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25. 26. -- --------~--- 27. Penaltie~' Late payment of all benefits must include the self-imposed penalty in accordance with California law. The City will be provided a listing of any administrative penalties paid during the quarter, which were the responsibility of the TP A, and a check from the TP A payable to the City of Redwood City for reimbursement. ra~e rlo~lIre: The supervisor must review all Medical Only claims open beyond ninety (90) days from the date of entry by the TP A, for potential closure or conversion to Indemnity claim status. Claims with $3,000 (three thousand dollars) or more paid to date and any claim open beyond one hundred eighty days from date of entry must be converted to Indemnity status and a reasonable, precautionary indemnity reserve placed on the claim(s). All indemnity cases where permanent disabilityis noLan issue will be~cl0sedwithin sixty (60) days of the final financial transaction or final correspondence to the injured worker as required by law. All indemnity claims where permanent disability is an issue will remain open for two (2) years from the last payment of benefit and then closed within sixty (60) days of that date. The TPA will monitor stipulated cases with future medical provisions. Reserves for future medical will be reviewed semi-annually and adjusted according to use. Statll~ Report~: Special claim status reports requested by member cities outside the regular 90- day status reports shall be provided by the TP A to the respective city within ten (10) business days. Verbal status reports requested by member cities shall be provided by the TP A to the respective city within two (2) business days. Special computer generated loss data reports requested by member cities shall be provided within twenty (20) business days. 28. rIaim~ Reporting' The TPA shall maintain all loss information as required by the Workers' Compensation Insurance Rating Bureau. The TP A shall assist in the preparation of all reports that are now, or will be required by the State of California or other government agencies with respect to self-insurance programs. The TP A will also assist in the preparation of all reports or databases required by the California Institute for Public Risk Analysis (CIPRA) or other statistical database organizations as requested by the City. 29. Rec.ord Retention' All claim files shall be maintained in accordance with statutory time requirements and the City's Record Retention Policy. 30. rlaim SlIpervi~ion' The TPA shall provide supervisory staffthat will regularly review the work product of the claims examiners. The supervisor shall review at least ten percent (10%) of each examiner's case load each month to ensure each examiner is following the performance standards outlined in this document. In addition, the supervisor shall conduct a regular quarterly review of all open indemnity claims with reserves in excess of $100,000 and all problem or complex claims. 31. Availahility of Per~onnel' The TPA shall ensure at least one (1) or more of the examiners assigned to the City of Redwood City are on-site and available to the City every business day throughout the term of the approved contract between the City and the TP A. 32. Examiner Trainine' The TPA shall annually certify to the City of Redwood City that each claims examiner handling the City's claims is in compliance with all legal and regulatory licensing and City of Redwood City Perfonnance Standards Page 6 of7 April 28, 2006