2001-24232 RESO
RESOLUTION NO, 2001-24232
A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF
THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE
RANKING OF THE PROPOSALS RECEIVED AND
AUTHORIZING THE ADMINISTRATION TO ENTER INTO
NEGOTIATIONS AND, IF SUCCESSFUL, AUTHORIZING THE
MAYOR AND CITY CLERK TO EXECUTE A CONTRACT WITH
THE NUMBER-ONE RANKED FIRM, JOHNS EASTERN CO"
PURSUANT TO REQUEST FOR PROPOSALS (RFP) NO, 145--99/00
FOR CLAIM ADMINISTRATION SERVICES FOR THE CITY OF
MIAMI BEACH SELF-INSURED WORKERS' COMPENSATION
PROGRAM WITH AN ESTIMATED ANNUAL FEE FOR THE
FIRST TWO YEARS, IN THE AMOUNT OF $265,315.00, TO BE
INCREASED BY A MAXIMUM NOT TO EXCEED SEVEN
PERCENT (7%) FOR YEARS THREE AND FOUR,
RESPECTIVELY; SHOULD THE ADMINISTRATION BE UNABLE
TO REACH AGREEMENT WITH JOHNS EASTERN CO"
AUTHORIZING THE ADMINISTRATION TO ENTER INTO
NEGOTIATIONS WITH THE NUMBER-TWO RANKED FIRM,
JLT INSURANCE SERVICES, AND IF UNSUCCESSFUL,
AUTHORIZING THE ADMINISTRATION TO ENTER INTO
NEGOTIATIONS WITH THE NUMBER-THREE RANKED FIRM,
MULTI-LINE CLAIMS SERVICE.
WHEREAS, on November 3, 2000, the City issued Request for Proposals (RFP) No, 145-
99/00 for Claim Administration Services for the City of Miami Beach Self-Insured Workers'
Compensation Program; and
WHEREAS, thirty eight (38) specification packages for RFP No, 145-99/00 were issued
resulting in the receipt of nine (9) responsive proposals; and
WHEREAS, an Evaluation Committee recommended by the City Manager met on
December 19, 2000, and recommended the firm of Johns Eastern Co" as the number-one ranked
respondent, JL T Insurance Services, as the number-two ranked respondent, and Multi-Lines Claim
Service, as the number-three ranked respondent; and
WHEREAS, funding is available from the SelfInsurance Fund Number 540,1790,000381 and
Fund Number 540,1790.000312; and
WHEREAS, the City Manager has reviewed the responses and recommendation of the
Evaluation Committee, and concurs with the Evaluation Committee's recommendation,
NOW, THEREFORE, BE IT DULY RESOLVED BY THE MAYOR AND THE CITY
COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, that the Mayor and City
Commission hereby authorize the Administration to enter into negotiations and, if successful,
authorizing the Mayor and City Clerk to execute a contract with the number-one ranked firm, Johns
Eastern Co" pursuant to Request for Proposals (RFP) No. 145-99/00 for Claim Administration
Services for the City of Miami Beach Self-Insured Workers' Compensation Program, with an estimated
annual rate for the first two years, in the amount of$265,315,OO, to be increased by a maximum not to
exceed seven percent (7%) for years three and four, respectively; should the Administration be unable
to reach agreement with Johns Eastern Co., authorizing the Administration to enter into negotiations
with the number-two ranked firm, JL T Insurance Services, and if unsuccessful, authorizing the
Administration to enter into negotiations with the number-three ranked firm, Multi-Line Claims
Service,
PASSED AND ADOPTED this 10th day of
,...u, W/!j 2001
Mayor
ATTEST:
JILwJ P ~
City Clerk
APPROVED AS TO
FORM & lANGUAGE
& FOR EXECUTION
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Om...
CITY OF MIAMI BEACH
CITY HALL 1700 CONVENTION CENTER DRIVE MIAMI BEACH, FLORIDA 33139
http:\\ci.miami+beach.f1.us
COMMISSION MEMORANDUM NO. ?..O-o I
TO:
Mayor Neisen O. Kasdin and
Members of the City Commission
DATE: January 10, 2001
FROM:
Jorge M. Gonzalez
City Manager
\~
SUBJECT: A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE
CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE RANKING OF
THE PROPOSALS RECEIVED AND AUTHORIZING THE
ADMINISTRATION TO ENTER INTO NEGOTIATIONS AND, IF
SUCCESSFUL, AUTHORIZING THE MAYOR AND CITY CLERK TO
EXECUTE A CONTRACT WITH THE NUMBER-ONE RANKED FIRM,
JOHNS EASTERN CO., PURSUANT TO REQUEST FOR PROPOSALS
(RFP) NO, 145--99/00 FOR CLAIM ADMINISTRATION SERVICES FOR
THE CITY OF MIAMI BEACH SELF-INSURED WORKERS'
COMPENSATION PROGRAM WITH AN ESTIMATED ANNUAL FEE FOR
THE FIRST TWO YEARS, IN THE AMOUNT OF $265,315.00, TO BE
INCREASED BY A MAXIMUM NOT TO EXCEED SEVEN PERCENT (7%)
FOR YEARS THREE AND FOUR, RESPECTIVELY; SHOULD THE
ADMINISTRATION BE UNABLE TO REACH AGREEMENT WITH JOHNS
EASTERN CO., AUTHORIZING THE ADMINISTRATION TO ENTER
INTO NEGOTIATIONS WITH THE NUMBER-TWO RANKED FIRM, JLT
INSURANCE SERVICES, AND IF UNSUCCESSFUL, AUTHORIZING THE
ADMINISTRATION TO ENTER INTO NEGOTIATIONS WITH THE
NUMBER-THREE RANKED FIRM, MULTI-LINE CLAIMS SERVICE.
ADMINISTRATION RECOMMENDATION:
Adopt the Resolution,
ANALYSIS:
On October 18, 2000, the Mayor and City Commission authorized the Administration to issue a
Request for Proposals (RFP) for Claim Administration Services for the City of Miami Beach
Self-Insured Workers' Compensation Program,
AGENDA ITEM ~-y])
DATE
I --I D- 0 )
A Request for Proposal was issued on November 3, 2000 with an opening date of November 27,
2000, Thirty eight (38) specifications were issued, resulting in the receipt of proposals from the
following nine (9) firms:
JL T Services
F ,A, Richard and Associates
Bunch and Associates
Cinningham Lindsey
Gates McDonald
Multi-Lines Claims Service
Johns Eastern Co,
Gallagher Bassett Services, Inc,
Carson-Brooks
On December 19,2000, an Evaluation Committee composed of the following persons met to
review and discuss the proposals:
Mary Greenwood, Executive Assistant to the City Manager/Labor Relations
Clifton Leonard, Risk Manager
Ron Caplan, Safety Officer
Judith Weinstein, First Assistant City Attorney
Linda Gonzalez, Human Resources Administrator
Risk Management provided an analysis of the proposals to the Evaluation Committee, The
analysis indicates that all proposers are certified by the State of Florida and are capable of
providing the required services, The Evaluation Committee concurred with the analysis provided
by Risk Management and determined all firms to be responsive to the RFP and capable of
providing required services.
Separate fees were proposed by all firms for Claims Administration and Managed Care, All
firms proposed either a guaranteed annual fee or a guaranteed per claim rate for Claims
Administration, Managed Care Fees were proposed on a per claim rate or a per claim rate
combined with an additional hourly rate for long term claims, The estimated Claims
Administration Fee and Managed Care Fees for all responses to the RFP are as follows (the rates
for those firms other than Johns Eastern Co" and Multi-Lines Claim Services are minimum
estimates and may increase due to additional fees for long term claims):
Administrator Total Fee
Johns Eastern Co, Inc, $265,315 (Capped)
JL Tins, Serv, $289,775
Multi-Lines Claims Serv, $318,250 (Capped)
Cunningham Lindsey $354,895
Bunch & Associates $367,260
Gallagher Bassett Services, Inc, $360,399
F.A Richard and $402,375
Associates
Carson-Brooks $403,683
Gates McDonald $617,621
Johns Eastern Co" proposed the overall lowest fee for all services with a guaranteed rate for the
two years with a maximum rate increase of no more than seven percent (7%) for year three and
year four,
The Evaluation Committed has ranked Johns Eastern Co" as the Number-One firm as they are
capable of providing the required services with the most cost effective fee, JL T Insurance
Services was ranked as the number-2 proposer and Multi-Line Claims Service was ranked as the
number-3 proposer. During the evaluation process, the Evaluation Committee determined that
the current services provided by Johns Eastern Co, are satisfactory, In accordance with the terms
of the RFP, the City Manager has reviewed the Evaluation Committee's recommendation and
concurs with its ranking of proposals, Funds are available Self Insurance Fund Number
540.1790,000381 and Fund Number 540.1790,000312,
The City Administration recommends that the City Commission authorize the Administration to
enter into negotiations and, if successful, authorize the Mayor and City Clerk to execute a
contract with Johns Eastern Co" pursuant to Request For Proposals (RFP) 145-99/00 for Claim
Administration Services for the City of Miami Beach Self-Insured Workers' Compensation
Program with an estimated annual fee for the first two years in the amount of$265,315,00 to be
increased by a maximum not to exceed seven percent (7%) for years three and four respectively;
should the Administration be unable to reach agreement with Johns Eastern Co" authorize the
Administration to enter into negotiations with the number-two ranked firm, JL T Insurance
Services, and if unsuccessful, authorize the Administration to enter into negotiations with the
number-3 ranked firm, Multi-Line Claims Service,
JG:~cI~~
Attachments
f:\RlSK\SALL\CliffiWorkcomp\crnwcOO,wpd
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SERVICE CONTRACT FOR WORKERS' COMPENSATION
CLAIMS HANDLING
THIS SERVICE CONTRACT FOR WORKERS' COMPENSA nON CLAIMS HANDLING is
made and entered into this 30th day of January, 2001, but is effective for all purposes as of the 1 st day
of February, 2001, by and between CITY OF MIAMI BEACH (referred to as the "Employer"), and
JOHNS EASTERN COMPANY, INe. (referred to as the "Service Agent"),
WITNESSETH:
WHEREAS, the Employer has undertaken to self-insure its Workers' Compensation Liability
in accordance with the Florida Workers' Compensation Law and other applicable Florida statutes and
regulations; and
WHEREAS, the Service Agent is engaged in the supervision and administration of programs
for self-insured employers;
WHEREAS, the Employer desires to engage the Service Agent for, and the Service Agent
desires to assist the Employer in, workers' compensation claims handling;
NOW, THEREFORE, for and in consideration of the premises and ofthe mutual obligations,
performance of services, and payment of compensation set forth herein, the parties agree as follows:
1, Enl!al!ement. The Employer hereby engages the Service Agent to supervise and
administer the Self-Insured Workers' Compensation Program of the employer in
accordance with the Workers' Compensation Law as adopted and amended by the State
of Florida (the "Law") and the applicable rules and regulations as promulgated by the
applicable agencies of the State of Florida relating to the Law (the "Rules"), all in
accordance with the Service Agent's proposal dated November 27, 2000, a copy of
which is attached hereto and incorporated herein by this reference (the "Proposal"),
2, Term, Subject to termination pursuant to paragraph 8, the term of this Agreement shall
begin as of February 1, 2001 and shall terminate on January 31, 2005,
3. Fund for Pavment of Claims. The Employer has the sole obligation and responsibility
for funding the payment of claims made by its employees under the Law and Rules, The
Service Agent assumes no duty to fund any such claims at any time and shall have no
obligation to advance funds for any such payment. The Employer agrees to maintain all
necessary funds for payment of claims in accordance with the Law and Rules and to
inform the Service Agent of all relevant details with respect to any such accounts in
order for the Service Agent to perform its duties under this Agreement. The Employer
shall add to or increase the amount in any such accounts as needed, and, in any event,
within five (5) business days from the Service Agent's notice to the Employer to such
effect.
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,
4, Allocated Claims Exnenses, "Allocated Claims Expenses" shall be defined as expenses
arising in connection with the settlement of claims, which shaH be defined as expenses
directly allocated to a particular claim to be discharged from the accounts funded by the
Employer 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 employees,
e, Fees for medical management, case management and cost containmentlbill
review,
f, Fees for over-night or special mail service for various documents,
g, Fees for examining and reducing hospital and medical bills as appropriate,
h, Photocopying and review of relevant documentation,
5, Compensation for the Service Al!ent. For performing its services under this
Agreement, the Service Agent shaH be entitled to the foHowing compensation:
a. Fees for claims handling for the Employer for exposures whose dates of\oss faH
between February I, 2001 and January 31, 2003 will be an annual fee of
$188,280,00. This annual fee will be billed on a quarterly basis, with the first
payment due upon program inception. This fee contemplates handling 600
workers' compensation exposures, Ifthe number of exposures exceeds 600,
then the fees will be increased proportionately,
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b, The above fee will be guaranteed for the first and second years of the program.
Service fees for subsequent years are guaranteed not to exceed a 7% increase
over the previous year's fee,
c, As medical management/managed care arrangement (MCA) services are
required, the Service Agent will furnish them in-house in conjunction with the
Employer's third party administration, The Service Agent has developed the
MCA for the Employer in its entirety, There will be no cost involved with the
exception offees required by ARCA.
Fees for telephonic managed care services during February I, 200 I and
January 31, 2003 will be $155.00 per medical only and lost time
exposure.
d, Other managed care services available through Service Agent or other outside
provider:
On-site case management
Peer Review
Medical Care Audit
Medical Bill Audit
Pre-Certification In-Patient/Out-Patient
$65.00/hour
$65.00/hour
$65,OO/hour
$65,OO/hour
$99,OO/each
e, Provider bill review/cost containment services will be provided at the rate of
$5.50 per bill and 30% ofPPO reductions.
f. Information systems dial-up services are included.
g, The "Looking Glass" program is included,
6, Continuine Handlin!! of Claims After Termination of Contract or Le!!allv Imuosed
Mandates, Upon termination of this Agreement as set forth in paragraph 8, the Service
Agent agrees to continue handling all claims that have been made and reported to it prior
to such date oftermination for ninety (90) days unless the parties have agreed otherwise
in writing,
Upon repeal of any service mandated by the workers' compensation law and/or other
applicable statutes and/or regulations, the Service Agent agrees to continue handling all
claims under the repealed service that have been reported to it prior to the date of such
repeal for ninety (90) days unless the parties have agreed otherwise in writing.
All data contained in the Service Agent's computer system will be provided to the
Employer on nine-track tape or diskette with corresponding file layout. The cost for this
will be no greater than $2,000,00, The Employer will be billed for any additional
programming to help in data transfer,
7. Disuutes Subiect to Arbitration, Any dispute or claim arising out of or relating to this
Agreement or any breach thereof shall be resolved through mediation, if mediation
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7, Disputes Subiect to Arbitration, Any dispute or claim arising out of or relating to this
Agreement or any breach thereof shall be resolved through mediation, if mediation
cannot resolve the dispute, it will be resolved by submission of such dispute or claim to
an arbitration panel composed as fo1lows: The Employer and the Service Agent sha1l
each select one member of the panel and the two selected members sha1l select a third
member. The parties agree to fo1low the rules ofthe American Arbitration Association,
8, Litil!ation JurisdictionN enue, This Agreement sha1l be enforceable in Miami-Dade
County, Florida, and if legal action is necessary by either party with respect to the
enforcement of any or all of the terms or conditions herein exclusive venue for the
enforcement of same sha1l lie in Miami-Dade County, Florida.
9. Termination, This Agreement may be terminated by either the Employer or the Service
Agent by giving prior written notice of ninety (90) days. In the event of such
termination, compensation paid or payable to Service Agent under paragraphs 5.a
through 5.g sha1l be prorated as appropriate, Notwithstanding anything in this paragraph
8 to the contrary, the insolvency or filing for relief from creditors of any party pursuant
to the United States Bankruptcy Code or the material breach of a material provision of
this Agreement by any party sha1l permit the other party to cancel this Agreement
immediately upon written notice,
10. Covenants of the Service Al!ent and the EmDlover, Each of the Service Agent and
the Employer agrees to use its normal and ordinary professional care and diligence in
the performance of its duties under this Agreement and wi1l use its best efforts to comply
at all times with the Law and the Rules,
II, Indemnification, Service Agent agrees to indemnify and hold harmless the employer
and its directors, officers, employees, stockholders, and agents against any and a1l
claims, lawsuits, settlements, judgments, costs, penalties, and expenses, including,
without limitation, attorneys' and legal assistants' fees before and at trial, on appeal, or
otherwise, resulting from the breach of, or negligence or misconduct in performing, any
provision of this Agreement, by such party or by its directors, officers, employees,
stockholders or agents, whether acting alone or in co1lusion with others,
12, Miscellaneous,
a. Each party represents and warrants that it has full power and authority to enter
into this Agreement.
b. All notices, requests, demands and other communications which are required or
may be given under this Agreement shall be in writing and sha1l be deemed to
have been duly given when received ifpersona1ly delivered; when transmitted
if transmitted by telecopy, electronic telephone line facsimile transmission, or
other similar electronic or digital transmission method; the day after it is sent,
if sent by recognized expedited delivery service; and five (5) days after it is sent,
if mailed, certified or registered mail, return receipt requested, postage prepaid,
In each case, notice shall be sent to:
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If to the Employer:
City of Miami Beach
1700 Convention Center Drive
Miami Beach, FL 33139
If to the Service Agent:
Johns Eastern Company, Inc,
Post Office Box 4175
Sarasota, FL 34230
or to such other address as either party may have specified in writing to the other
using the procedures specified above in this paragraph,
c,
(i)
This Agreement shall be construed pursuant to and governed by the
substantive laws of the State of Florida (and any provision of Florida
law shall not apply ifthe law of a state or jurisdiction other than Florida
would otherwise apply),
(ii) The headings of the various paragraphs in this Agreement are inserted
for the convenience of the parties and shall not affect the meaning,
construction, or interpretation of this Agreement.
(iii) Any provision of this Agreement which is determined by a court of
competent jurisdiction to be prohibited, unenforceable ornot authorized
in any jurisdiction shall, as to such jurisdiction, be ineffective to the
extent of such prohibition, unenforceability or nonauthorization without
invalidating the remaining provisions hereof or affecting the validity,
enforceability or legality of such provision in any other jurisdiction, In
any such case, such determination shall not affect any other provision of
this Agreement, and the remaining provisions of this Agreement shall
remain in full force and effect. If any provision or term of this
Agreement is susceptible to two or more constructions or
interpretations, one or more of which would render the provision or term
void or unenforceable, the parties agree that a construction or
interpretation which renders the term or provision valid shall be favored.
d, This Agreement constitutes the entire Agreement, and supersedes all prior
agreements and understandings, oral and written among the parties to this
Agreement with respect to the subject matter hereof.
e,
(i)
If, within ten (10) days after demand to comply with the obligations of
one of the parties to this Agreement served in writing on the other,
compliance or reasonable assurance of compliance is not forthcoming,
and the other party takes steps to enforce rights under this Agreement
pursuant to paragraph 7 or otherwise, the prevailing party in any action
shall be entitled to recover all reasonable costs and expenses (including
reasonable attorneys' and legal assistants' fees before and at trial, on
appeal, or otherwise,)
(ii) If any monies shall be due either of the parties to this Agreement
hereunder and shall not be paid within thirty (30) days from the due date
of such payment, interest shall accrue on such unpaid amount at the rate
of I % per month in accordance with the Florida Prompt Payment Act -
F,S,218,70-79,
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.,
f, This Agreement shall be binding upon and inure to the benefit of the successors
in interest and assigns of the parties,
g, The parties to this Agreement will execute and deliver, or cause to be executed
and delivered, such additional or further documents, agreements, or instruments
and shall cooperate with one another in all respects for the purpose of carrying
out the transactions contemplated by this Agreement.
h, This Agreement may be executed in any number of counterparts, each of which
shall be considered an original, but all of which together shall constitute one and
the same instrument and shall become effective when each of the parties has
executed at least one ofthe counterparts even if all the parties have not executed
the same counterpart,
IN WITNESS WHEREOF, the parties have executed this Agreement effective for all purposes
as of February 1,2001.
-.--'
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, STERN~/c?
Allen L. Ladd
Executive Vice President
J
~ASTO
fOAM & LANGUAGE
a FOR PECUT\ON
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