D.02_REPORTING_REQUIREMENTS.pdf
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- Solicitation number
- 89303919REM000007
- Issued by
-
Department of Energy Headquarters
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D.02 REPORTING REQUIREMENTS
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Solicitation # 89303919REM000007 Section D
Workers’ Compensation Claims Services Attachment D.2
ATTACHMENT
D.2 REPORTING REQUIREMENTS
Reporting Requirements
a. The following reports are required to be submitted electronically.
b. The Contractor shall provide the monthly, quarterly, bi-annual and annual reports within ten business days following the end of the reporting period:
Title Content Frequency Recipient
(A)
Performance
Requirements
Summary
Contractor’s Self-evaluation of Performance shall be submitted monthly, up to ten days after the end of each month being reported along with the contractor’s properly certified invoice, complete with backup and analyses for all work completed in performance of this contract.
Monthly CO
(B) Summary of Customer
Feedback
Comments
Provide a summary of substantiated comments received, comment responses, the number and nature of any unsubstantiated comments, the status of any changes or improvements made in response to comments, and any trend analysis related to comments received
Monthly CO
(C) Open
Claims
Report by Hanford Site Contractor/ Subcontractor of all open claims. The reports shall include: claim number, claimant name, date of injury, type of injury, date received by Contractor, body part, reserves, payments to date, status, days open, adjusters name.
Monthly
CO
Current covered
Site Contractor(s) receive their claims only
(D) New and
Closure
Claims
Report by Hanford Site Contractor/ Subcontractor of opened and/or closed claims during the previous month. The reports shall include: total number of claims, type of injury, claim number and claimant name.
Monthly
Current covered
Site Contractor(s) receive a report of their claims only
(E) EEOICPA
Hours
Hourly charges for EEOCIPA records requests shall be supported by an accounting of the actual time spent (in 10 minute increments) performing this service for each request, itemized by claim number
Monthly CO
(F) Funds
Request
Provide bi-monthly (twice a month) funds request including
ASAP drawdown amounts, void/stop pay/return details, and backup documentation
Bi-
Monthly
CO and DOE
Hanford Finance
(G) Check
Register
Report of payments made during the month. Such reports shall include the check number, payee, type of payment, amount, check date, file number, claimant name, date of service, and the beginning and ending balance of the account.
Monthly CO and DOE
Hanford Finance
(H) Pensioner
List and
Variance
Analysis
List of pensioners and variance analysis of quarterly pension payments. Submit payment recommendation with supporting documentation, and, upon approval, make payment to L&I. Upon payment, send formal correspondence to DOE Hanford Finance containing evidence of payment
Quarterly CO and DOE
Hanford Finance
(I) Quarterly
Report for
Self-Insured
Business
Complete the Quarterly Report for Self-Insured Business form, submit form and supporting documentation to DOE
Hanford Finance for approval, and, upon approval, make payment to L&I. Upon payment, send formal correspondence to DOE Hanford Finance containing evidence of payment.
Quarterly CO and DOE
Hanford Finance
(J) Banking
Reconciliation
Provide quarterly Banking Reconciliations to DOE-RL
Finance Quarterly
CO and DOE
Hanford Finance
(K) Offsite
Medical
Treatment
Costs
Report offsite medical treatment costs incurred by the
Hanford Site Occupational Medical Provider and PNNL
Occupational Medical Provider, associated with an accepted workers’ compensation claim.
Quarterly CO and DOE
Hanford Finance
(L) Legal
Services
Claims with outside counsel, to include the below and others as appropriate:
Current Status
Assigned Counsel
Projected Results
Cost of Services (Detailed Breakdown)
Final Outcome
Quarterly DOE Counsel and
CO
(M) Reserves Report by Hanford Site Contractor/Subcontractor of liabilities on all claims.
Semi-annually
CO and DOE
Hanford Finance
(N) Penalties
Penalties paid indicating the reason for the penalty, whether it is valid and/or in dispute, and the party responsible for the penalty.
Semi-annually
CO and DOE
Hanford Finance
(O) Injury/
Costs
Report by Hanford Site Contractor/Subcontractor of numbers, average length, and costs of injuries by injury types/nature, etc.; of claims.
Semi-annually
CO and DOE
Hanford Finance
(P)
Rehabilitation
Claims assigned to Vocational Services, current status, and projected results and cost of services.
Semi-annually
CO
(Q) Claims
Status
Fiscal Year Graphs (Site and by Contractor) to include the below and others as appropriate:
Total Incurred Cost
Claim Cost by Pay Type
Average Cost per Claim Type
Claims Opened and Denied by Claim Type
Claims Filed/Claims Closed Ratio
Allow/Denied Ratio
Claims by Loss Nature
Annually CO
(R) Records
Inventory and
Disposal
Schedules
Identifies active records and approved schedule for disposition of records
Review
Annually
CO and RL
Records Manager
(S) Legal
Management
Plan
See Attachment D.4
60 Days
After
Contract
Award
DOE Counsel and
(T) Quality
Assurance
Program
See Attachment D.5
60 Days
After
Contract
Award/
Review
Annually
CO
(U) Continuity of Operations
Plan (COOP)
(applicable to
CRD 150.1)
See Section D.8
60 Days
After
Contract
Award
CO
(V)
Declaration of
Readiness
Contractor shall submit a declaration to DOE-RL indicating readiness to assume responsibility for the execution of the
Contract.
60 Days
After
Contract
Award
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