Title
Recommendation to Authorize the City Attorney to Execute a Second Amendment to the Agreement with Sedgwick Claims Management Services, Inc. for Professional Services as the Third Party Administrator of the City of Alameda's Self-Insured Workers' Compensation Program, Extending the Term One Year with the Option of an Additional One Year Extension, for a Total Two Year Compensation Not to Exceed $333,507. (City Attorney 711)
Body
To: Honorable Mayor and Members of the City Council
EXECUTIVE SUMMARY
The City of Alameda (City) has engaged Sedgwick Claims Management Services Inc. (Sedgwick), as successor in interest to York Risk Services Group, Inc. (York), as the Third Party Administrator (TPA) of the City's self-insured workers' compensation program from July 1, 2012 through June 30, 2020. Staff is recommending that the City Council authorize the City Attorney to execute an amendment to the agreement with Sedgwick for professional services as the TPA of the City's self-insured workers' compensation program for the period from July 1, 2020 through June 30, 2021, with an additional one year option at the City's discretion to exercise. The proposed annual fee for Fiscal Year (FY) 2020-21 is $164,695 and is $168,812 for the optional FY 2021-22.
BACKGROUND
Workers' compensation is mandated under California Labor Code ? 3600 and provides medical care and compensation as the remedy for workplace injuries or illnesses.
Since July 1, 2012, the City has contracted with a TPA to assist in administering and adjusting workers' compensation claims. The TPA model allows the City to benefit from professional, experienced claims handlers who are able to administer multiple facets of the City's workers' compensation program, including claims adjusting, bill and utilization review, oversight of nurse case management needs, subrogation recovery, and mandatory Medicare/Medicaid reporting. These services help ensure that the City is properly providing the required benefit...
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