AGENDA MEMORANDUM

 

 

Meeting Date:           February 14, 2011

 

From:                          Dann Herrin, Risk Manager

 

Subject:                      Resolution for Third Party Claims Administration Services for the self-funded workers’ compensation program

 

 

Staff Recommendation:

Staff recommends approval of the contract with Preferred Governmental Claims Solutions (PGCS) for third party claims administration (TPA) of the City of Leesburg self-funded workers’ compensation program.

 

Background:

The City of Leesburg maintains a self-funded worker’s compensation program which requires the City to contract with a company to provide third party claims administration (TPA). Claims administration services include:

 

·         Claims management including claims investigation, claims processing, and payment of medical bills, wage loss benefits to injured employees and other claims expenses.

 

·         Access to a managed care network of medical providers for the treatment of injured employees.

 

·         Filing all necessary reports to the various regulatory agencies including the State of Florida, Division of Workers’ Compensation, and the Centers for Medicare and Medicaid Services.

 

The City has contracted with Alternative Service Concepts, LLC, since October 2008. Alternative Service Concepts, LLC is a third party claims administration (TPA) service offered through the Florida League of Cities. The quality of service from Alternative Service Concepts, LLC, has become unacceptable which is why City staff recommends non-renewal of our contract with Alternative Service Concepts, LLC.

 

Preferred Governmental Claims Solutions has been providing claims administration of our property and liability claims since 2002. The quality of service from Preferred Governmental Claims Solutions has been excellent.

 

In addition, based upon an average of 63 workers’ compensation claims per year, Preferred Governmental Claims Solutions will save the City $4,047 or 4% in total claims administration fees over the next three years as illustrated below:

 

Account Administration Fees

Per Claim Fee *

Third Party Claims Administrator

2011

2012

2013

2011

2012

2013

3 Year Total

Alternative Service Concepts

$6,474

$6,974

$7,474

$23,625

$23,625

$23,625

$91,797

Preferred Governmental Claims Solutions

$7,200

$7,200

$7,200

$22,050

$22,050

$22,050

$87,750

Savings:

$4,047

* Per Claim Fee is based upon an average of 63 claims per year.

 

Options:        

  1. Approve contract with Preferred Governmental Claims Solutions.
  2. Such alternative action as the Commission may deem necessary.

 

Fiscal Impact:

The first year cost of this contract is an estimated $29,250 based upon 63 claims. Preferred Governmental Claims Solutions has agreed to pay the one-time fee of $2,500 charged by Alternative Service Concepts for the transfer of claims records.

 

Submission Date and Time:    2/9/2011 10:08 AM____

 

Department: ______________________

Prepared by:  ______________________                      

Attachments:         Yes____   No ______

Advertised:   ____Not Required ______                     

Dates:   __________________________                     

Attorney Review :       Yes___  No ____

                                                 

_________________________________           

Revised 6/10/04

 

Reviewed by: Dept. Head ________

 

Finance  Dept. ________JB________                                     

                              

Deputy C.M. ___________________                                                                         

Submitted by:

City Manager ___________________

 

Account No. _________________

 

Project No. ___________________

 

WF No. ______________________

 

Budget  ______________________

 

Available _____________________


 

RESOLUTION NO._______________

 

RESOLUTION OF THE CITY COMMISSION OF THE CITY OF LEESBURG, FLORIDA, AUTHORIZING A CONTRACT WITH PREFERRED GOVERNMENTAL CLAIMS SOLUTIONS TO PROVIDE THIRD PARTY CLAIMS ADMINISTRATION SERVICES FOR THE CITY’S SELF-FUNDED WORKERS’ COMPENSATION PROGRAM; AND PROVIDING AN EFFECTIVE DATE.

 

 

BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF LEESBURG, FLORIDA:

 

THAT the Mayor and City Clerk are hereby authorized to execute a contract with Preferred Governmental Claims Solutions whose address is 615 Crescent Executive Court, Suite 600, Lake Mary, Florida 32746; for providing third party claims administration services for the City’s Self-Funded Workers’ Compensation Program.

 

THAT this resolution shall become effective immediately.

 

PASSED AND ADOPTED by the City Commission of the City of Leesburg, Florida, at a regular meeting held the 14th day of February 2011.

 

 

 

                                                                            __________________________

                                                                             Mayor

 

ATTEST:

 

 

__________________________

City Clerk