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COMPREHENSIVE WORKERS COMPENSATION MANAGED CARE ARRANGEMENT .1 I AGREEMENT Between CITY OF CLEARWATER And CORVEL CORPORATION This document represents an agreement between the City of Clearwater, hereinafter referred to as "CITY", and CorVel Corporation, hereinafter referred to as "CORVEL". The purpose of this agreement is to establish a business relationship between the parties hereto for the purpose of developing and implementing a comprehensive workers' compensation managed care arrangement (MCA) for the CITY in the State of Florida, with regard to the servicing of CITY'S injured employees whose claims are self-administered by the CITY in compliance with Chapter 440, Florida Statutes (Florida Workers' Compensation Law). In consideration of the premises hereof, and the mutual promises and agreements made herein, the parties hereto, intending to be legally bound, hereby agree to the provisions set forth in this agreement and in the CITY'S Managed Care Arrangement which include, but are not limited to the following: OBLIGATIONS OF CORVEL: 1) CORVEL will develop and maintain, through credentialing and re-credentialing of: medical providers, the operations of a M CA Preferred Provider Network (CorCare) in the service area consisting of Pinellas, Hillsborough, and Pasco Counties which include primary care physicians and other medical specialist, and other health care providers satisfactory to CITY, to include hospitals, clinics, and ancillary health care servIces. 2) CORVEL will implement and maintain utilization management programs and services as defined in the MCA. 3) CORVEL will assist, through communication with CITY'S workers' compensation adjuster(s), the CITY'S injured employees with grievance procedures as defined in the MCA. (J{!:~ 1 I I 4) CORVEL will develop and maintain the CorCare Network Quality Assurance program and provide case management services as defined in the MCA. 5) CORVEL will assist CITY with MCA educational seminars. 6) CORVEL will assist CITY with preparation of its MCA and file the same with Florida's Agency For Health Care Administration (AHCA) along with semi-annual updated provider lists as provided by Florida law. 7) CORVEL will invoice CITY monthly for use of its medical care network and its managed care services in accordance with the pricing schedule set forth in paragraph 19 hereof. 8) CORVEL will provide sample education materials for CITY and will assist CITY with proper distribution of such materials. 9) CORVEL will provide directory updates to CITY for appropriate channeling into the CorCare Network. 10) CORVEL will provide reports to CITY monthly substantiating cost savings through the CITY'S MCA. 11) CORVEL will work with CITY workers' compensation adjusters to: a) Notify employees of the necessity of using the MCA; b) Direct employees to CorCare providers; c) Assist employees with return to work opportunities. OBLIGATIONS OF CITY: 12) CITY will refer all inpatient and outpatient invoices, except pharmacy invoices to CORVEL for all workers' compensation cases regardless of date of accident. COR VEL will then review each invoice submitted, reduce to fee schedule, apply all PPO discounts, and return the invoice to CITY in adequate time for CITY to pay each invoice within the time allotted for payment of invoices pursuant to Florida Workers' Compensation Law. Hospital invoices shall be audited by CORVEL only if requested by CITY. 2 I I 13) CITY shall pay CORVEL for services rendered within thirty (30) days of the date of receipt by CITY of an invoice from CORVEL. MISCELLANEOUS PROVISIONS: 14) The term of this agreement is for a period of one (1) year from its effective date. This agreement may be renewed for two (2) additional one (1) year periods on the same terms and condition if mutually agreed to by the parties hereto. Notice of intent to renew will be given by each party within sixty (60) days of the expiration date. 15) The terms of paragraph 14 hereof to the contrary notwithstanding, this agreement can be terminated by either party with or without cause upon thirty (30) days written notice submitted at any time. It is the expressed intent of the parties that the business relationship between the parties hereto shall last only so long as the parties are mutually satisfied with the business relationship existing between the parties. 16) CORVEL, will, at its own expense, maintain, at all times during the term of the agreement, the required professional liability, errors and omissions, workers' compensation, general and auto liability insurance coverages as set forth on Exhibit A attached hereto and made a part hereof. 17) This contract is expressly conditioned upon CORVEL adding to either its provider network or to CITY'S MCA those medical providers desired by CITY - particularly Morton Plant Hospital and its affiliated Mease hospitals. 18) CORVEL shall be responsible for the recommendations, acts or omissions of any of its employees, agents, representatives, or independent contractors in connection with the provision of its managed care services as described in its marketing brochures and/or service proposals or RFP response as provided to CITY, and shall indemnify, defend, and hold harmless CITY, its agents, representatives, elected officials, and employees, from any claims, actions, suits, proceedings, costs, expenses, damages, injuries, and liabilities, including attorney's fees, arising from its recommendations, acts or omissions. The above stated rights to indemnification shall not apply (a) to any case where CITY, its agents, representatives, or employees in any way modify or disregard CORVEL'S recommendations or fail to implement them in a timely manner or (b) to the extent the cause of action or liability arises from the negligent acts or omissions or willful misconduct of CITY, its employees, agents, employees, elected officials, or representatives. 3 I I 19) The parties hereby agree to CORVEL'S prices for its managed care services to CITY as follows: a) Standard fees are $1.25 per line (line means CPT code) with a two (2) line minimum for review of invoices for medical services covered by the State of Florida's workers' compensation fee schedule; b) Standard fees are $1.40 per line with a two (2) line minimum for review of invoices for medical services not covered by the State of Florida's workers' compensation fee schedule; c) A fee of $68.00 per hour for telephonic and field case management of cases that are specifically referred to CORVEL by CITY; d) If CITY uses, which it is not required to use, CorCare RX Pharmacy program CORVEL shall receive 30% of any savings, with no charge to be made if no savmgs occurs. e) CORVEL shall receive 30% of any savings generated from its PPO re-pricing based on medical provider discounts that CORVEL has negotiated into its managed care network. f) Based on the anticipated usage of COR VEL'S Managed Care Network by City and the level of expenditures for workers' compensation medical benefits paid by the City in the past two years, together with the PPO savings to inure to the City by virtue of City's use of the CORVEL Managed Care Network, the parties anticipate a net expenditure annually by CITY ofless than $25,000. 20) The effective date of this agreement will be January 1, 1997, but ifthe City Attorney of Clearwater determines that this agreement needs to be ratified and confirmed by the Clearwater City Commission, then this agreement will be voidable by CITY until such time as the agreement is ratified and confirmed by the Clearwater City Commission. CORVEL CORPORATION, a, Delaware Corporation CITY OF CLEARWATER, a Florida Municipal Corporation By r;-~~ ~ ~ty Mager f//r.'/~7 f Date: 4 I I " EXHIBIT A to Agreement Between CITY OF CLEARWATER And CORVEL Dated December, 1996 INSURANCE REQUIREMENTS 1. Insurance. CORVEL shall furnish, pay for, and maintain during the life of the contract with the City the insurance coverages shown below: a. General Liability insurance on an "occurrence" basis in an amount not less than $500,000 combined single limit Bodily Injury Liability and Property Damage Liability. b. Business Auto Liability insurance on an "occurrence" basis in an amount not less than $500,000, for liability arising out of operation, maintenance or use of any auto, including owned, non-owned and hired automobiles and employee non-ownership use. c. Worker's Compensation Insurance applicable to its employees, if any, for statutory coverage limits in compliance with Florida laws. d. Professional Liability/Malpractice/Errors or Omissions Insurance with minimum limits of$l,OOO,OOO per occurrence. 2. Additional Insured. The City is to be specifically included as an additional insured on all liability coverage described above. 3. Notice of Cancellation or Restriction. All policies of insurance must be endorsed to provide the City with thirty (30) day's notice of cancellation or restriction. 4. Certificates oflnsurance/Certified Copies of Policies. CORVEL shall provide the City with a certificate or certificates of insurance showing the existence of the coverages required by its contract with the CITY. CORVEL will maintain these coverages with a current certificate or certificates of insurance throughout the term stated in the proposal. When specifically requested by City in writing, the Vendor will provide City with certified copies of all policies of insurance as required above. New certificates and new certified copies of policies, if certified copies of policies have been requested, shall be provided City whenever any policy is renewed, revised, or obtained from other insurers. 1 I I !" ,.." 5. The address where such certificates and certified polices shall be sent or delivered is as follows: City of Clearwater Attention: Risk Management P.O. Box 4748 Clearwater, FL 34618-4748 2 ~ j~@ttttt}~I~;~~~~m~~~~~;r:~~m1~~~~*~f:f:*~~~;1~tm;~~~~~m~m~~~~t*~r~~:" . '. Marsh , McLennan, Incorporated 500 W. Monroe chicaqo, IL 60661 ~~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. THIS CERTIFICATE OOES NOT AMEND, EXTEND OR AL TEA THE COVERAGE AFFORDED BY THE POLICIES LISTED HEREIN. COWPAI'lf lETTER COMPANIES AFFORDING COVERAGE A COLUMBIA CASUALTY CO Barbara Covell INSURED CorVel Corporation 1920 Main Street suite 1090 Irvine, CA 92714 COWPAI'lf lETTER B COMPAI'lf LETTER C COMPAI'lf lETTER D ;.:.;:;.2~.'elm:l;:::::~:::lI:::::::::::::::l:::::I::::::I:III::::::l:l:::::II:1IlIIIlI::II:1:::Il:MMI:11::;l.1lII::::~:~:lI:~:I:IiI:::II::::::::I:::::::::~::::I::~:I;:;:;II:;~;:;IIIII:::::::::;:I:::::::::~;:;::~;~:::III::~::I:;:::::::::::::::::::::::~::::::::~::::;:;:~~:::III1II::i::::::::::::I:::~::~::~::I:::::~::;f:::::: THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANl.'E AFFORDED 6'( THE ?OUCI!:S L!STED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . PClUCY EFFECTNE PClUCY EXPIRATlCI\I PClUCY NUMBER DAlE (JIMfDDfYY) DAlE co LTR TVPE OF IlSURANCE LMTS GENERAL UABaITY COMMERCIAL GENERAL UABIUTY DaAlMS MAOEDoccUR. OWNER'S CONTRACTOR'S PROTo AUlllMOIlU UABlLTY AI'lf AUTO AU. OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GENERAL AGGREGATE $ PRODUCTS-COMP lOP AGG $ PERSONAL & ADV INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED. EXPENSE (Any one person) $ I~ ~~ COMBINED SINGlE UMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ -, 19~ I PROPERTY DAMAGE $ GARAGE UABWTY AI'lf AUTO ANAG MENT AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY EACH ACCIDENT $ $ $ $ EXCESS UABIJTY AGGREGATE EACH OCCURRENCE AGGREGATE UM~HEi.1A i'UHM OTHER THAN UMBR8.LA FORM WORKERS' COMPENSATlCI\I AND EMPLOYERS UABIJTY STATUTORY UMrTS EACH ACCIDENT DISEASE - POLICY UMrT DISEASE - EACH EMPLOYEE $ $ $ OTHER PROF LIAB -OTH PMC 1023817904 10L31/96 10/31/97 RETRO-DATE: 10/31/88 LIMITS OF LIABILI Y: $5,000,000 EACH CLAIM; $ f,000,000 AGG.; DEDUCTIBLE: 10 0 0 EACH CLAIM. CLAI S-MADE ICY. DESCRIPTION OF OPERATIONS/lOCATIONS/llEHIO.ES/SPECIAlITEMS city of Clearwater is Additional Insured with respect their interest. CERTIFICATE HOLDER City of Clearwater 100 S. Myrtle Ave. Clearwater, FL 34616 CANCELlATION SHOULD ANY OF THE POLICIES LISTED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES. OR THE ISSUER OF THIS CERTIFICATE. MARSH & Ma.ENNAN, INCORPORATED BY: II MMl1 (8/tS) VAUD AS OF: 1/02 97 PAGE: 1 OF 1 t 41581 PRODUCER Marsh , McLennan, Incorporated 500 W. Monroe chicaqo, IL 60661 Barbara Covell THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY, THIS CERTIFICATE OOES NOT AMEND, EXTEND OR ALTEA THE COVERAGE AFFORDED BY THE POLICIES LISTED HEREIN. COMPAI'lf lETTER COMPANIES AFFORDING COVERAGE A COLOMBIA CASUALTY CO "SURED CorVel corporation 1920 Main street suite 1090 Irvine, CA 92714 COMPAI'lf lETTER B COMPAI'lf lETTER C COMPAI'lf lETTER D ;,:,;:;,}!e.eHi.~::~II::::::::::::!:::::::::!:::::::l::::::::::::::::::::!:::::::!::::::::i.:::~:!::i.:::~~::::::~i.M:::::::::~i.:l::@~~:::::::::M:I::~::::l:H::::::::i.:::::I:UH:::::::I~:::::::::':::::::~::~~~~ml:!:::I::::~~::::::::::::::::::!::::::::::~:'::r:::::::::':::::::~:::::II::::::t::~:::I::::t~:~:::::::::::::::':'~::::t::':'::::::::':':::::':::':':'::!:!::::!:::':'!::':::::::::~::~:rr:::::~:::::I:::::l:::t:::::!:::::f:':::':"':':,:,: THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TEAM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 6Y THE roUCI!:S L!STED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . N POUCY IEFFECTI\IE TYPE OF "SURANCE POUCY UMBER DAlE ,./DD/YYl GENERAL UABIJTY COMMERCIAL GENERAL UABIUTY o a.AIMS MADEDoocuR. OWNER'S CONTRACTOR'S PROT. LNTS co LTR GENERAL AGGREGATE $ PRODUCTS-COMP lOP AGG $ PERSONAL & ADV INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED. EXPENSE (Any one person) $ AUTOMOBLE UABlLTY AI'lf AUTO ALL OWNED AUTOS SCHEDUlED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE UA8RJTY AI'lf AUTO ~ ~~ COMBINED SINGLE UMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ .' 19~ PROPERTY DAMAGE $ EXCESS UA8RJTY ANAG MENT AUTO ONLY. EA ACCIDENT $ OTHER THAN AUTO ONLY EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ lJMt.ltiEUi\ FUHM OTHER THAN UMBR8lA FORM WORKERS' COMPENSATION AND EMPLOYERS UABIJTY STATUTORY UMITS EACH ACCIDENT DISEASE. POUCY UMIT DISEASE - EACH EMPlOYEE $ $ $ OTHER PROF LIAB -OTH LIMITS OF LIABILI 10/31/88 Insured with respect their interest. City of Clearwater 100 S. Myrtle Ave. Clearwater, FL 34616 CANCELlATION SHOULD ANY OF THE POLICIES LISTED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE ISSUER OF THIS CERTIFICATE. MARSH & Ma.ENNAN, INCORPORATED BY: CERTIRCATE HOLDER MM 1 (B/95) PAGE: 1 OF 1