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Agmt10 Athens Administrators
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Agmt10 Athens Administrators
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Last modified
8/30/2010 9:29:47 AM
Creation date
8/30/2010 9:29:45 AM
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Template:
Agreement
Contractor Name
Athens Administrators
PROJECT NAME
Ca. Workers' Compensation Service Agreement
RMP File Number
304
Date
6/22/2010
MO Ref
10-111
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<br />. <br />. <br /> <br />, <br /> <br />it L~:N~:A~~ <br /> <br />(2) . Computerized loss reports In an acceptable format as mutually agreed upon <br />at the effective date of this Agreement, showing descriptive data, details of <br />each month's payments, total payments, reserves and total experience and <br />incurred loss values for each claim. <br /> <br />(3) Any and all other reports as required by Employer. <br /> <br />b. Provide oral claims reports on demand, special specific-focus loss run reports within twenty- <br />four (24) hours and larger or major computer analysis reports within seven (7) working daYSI <br />excluding weekends and holidays. It is further agreed and understood that should Employer <br />require that Administrator prepare for Employer special reports, which require additional <br />programming costs there may be an additional charge for said reports. <br /> <br />c. Maintain all records and statistical data on each employee claim of Injury or Illness, including, <br />but not limited to, a record of each denial, delay, litigated claim and loss, which records and <br />data shall be available upon request by Employer. Employer, at Employer's discretion, may <br />audit all records maintained by Administrator including, but not limited to, all payments made <br />on behalf of Employer. Such audit may Incorporate random sampling or other audit <br />procedures suitable to Employer. <br /> <br />d. Prepare and submit Federal Information Return (Form 1099) by statutory deadline for <br />applicable payments made by Administrator on Employer's behalf, during the term of this <br />Agreement and as specified under Section 1.02. (e) of this Agreement. <br /> <br />e. Prepare all other reports as necessary to remain in compliance with all Workers' <br />Compensation Laws and other state and federal laws, rules and regulations. <br /> <br />f. Provide report to Accounting Department of Employer of all payments when made and any <br />other information necessary for Employer to adequately fund the bank trust account. All such <br />payments shall be supported with check payment detail and monthly summary report <br />showing all payees, payment amounts and dates of payment. <br /> <br />g. Provide for Employer the ability to be on-line with Administrator's computer system. This <br />system will prOvide Employer with all financial and statistical data relating to Employer's <br />workers' compensation claims, together with narrative topical"notepad" reports, on each <br />individual claim. This system will also include electronic mail service between Administrator <br />and Employer; the ability to electronically transmit S020's (Employer's First Report of <br />Industriallnjury/lllness)i OSHA Log generation; and complete report generation capabilities. <br /> <br />v. EMPLOYER'S DUTIES <br /> <br />5.01. Employer agrees to perform as follows: <br /> <br />a. Promptly report to Administrator as they shall occur and become known to Employerl the <br />employee claims of occupational injury, disease, Illness, or death. <br /> <br />b. Promptly forward to Administrator all applications, notices of claims, notices of hearings or <br />The CIty of Redwood CIty - Claim Service Asreement - 2010 - 2012 <br /> <br />6 <br />
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