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Agmt12 Athens Administrators
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Agmt12 Athens Administrators
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Last modified
8/28/2012 2:17:00 PM
Creation date
8/28/2012 2:17:00 PM
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Template:
Agreement
Contractor Name
Athens Administrators
PROJECT NAME
Workers' Compensation Service Agreement
RMP File Number
304
Date
6/25/2012
MO Ref
12-128
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. <br /> i <br /> • <br /> 6.04 Copies of Files <br /> Administrator may, at its discretion keep a copy of Employer's files if it deems it necessary to <br /> comply with or defend itself in relation to any obligation or rights that it has under this <br /> Agreement,applicable laws or regulations. <br /> VI1. FINES.PENALTIES AND STANDARDS <br /> 7.01. All services as described in this Agreement shall be performed in accordance with all <br /> applicable laws,rules and regulations of any and all governmental authorities and applicable <br /> standards, and specifically performed in accordance with aii applicable Workers' <br /> Compensation Laws of the State of California. <br /> 7.02. Administrator and Employer acknowledge the obligations and penalties contained in the <br /> California Workers' Compensation Reform Act of 1989 that may be imposed on both <br /> employers and claim administrators and agree to the following: <br /> a. Penalties for errors or omissions caused by Employer's failure to act or timely report claims or <br /> issues to Administrator that create a delay in payment of benefits, incorrect payment of <br /> benefits, or administrative fine(s) or penalty(s) shall be the responsibility of Employer. <br /> Penalties for errors or omissions caused by Administrator's performance of services under <br /> this contract that create a delay in payment of benefits, incorrect payment of benefits, or <br /> administrative fine(s)or penalty(s)shall be the responsibility of Administrator. <br /> b. Administrator shall provide Employer with a quarterly accounting of penalties paid by <br /> Administrator on behalf of Employer including a description and detailed listing of each <br /> penalty payment and the specific claim file to which the penalty payment was charged. <br /> Penalties, which are computed by Administrator, shall be paid out of Employer's benefit <br /> account and Administrator shall then reimburse Employer quarterly for those penalties, <br /> which are the responsibility of Administrator under the terms and conditions of this <br /> Agreement,with pro-rated interest at the prevailing prime interest rate. <br /> c. Without limiting the provisions set forth in the above two paragraphs it is agreed that upon <br /> receipt by Administrator of a notice of claim from Employer,upon which indemnity benefits <br /> shall be paid or notice given promptly to the employee in order to avoid late payment or <br /> notice of benefit penalties,Administrator shall have ten working days(excluding weekends <br /> and holidays)from the date of receipt of the claim from Employer,to investigate and pay the <br /> temporary disability or send the required wage continuation notice,and that failure on the <br /> part of Administrator to do so within this time frame shall be the financial responsibility of <br /> Administrator for any fine imposed for late notice or payment of benefits. Any fines or <br /> penalties for late payment or notice of benefits on claims,which are received from Employer <br /> by Administrator on or,after the ninth day following the date Employer knew or should have <br /> known about the claim(s)shall be the responsibility of Employer. <br /> d. Administrator will be responsible for any fines or penalties associated with questionable or <br /> controverted claims which Administrator denies without first consulting and obtaining <br /> approval by Employer for denial of the claim(s)Administrator will not be responsible for any <br /> fines or penalties levied by the Division of Workers' Compensation or any other judicial or <br /> quasi-judicial organization for improper denial of a claim(s)if,over the written objections of <br /> The City of Redwood City- Claim Service Agreement- 2012-2014 <br /> 8 <br />
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