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ATTACHMENT A <br />WORKERS' COMPENSATION CLAIMS ADMINISTRATION <br />SCOPE OF SERVICES <br />ADMINISTRATIVE SERVICES <br />TPA will provide the following administrative services: <br />1. In accordance with state mandated time frames, prepare (with IRC's assistance) and file with the <br />appropriate state agencies all applications, bonds, documentation, and data required (if any) for <br />implementation and continuance of the program. <br />2. In accordance with state mandated time frames, prepare, maintain, and file all records and reports <br />as may be required by legal authorities (state, local, and federal). <br />3. Prepare, maintain, and file statistical or otherrecords and reports as required by IRC's excess <br />insurers. Report claims to IRC's excess insurer(s) in accordance with the requirements of the <br />excess insurer(s). Provide a copy of the reports to IRC. Follow specific written investigation <br />procedures for any case for which excess Workers' Compensation insurers require specific <br />notification or investigation. It is the responsibility of IRC to provide accurate coverage <br />information regarding any insurance policies insuring claims covered by this Agreement. New <br />insurance information on renewal years will be made within 90 days of renewal date. Excess <br />information will include name and claims reporting address and phone number of all carriers, <br />policy number, effective dates, limits of liability, deductibles, specific retentions and loss funds. <br />Actual polices will be provided. This information is required for each claim year that TPA is <br />handling for IRC. If this information is not made available as outlined in this paragraph, TPA will <br />not be responsible for any penalties, interest, or reductions in excess recoveries because of late <br />reporting. <br />4. In accordance with state mandated time frames, prepare, maintain, and file statistical information <br />required by Workers' Compensation Rating Bureaus or appropriate state agencies, including <br />electronic data interface (EDI) and data necessary for the promulgation of experience <br />modifications. <br />5. Comply fully with all rules, regulations, guidelines or procedures established by IRC and the State <br />of Florida, including EDI. <br />6. Provide IRC, annually, with the latest paylag report from the State of Florida. <br />7. Annually, provide IRC with a SSAE-18 audit as required by the financial auditors. <br />8. Prepare and follow provisions specific to IRC, for approval by IRC, for ensuring services in the <br />event of an emergency; e.g., hurricane preparedness, including how TPA services will continue, <br />99 <br />