For City Council Meeting [June 11, 2019]
TO: Honorable Mayor and City Council
APPROVAL: Sean Grayson, Interim City Administrator
FROM: Cindy Balderas, Human Resources Manager
Title
Request City Council to Approve Contract Amendment No. 1 (Three-Year Renewal Option) for Third-Party Administration of Workers' Compensation to LWP Claims Solutions, Inc. for an Amount Not to Exceed $220,644 for FY2019/2020; $226,160 for FY2020/2021 and $231,814 for FY2021/2022.
(ACTION)
Body
BACKGROUND:
The City of Rialto currently manages workers' compensation claims as a Self-Insured agency. The City utilizes a Third Party Administrator (TPA) to administer its workers' compensation claims ensuring efficient and effective claim management. The duties of the TPA include, but are not limited to: claims administration and adjustment within legal deadlines, setting of and monitoring reserves, scheduling of medical appointments, litigation and subrogation recovery services, organizing subrosa, reviewing and determining requests for approval for medical recommendations, bill review and adjustment, updating procedures as the applicable law changes and reporting of Medicare and Medicaid information as directed by Federal regulation.
ANALYSIS/DISCUSSION:
On September 27, 2016 City Council awarded a three-year contract to LWP Claims Solutions, Inc. (LWP), with a three-year renewal option subject to satisfactory performance.
LWP has worked diligently in managing the city's worker's compensation claims. Below is a chart showing the history of claims that have been processed and closed over the past three-years.
Opened Claims - First Aid (no lost time)
Opened Claims - Indemnity
Opened Claims - Medical (no lost time)
Closed Claims - First Aid (no lost time)
Closed Claims - Indemnity
Closed Claims - Medical (no lost time)
FY2016
|1010|
48
24
46
21
24
FY2017
14
34
19
14
16
18
FY2018
10
33
20
10
|10 10|
16
LWP has not proposed any changes in language in the curren...
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