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AgdaPkt 2015-04-27 Interview and Joint SA and PFA
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AgdaPkt 2015-04-27 Interview and Joint SA and PFA
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Last modified
4/28/2015 9:39:13 AM
Creation date
4/23/2015 1:20:34 PM
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Template:
CC Index
CC Index - Document Type
Agenda Packet
Meeting Type
Joint
Agency Type
City Council and Successor Agency and Public Financing Authority
Date
4/27/2015
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7.1.C. - Page 7 <br /> G. "MANAGED CARE" includes, but is not limited to, repricing of medical <br /> bills to the Official Medical Fee Schedule, repricing of medical bills based on network <br /> contracts, pre-negotiated agreements for medical services, Utilization Review pursuant <br /> to Labor Code 4610, optional use of the WellComp Medical Provider Network <br /> established pursuant to LC 4616, and nurse case management services. <br /> H. "SYSTEMS" shall mean severally or collectively, YORK's proprietary <br /> claims handling system. <br /> II. TERM OF AGREEMENT <br /> The term of this Agreement shall commence on July 1, 2015 and shall continue <br /> until and through June 30, 2018 (the "TERM") with two (2) additional one (1) year <br /> extension options, each to be exercised at the sole option of PRINCIPAL to be written <br /> with mutual agreement of YORK. This Agreement will be deemed extended to cover <br /> each additional claim that PRINCIPAL refers to YORK after the end of the aforesaid <br /> period (subject to the extensions as aforesaid) and which YORK accepts for handling. <br /> During the Term, all services are to be delivered as a whole, contingent on one another, <br /> and separation of any services during the above stated Term requires a new written <br /> pricing agreement as to remaining services. <br /> III. CLAIMS ADMINISTRATION SERVICES (the "Services") <br /> PRINCIPAL hereby retains YORK to provide Claims Administration Services, as <br /> set forth in this Agreement, including any Exhibits attached hereto, for the Claims that <br /> arise out of PRINCIPAL'S self-insured workers compensation program and that are <br /> assigned by PRINCIPAL to YORK. <br /> A. The Services to be rendered by YORK shall be in conformance with the <br /> requirements and provisions of this Agreement together with all applicable rules, orders, <br /> and interpretations issued by the applicable regulatory authorities as of the date hereof. <br /> B. YORK acknowledges its obligation to comply with all applicable statues <br /> and any rules or regulations of the applicable regulatory authorities. <br /> C. York shall perform Claims Administration Services for each Claim <br /> assigned to it hereunder during the life of the agreement. <br /> D. YORK acknowledges that execution of this Agreement does not <br /> guarantee that YORK will be assigned any particular number of Claims by PRINCIPAL. <br /> ATTY/AG R/2015.068/YORK TPA REDWOOD CITY <br /> REV:04-20-15 MLG <br /> Page 3 of 17 <br />
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