must provide comprehensive claims management and administration, including assuming the handling of existing open cases. This will include investigation, case management, defense management and settlement/negotiations. All claims are to be managed to their final conclusion.
x. The County reserves the right to approve or change an investigation firm, appraiser or similar service provider related to handling claims that may be recommended by TPA.
xi. TPA must ensure that the services provided by outside counsel are in accord with the County’s retainer agreement and RFP for outside law firms. Cases directly handled by OCC should meet the reporting requirements applicable to outside counsel.
xii. TPA must proactively manage County claims, identify loss trends, and suggest steps that might be taken to mitigate future claims.
xiii. TPA must recommend or provide experts to assist County staff in their ongoing efforts to identify and evaluate means to reduce potential future risk. TPA will also provide assistance in monitoring and critiquing the County’s overall liability program.
xiv. TPA shall be required to report to the County any assigned claims determined to present a potential conflict of interest. TPA will not represent the County where a conflict may exist without a written waiver from the County.
xv. Bidder, as part of the cost submitted on Exhibit B – Bid Form, shall include the cost of obtaining the claims files from the prior TPA. At the end of the contract term, the TPA will transfer the files to any new TPA without additional cost.
- The County requires TPA to provide the following case and claims management services:
i. TPA shall be able to manage and administer liability claims on open existing cases or as may be assigned by the County during the term of this agreement. TPA shall investigate, evaluate, process, manage and resolve bodily injury, personal injury and property damage claims and potential claims for money damages asserted by third parties against County, its officers, agents, or employees for which County, its officers, departments, commissions, related agencies, or any of its employees are alleged to be legally responsible. TPA shall coordinate, consult, and fully cooperate with County personnel in the administration of those claims.
ii. TPA shall be qualified to perform as the administrator of the County’s self-insured liability program.
iii. TPA shall, as part of its proposal, outline its procedures regarding timely and appropriate file closures.
iv. TPA shall conduct timely and complete investigations and assemble documentation of all claims including, if applicable, loss scene photographs, statements, interviews, medical documentation, etc.