PROPOSAL #RFP13-12-13
WORKERS’ COMPENSATION CLAIMS ADMINISTRATRATION
SANTA CLARA COUNTY OFFICE OF EDUCATION
January 7, 2013
ADDENDUM #1
FOR
WORKERS’ COMPENSATION CLAIMS ADMINISTRATRATION
AT
SANTA CLARA COUNTY OFFICE OF EDUCATION
This Addendum forms a part of the Proposal Documents for above subject project and modifies the original project specifications as noted below. Acknowledge receipt of this Addendum in your proposal response. Failure to do so may subject your response to disqualification.
The following items in RFP13-12-13 have been amended as follows:
Section V, item 5.2: One original and six five copies.
Q & A’s
The following questions and answers were generated from emails, phone-in questions, and inquiries through Monday, January 7, 2013. Any responses resulting in a change to the requirements of the RFP are noted above.
1.Q.Must the response be limited to 75 pages?
A.No, please use that only as a guide. If your financial summary is more than four or five pages, it is too long.
2. Q.Which directions do I follow to respond, Section V or Section VII?
A.Section V is a general description of what should be in the proposal, sections VII and VIII elaborate on those areas.
3.Q.Five copies plus original?
A.Yes, five copies plus original.
4. Q. How long has incumbent been handling your claims/where?
A.Approx. 5 years with EOS, then Tristar bought them out, about 7 years w/Tristar in Walnut Creek, CA.
5.Q.What is current pricing for administration?
A. $16,245 per month, bill review and PPO fees are separate.
6.Q.Current staffing allocated from TPA?
A.1 dedicated Senior Claims Examiner, 1 Supervisor, 1 Claims Assistant + analytical assistance from management.
7.Q.Who handles PPO, UR, NCMS, Bill Review?
A.All handled in-house by Tristar. (open to consideration of unbundling)
8.Q.How many claims? How many indemnity, MO, FAO?
A.Please see attached SIP report for 11-12.
9.Q.Does RFP include tail claims?
A.Yes, all claims will be transitioned to new TPA.
10.Q.What about SCIF claims?
A.We do not have any claims with SCIF,
11.Q.Does SCCOE have a nurse triage 24-hour program?
A.No, we do not want this.
12.Q.Is a pharmacy program in place?
A.Yes
13.Q. Are you happy with your current administrator?
A.As happy as can be expected. Our contract has run out so we are completing our due diligence.
NOTE: A second addendum will be issued by no later than close of business Wednesday, January 9th containing responses to questions made at our pre-proposal meeting to be held on Tuesday, January 8th, 2013 (Agenda attached).
++ END OF ADDENDUM ONE ++
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A. D. Bursch CPM
Purchasing Manager