Schedule A Statement of Work.docx

Michigan.gov/MiProcurement

SCHEDULE A - STATEMENT OF WORK CONTRACT ACTIVITIES

Request for Proposal No.240000001469 Workers Compensation Insurance Administration Services This schedule identifies the anticipated requirements of any Contract resulting from this RFP. The term “Contractor” in this document refers to a bidder responding to this RFP, as well as the Contractor who is awarded the contract. The term “Bidder” is used to identify where specific responses to the RFP are required.

The Contractor must respond to each requirement or question and explain how it will fulfill each requirement. Attach any supplemental information and appropriately reference within your response.

IMPORTANT NOTE TO CONTRACTORS/BIDDERS: There are specific requirements for which acceptance must be simply acknowledged through a checkbox(es), and others that require further explanation. Click the appropriate checkbox and complete the entries as appropriate.

BACKGROUND

The State of Michigan is self-insured for its obligations pursuant to the Workers’ Disability Compensation Act (WDCA) and provides for wage loss and medical payments for work-related injuries and illnesses. Michigan Office of the State Employer (OSE) is responsible for the administration of the WDCA for State of Michigan employees.

SCOPE

This Contract is to provide third party claims administration for Workers’ Compensation for State of Michigan employees and individuals covered by the State of Michigan’s Workers’ Compensation Plan. The Contractor must provide claims administration, claim processing, claim reporting and record keeping, overpayment recovery, subrogation, dispute resolution, auditing and billing, claim reserving, claims investigation and assistance to the Attorney General’s Office (AG) supporting the AG representation in litigated matters.

The effective date of the contract is estimated to be October 1, 2024, through March 31, 2029, with six optional one-year renewals. The implementation period is October 1, 2024, to March 29, 2025; no payment will be made to the Contractor during the implementation period. The Contractor must commence performance of all Contract Activities, without interruption on March 30, 2025.

1. Requirements

1.1 General Requirements

1.1.1 The Contractor must provide fully functional Workers’ Compensation plan as defined by the OSE.

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1.1.2 The Contractor must be a licensed Third-Party Administrator (TPA) in the State of Michigan or insurance company licensed to do business in Michigan, or must qualify in any other capacity as an entity that is properly licensed by statute to provide administrative services only and cost-plus arrangements, or to act as a TPA.

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1.1.3 The Contractor must partner with the Plan Sponsor to manage the Plan effectively and collaborate with the Plan Sponsor to provide Plan updates and services to ensure the ability of the Plan to continue to offer Workers’ Compensation coverage and support the Plan Sponsor’s strategic planning process.

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1.1.4 The Contractor must provide financial management, reporting, and analytical support as required by this contract and which meets or exceeds current industry standards.

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1.1.5 The Contractor must comply with the State of Michigan’s Public Act 454 of 2004 (Social Security Number Privacy Act).

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1.1.6 The Contractor must monitor, review and implement all legislation and guidance that applies to this Contract.

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1.1.7 The Contractor must provide exceptional customer service for both OSE personnel and State employees and individuals covered by the State of Michigan’s Workers’ Compensation Plan.

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1.1.8 The Contractor must provide services that meet or exceed current industry standards in the administration of eligibility, claims processing, servicing customers, and review and administration of appeals.

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1.1.9 The Contractor must provide support of strategic planning efforts and identifying areas of improvement upon request including, but not limited to, comparative analysis of Plan Sponsor’s covered individuals to other like groups across Contractor’s book of business.

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1.1.10 The Contractor must provide all administrative functions set forth in this Contract. This must include, but is not limited to: claims administration, claim processing, claim investigation, claim reporting (including IBNR fund analysis), record keeping, overpayment recovery, appeal process administration, subrogation, dispute resolution, auditing and billing, claim reserving, claims investigation for disability claims from individuals enrolled in the program.

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1.1.11 The Contractor must maintain confidentiality of all data collected by the Contractor, according to all applicable laws, rules and regulations. All data identifying specific enrollees and their dependents is to be treated and secured according to HIPAA privacy and security regulations. The Contractor must comply with all applicable requirements of HIPAA, as amended.

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1.2 Disability Management

1.2.1 Contractor must proactively facilitate and support return to work efforts appropriate for the specific disability and consistent with direction provided by the Program Manager.

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1.2.2 The State of Michigan promotes case management in each department throughout state government. Each department typically has a Case Manager who is designated as the department’s representative dealing with the third-party administrator and return to work issues. The Contractor must make all efforts to assist the departmental Case Managers and, when requested, to participate in any case management meetings reasonably scheduled by the Program Manager.

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Bidder must describe in detail how you work with the employer and treating physicians to facilitate an employee’s early return to work through the entire process. What criteria are used, if any?:

1.2.3 The State of Michigan supports and promotes the use of vocational rehabilitation services as a means to enhance a claimant’s ability to return to work in a more expeditious manner. The Contractor will identify claims that will benefit from vocational rehabilitation services and will make recommendations to the Program Manager.

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1.2.4 If vocational rehabilitation is approved, the Contractor will only use vocational rehabilitation providers that have been approved through the Department of Labor and Economic Opportunity (LEO) Workers’ Compensation Agency.

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If the employer makes alternate duty or temporary transitional work available, how is this information captured and used? Bidder Response:

How does your company Best Practices support early return to work? Bidder Response:

1.3 Covered Individuals Support

1.3.1 General Covered Individuals Support

1.3.1.1 The Contractor’s Customer Service team and Claim Adjuster team must respond to all inquiries from the Plan Sponsor and/or covered individuals within one business day. See also Schedule A, Service Level Agreements (SLAs), Section 10.

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1.3.1.2 The Contractor’s Customer Service team and Claim Adjuster team must log and manage all incoming and outgoing Covered Individual calls and correspondence.

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1.3.1.3 The Contractor must use the information captured in the communication tracking system to target improvement opportunities (e.g., reducing call volume, providing online capabilities, identifying issues, etc.).

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1.3.1.4 The Contractor must provide a telephone recording system for all adjusting staff to be provided for recorded conversations and quality assurance. The Contractor must record and preserve 100% of incoming and outgoing Covered Individual calls for the life of the claim.

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Bidder must describe Bidder’s current system or steps for implementation or development in your response.

1.3.1.4.1 The State must have access to any recorded conversations upon Plan Sponsor request.

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1.3.1.5 The Contractor must review Covered Individual calls for quality monitoring purposes.

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1.3.1.6 The Contractor must notify the Plan Sponsor immediately of any developing situation that may impact operations or service to Covered Individuals.

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1.3.1.7 The Contractor must have the capability of addressing special needs of Covered Individuals, including, but not limited to, TTY or relay services for the hearing impaired.

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1.3.1.8 Information on how to access Contractor’s Customer Service must be clearly communicated in all Plan-specific correspondence, and other Covered Individual materials.

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1.3.2 Customer Service Call Center

1.3.2.1 The Contractor must provide a Customer Service call center, where it will maintain staff dedicated to supporting the needs of the Plan Sponsor’s Covered individuals. The call center must be in the United States of America, but the Plan Sponsor prefers that the call center be located in Michigan. The Contractor’s call center must be available to receive inbound calls Monday through Friday from 8:00 AM to 5:00 PM Eastern Standard Time (EST). The Customer Service call center must, at a minimum include:

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1.3.2.1.1 A single front-end toll-free telephone number with touch-tone routing (if necessary) for Customer Service staff to respond to Covered Individual requests for questions on eligibility, claims, and addressing complaints.

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1.3.2.1.2 A customer service system that can handle a population of over 50,000 individuals and scalable to future demand if determined by Plan Sponsor.

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1.3.2.1.3 An advanced telephone system that provides the Plan Sponsor with management tracking and reporting capabilities.

1) Methods for logging calls, recording call data and content.

2) Methods to report metrics, standards and ad-hoc report generation.

3) Methods to monitor calls for quality.

4) An interactive voice response (IVR) system with a user- friendly menu.

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1.3.2.1.4 The Contractor must attempt to address a Covered Individual’s issue during the initial contact with the Covered Individual. For those issues not resolved immediately, Contractor must contact Covered individuals about their issues within one business day of Covered Individual contact.

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How are management reports generated daily to depict the frequency, type and outcomes of calls received? Bidder Response:

1.3.3 Web-based Support

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1.3.6 Regarding Requirements in Section 1.3.3, 1.3.4, and 1.3.5 above:

Bidder must provide details of the services and functions that will be available to the Claimants/Employees on the Web and/or via mobile applications. See also Schedule A, Section 2.4 Mobile Responsiveness:

Bidder Response:

1.4 Covered Individual Communications Materials, Meetings and Satisfaction

1.4.1 Covered Individual Communication Materials

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1.4.1.2 The Contractor must assist the State of Michigan in developing informational material that informs the employee of their rights under the State’s disability programs and must assure that information is readily provided to assist employees.

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1.4.1.3 The Contractor must prepare and distribute, at its own cost, ad hoc communications where desired by the Plan Sponsor, including but not limited to announcements, letters, notices, brochures, forms, postage, and other supplies and services for U.S. mail distribution (and email at the Plan Sponsor’s discretion) to Covered individuals.

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1.4.1.4 Customized Covered Individual communications must be provided, by the Contractor to Covered individuals, at no additional charge and are subject to the Plan Sponsor’s approval. This also includes co-branding materials with the name of Contractor and Plan Sponsor, where desired by Plan Sponsor.

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Bidder must describe what types of measurement tools are used (e.g. satisfaction surveys etc.) to assess customer satisfaction and quality assurance:

Bidder must describe Bidder’s methodologies to solicit feedback about services rendered by Bidder, and how does Bidder monitor and track complaints?

What have Bidder’s satisfaction rates been for the last 3 years? Bidder Response:

How often are these tools performed? Bidder Response:

Are they performed by internal or external sources? Bidder Response:

How are clients notified of their results? Bidder Response:

1.5 Enrollment, Eligibility, and Data Interface

1.5.1 The Contractor must maintain a system and be prepared to accept, and coordinate, one or more data files from the Plan Sponsor, as indicated in Schedule F - File Layouts.

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1.5.2 Data for Covered Individuals will be supplied through the Human Resource Management Network (HRMN). Eligibility information will be transferred, by the Plan Sponsor, via FTS (or another method selected by the State). The State sends a full eligibility and demographic file on a weekly basis.

The Contractor must maintain and update the system based on weekly eligibility files received by the State.

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1.5.3 The State requires use of its FTS (or another method selected by the State) for all file transmissions. Electronic transmission of identifiable data must be protected by passwords and a Secure File Transfer Protocol (SFTP) method. The Contractor must develop protocols for electronic data transfer that are consistent with the State of Michigan requirements to ensure data security; see also Schedule A, Section 2 and Schedule E Data Security Requirements. The Contractor must also interface with the Long Term Disability third party administrator.

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1.5.4 The Contractor must accept, load, store and maintain Covered Individual demographic and eligibility as transmitted on the weekly file(s).

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1.5.5 The eligibility files must be accepted and utilized for claim management and employee eligibility, upon notification from the Plan Sponsor or its designee.

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1.5.6 Upon written or verbal notification by authorized Plan Sponsor representatives, Covered Individual updates must be completed in real-time by the Contractor.

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1.5.7 The Contractor must have accessible and experienced information technology professionals to provide timely programming who are capable and authorized to implement system changes and produce reports.

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1.5.8 The Contractor must use a forced TLS secured connection between the State’s email servers and theirs as an additional layer of protection for all administrative communications concerning individual Covered Individuals.

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1.5.9 The Contractor is responsible for any changes, and any associated costs therein, to their systems or processes required to support the receipt and processing of Plan Sponsor’s enrollment and eligibility files. The Contractor must work with the Plan Sponsor to develop a timeline for implementation and testing of any system changes. The Contractor must maintain a testing environment for such purposes. See also Schedule A Section 5.2.1 Implementation Plan.

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1.5.10 The Contractor must allow Plan Sponsor, or Plan Sponsor's designee, the right to review the internal testing completed for Plan Sponsor's Workers’ Compensation Plan, if applicable, prior to the effective date of the plans on an annual basis.

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1.5.11 All records passed from the Plan Sponsor to the Contractor must be uploaded within one business day in the order required by the Plan Sponsor. The Contractor must have validation edits in place to ensure, for each data load, that all fields transmitted are properly uploaded, read, and populated in their system. Any records that do not pass Contractor’s validation tests must be reported to Plan Sponsor within two business days after the file has been uploaded.

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1.5.12 Contractor is responsible for any changes, and any associated costs therein, to their systems/Software or processes required to support the receipt and processing of State of Michigan files. Electronic protocols for electronic data transfer must be consistent with Schedule E Data Security Requirements. See also Schedule A, Section 2.. The Contractor must work with the Plan Sponsor to develop a timeline for implementation and testing of any system/Software changes. The Contractor must maintain a testing environment for such purposes. See also Schedule A Section 5.2.1 Implementation Plan.

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1.5.13 Within 5 business days of verbal or written notice to the Contractor of the need for such information, the State of Michigan must receive all paper and electronic files and have electronic and paper access to any and all files maintained by the Contractor. All requests for such information must be provided through the State’s Program Manager. The Contractor must comply with all legislated medical information privacy requirements.

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1.5.14 All hard copy and electronic claim files, data and documentation associated with all claim files is the property of the State of Michigan. See also Hybrid Contract Terms, Section 36.

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1.6 Claims Processing

1.6.1 The Contractor must provide Claims Processing services on an accurate and timely basis. Claim accuracy is defined by industry standards. See also SLAs in Schedule A, Section 10.

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Bidder must describe Bidder’s claims processing procedures and edits that are applied when claims are opened, pended, approved, or denied:

How often are open claims reviewed and by whom and describe your process of identifying and reviewing claims:

1.6.2 The Contractor must be able to receive claims by any method, including telephone (toll-free), facsimile (fax), e-mail, regular mail delivery, electronic data transfer, and Internet based claim services. The Contractor must implement any of these claim-reporting methodologies upon request.

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1.6.6 The Contractor must only pay eligible claims for Covered Individuals.

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1.6.7 For the first check process, the Contractor must send one check via EFT to SOM (or a few separate checks based on process level if approved by the Plan Sponsor) along with an excel spreadsheet with the pertinent information.

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1.6.8 The Contractor must administer claims in conformity with the WDCA and in compliance with any changes made to the WDCA.

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1.6.9 The Contractor must administer eligibility and claims administration in accordance with the State of Michigan Workers’ Compensation Plan.

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1.6.10 All indemnity claims require a 3-point contact be initiated within 1 business day of receipt of claim by Contractor and documented in the claim file. A 3-point contact must include: employee interview, interview with employee agency, and medical provider to confirm the injury description, initial diagnosis, estimated length of disability, treatment plan and employee physical capabilities (work status). See also Schedule A, Section 10.11 SLA #5.

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1.6.11 All Medical Only Claims for motor vehicle and parking lot accidents as well as any medical only claim with time off work require a 2 point contact be initiated within 1 business day of receipt of claim by Contractor and documented in the claim file. A 2-point contact must include: interview with employee agency, and medical provider to confirm the injury description, initial diagnosis, estimated length of disability, treatment plan and employee physical capabilities (work status). See also Schedule A, Section 10.12 SLA #6.

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1.6.12 As a representative of the State of Michigan, contact with employees by the Contractor must be conducted in a polite and professional manner. Claim Adjusters or other representatives of the Contractor who conduct themselves in a manner deemed inappropriate by the State of Michigan must be removed from the State account. The Project Manager and Program Manager will establish specific evaluation criteria. The decision of the State shall be final.

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1.6.13 The Contractor must document all attempts to contact, and all contacts with the employee, the employer, and the treating provider. The information obtained from these contacts must be accurately documented in the claim file. This information will the basis for any subsequent decisions relative to the payment or denial of the claim and must be placed in the file within 24 hours of contact.

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1.6.14 Data collected on behalf of the State is not to be distributed to any party without the written consent of the State. Except for such use solely limited for the purpose of providing Contract Activities, State Data is not to be used by the Contractor for any purpose without express, written approval by the State.

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1.6.15 All files must be documented in a logical manner that allows a reviewer the ability to quickly review all claim activity and determine the current status of a claim. Files must also be documented in a consistent manner with all pertinent material related to the claim and such documentation shall be current in the file from receipt by the Contractor.

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1.6.16 Claim files must be separated to reflect the distinct aspects of the claim. Examples include but are not limited to medical documentation, legal notices, litigation correspondence, payment information, claim notes, forms required by the State of Michigan Workers’ Compensation Act etc.

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1.6.17 Claim Adjuster notes must be current and maintained electronically in a current and accurate manner.

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1.6.18 Claim file notes must contain but not be limited to, statement of coverage, detailed and comprehensive summary of all telephone conversations, attempted telephone contacts, summary of investigations, compensability determination and rationale, subrogation potential, summary of medical received, plan of action (including current summary of claim, medical status, proactive action based strategy, and anticipated date of claim resolution), disputes, and detailed summary of any communications regarding the claim.

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1.6.19 All claim files and information must be securely retained by the Contractor for the life of this contract. Upon expiration or termination of this contract, all claim files and related information shall be returned to the State of Michigan or its designated representative in electronic form. Any paper records transferred from the previous contractor, may be converted to electronic for, however the paper record must be returned to the Plan Sponsor. Any new paper records must be converted to electronic form.

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1.6.20 All claim files and information must be securely retained by the Contractor for the life of this contract. Upon expiration or termination of this contract, all claim files and related information must be returned to the State of Michigan or its designated representative in electronic form. Any paper records that exist must be converted to electronic form.

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1.6.21 Some of the current claims in open or re-open status have an electronic claim file along with an associated paper claim file. The paper claim file may contain information not converted into the electronic file. Contractor must confirm with Plan Sponsor whether paper file exists.

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1.6.22 Contractor will make claim compensability determinations within 14 calendar days from the date employer was notified of the injury. If claim determination is unable to be made within 14 calendar days from the date the employer was notified of the injury, Contractor will file statutory forms to indicate what is needed in order to complete the investigation and will communicate current status to the appropriate state of Michigan departmental contact and claimant.

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Bidder must describe steps taken to ensure disability determination decisions are appropriately made:

Bidder must describe steps taken to ensure timely disability determination decisions:

How are departments and claimants notified of pended claims, claim approval and denials? Bidder Response:

1.6.23 The Contractor must make payment decisions on behalf of the State of Michigan within the parameters described in all applicable statutes and policies of the State and shall be responsible for the processing of all claim payments unless otherwise determined by the Program Manager.

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1.6.24 All claim payments are to be made in accordance with statutory requirements as provided in the Workers’ Disability Compensation Act or procedures established by the State of Michigan along with proper documentation and notice to all relevant parties. See also SLAs in Schedule A, Section 10.

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Provide a detailed explanation of your medical bill review and payment process. Identify any subcontractors involved in this process. Bidder Response:

What is your average turn-around time (calendar days) for medical bill payments from the date the bill is received? Bidder Response:

How are medical provider reconsiderations of medical bill payments reviewed and processed? Bidder Response:

1.6.25 The Contractor must undertake responsibility for providing Organization Determinations, including full and fair review of claims appeals by Covered individuals that have been denied either in full or in part. The Contractor’s claims appeals process must comply with the Plan Sponsor’s claims appeals process as provided in the Workers’ Disability Compensation Act. The Contractor’s claims appeals reporting must comply with Plan Sponsor’s claims appeals reporting requirements.

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1.6.26 The Contractor must capture and store all claim data elements involved in the processing or payment of claims.

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1.6.27 The Contractor must capture additional claim data elements, if requested by the Plan Sponsor.

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1.6.28 The Contractor must have processes in place to detect, prevent, and correct fraud, waste, and abuse. Where fraud or abuse is discovered, the Contractor must reimburse the Plan Sponsor and attempt to make recoveries when applicable. Detected fraud, waste or abuse must be reported to the Plan Sponsor immediately with any and all relevant evidence to substantiate the detection of such fraudulent activity, and must be remedied in conjunction with the monthly reporting schedule in Schedule A, Section 5.4 Reporting.

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1.6.29 The Contractor must have procedures for handling overpayments and recoveries in place.

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1.6.29.1 In the event of an overpayment, Contractor will immediately notify the designated department contact and claimant and document in the claim file the reason for the overpayment, amount of the overpayment and plan of action for recovery.

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1.6.29.2 The State of Michigan will not be responsible for overpayments on claims resulting from error within the scope of Contractor’s control. Any overpayment resulting from error within the scope of Contractor’s control is the responsibility of the Contractor. Contractor will immediately credit the State of Michigan in full amount of the overpayment and apply the credit directly to the affected claim. Overpayment recovery is the responsibility of the Contractor and all recoveries must be credited to the affected claim.

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1.6.29.3 Contractor must provide an overpayment process to minimize overpayment occurrence and maximize overpayment recovery. Implementation of this process will require approval from the Program Manager. The Program Manager reserves the right to require changes to the Contractor’s overpayment process in the event the Program Manager finds the process ineffective.

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1.6.29.4 All claims, payments and associated claims expenses must be recorded as associated with the individual claim. All claim benefit checks issued by the Contractor shall include expiration statement of 180 days from the date it was issued if not cashed by recipient within that period of time.

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Do you have different information systems for claim payment versus claim management? If yes, how is this information integrated for the Plan Sponsor. Bidder Response:

How often are open claims reviewed and by whom? Bidder Response:

Is this review dependent on automated system edits or a manual look up? Bidder Response:

What procedures are in place to assure timely and accurate coordination of supplements and offsets (e.g., LTD, Social Security, Retirement, Unemployment Benefits etc.) Bidder Response:

1.6.30 The Contractor must have a claims processing team that is experienced in processing complex claims, handling recoveries, and have experienced staff to handle claims that require manual intervention.

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1.6.31 System rules or programming errors that result in improper payment of claims or payment of ineligible claims or payment to ineligible individual will be considered financial errors.

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1.7 Subrogation

1.7.1 The Contractor must review and monitor all claims for subrogation potential involving third-party liability against any and all outside parties for which this subrogation may be appropriate. All reviews for subrogation potential must be documented in the claim notes.

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1.7.2 The Contractor must document all subrogation efforts. The Contractor must collectively consult with the State’s Departmental contact and appropriate division of the Attorney General’s office and the State’s Program Manager prior to actively pursuing any questionable third-party situation.

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1.7.3 All amounts received through subrogation must be provided to the State of Michigan as a reduction of the cost of the claim expenses recorded for that specific claim. Subrogation expenses must be included as part of the per claim fees assessed by the Contractor as part of the normal claim fee. This includes bankruptcy court filing and action for overpayment recoveries.

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Does your organization actively pursue subrogation opportunities? What resources are used to pursue these dollars? Bidder response:

1.9 Litigation Support

1.9.1 Once it is apparent that a claim is going into litigation, the Contractor must notify the Program Manager and Labor Division, State Claims Section of the Attorney General’s Office. The specific process for this notification to occur and the forms and protocols will be established by the Labor Division, State Claims Section of the Attorney General’s Office and the State’s Program Manager, and provided to the Contractor.

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1.9.2 Once a claim is in litigation, the responsibility for the claim rests with the appropriate division with the Attorney General’s office and the staff attorney assigned to the claim.

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1.9.3 The Contractor must provide any and all support requested by the designated Attorney General’s representative in an accurate and timely manner satisfactory to the Attorney General, and subject to agreement by the Plan Sponsor. The Contractor must continue to monitor and provide supporting information for all claims in litigation.

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1.9.4 The Contractor must provide timely and accurate file documentation to the Attorney General in the form and nature defined by the State of Michigan. The utilization of the Contractor’s forms and documents must be with the consent and approval of the Program Manager.

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1.9.5 The appropriate division of the Attorney General’s Office or designee, will control all investigation activity, settlement negotiations and settlements conducted on behalf of the State of Michigan for all litigated claims, with the advice and consent of the State’s Program Manager.

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1.9.6 All billings for “outside investigators”,…