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Home My WebLink About2012-184 10� � al � '1 g . N • ll,�ax�rs ► l�raiiY Io �a - 18 Claim Adjusters and Third Parry Administrators ADDENDUM NUMBER II TO SERVICE CONTRACT FOR MULTIPLE LINES CLAIMS HANDLING This is the Second Addendum to the Agreement entered into between JOHNS EASTERN COMPANY, INC., hereinafter called the SERVICE AGENT, and INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS, hereinafter called the CLIENT, dated the 1st day of October, 2011 . This Addendum affects the remuneration to be paid by the CLIENT to the SERVICE AGENT for the handling of claims with a date of loss of October 1, 2012 through September 30, 2016. All other terms of the original Contract remain unchanged. The remuneration to be paid to the SERVICE AGENT under this Agreement by the CLIENT for workers' compensation claims handling and safety services during the term of this Agreement shall be as follows: 4 . Allocated Claims Expenses. Charges for services below are billed at negotiated rates for vendors selected by CLIENT/SERVICE AGENT unless otherwise outlined below. "Allocated Claims Expenses" shall be defined as expenses arising in connection with the settlement of claims, which shall be defined as expenses directly allocated to a particular claim to be discharged from the accounts funded by the CLIENT specified in Paragraph 3, including, but not limited to : a . Attorneys' and legal assistants' fees for claim and any lawsuits, before and at trial, on appeal, or otherwise, b . Court and other litigation and settlement expenses, including, without limitation : (i ) Medical examinations to determine extent of liability; ( ii ) Expert medical and other testimony; (iii ) Laboratory, X-ray and other diagnostic tests; (iv) Autopsy, surgical reviews, and other pathology services; (v) Physician and related fees and expenses in reading, interpreting, or performing any of the foregoing tests or services ; (vi ) Stenographer, process server, and other related trial preparation, trial, settlement, and court costs; (vii ) Witnesses fees and expenses before and at trial, deposition, settlement discussions, or otherwise, and c. Fees and expenses for surveillance, private investigators, or otherwise, d . Fees for the indexing of injured claimants, e. Fees for any work done outside the office, including, but not limited to, field investigations necessary to determine compensability, liability, Special Disability Trust Fund or subrogation recoverability, claimant control, attendance at mediations, hearings and depositions, attendance at management meetings, attendance at medical consultations or hearings, appraisals, case management, recorded statements, f. Fees for any field investigation will be $ 105 .00, $0. 55 a mile and $ 1 . 00 per photograph, and administrative expenses. We will bill at these rates all activities involving, handling, controlling, or settling a client's liability on claim , g. Fees for over-night or special mail service for various documents, h . Fees for examining and reducing hospital and medical bills as appropriate i . Photocopying and/or CD- ROM copies, review of relevant documentation . j . Pre-Certification of Hospital Admissions, On-Site Case Management, Peer Review, Medical Care Audits, and Hospital Bill Audits . k. Medical Management — Telephonic case management would be provided on all cases at a rate of: • $525 .00 per lost time exposure • $ 125 .00 per medical only exposure I . Provider Bill Review/Cost Containment Services — Fees for these services are : • $5 .95 per bill • 30% of all savings over and above Fee Schedule reductions • 35% out-of-network and hospital audits m . Medicare Set-Aside ( MSA) services to include; recommendation for MSA submission, MSA cost projection, MSA submission, liability MSA services, comprehensive drug utilization review, lien search, conditional lien dispute, projection update. 5 . Compensation for the Service Agent: For performing its services under this Agreement, the Service Agent shall be entitled to the following compensation : a . Fees for handling the CLIENT'S workers' compensation exposures whose dates of loss fall between October 1, 2012 and September 30, 2013 will be a minimum and deposit of $ 64,844.00. This fee contemplates handling 150 workers' compensation exposures . If the number of exposures exceeds 150, then the fees will be increased proportionately. All years subject to audit. b . Fees for handling the CLIENT'S non-workers' compensation exposures whose dates of loss fall between October 1, 2012 and September 30, 2013 will be a minimum and deposit of $ 13,400 .00. This fee contemplates handling 22 non-workers' compensation exposures . If the number of exposures exceeds 22, then the fees will be increased proportionately. All years subject to audit . c. Fees for handling the CLIENT'S workers' compensation exposures whose dates of loss fall between October 1, 2013 and September 30, 2014 will be a minimum and deposit of $ 67,438 .00. This fee contemplates handling 150 workers' compensation exposures . If the number of exposures exceeds 150, then the fees will be increased proportionately. All years subject to audit. d . Fees for handling the CLIENT'S non-workers' compensation exposures whose dates of loss fall between October 1, 2013 and September 30, 2014 will be a minimum and deposit of $ 13,936 .00. This fee contemplates handling 22 non-workers' compensation exposures . If the number of exposures exceeds 22, then the fees will be increased proportionately. All years subject to audit. e. Fees for handling the CLIENT'S workers' compensation exposures whose dates of loss fall between October 1, 2014 and September 30, 2015 will be a minimum and deposit of $70, 136 .00. This fee contemplates handling 150 workers' compensation exposures . If the number of exposures exceeds 150, then the fees will be increased proportionately. All years subject to audit. f. Fees for handling the CLIENT' S non-workers' compensation exposures whose dates of loss fall between October 1, 2014 and September 30, 2015 will be a minimum and deposit of $ 14,493 .00 . This fee contemplates handling 22 non-workers' compensation exposures. If the number of exposures exceeds 22, then the fees will be increased proportionately. All years subject to audit. g. Fees for handling the CLIENT'S workers' compensation exposures whose dates of loss fall between October 1, 2015 and September 30, 2016 will be a minimum and deposit of $71,539 .00. This fee contemplates handling 150 workers' compensation exposures. If the number of exposures exceeds 150, then the fees will be increased proportionately. All years subject to audit . h . Fees for handling the CLIENT' S non-workers' compensation exposures whose dates of loss fall between October 1, 2015 and September 30, 2016 will be a minimum and deposit of $ 14,783 .00 . This fee contemplates handling 22 non-workers' compensation exposures. If the number of exposures exceeds 22, then the fees will be increased proportionately. All years subject to audit. All other terms of the original contract remain unchanged . IN WITNESS WHEREOF, the SERVICE AGENT and the CLIENT have each caused this Addendum to be executed by its duly authorized representative to be effective the 1st day of October 2012 . WITN ES: JOHN ASTERN COMPANY, INC. B ve y Adkin IC, AIM G� E utive Vic resident Special Account Services Qp°,�y�pMMISs j0 4.,� +' v' •; '. INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS e n s ° 'QQ� %q?i ' y�:•'° Gary C . Wh r, Chairman 17ppp°° pp° pM°q° ATTEST: Jeffrey R. Smith BCC approved : 30 /09 / 2012 Cl rk of Cou B Y• Deputy Clerk Approved as to form and legal sufficiency.