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HomeMy WebLinkAboutR-98-0243J-98-153 3/1/98 RESOLUTION NO. 9 8- 243 A RESOLUTION, WITH ATTACHMENTS, AUTHORIZING THE CITY MANAGER TO ENTER INTO AN AGREEMENT, IN SUBSTANTIALLY THE ATTACHED FORM, WITH VINCAM OCCUPATIONAL HEALTH SYSTEMS, INC. ("VOHS"), FOR THE PROVISION OF MANAGED CARE SERVICES FOR WORKERS COMPENSATION, FOR A PERIOD OF TWO YEARS, AT AN ANNUAL AMOUNT NOT TO EXCEED $300,000, WITH THE OPTION OF THE CITY TO EXTEND SAID AGREEMENT FOR THREE (3) ADDITIONAL ONE (1) YEAR PERIODS, SAID AGREEMENT TO PROVIDE INCENTIVES TO VOHS SHOULD PERFORMANCE EXCEED GUARANTEED TARGETS, AND TO REQUIRE APPROPRIATE REFUNDS BY VOHS TO THE CITY SHOULD PERFORMANCE FALL SHORT OF GUARANTEED TARGETS; ALLOCATING FUNDS THEREFOR FROM THE SELF INSURANCE AND INSURANCE TRUST FUND, ACCOUNT CODE NO. 515001.424401.6.668. WHEREAS, the City as an employer is required to furnish medical treatment solely through managed care arrangements to its employees for compensable injuries covered under the Florida Worker's Compensation Act; and WHEREAS, on January 13, 1998, the City Commission adopted Resolution No. 98-17, accepting the findings of the selection committee, and instructing the City Manager to negotiate an agreement with the top ranked firm; NOW, THEREFORE, BE IT RESOLVED BY THE COMMISSION OF THE CITY OF MIAMI, FLORIDA: Section 1. The recitals and findings contained in the Preamble to this Resolution are hereby adopted by reference IATTACHMENT (S)I CONiA1NE0' CITY CO1VII1MMON MEETING Cr MAR 10 1998 -q—otud= No. 98-r 243 thereto and incorporated herein as if fully set forth in this Section. Section 2. The City Manager is hereby authorized to enter into an agreement, in substantially the attached form, with Vincam Occupational Health Systems, Inc. ("VOHS"), for the provision of managed care services for workers compensation, for a period of two years, at an annual amount not to exceed $300,000, with the option of the City to extend said agreement for three (3) additional one (1) year periods, said agreement to provide incentives to VOHS should performance exceed guaranteed targets, and to require appropriate refunds by VOHS to the City should performance fall short of guaranteed targets, with funds therefor hereby allocated from the Self -Insurance and Insurance Trust Fund, Account Code No. 515001.424401.6.668. Section 3. This Resolution shall become effective immediately upon its adoption. PASSED AND ADOPTED this loth day of March 1998. XAVIER L. SUAREZ, MAYOR In accordance with Miami Code Sec. 2-6, since the Mayor did not indicate approval of this legislation by signing it in the designated place provided, said legislation now becomes effective with the elapse of ten (10) days m the date of Corn " sion action regarding same, without the Mayor exerci ng o. ATTEST: Wa eman, City Clerk WALTER J. FOEMAN CITY CLERK 2 - 98- 243 PREPARED AND REVIEWED BY: RAFAEL 0. DIAZ DEPUTY CITY ATTORNE APPROVED AS TO FORM AND CORRECTNESS: EDWARD IM CITY 235:BSS - 3 - 98- 243 WORKERS' COMPENSATION MANAGED CARE SERVICES AGREEMENT This Workers' Compensation Services Agreement ("Agreement"), made and entered into as of the day of , 1998 and effective as the day of 1998 by and between Vincam Occupational Health Systems, Inc. ("VOHS"), whose address is 2850 Douglas Road, Coral Gables, Florida 33134 and the City of Miami ("City"), whose physical address is 3500 Pan American Drive, Miami, Florida 33133. In exchange for mutual and valuable consideration, the parties hereby mutually agree as follows: RECITALS A. The City is an employer authorized to self -insure its workers' compensation liabilities pursuant to applicable state law. B. The City has issued a Request for Proposals ("RFP") for the delivery of certain managed care services, as specifically described in the RFP (the "Services"). C. VOHS; proposal ("Proposal") in response to the RFP, has been selected as the most qualified proposal for the provision of the Services. The RFP and the Proposal are sometimes referred to herein, collectively, as the Solicitation Documents, and are by this reference incorporated into and made a part of this Agreement. D. The City wishes to contract with VOHS for the utilization of VOHS' services, and VOHS wishes to provide such services to the City, under the terms and conditions set forth herein. E.. The Commission of the City of Miami, by Resolution No. - , adopted on , 199_, approved the selection of VOHS and authorized the City Manager to execute this Agreement. NOW, THEREFORE, in consideration of the mutual covenants and promises herein contained, Provider and the City agree as follows: ARTICLE I DEFINITIONS As used in this Agreement, the following definitions will apply. - Section 1.1. Administrative Procedures: Means the procedures developed and agreed upon by the City and VOHS regarding notification, pre -certification and authorization of treatment, payment procedures, documentation, timeframes and other administrative procedures to be followed and/or provided by each party. 98- 243 Section 1.2. Covered Services: Means medical treatment, care and attendance that injured workers are entitled to receive in accordance with the applicable state workers' compensation law. Section 1.3. Injured Worker: Means an employee of the City who, at all pertinent times, meets the City's employment eligibility requirements and the applicable provisions of the state workers' compensation law. Section 1.4. Service Area: Means the service area described on Schedule B attached hereto, as may be modified from time to time by both parties in a subsequent writing that incorporates is agreement by reference. Section 1.5. Participating Provider: Means an organization, network, or individual that has contracted directly with VOHS or any of its sub -contractors to provide medical treatment or drug testing to persons eligible to receive services through VOHS. Section 1.6. Non -Participating Provider: Means an organization, network or individual engaged in the provision and delivery of medical treatment or drug testing that is not a participating provider. ARTICLE H DUTIES OF VOHS Section 2.1. The Services: VOHS agrees to provide the Services described in Schedule "C" hereto, which by this reference is incorporated into and made a part of this Agreement. VOHS represents and warrants to the City -that: (i) it possesses all qualifications, licenses and expertise required under the Solicitation Documents for the performance of the Services; (ii) it is not delinquent in the payment of any sums due the City, including payment of permit fees, occupational licenses, etc., nor in the performance of any obligations to the City; and (iii) all personnel assigned to perform the Services are and shall be, at all times during the term hereof, fully qualified and trained to perform the tasks assigned to each. Section 2.2. Managed Care Services: VOHS will provide the Services in a manner and as may be required by Florida law, applicable regulations, or the Agency for Health Care Administration. These services include workers' compensation medical case management for injured workers who incur occupational injuries, including medical triage of new injuries, assignment of case managers, medical coordinator oversight, and treatment plan review and authorization. In addition, VOHS will maintain an adequate level of staffing to operate an assigned case management team(s) and call center for 24 hour notice of injury intake and case management support. Section 2.3. Network Access: Participating Providers: VOHS will provide the City and its injured workers with access to its comprehensive, proprietary statewide network of occupational providers, including a comprehensive network of drug testing and collection facilities, for the purpose of receiving covered services as may be medically necessary and et:W214WCMn1;cdCarc-doc 2 9 8_ 243 appropriate pursuant to applicable workers' compensation statutes. VOHS will conduct provider training, credentialing, certification, and quality improvement services as VOHS deems appropriate and as may be required by Florida law. VOHS will recredential providers on a two- year basis. Section 2.4. Provider Directory and Referral: VOHS will create and maintain a directory of participating providers. Upon notification of a worksite injury, VOHS will refer the injured worker to the participating provider or providers that are medically and geographically appropriate to the injured worker's medical condition and geographic location. In the event that appropriate participating providers are not available, VOHS will refer the injured workers to a non -participating provider or providers, as appropriate and as may be requested by the City. VOHS warrants that all such referrals will be consistent with Florida workers' compensation law applicable to the employee's choice of provider. Section 2.5. Bill & Utilization Review: Utilization Renorts: VOHS will implement a process of utilization review and control, including evaluation of the appropriateness of health care services provided to injured workers and review provider invoices to identify instances of over -utilization. VOHS or its subcontractors will apply applicable discounts to invoices submitted by participating providers. VOHS will maintain utilization data and generate reports on behalf of the City as may be reasonably required and agreed upon by the parties, at least quarterly. Section 2.6. Management and Employee Training: To acquaint the City management and employees with VOHS managed care procedures and resources available through the managed care program. VOHS will provide training sessions at times and locations agreed upon by the parties. VOHS will provide all the City injured workers with a booklet that explains VOHS managed care procedures. Section 2.7. Administrative Procedures: VOHS shall develop administrative procedures mutually acceptable to the parties for the delivery of services that are the subject of this agreement. Section 2.8. Return-To-WorkProgram: VOHS and the City will mutually develop a Return -To -Work program for injured workers that includes physician return -to -work assessments, transitional duty positions, and job descriptions appropriate to medical and physical limitations. The Return -To -Work program may incorporate existing the City programs as determined by the parties. Section 2.9. Grievance and Appeals Program: VOHS will maintain grievance procedures and an appeals program in accordance with the requirements of Florida Statute 440.134. VOHS attempt in good faith to resolve grievances presented by injured workers in accordance with the grievance procedures and appeals program. Section 2.10. Ouality Improvement Program: VOHS agrees to provide and maintain a quality assurance program in accordance with URAC (Utilization Review Accreditation Commission) standards and the requirements of Florida Statute 440.134, including, but not limited to, provider profiling, return -to -work outcomes by diagnosis, training and �K: W 214 W C MngcJCaro.Jox: 3 98- 243 education as needed for participating providers, and other program components as VOHS may deem appropriate. Section 2.11. Not An Insurer: This agreement shall not be construed to mean, and parties warrant and acknowledge, that VOHS is not and does not purport to be an insurer or third party administrator of workers' compensation and/or medical benefits. Section 2.12. Contract Manager: VOHS shall designate a manager to serve as liaison between VOHS and the City in connection with this Agreement. VOHS will periodically evaluate treatment plans and medical progress to ascertain need, adequacy, and effectiveness of continuing treatment modalities. ARTICLES III DUTIES OF THE CITY Section 3.1. Retention of Services: The City hereby retains VOHS to provide the services identified in this agreement, including workers' compensation medical management and access to a network of participating providers for the delivery of covered services. The City Agrees to use good faith efforts to educate the City and its officers, managers, and injured workers regarding the VOHS program, including procedures for notification of injury and communication with VOHS case managers. Section 3.2. Iniured Worker Eligibility: The City will provide all information reasonably necessary to allow VOHS to verify the eligibility of all persons seeking workers' compensation health benefits and services through the VOHS/City. This paragraph shall not be construed to vest VOHS with responsibility for claims administration or compensability determinations. Section 3.3. Notification of Iniurv: The City will notify VOHS immediately of all work site injuries and any available information pertaining to cause of injury and the employee's physical condition. Upon receipt of notice of injury, VOHS will authorize appropriate treatment, complete a notice of injury form, and assign identification/case number. The City will be advised the same working day of the medical and work status of the injured employee. All referrals and pre -certifications for treatment will be initiated by VOHS. Section 3.4. Claims Administration: The City will be responsible for workers' compensation claims administration, including but not limited to compensability determinations, processing of benefit payments, claims investigation, second injury fund claims, and coordination of legal activity. Section 3.5. Provider Payment: VOHS will provide City with adjudicate medical bills or providers who render approved services to injured workers, reduced to the applicable fee schedule and with VOHS' provider discounts applied, and the City will be responsible for payment of same. The parties warrant and acknowledge that this agreement shall not authorize or create a right of provider payment from or by VOHS. el: W214WC MngedCare.doc 4 8 8- 243 Section 3.6. Compensation of VOHS: Time For Payment: The City will compensate VOHS for the services in accordance with Schedule A to this agreement. The City will pay all VOHS invoices within forty-five (45) days of the date of receipt. ARTICLE IV RELATIONSHIP OF PARTIES Section 4.1. Provider-Patient/Provider-City Relationship: The parties acknowledge that providers are exclusively responsible for the maintenance of the provider-patient/provider- City and hospital -patient relationships with injured workers. ARTICLE V INDEMNIFICATION AND INSURANCE Section 5.1 Hold Harmless: VOHS shall indemnify, defend and hold harmless the City and its officials, employees and agents (collectively referred to as "Indemnities") and each of them from and against all loss, costs, penalties, fines, damages, claims, expenses (including attorney's fees) or liabilities (collectively referred to as "Liabilities") by reason of any injury to or death of any person or damage to or destruction or loss of any property arising out of, resulting from, or in connection with (i) the performance or non-performance of the services or activities contemplated by this Agreement which is directly or indirectly caused, in whole or in part, by the negligence (whether active or passive) of VOHS or its employees, agents or subcontractors (collectively referred to as "VOHS"), regardless of whether it is, or is alleged to be, caused in whole or part (whether joint, concurrent or contributing) by any act, omission, default or negligence (whether active or passive) of the Indemnities, or any of them or (ii) the failure of VOHS to comply with any of the paragraphs herein or the failure of VOHS to conform to statutes, ordinances or other regulations or requirements of any governmental authority, federal or state, in connection with the performance of this Agreement. VOHS further agrees to indemnify, defend and hold harmless the Indemnities from and against (i) any and all Liabilities imposed on account of the violation of any law, ordinance, order, rule, regulation, condition, or `fequirement, in any way related, directly or indirectly, to VOHS's performance hereunder, compliance with which is left by this Agreement to VOHS, and (ii) any and all claims, liens and/or suits for labor and materials furnished by VOHS or procured by VOHS to perform this contract or otherwise. Section 5.2 Insurance: VOHS shall take out, pay for, and at all times during the performance of work hereunder maintain, such public, contingent (where applicable, professional malpractice) and employer's liability insurance as will satisfy the foregoing indemnity requirements of the Agreement and protect VOHS and the City from claims by VOHS employees under workers' compensation and other employee benefit acts (the "Insurance"). The insurance shall include comprehensive general liability and property and damage, including automobile, products completed operations and broad form contractual covering liability assumed by the VOHS under this Agreement. The comprehensive general liability insurance shall: (i) include the City as an additional insured; (ii) be primary insurance written on an occurrence basis to the full ot: W 214 W C N4ng%:JCaro.J,k 5 ��� 243 limits of liability hereinafter stated, and should the City have other valid insurance, the City's insurance shall be excess insurance only, (iii) include a waiver of subrogation against the City, its officers, agents and employees, (iv) include a severability clause substantially in the following form: "The insurance afforded applies separately to each insured against whom claim is made or suit is brought, but the inclusion hereunder of more than one insured shall not operate to increase the limits of the insurance carrier's liability. The inclusion of any person or organization as an insured shall not affect any right that such person/organization would have as a claimant if not so included," and (v) contain an endorsement substantially stating: "Cancellation or expiration of the policy to which this endorsement is attached shall not become effective until after thirty (30) days advance written notice has been delivered to the City. City of Miami Risk Management Attention: Mario Soldevilla, Administrator 444 S. W. 2°d Avenue, 9t' floor Miami, Florida 33130 Without limitation of the requirements set forth in this Section 5.2 VOHS shall maintain insurance applicable to its employees and business operations, including the provision of services under this Agreement, with coverage and minimal limits of liability as follows: (1) Workers' Compensation and Employer's Liability providing statutory coverage for VOHS employees under the Workers' Compensation and Occupational Disease Laws of the state where operations are being performed under this Contract. (2) Comprehensive General Liability affording (i) Bodily Injury Liability (or death) with limits of at least $1,000,000 for each person and, where applicable, at least $2,000,000 in the aggregate, and (ii) Property Damage Liability with limits of at least $1,000,000 for each occurrence and at least $1,000,000 in the aggregate, such coverage to include: Products Completed Operations, Broad Form Contractual Liability covering liability assumed under this Contract, and Provider's Contingent (Protective) Liability with respect to work subcontracted by the Provider. (3) Comprehensive Automobile Liability affording (i) Bodily Injury Liability (or death) with limits of at least $500,000 each person and at least $1,000,000 each occurrence; and (ii) Property Damage Liability with a limit of at least $250,000 each occurrence, or a combined single limit of at least $1,000,000, such et: W 214WCMngedCare.dcx: 6 98- 243 coverage to include liability for the operation of owned, hired, and non -owned vehicles. (4) Professional Liability insurance to include Errors and Omissions with limits of at least $1,000,000, each occurrence. In no event shall the provisions of this Section be construed in any way to limit VOHS's obligations under any provision of this Agreement, including, but not limited to, VOHS's obligations to indemnify, defend and hold harmless the City. The insurance coverage required herein shall be through policies issued by companies authorized to do business under the laws of the state where the work is performed. The Company must be rated by the latest edition of Best's Insurance Guide, published by Alfred M. Best Company, Inc. (or other recognized organization] at no less than an "A" Best Policyholders Rating and no less than an "X" rating in Best's Financial Size Category. All such insurance, including renewals, shall be subject to the approval of the City for adequacy of protection, and evidence of such coverage shall be furnished to the City on Certificates of Insurance indicating such insurance to be in force and effect and providing that it will not be canceled during the performance of the services under this contract without thirty (30) calendar days prior written notice to the City. Completed Certificates of Insurance shall be filed with the City prior to the performance of services hereunder, provided, however, that VOHS shall at any time upon request file duplicate copies of the policies of such insurance with the City. If, in the reasonable judgment of the City, prevailing conditions warrant the provision by VOHS of additional liability insurance coverage or coverage which is different in kind, the City reserves the right to require the provision by VOHS of an amount of coverage different from the above stated amounts or kind and shall afford written notice of such change in requirements thirty (30) days prior to the date on which the requirements shall take effect. Should VOHS fail or refuse to satisfy the requirement of changed coverage within thirty (30) days following the City's written notice, this Contract shall be considered terminated on the date that the required change in policy coverage would otherwise take effect." ARTICLE VI TERM AND TERMINATION OF AGREEMENT Section 6.1. Term: This Agreement shall be for an initial term of two (2) years, commencing on the date of execution. The City shall have the option to extend the Contract for three (3) additional periods of one (1) year each by giving VOHS at least thirty (30) days prior written notice. Extension of the term of the Agreement beyond the initial period is an option of the City to be exercised in its sole discretion and which does not confer any rights upon VOHS. Section 6.2. Default: If VOHS fails to comply with any term or condition of this Agreement, or fails to perform any of its obligations hereunder, then VOHS shall be in default. Upon the occurrence of a default hereunder, which is not cured within a period of thirty (30) days ct:W214WCMngcdC'are.d„c 7 9 8- 243 following the City's notice of default to VOHS, the City, in addition to all remedies available to it by law, may immediately, upon written notice to VOHS, terminate this Agreement. The written notice of default shall be sufficiently specific to put VOHS on notice of the alleged acts or non- performance and to permit VOHS a reasonable opportunity to cure. Upon termination of this Agreement, pursuant to this paragraph, VOHS shall immediately repay all monies or other compensation received by it during the period of the default, except where the parties reasonably disagree as to performance and VOHS has requested dispute resolution by the City Manager, pursuant to paragraph within ten (10) days of receipt of notice of default. Should VOHS be unable or unwilling to commence to perform the Services within the time provided or contemplated herein, then, in addition to the foregoing, VOHS shall be liable to the City for all expenses incurred by the City in preparation and negotiation of this Agreement, as well as all costs and expenses incurred by the City in the re -procurement of the Services. If City commits and event of default under this Agreement which is not cured within thirty (30) days following VOHS' notice of default to the City, which notice shall be sufficiently specific to pay City on notice of the alleged acts on non-performance and to permit the City a reasonable opportunity to cure, then VOHS may terminate this Agreement by giving the City at least thirty (30) days prior written notice to the City. Section 6.3. Resolution of Contract Disputes: VOHS understands and agrees that all disputes between VOHS and the City based upon an alleged violation of the terms of this Agreement by the City shall be submitted to the City Manager for his/her resolution, prior to Provider being entitled to seek judicial relief in connection therewith. In the event that the amount of compensation hereunder exceeds $4,500, the City Manager's decision shall be approved or disapproved by the City Commission. VOHS shall not be entitled to seek judicial relief unless: (i) it has first received City Manager's written decision, approved by the City Commission if the amount of compensation hereunder exceeds $4,500, or (ii) a period of sixty (60) days has expired, after submitting to the City Manager a detailed statement of the dispute, accompanied by all supporting documentation (90 days if City Manager's decision is subject to City Commission approval); or (iii) City has waived compliance with the procedure set forth in this section by written instruments, signed by the City Manager. Section 6.4. City's Termination Rights: The City shall have the right to terminate this Agreement, in its sole discretion, at any time, by giving written notice to VOHS at least sixty (60) days prior to the effective date of such termination. In such event, the City shall pay to VOHS compensation for services rendered and expenses incurred prior to the effective date of termination. In no event shall the City be liable to VOHS for any additional compensation, other than that provided herein, or for any consequential or incidental damages Section 6.5. Effect of Termination: Termination of this Agreement shall not affect the rights and obligations of the parties hereto arising out of the transactions occurring prior to the termination. et: W214W •MngcdCarcAoc 8 8 8- 243 ARTICLE VII CONFIDENTIALITY Section 7.1. Medical Records: Neither the City, its designated representative(s) nor VOHS will disseminate information concerning an employee's medical records to any third party without the consent of the employee in compliance with all applicable state and federal laws and regulations and subject to legal process. The City and its designated representative and VOHS shall follow appropriate procedures to ensure that employee confidentiality rights are not abridged. The City's and VOHS's obligations under this Section 5.1 shall survive the termination of this Agreement. Section 7.2. Proarietary Information: VOHS and the City acknowledge that in order to effectively administer and execute this program either party may require or provide access to certain privileged and proprietary information, including but not limited to marketing and trade secrets, the City information, and employee information. VOHS and the City respectively agree not to exploit or disclose, directly or indirectly, verbally or in writing, proprietary information, materials, documents or data any such confidential information unless authorized by express written permission of the interested party, or where required by statute, regulation, or court process. Section 7.3. Limited Disclosure Permitted: Notwithstanding any other provision of this agreement, VOHS shall be authorized to disclose, at its discretion, the nature of its relationship with and services to the City in order to develop provider and other the City relationships. ARTICLE VM . AUDIT AND INSPECTION RIGHTS The City may, at reasonable times, and for a period of up to three (3) years following the date of final payment by the City to VOHS under this Agreement, audit , or cause to be audited, those books and records of VOHS which are related to VOHS's performance under this Agreement. VOHS agrees to maintain4ll such books and records at its principal place of business for a period of three (3) years after final payment is made under this Agreement. ARTICLE IX NONDISCRIMINATION VOHS represents and warrants to the City that it does not and will not engage in discriminatory practices and that there shall be no discrimination in connection with its performance under this Agreement on account of race, color, sex, religion, age, handicap, marital status or national origin. VOHS further covenants that no otherwise qualified individual shall, solely by reason of his/her race, color, sex, religion, age, handicap, marital status or national origin, be excluded from participation in, be denied services, or be subject to discrimination under any provision of this Agreement. ut: W 214 WC MngedC are.dua 9 93- 243 ARTICLE X COMPLIANCE WITH LAWS VOHS understands that agreements between private entities and local governments are subject to certain laws and regulations, including laws pertaining to public records, conflict of interest, record keeping, etc. City and VOHS agree to comply with and observe all applicable laws, codes and ordinances as the may be amended from time to time. ARTICLE XI CONTINGENCY CLAUSE Funding for this Agreement is contingent on the availability of funds and continued authorization for program activities and the Agreement is subject to amendment or termination due to lack of funds, reduction of funds and/or change in regulations, upon sixty (60) days notice. ARTICLE XII REAFFIRMATION OF REPRESENTATIONS VOHS hereby reaffirms all of the representations contained in the Solicitation Documents. ARTICLE XIII AWARD OF AGREEMENT VOHS represents and warrants to the City that it has not employed or retained any person or company employed by the City to solicit or secure this Agreement and that it has not offered to pay, paid, or agreed to pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with, the award of this Agreement. ARTICLE XIV PUBLIC RECORDS VOHS understands that the public shall have access, at all reasonable times, to all documents and information pertaining to City contracts, subject to the provisions of Chapter 119, Florida Statutes, and agrees to allow access by the City and the public to all documents subject to disclosure under applicable law. VOHS's failure or refusal to comply with the provisions of this section shall constitute an event of default under this Agreement. ARTICLE XV MINORITY AND WOMEN BUSINESS AFFAIRS AND PROCUREMENT PROGRAM The City has established a Minority and Women Business Affairs and Procurement Program (the "M/WBE Program") designed to increase the volume of City procurement and contracts with Blacks, Hispanic and Women -owned business. The M/WBE Program is found in Ordinance No. 10062, a copy of which has been delivered to, and receipt of which is hereby e1:W214WCMngcdCare.da: 1 88- 243 acknowledged by, VOHS. VOHS understands and agrees that the City shall have the right to terminate and cancel this Agreement, without notice or penalty to the City, and to eliminate VOHS from consideration and participation in future City contracts if VOHS, in the preparation and/or submission of the Proposal, submitted false of misleading information as to its status as Black, Hispanic and/or Women owned business and/or the quality and/or type of minority or women owned business participation. ARTICLE XVI MISCELLANEOUS Section 16.1. Non -Exclusive Agreement: The parties agree that VOHS is not precluded from entering into other agreements to provide the types of services set forth herein to any other entities, persons, or organizations. Section 16.2. Additional Assurances: The provisions of this Agreement are self - operative and do not require further agreement by the parties, except as may be herein specifically provided to the contrary, provided, however, at the request of either party, the party requested shall execute additional instruments and take such additional acts as may be reasonably requested in order to effectuate this Agreement. Section 16.3. Attorney's Fees: In the event that legal action is taken by either party to enforce any of the provisions of this agreement, the prevailing party shall be entitled to reasonable attorney's fees in connection with any such action. Section 16.4. Choice of Law and Venue: Whereas, VOHS's principal place of business and the location of the final act to effectuate this Agreement are in the State of Florida, and the parties agree that, in addition to the American Arbitration Association Rules, this Agreement shall be governed by and construed in accordance with the laws of the State of Florida. Section 16.5. Force Maieure." Neither party will be liable or deemed to be in default for any delay or failure to perform this Agreement deemed to result, directly or indirectly, from Acts of God, civil or military authority, acts of public enemy, war, fires, explosions, earthquake, hurricane, floods, strikes or any other cause beyond the reasonable control of either party. Section 16.6. Time is of the Essence/Notice: Time is of the essence in this Agreement. Parties shall perform their obligations within the time specified. Section 16.7. Severability: In the event any provision of this Agreement is held invalid, illegal, or unenforceable for any reason and in any respect, such invalidity, illegality, or unenforceability will in no event affect, prejudice or disturb the validity of the remainder of this Agreement, which shall be in full force and effect, enforceable in accordance with its terms. et: W 2 1 4 W C MngcdC ara.&w I I 98- 243 Section 16.8. Arbitration: In the event of any dispute of any kind concerning this Agreement and/or the performance of obligations thereunder, such dispute shall be submitted to arbitration in accordance with the rules of the American Arbitration Association. The parties agree to be bound by and consider final the results of such arbitration. Section 16.9. Integration: This Agreement represents the entire agreement between the parties except to the extent modified by a subsequent Agreement by the parties that specifically incorporates this Agreement by reference. This Agreement supersedes all prior written and oral contracts which pertain to the services provided herein. This Agreement does not preclude or supersede other agreements with VOHS, its corporate parent, or its affiliates, for managed care or other services. }Section 16.10. Section and Paraerauh Titles: The use of section titles in this Agreement is for convenience only and same have no legal effect whatsoever in construing the provisions contained herein. Section 16.11. Waiver: The waiver of either party of a default, breach or violation of one of the terms, covenants or provisions of this Agreement shall not operate as, or be construed to be, a waiver of any subsequent default or breach of the same or other provision contained herein. Section 16.12. Third Party Rights: No rights in any third party are created by this Agreement, and no person not a party to this Agreement may rely on any aspect of this Agreement notwithstanding any representation, written or oral, to the contrary. Section 16.13. Notices: A notice which makes a demand upon one of the parties hereto to cure a default or breach of this Agreement is required to be sent by certified mail return receipt requested. Any other notice or communication may be sent via first class mail, facsimile or personal delivery, to the following addresses: Notice shall be deemed given on the day on which it was received or on the fifth day after being post marked via U.S. mail or commercial mail carrier. CITY OF MIAMI 3500 Pan American Drive Miami, Florida 33133 ATTN: Jose Garcia -Pedrosa City Manager VINCAM OCCUPATIONAL HEALTH SYSTEMS, INC. 2850 Douglas Road Coral Gables, Florida 33134 ATTN: Andrea Velasquez, President Vincam Managed Solutions Section 16.14. Warranties: The undersigned individual warrants that he or she has the authority and is authorized to enter into this Agreement on behalf of the legal entity named herein, and that, entity has passed a resolution to enter into this Agreement, and that, where applicable, the entity has been duly organized in the state in which the entity is registered, ct: W 214 WC MngcdCarc.doc 12 98- 243 licensed, or incorporated. Further, the parties shall immediately notify the other of any change which materially affects the entity's registration, license or incorporation. Section 16.15. Successors and Assigns: This Agreement shall be binding upon the parties hereto, their heirs, executors, legal representatives, successors, or assigns. Section 16.16. Counterparts: This Agreement may be executed in two or more counterparts, each of which shall constitute an original but all of which, when taken together, shall constitute one and the same agreement. ARTICLE X VII APPROVAL BY THE OVERSIGHT BOARD The State of Florida has appointed an Emergency Financial Oversight Board (the "Oversight Board") which is empowered to review and approve all pending City of Miami contracts. As a result, contracts shall not be binding on the city until such time as they have been approved by the Oversight Board. Execution of this Agreement by the City Manager shall constitute evidence of its approval by the Oversight Board. IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed by their respective officials thereunto duly authorized, this the day and year above written. ATTEST: Walter Foeman, City Clerk ATTE II / n ame: I,za.h&h Marsfav� F _ Title: Corporate Secretary "City" CITY OF MIAMI, a municipal corporation By: Jose Garcia -Pedrosa, City Manager "VOHS" Vincam Occupational Health Systems, Inc. a Florida corporation BY: c o" Print Name: Andrea Velasquez Title: President _ Dc v c1:W214WCMngedC;amAx- 13 9 8 -- 243 APPROVED AS TO FORM AND CORRECTNESS: JOEL EDWARD MAXWELL Interim City Attorney w APPROVED AS TO INSURANCE REQUI NTS: 77 MARIO SOLDEVILLA Administrator Risk Management Division el: W214WCMngcWam.doc. 14 98- 243 SCHEDULE A Financial Agreement Definitions Claim Year One: The first year or twelve (12) months of the Agreement, beginning on the effective date of , 1998 and ending on , 1999. Claim Year Two: The second year or twelve (12) months of the Agreement, beginning on the effective date of , 1999 and ending on , 2000. Year One Tail Period: The twenty-four (24) month period beginning on the effective date of , 1998 and ending on 2000, used for calculation of Paid Losses. Year Two Tail Period: The twenty-four (24) month period beginning on the first anniversary of the effective date, or from 1999 to , 2001. Actual Paid Losses: For claims with dates of accident during a given Claim Year, workers' compensation expenses paid during the 24-month Tail Period following the Claim Year, including medical bills authorized by VOHS, indemnity payments to the claimant, and the administrative fee(s) paid to VOHS. Paid Losses shall be reduced by actual subrogation recoveries. Actual Paid Losses Per Claim: Actual Paid Losses divided by the number of claims occurring during the Year. Target Paid Losses Per Claim: The parties establish a target for Actual Paid Losses per Claim, for purposes of calculation of the performance bonus or penalty for that year, which is based on the difference between Actuaf'Paid Losses Per Claim and Target Paid Losses Per Claim. Reimbursement and Financial Arrangements 1. Finances - Administrative Fee A.1 The City will pay VOHS an administrative fee of $300,000 per year, payable monthly. VOHS guarantees performance at or exceeding target, and will be responsible for part of any shortfall or qualify for a bonus if performance exceeds target. A.2 The City will reimburse VOHS for drug testing services at the rate of $35 if VOHS drug testing services are utilized. %K:W214WCMngedCarcA)-_- 15 9 g- 243 2. Performance Guarantee The parties establish a Target Paid Loss Per Claim of $3,200 for Claim Year One and Claim Year Two, based on historical information provided by the City, which represents approximately a 20% savings over historical paid losses. The following steps show how the Target Paid Loss Per Claim will be used to calculate performance bonuses or the trigger of a penalty. Calculation of the penalty or bonus will be made within thirty (30) days after the close of the applicable Claim Year. (1) Calculate Actual Paid Losses Per Claim. (2) Calculate the difference between Actual Paid Losses Per Claim and Target Paid Losses Per Claim. (3) If Actual Paid Losses Per Claim is less than Target Losses Per Claim, VOHS's will receive a bonus of 50% of the difference, up to $500,000, and payable within thirty (30) days of the settlement date. (4) If Actual Paid Losses Per Claim is greater than Target Losses Per Claim, VOHS will reimburse the City_for 50% of the difference up to a maximum amount of $150,000, which represents 50% of its administrative fee. ct:W214WCMnjjcWare.&)c 16 9 8- 243 SCHEDULE B VOHS Service Area B.1 The Service Area includes Dade County, Monroe County, Broward County and Palm Beach County. 92 ct:W214WCMnpdCam.dm 17 9 8- 243 SCHEDULE C Covered Services The general terms and conditions, the special terms and conditions, the performance expectations, VOHS' response and documentation, price sheet, and the purchase order shall be part of the Agreement between the VOHS and the City. C.1 VOHS will provide managed care service for occupational injuries occurring on or after the effective date of this agreement, including: 1. Preparation of notice of injury form 2. Treatment authorizations 3. Case management and medical review of all treatment plans 4. Telephonic coordination of return to work 5. Coordination with the City carrier or in-house adjusters 6. Customization of network/assignment of provider(s) to each location 7. Bill review for pre -certification and medical necessity 8. On -site catastrophic case management for cases meeting catastrophic injury criteria. C.2 VOHS will provide access to a proprietary network of occupational providers. C.3 VOHS will provide training sessions for the Risk Management Division and supervisors of other City departments at locations mutually agreed upon by the parties and provide orientation materials for each City location. CA VOHS will customize its provider network where possible to accommodate reasonable requests by the City. C.5 VOHS will make available a Field Service Manager based in Miami for training as identified in this Agreement and other services deemed necessary by VOHS. C.6 VOHS will interface with Corporate Systems as required. s*t: W214WCMngedCmeA) ; 18 98- 243 CITY OF MIAMI, FLORIDA CA=15 INTER-OFFICE MEMORANDUM TO: Honorable Chairman and Members DATE:MAR - _ FILE of the City Commission SUBJECT: Workers' Compensation Managed Care Arrangement FROM: Jose Garcia -Pedrosa REFERENCES: City Manager IV ENCLOSURES: RECOMMENDATION: It is respectfully recommended that the City Commission adopt the attached resolution authorizing the City Manager to execute the enclosed agreement with Vincam OHS for the provision of a managed care arrangement for Workers' Compensation. I: _1Tff311U)L" Pursuant to the Workers' Compensation statutes, the City, as an employer, is required to furnish medical treatment to its employees solely through managed care arrangements for compensable injuries covered under the Florida Workers' Compensation Act. On January 13, 1998, the City Commission adopted Resolution No.- 98-17 accepting the - findings of the Selection Committee and instructing the City Manager to negotiate an agreement with the top ranked firm for the provision of these services. As a result of our negotiation, the attached agreement is presented for your ratification. The salient points of this agreement are as follows: • 24 hour notice of injury intake • Network access to participating providers • Bill and utilization review • Management and employee training • Grievance and Appeals Program Quality improvement • 2 year term not to exceed $300,000 per year • Incentive bonus, 50% of savings exceeding targeted paid losses to a maximum of $500,000 0 Reimbursement to the City, 50% of shortfall from targeted paid losses to a maximum of $150,000 • Three one year extensions at the option of the City JGP:CMoC�:ME�S:bw c: Honorable Mayor Xavier L. Suarez 98- 243 WORKERS' COMPENSATION MANAGED CARE SERVICES AGREEMENT This Workers' Compensation Services Agreement ("Agreement"), made and entered into as of the day of , 1998 and effective as the day of 1998 by and between Vincam Occupational Health Systems, Inc. ("VOHS"), whose address is 2850 Douglas Road, Coral Gables, Florida 33134 and the City of Miami ("City"), whose physical address is 3500 Pan American Drive, Miami, Florida 33133. In exchange for mutual and valuable consideration, the parties hereby mutually agree as follows: RECITALS A. The City is an employer authorized to self -insure its workers' compensation liabilities pursuant to applicable state law. B. The City has issued a Request for Proposals ("RFP") for the delivery of certain managed care services, as specifically described in the RFP (the "Services"). C. VOHS; proposal ("Proposal") in response to the RFP, has been selected as the most qualified proposal for the provision of the Services. The RFP and the Proposal are sometimes referred to herein, collectively, as the Solicitation Documents, and are by this reference incorporated into and made a part of this Agreement. D. The City wishes to contract with VOHS for the utilization of VOHS' services, and VOHS wishes to provide such services to the City, under the terms and conditions set forth herein. E.. The Commission of the City of Miami, by Resolution No. - adopted on , 199approved the selection of VOHS and authorized the City Manager to execute this Agreement. NOW, THEREFORE, in consideration of the mutual covenants and promises herein contained, Provider and the City agree as follows: ARTICLE I DEFINITIONS As used in this Agreement, the following definitions will apply: Section 1.1. Administrative Procedures: Means the procedures developed and agreed upon by the City and VOHS regarding notification, pre -certification and authorization of treatment, payment procedures, documentation, timeframes and other administrative procedures to be followed and/or provided by each party. 98- 243 Section 1.2. Covered Services: Means medical treatment, care and attendance that injured workers are entitled to receive in accordance with the applicable state workers' compensation law. Section 1.3. Injured Worker: Means an employee of the City who, at all pertinent times, meets the City's employment eligibility requirements and the applicable provisions of the state workers' compensation law. Section 1.4. Service Area: Means the service area described on Schedule B attached hereto, as may be modified from time to time by both parties in a subsequent writing that incorporates is agreement by reference. Section 1.5. Participating Provider: Means an organization, network, or individual that has contracted directly with VOHS or any of its sub -contractors to provide medical treatment or drug testing to persons eligible to receive services through VOHS. Section 1.6. Non -Participating Provider: Means an organization, network or individual engaged in the provision and delivery of medical treatment or drug testing that is not a participating provider. ARTICLE II DUTIES OF VOHS Section 2.1. The Services: VOHS agrees to provide the Services described in Schedule "C" hereto, which by this reference is incorporated into and- made a part of this Agreement. VOHS represents and warrants to the City that: (i) it possesses all qualifications, licenses and expertise required under the Solicitation Documents for the performance of the Services; (ii) it is not delinquent in the payment of any sums due the City, including payment of permit fees, occupational licenses, etc., nor in the performance of any obligations to the City; and (iii) all personnel assigned to perform the Services are and shall be, at all times during the term hereof, fully qualified and trained to perform the tasks assigned to each. Section 2.2. Managed Care Services: VOHS will provide the -Services in a manner and as may be required by Florida law, applicable regulations, or the Agency for Health Care Administration. These services include workers' compensation medical case management for injured workers who incur occupational injuries, including medical triage of new injuries, assignment of case managers, medical coordinator oversight, and treatment plan review and authorization. In addition, VOHS will maintain an adequate level of staffing to operate an assigned case management team(s) and call center for 24 hour notice of injury intake and case management support. Section 2.3. Network Access: Participating Providers: VOHS will provide the City and its injured workers with access to its comprehensive, proprietary statewide network of occupational providers, including a comprehensive network of drug testing and collection facilities, for the purpose of receiving covered services as may be medically necessary and et:W214WUN&gedCare.doc 2 08- 243 appropriate pursuant to applicable workers' compensation statutes. VOHS will conduct provider training, credentialing, certification, and quality improvement services as VOHS deems appropriate and as may be required by Florida law. VOHS will recredential providers on a two- year basis. Section 2.4. Provider Directory and Referral: VOHS will create and maintain a directory of participating providers. Upon notification of a worksite injury, VOHS will refer the injured worker to the participating provider or providers that are medically and geographically appropriate to the injured worker's medical condition and geographic location. In the event that appropriate participating providers are not available, VOHS will refer the injured workers to a non -participating provider or providers, as appropriate and as may be requested by the City. VOHS warrants that all such referrals will be consistent with Florida workers' compensation law applicable to the employee's choice of provider. Section 2.5. Bill & Utilization Review: Utilization Reports: VOHS will implement a process of utilization review and control, including evaluation of the appropriateness of health care services provided to injured workers and review provider invoices to identify instances of over -utilization. VOHS or its subcontractors will apply applicable discounts to invoices submitted by participating providers. VOHS will maintain utilization data and generate reports on behalf of the City as may be reasonably required and agreed upon by the parties, at least quarterly. Section 2.6. Management and Employee Training: To acquaint the City management and employees with VOHS managed care procedures and resources available through the managed care program. VOHS will provide training sessions at times and locations agreed upon by the parties. VOHS will provide all the City injured workers with a booklet that explains VOHS managed care procedures. Section 2.7. Administrative Procedures: VOHS shall develop administrative procedures mutually acceptable to the parties for the delivery of services that are the subject of this agreement. Section 2.8. Return -To -Work Program: VOHS and the City will mutually develop a Return -To -Work program for injured workers that includes physician return -to -work assessments, transitional duty positions, and job descriptions appropriate to medical and physical limitations. The Return -To -Work program may incorporate existing the City programs as determined by the parties. Section 2.9. Grievance and Appeals Program: VOHS will maintain grievance procedures and an appeals program in accordance with the requirements of Florida Statute 440.134. VOHS attempt in good faith to resolve grievances presented by injured workers in accordance with the grievance procedures and appeals program. Section 2.10. Ouality Improvement Program: VOHS agrees to provide and maintain a quality assurance program in accordance with URAC (Utilization Review Accreditation Commission) standards and the requirements of Florida Statute 440.134, including, but not limited to, provider profiling, return -to -work outcomes by diagnosis, training and erW214WCMngedCare.doc 3 98- 243 education as needed for participating providers, and other program components as VOHS may deem appropriate. Section 2.11. Not An Insurer: This agreement shall not be construed to mean, and parties warrant and acknowledge, that VOHS is not and does not purport to- be an insurer or third party administrator of workers' compensation and/or medical benefits. Section 2.12. Contract Manager: VOHS shall designate a manager to serve as liaison between VOHS and the City in connection with this Agreement. VOHS will periodically evaluate treatment plans and medical progress to ascertain need, adequacy, and effectiveness of continuing treatment modalities. ARTICLES III DUTIES OF THE CITY Section 3.1. Retention of Services: The City hereby retains VOHS to provide the services identified in this agreement, including workers' compensation medical management and access to a network of participating providers for the delivery of covered services. The City Agrees to use good faith efforts to educate the City and its officers, managers, and injured workers regarding the VOHS program, including procedures for notification of injury and communication with VOHS case managers. Section 3.2. Iniured Worker Eligibility: The City will provide all information reasonably necessary to allow VOHS to verify the eligibility of all persons seeking workers' compensation health benefits and services through the VOHS/City. This -paragraph shall not be construed to vest VOHS with responsibility for claims administration or compensabll-ty determinations. Section 3.3. Notification of Iniurv: The City will notify VOHS immediately of all work site injuries and any available information pertaining to cause of injury and the employee's physical condition. Upon receipt of notice of injury, VOHS will authorize appropriate treatment, complete a notice of injury form, and assign identification/case number. The City will be advised the same working day of the medical and work status of the injured employee. All referrals and pre -certifications for treatment will be initiated by VOHS. Section 3.4, Claims Administration: The City will be responsible for workers' compensation claims administration, including but not limited to compensability determinations, processing of benefit payments, claims investigation, second injury fund claims, and coordination of legal activity. Section 3.5. Provider Payment: VOHS will provide City with adjudicate medical bills or providers who render approved services to injured workers, reduced to the applicable fee schedule and with VOHS' provider discounts applied, and the City will be responsible for payment of same. The parties warrant and acknowledge that this agreement shall not authorize or create a right of provider payment from or by VOHS. et: W214WCMngedCwe.doc 4 98- 243 Section 3.6. Compensation of VOHS: Time For Payment: The City will compensate VOHS for the services in accordance with Schedule A to this agreement. The City will pay all VOHS invoices within forty-five (45) days of the date of receipt. - ARTICLE IV RELATIONSHIP OF PARTIES Section 4.1. Provider-Patient/Provider-City Relationship: The parties acknowledge that providers are exclusively responsible for the maintenance of the provider-patient/provider- City and hospital -patient relationships with injured workers. ARTICLE V INDEMNIFICATION AND INSURANCE Section 5.1 Hold Harmless: VOHS shall indemnify, defend and hold harmless the City and its officials, employees and agents (collectively referred to as "Indemnities") and each of them from and against all loss, costs, penalties, fines, damages, claims, expenses (including attorney's fees) or liabilities (collectively referred to as "Liabilities") by reason of any injury to or death of any person or damage to or destruction or loss of any property arising out of, resulting from, or in connection with (i) the performance or non-performance of the services or activities contemplated by this Agreement which is directly or indirectly caused, in whole or in part, by the negligence (whether active or passive) of VOHS or its employees, agents or subcontractors (collectively_ referred to as "VOHS"), regardless of whether it is, or is alleged to be, caused in whole or part (whether joint, concurrent or contributing) by any act, omission, default or negligence (whether active or passive) of the Indemnities, or any of them or (ii) the failure of VOHS to comply with any of the paragraphs herein or the failure of VOHS to conform to statutes, ordinances or other regulations or requirements of any governmental authority, federal or state, in connection with the performance of this Agreement. VOHS further agrees to indemnify, defend and hold harmless the Indemnities from and against (i) any and all Liabilities imposed on account of the violation of any law, ordinance, order, rule, regulation, condition, or requirement, in any way related, directly or indirectly, to VOHS's performance hereunder, compliance with which is left by this Agreement to VOHS, and (ii) any and all claims, liens and/or suits for labor and materials furnished by VOHS or procured by VOHS to perform this contract or otherwise. Section 5.2 Insurance: VOHS shall take out, pay for, and at all times during the performance of work hereunder maintain, such public, contingent (where applicable, professional malpractice) and employer's liability insurance as will satisfy the foregoing indemnity requirements of the Agreement and protect VOHS and the City from claims by VOHS employees under workers' compensation and other employee benefit acts (the "Insurance"). The insurance shall include comprehensive general liability and property and damage, including automobile, products completed operations and broad form contractual covering liability assumed by the VOHS under this Agreement. The comprehensive general liability insurance shall: (i) include the City as an additional insured; (ii) be primary insurance written on an occurrence basis to the full et: W214W CMngedCare.doc 98' 243 limits of liability hereinafter stated, and should the City have other valid insurance, the City's insurance shall be excess insurance only; (iii) include a waiver of subrogation against the City, its officers, agents and employees, (iv) include a severability clause substantially in the following form: "The insurance afforded applies separately to each insured against whom claim is made or suit is brought, but the inclusion hereunder of more than one insured shall not operate to increase the limits of the insurance carrier's liability. The inclusion of any person or organization as an insured shall not affect any right that such person/organization would have as a claimant if not so included," and (v) contain an endorsement substantially stating: "Cancellation or expiration of the policy to which this endorsement is attached shall not become effective until after thirty (30) days advance written notice has been delivered to the City. City of Miami Risk Management Attention: Mario Soldevilla, Administrator 444 S. W. 2nd Avenue, 9t' floor Miami, Florida 33130 Without limitation of the requirements set forth in this Section 5.2 VOHS shall maintain insurance applicable to its employees and business operations, including the provision of services under this Agreement, with coverage and minimal limits of liability as follows: - - (1) Workers' Compensation and Employer's Liability providing statutory coverage for VOHS employees under the Workers' Compensation and Occupational Disease Laws of the state where operations are being performed under this Contract. (2) Comprehensive General Liability affording (i) Bodily Injury Liability (or death) with limits of at least $1,000,000 for each person and, where applicable, at least $2,000,000 in the aggregate; and (ii) Property Damage Liability with limits of at least $1,000,000 for each occurrence and at least $1,000,000 in the aggregate, such coverage to include: Products Completed Operations, Broad Form Contractual Liability covering liability assumed under this Contract, and Provider's Contingent (Protective) Liability with respect to work subcontracted by the Provider. (3) Comprehensive Automobile Liability affording (i) Bodily Injury Liability (or death) with limits of at least $500,000 each person and at least $1,000,000 each occurrence; and (ii) Property Damage Liability with a limit of at least $250,000 each occurrence, or a combined single limit of at least $1,000,000, such et:W214WC1MngedCare.doc 6 -98- 24'3 coverage to include liability for the operation of owned, hired, and non -owned vehicles. (4) Professional Liability insurance to include Errors and Omissions with limits of at least $1,000,000, each occurrence. In no event shall the provisions of this Section be construed in any way to limit VOHS's obligations under any provision of this Agreement, including, but not limited to, VOHS's obligations to indemnify, defend and hold harmless the City. The insurance coverage required herein shall be through policies issued by companies authorized to do business under the laws of the state where the work is performed. The Company must be rated by the latest edition of Best's Insurance Guide, published by Alfred M. Best Company, Inc. (or other recognized organization] at no less than an "A" Best Policyholders Rating and no less than an "X" rating in Best's Financial Size Category. All such insurance, including renewals, shall be subject to the approval of the City for adequacy of protection, and evidence of such coverage shall be furnished to the City on Certificates of Insurance indicating such insurance to be in force and effect and providing that it will not be canceled during the performance of the services under this contract without thirty (30) calendar days prior written notice to the City. Completed Certificates of Insurance shall be filed with the City prior to the performance of services hereunder, provided, however, that VOHS shall at any time upon request file duplicate copies of the policies of such insurance with the City. If, in the reasonable judgment of the City, prevailing conditions warrant the provision by VOHS of additional liability insurance coverage or coverage which is different in kind, the City reserves the right to require the provision by VOHS of an amount of coverage different from the above stated amounts or kind and shall afford written notice of such change in requirements thirty (30) days prior to the date on which the requirements shall take effect. Should VOHS fail or refuse to satisfy the requirement of changed coverage within thirty (30) days following the City's written notice, this Contract shall be considered terminated on the date that the required change in policy coverage would otherwise take effect. ARTICLE VI TERM AND TERMINATION OF AGREEMENT Section 6.1. Term: This Agreement shall be for an initial term of two (2) years, commencing on the date of execution. The City shall have the option to extend the Contract for three (3) additional periods of one (1) year each by giving VOHS at least thirty (30) days prior written notice. Extension of the term of the Agreement beyond the initial period is an option of the City to be exercised in its sole discretion and which does not confer any rights upon VOHS. Section 6.2. Default: If VOHS fails to comply with any term or condition of this Agreement, or fails to perform any of its obligations hereunder, then VOHS shall be in default. Upon the occurrence of a default hereunder, which is not cured within a period of thirty (30) days et:W214WCMngedCare.doc 7 98` 243 following the City's notice of default to VOHS, the City, in addition to all remedies available to it by law, may immediately, upon written notice to VOHS, terminate this Agreement. The written notice of default shall be sufficiently specific to put VOHS on notice of the alleged acts or non- performance and to permit VOHS a reasonable opportunity to cure. Upon termination of this Agreement, pursuant to this paragraph, VOHS shall immediately repay- all monies or other compensation received by it during the period of the default, except where the parties reasonably disagree as to performance and VOHS has requested dispute resolution by the City Manager, pursuant to paragraph within ten (10) days of receipt of notice of default. Should VOHS be unable or unwilling to commence to perform the Services within the time provided or contemplated herein, then, in addition to the foregoing, VOHS shall be liable to the City for all expenses incurred by the City in preparation and negotiation of this Agreement, as well as all costs and expenses incurred by the City in the re -procurement of the Services. If City commits and event of default under this Agreement which is not cured within thirty (30) days following VOHS' notice of default to the City, which notice shall be sufficiently specific to pay City on notice of the alleged acts on non-performance and to permit the City a reasonable opportunity to cure, then VOHS may terminate this Agreement by giving the City at least thirty (30) days prior written notice to the City. Section 6.3. Resolution of Contract Disuutes: VOHS understands and agrees that all disputes between VOHS and the City based upon an alleged violation of the terms of this Agreement by the City shall be submitted to the City Manager for his/her resolution, prior to Provider being entitled to seek judicial relief in connection therewith. In the event that the amount of compensation hereunder exceeds $4,500, the City Manager's decision shall be approved or disapproved by the City Commission. VOHS shall not be . entitled to seek judicial relief unless: (i) it has first received City Manager's written decision, approved by the City Commission if the amount of compensation hereunder exceeds $4,500, or (ii) a period of sixty (60) days has expired, after submitting to the City Manager a detailed statement of the dispute, accompanied by all supporting documentation (90 days if City Manager's decision is subject to City Commission approval); or (iii) City has waived compliance with the procedure set forth in this section by written instruments, signed by the City Manager. Section 6.4. Citv's Termination Rishts: The City shall have the right to terminate this Agreement, in its sole discretion, at any time, by giving written notice to VOHS at least sixty (60) days prior to the effective date of such termination. In such event, the City shall pay to VOHS compensation for services rendered and expenses incurred prior to the effective date of termination. In no event shall the City be liable to VOHS for any additional compensation, other than that provided herein, or for any consequential or incidental damages Section 6.5. Effect of Termination: Termination of this Agreement shall not affect the rights and obligations of the parties hereto arising out of the transactions occurring prior to the termination. et:W214WCMngedCwe.doc 8 98- 243 ARTICLE VII CONFIDENTIALITY Section 7.1. Medical Records: Neither the City, its designated representative(s) nor VOHS will disseminate information concerning an employee's medical records to any third party without the consent of the employee in compliance with all applicable state and federal laws and regulations and subject to legal process. The City and its designated representative and VOHS shall follow appropriate procedures to ensure that employee confidentiality rights are not abridged. The City's and VOHS's obligations under this Section 5.1 shall survive the termination of this Agreement. Section 7.2. Proprietary Information: VOHS and the City acknowledge that in order to effectively administer and execute this program either party may require or provide access to certain privileged and ,proprietary information, including but not limited to marketing and trade secrets, the City information, and employee information. VOHS and the City respectively agree not to exploit or disclose, directly or indirectly, . verbally or in writing, proprietary information, materials, documents or data any such confidential information unless authorized by express written permission of the interested party, or where required by statute, regulation, or court process. Section 7.3. Limited Disclosure Permitted: Notwithstanding any other provision of this agreement, VOHS shall be authorized to disclose, at its discretion, the nature of its relationship -with and services to the City in order to develop provider and other the City relationships. ARTICLE VIII AUDIT AND INSPECTION RIGHTS The City may, at reasonable times, and for a period of up to three (3) years following the date of final payment by the City to VOHS under this Agreement, audit , or cause to be audited, those books and records of VOHS which are related to VOHS's performance under this Agreement. VOHS agrees to maintain all such books and records at its principal place of business for a period of three (3) years after final payment is made under this Agreement. ARTICLE IX NONDISCRIMINATION VOHS represents and warrants to the City that it does not and will not engage in discriminatory practices and that there shall be no discrimination in connection with its performance under this Agreement on account of race, color, sex, religion, age, handicap, marital status or national origin. VOHS further covenants that no otherwise qualified individual shall, solely by reason of his/her race, color, sex, religion, age, handicap, marital status or national origin, be excluded from participation in, be denied services, or be subject to discrimination under any provision of this Agreement. et:W214WCMngedCare.doc 9 98- 243 ARTICLE X COMPLIANCE WITH LAWS VOHS understands that agreements between private entities and local governments are subject to certain laws and regulations, including laws pertaining to public records, conflict of interest, record keeping, etc. City and VOHS agree to comply with and observe all applicable laws, codes and ordinances as the may be amended from time to time. ARTICLE XI CONTINGENCY CLAUSE Funding for this Agreement is contingent on the availability of funds and continued authorization for program activities and the Agreement is subject to amendment or termination due to lack of funds, reduction of funds and/or change in regulations, upon sixty (60) days notice. ARTICLE XII REAFFIRMATION OF REPRESENTATIONS VOHS hereby reaffirms all of the representations contained in the Solicitation Documents. ARTICLE XIII AWARD OF AGREEMENT VOHS represents and warrants to the City that it has not employed or retained any person or company employed by the City to solicit or secure this Agreement and that it has not offered to pay, paid, or agreed to pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with, the award of this Agreement. ARTICLE XIV PUBLIC RECORDS VOHS understands that the public shall have access, at all reasonable times, to all documents and information pertaining to City contracts, subject to the provisions of Chapter 119, Florida Statutes, and agrees to allow access by the City and the public to all documents subject to disclosure under applicable law. VOHS's failure or refusal to comply with the provisions of this section shall constitute an event of default under this Agreement. ARTICLE X V MINORITY AND WOMEN BUSINESS AFFAIRS AND PROCUREMENT PROGRAM The City has established a Minority and Women Business Affairs and Procurement Program (the "NI/WBE Program") designed to increase the volume of City procurement and contracts with Blacks, Hispanic and Women -owned business. The M/WBE Program is found in Ordinance No. 10062, a copy of which has been delivered to, and receipt of which is hereby et: W214WCMngedCare.doc 10 98- 243. acknowledged by, VOHS. VOHS understands and agrees that the City shall have the right to terminate and cancel this Agreement, without notice or penalty to the City, and to eliminate VOHS from consideration and participation in future City contracts if VOHS, in the preparation and/or submission of the Proposal, submitted false of misleading information as to its status as Black, Hispanic and/or Women owned business and/or the quality and/or type of minority or women owned business participation. ARTICLE XVI MISCELLANEOUS Section 16.1. Non -Exclusive Agreement: The parties agree that VOHS is not precluded from entering into other agreements to provide the types of services set forth herein to any other entities, persons, or organizations. Section 16.2. Additional Assurances: The provisions of this Agreement are self - operative and do not require further agreement by the parties, except as may be herein specifically provided to the contrary, provided, however, at the request of either party, the party requested shall execute additional instruments and take such additional acts as may be reasonably requested in order to effectuate this Agreement. Section 16.3. Attorney's Fees: In the event that legal action is taken by either party to enforce any of the provisions of this agreement, the prevailing party shall be entitled to reasonable attorney's fees in connection with any such action. Section 16.4. Choice of Law and Venue: Whereas, VOHS's principal place of business and the location of the final act to effectuate this Agreement are in the State of Florida, and the parties agree that, in addition to the American Arbitration Association Rules, this Agreement shall be governed by and construed in accordance with the laws of the State of Florida. Section 16.5. Force Maieure: Neither party will be liable or deemed to be in default for any delay or failure to perform this Agreement deemed to result, -directly or indirectly, from Acts of God, civil or military authority, acts of public enemy, war, fires, explosions, earthquake, hurricane, floods, strikes or any other cause beyond the reasonable control of either party. Section 16.6. Time is of the Essence/Notice: Time is of the essence in this Agreement. Parties shall perform their obligations within the time specified. Section 16.7. Severability: In the event any provision of this Agreement is held invalid, illegal, or unenforceable for any reason and in any respect, such invalidity, illegality, or unenforceability will in no event affect, prejudice or disturb the validity of the remainder of this Agreement, which shall be in full force and effect, enforceable in accordance with its terms. &W214WCMngedCam.doc 1 j 98- 243 Section 16.8. Arbitration: In the event of any dispute of any kind concerning this Agreement and/or the performance of obligations thereunder, such dispute shall be submitted to arbitration in accordance with the rules of the American Arbitration Association. The parties agree to be bound by and consider final the results of such arbitration, Section 16.9. Inteeration: This Agreement represents the entire agreement between the parties except to the extent modified by a subsequent Agreement by the parties that specifically incorporates this Agreement by reference. This Agreement supersedes all prior written and oral contracts which pertain to the services provided herein. This Agreement does not preclude or supersede other agreements with VOHS, its corporate parent, or its affiliates, for managed care or other services. Section 16.10. Section and Paragraph Titles: The use of section titles in this Agreement is for convenience only and same have no legal effect whatsoever in construing the provisions contained herein. Section 16.11. Waiver: The waiver of either party of a default, breach or violation of one of the terms, covenants or provisions of this Agreement shall not operate as, or be construed to be, a waiver of any subsequent default or breach of the same or other provision contained herein. Section 16.12. Third Party Rights: No rights in any third party are created by this Agreement, and no person not a party to this Agreement may rely on any aspect of this Agreement notwithstanding any representation, written or oral, to the contrary. Section 16.13. Notices: A notice which makes a demand upon one of the parties hereto to cure a default or breach of this Agreement is required to be sent by certified mail return receipt requested. Any other notice or communication may be sent via first class mail, facsimile or personal delivery, to the following addresses: Notice shall be deemed given on the day on which it was received or on the fifth day after being post marked via U.S. mail or commercial mail carrier. CITY OF MIAMI 3500 Pan American Drive Miami, Florida 33133 ATTN: Jose Garcia -Pedrosa City Manager VINCAM OCCUPATIONAL HEALTH SYSTEMS, INC. 2850 Douglas Road Coral Gables, Florida 33134 ATTN: Andrea Velasquez, President Vincam Managed Solutions Section 16.14. Warranties: The undersigned individual warrants that he or she has the authority and is authorized to enter into this Agreement on behalf of the legal entity named herein, and that, entity has passed a resolution to enter into this Agreement, and that, where applicable, the entity has been duly organized in the state in which the entity is registered, et:W214WCMngedC=.doc 12 98- 243 licensed, or incorporated. Further, the parties shall immediately notify the other of any change which materially affects the entity's registration, license or incorporation. Section 16.15. Successors and Assisns: This Agreement shall be binding upon the parties hereto, their heirs, executors, legal representatives, successors, or assigns. Section 16.16. Counterparts: This Agreement may be executed in two or more counterparts, each of which shall constitute an original but all of which, when taken together, shall constitute one and the same agreement. ARTICLE XVU APPROVAL BY THE OVERSIGHT BOARD The State of Florida has appointed an Emergency Financial Oversight Board (the "Oversight Board") which is empowered to review and approve all pending City of Miami contracts. As a result, contracts shall not be binding on the city until such time as they have been approved by the Oversight Board. Execution of this Agreement by the City Manager shall constitute evidence of its approval by the Oversight Board. IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed by their respective officials thereunto duly authorized, this the day and year above written. "City" CITY OF MIAMI, a municipal ATTEST: corporation Walter Foeman, City Clerk ATTE nt e: E 1 �Z�be�h ��,�� - Title: Corporate Secretary By: Jose Garcia -Pedrosa, City Manager "VOHS" Vincam Occupational Health Systems, Inc. a Florida corporation By: �� , � � Print Name. Andrea Velasquez Title: President -Di LfC. Lc+�J IM214WC"edCue.doc 13 " 8 243 APPROVED AS TO FORM AND CORRECTNESS: APPROVED AS TO INSURANCE REQ NTS: JOEL EDWARD MAXWELL MARIO SOLDEVILLA Interim City Attorney b'� Administrator Risk Management Division et:W214WCMngedCam.doc 14 98- 243 SCHEDULE A Financial Agreement Definitions Claim Year One: The first year or twelve (12) months of the Agreement, beginning on the effective date of , 1998 and ending on , 1999. Claim Year Two: The second year or twelve (12) months of the Agreement, beginning on the effective date of , 1999 and ending on , 2000. Year One Tail Period: The twenty-four (24) month period beginning on the effective date of , 1998 and ending on 2000, used for calculation of Paid Losses. Year Two Tail Period: The twenty-four (24) month period beginning on the first anniversary of the effective date, or from 1999 to _ 2001. Actual Paid Losses: For claims with dates of accident during a given Claim Year, workers' compensation expenses paid during the 24-month Tail Period following the Claim Year, including medical bills authorized by VOHS, indemnity payments to the claimant, and the administrative fee(s) paid to VOHS. Paid Losses shall be reduced by actual subrogation recoveries. Actual Paid Losses Per Claim: Actual Paid Losses divided by the number of claims occurring during the Year. Target Paid Losses Per Claim: The parties establish a target for Actual Paid Losses per Claim, for purposes of calculation of the performance bonus or penalty for that year, which is based on the difference between Actual Paid Losses Per Claim and Target Paid Losses Per Claim. Reimbursement and Financial Arrangements 1. Finances - Administrative Fee A.1 The City will pay VOHS an administrative fee of $300,000 per year, payable monthly. VOHS guarantees performance at or exceeding target, and will be responsible for part of any shortfall or qualify for a bonus if performance exceeds target. A.2 The City will reimburse VOHS for drug testing services at the rate of $35 if VOHS drug testing services are utilized. et: W214WCMngedCare.doc 15 98- 243 2. Performance Guarantee The parties establish a Target Paid Loss Per Claim of $3,200 for Claim Year One and Claim Year Two, based on historical information provided by the City, which represents approximately a 20% savings over historical paid losses. The following steps show how the Target Paid Loss Per Claim will be used to calculate performance bonuses or the trigger of a penalty. Calculation of the penalty or bonus will be made within thirty (30) days after the close of the applicable Claim Year. (1) Calculate Actual Paid Losses Per Claim. (2) Calculate the difference between Actual Paid Losses Per Claim and Target Paid Losses Per Claim. (3) If Actual Paid Losses Per Claim is less than Target Losses Per Claim, VOHS's will receive a bonus of 50% of the difference, up to $500,000, and payable within thirty (30) days of the settlement date. (4) If Actual Paid Losses Per Claim is greater than Target Losses Per Claim, VOHS will reimburse the City for 50% of the difference up to a maximum amount of $150,000, which represents 50% of its administrative fee. et; W214WCMngedCare.doc 16 98- 243 SCHEDULE B VOHS Service Area B.l The Service Area includes Dade County, Monroe County, Broward County and Palm Beach County. et:W214WCMngedCare.doc 17 9811— 243 SCHEDULE C Covered Services The general terms and conditions, the special terms and conditions, the performance expectations, VOHS' response and documentation, price sheet, and the purchase order shall be part of the Agreement between the VOHS and the City. C.1 VOHS will provide managed care service for occupational injuries occurring on or after the effective date of this agreement, including: 1. Preparation ofm5tice of injury form 2. Treatment authorizations 3. Case management and medical review of all treatment plans 4. Telephonic coordination of return to work 5. Coordination with the City carrier or in-house adjusters 6. Customization of network/assignment of provider(s) to each location 7. Bill review for pre -certification and medical necessity 8. On -site catastrophic case management for cases meeting catastrophic injury criteria. C.2 VOHS will provide access to a proprietary network of occupational providers. C.3 VOHS will provide training sessions for the Risk Management Division -and - - supervisors of other City departments at locations mutually agreed upon by the parties and provide orientation materials for each City location. CA VOHS will customize its provider network where possible to accommodate reasonable requests by the City. C.5 VOHS will make available a Field Service Manager based in Miami for training as identified in this Agreement and other services deemed necessary by VOHS. C.6 VOHS will interface with Corporate Systems as required. et:W214WCMngedCare.doc 18 98- 243 J- 8-153 3/1 98 RESOLUTION NO. /" A RESOLUTION, WITH ATTACHMENTS, AUTHOR ING THE CITY MANAGER TO ENTER INTO AN AGRERInENT, N SUBSTANTIALLY THE ATTACHED FORM` WITH NCAM OCCUPATIONAL HEALTH SYSTEM INC. (" OHS"), FOR THE PROVISION OF ED CARE SE R ICES FOR WORKERS COMPENSATI, FOR A PER D OF TWO YEARS, AT AN ANNU AMOUNT NOT TO E EED $300,000, WITH THE , TION OF THE CITY EXTEND SAID AGREEMENT OR THREE (3) ADDITIO ONE (1) YEAR 'PERIODS, SAID AGREEME TO PROVIDE INC IVES TO VOHS SHOULD PE ORMANCE EXCEED EED TARGETS, AND TO REQ APPROPRIAT REFUNDS BY VOHS TO THE CITY S ULD PERFO CE FALL SHORT OF GUARANTEED T ETS; AL GATING FUNDS THEREFOR FROM THE SELF S E ANINSURANCE TRUST FUND, ACCOUNT CO N °: 515001.424401.6.668. WHEREAS, the City as!an\employer is required to furnish medical treatment solely,,hrough anaged care arrangements to its employees for compens le injurieAcovered under the Florida Workers Compensatio Act; and �k WHEREAS, on nuary 13, 1998, the ity Commission adopted Resolution No. 8-17, accepting the findi'gs of the selection committee, a instructing the City Manageto negotiate an agreement w' h the top ranked firm;`"�; NOW, EREFORE, BE IT RESOLVED BY THE COMMISSIT OF THE CITY OF MI FLORIDA: ection 1. The recitals and findings containe in the Pr mble to this Resolution are hereby adopted by re rence AID f=cII1�iT:r �i=� S ZD ZTsll: MANAGED CARE PROGR9, FOR WORKER'S COMPENSATION —�_ M__--_----_—{2.—_—_—Y----Y_—_ N ��--------- BID =a. 8 RFP 96-97-017 --- ,OATS DID($) 0lsltsD: MARCH 2', 1997 11:00 a.m. ------------------------- it IMM PIP_10IP-LIf2 NUM 1J.DAMU SAMM-1 Mips!./ HUMANA CORPORATE OFFICE CRA MANAGED CARE, INC. (One envelope one box) INTRACORP RISCORP THE VINCAM GROUP-, INC. •• "Offers from the vendors listed herein a7 the my offers , other offers submitted in r=-c�a.^,:<<^ to th`s scl�c]ta!icpi, if any. Zr'iL* fit— "1 :fir*' — -------------- --•-------are ----------- ---------------------- ------------------ - -------------- ------------------------------- ---- --------- ------------------- I -------------- ---------------------- ---------------------- ----•=----------------- ------- --------- ------ -----------------=-------------• -------------------- ---- _—--------- --___1—_ ------------- -----------w— -----------_------------- ___.�_—_`�Pa'Iw.r—s _--_—•_ -------------- _---_--�._----- —----- _--`---------- -------------- ------- • _Y-. -- M— _ - _ --- — — Y— — — ------ -- — — — -- — -- — — — -- — — — ---- — - — — --- — — — ------------- --_1 — _ -- — _ -- — — — --- — — ---- -- ----------------------- ------------ -- — — — — — — — — — -e — — — —r — — -- — — — — — — — — — — — — — — — — — — — — — - — — — — — — — — — — — i _ _- taceir•t (� 3 •avalopa• on behalf of Isoz local— a b 41 G A/SOLID WASTE -PROCUREMENT DIVISION - -- _ .s (city Dep.sta••c) •pyt� Ctt� cl�si) %I �.NU.Vf) CARF ION, \'k k 1\ N I VVN SA 114 )N v tA NNORKERIS 4 4 $N1111f Nl`l k 1 14 ; 11I NJ) 1V4 )NA I it,% pip—f=CPAISTAM ZD 2TIli: CITY'S WORKER'S COMPENSATION PROGRAM - __ ---------- --- ---�__---- ----- --_- _ _----!_ 9b-97-017 3:s f0.s ---------------------- —� [/ 1 • MARCH 5, 1997 10:00 a.m. e Y ]Loses DID-3oxas.£I r- ZZ111! 1sD_l12MI WIM_A.Mg—..� NO BID !�!_------------ --- ��yy !��-�--------------1_ --------♦ - - - - ---- -- ------ -- - - - --- --- - - ---------- - -- -- ------ -- - - - -- --- -- ---- - --_-!_ __-_-- !_-- -- --- - i --- - i -- -- - - - - !- - - - - ---- ---- ----- - - -- - \ V \� - - -- - - -- - - - - - - -- -- -- --- - - - - - - - - -- • 1 - --- - - -- - - - - - - - - - -- - - - ----- - -- -- -- ------ --- -- � I -� - _- ----- - - - - - - -- - -- - -- -- -- --- - -- - -- - -- ---- A -- - - - - -- - - - - - - -- - -- -- - - -- - - - - - - - - - - - - - -- - - -- - -- - ------- -- -- -- - -- - - -- - - - - - -- - ------ - - -- ------ - - - - - - -_- - - - - - - --- - - --- - - --- -- ---- - - -- - -- - - - - --- _.. -- -- - - - -- - --- - - - - - - - -- - - - -- - - - - - - - ----- - - - -- -- - -�- --- -- --- - - - - ----- -- -- - --- ---- -- - -- - ---- - -- - - --- - --� -- - -- - ---- - - -- - - - - - - -- -- - - -- - ---- -- - - - -- -- ---- - ---- - - -- - - - - - - - - - -- -- -- -- - - - - - -- - - - - - - - - - - - - !- - - - - - -- - - - - - - - - - - - - - -r- - - - - - - - - - - - - -I - - - - - - - - - - - - - --------- bids) GSA/SOLID WASTE -PROCUREMENT DIVISION on � _ � � (city �tpastiiitj--------------------------------------- • �ti7 City Cyst) U,t#1j of ffliaml REY Opp F ,9� MICHAEL G. LAVIN F EDWARD MARQUEZ '9l FEE 11 P 2 :21 Acting Director City Manager �O�CO F,.O4,0 1 ALTEP J. FC)EMAN !� CITY CLERK CITY 17" r_" s11 FLJR. ADDENDUM NO. 1 VIA FAX AND REGULAR MAIL RFP NO. 96-97-017 JANUARY 27, 1997 MANAGED CARE PROGRAM FOR WORKER'S COMPENSATION This addendum was created as a result of the mandatory Pre -Proposal Conference held January 14, 1997 where questions were asked by participants which required research. In addition, subsequent to this meeting, several letters were received by the Procurement Management Division by two (2) firms who asked additional questions. The attached document cited as "Attachment A" and prepared by Mario Soldevilla, Risk Management Administrator, entitled "Managed Care Pre -Proposal Conference Meeting on January 14, 1997," addresses those issues. Please be advised that documentation and other attachments, including the number and amount of claims, union contracts, and other information, will be forwarded to everyone present at the Pre -Proposal Conference via regular mail this date. THE OPENING DATE AND TIME FOR THIS PROPOSAL HAS BEEN CHANGED. THE NEW DATE AND TIME PROPOSALS ARE DUE IS WEDNESDAY, MARCH 5,1997 AT 10:00 A.M. ALL OTHER TERMS AND CONDITIONS OF THE ORIGINAL PROPOSAL REMAIN THE SAME. INCERELY, J Y CART CHIEF PR U MENT OFFIC THIS ADDENDUM IS TO BE SIGNED AND DATED BY PROPOSERS AND SUBMITTED AS PROOF OF RECEIPT WITH THE SUBMISSION OF PROPOSALS. SIGNATURE: NAME OF FIRM: DATE: 4- DEPARTMENT OF FINANCE/ PROCUREMENT MANAGEMENT DIVISION 444 S.W, 2nd Avenue, 6th Floor/Miami, Florida 33130/(305) 416-1900/Fax: (305)416-1925 Mailing Address: P.O. Box 330708 Miami, FL 33233-0708 LEGAL ADVERTISEMENT RFP NO.96-97-017 Sealed Proposals will be received by the City Clerk at his office located at City Hall, 3500 Pan American Drive, Miami, Florida 33133 not later than February 17, 1997 at 10:00 a.m. from qualified firms to implement and administer a Managed Care Program for the City's Worker's Compensation program, for the Department of Risk Management. A Mandatory Pre -Proposal Conference will take place at the City of Miami Riverside Center, 444 S.W. 2nd Avenue, 9th Floor, Miami on Tuesday, ]anuary 14, 1997 at 10:00 a.m. Failure to attend shall disqualify any proposal submitted. Proposals submitted past such deadline and/or submitted to any other location or office shall be deemed non -responsive and will be rejected. Ordinance No. 10062, as amended, established a goal of awarding 51 % of the City's total dollar volume of all expenditures for all good and services to Black, Hispanic and Women Minority Business Enterprises on an equal basis. Minority and women vendors who are interested in submitting bids/proposals and who are not registered with the City as minority or women vendors are advised to contact the City Procurement Office located at the Miami Riverside Center, 444 S. W. 2nd Avenue, Sixth Floor, Miami, (305) 416-1906. Detailed specifications for the Proposal are also available at this address. The City reserves the right to request copies of the occupational license, professional and/or trade licenses, corporate chart and tax return and any other documents to verify the location of the firm's primary office. All vendors whose primary office is located within the City of Miami must provide a copy of their City Occupational License with their bids. The City Manager may reject all proposals and readvertise. (Ad No. 04301) Edward Marquez City Manager = -A r„ n �-. ry ._ ,,r '-.Y 00 L �% °F - City of Miami REQUISITION FOR ADVERTISEMENT This number must ear in the appear advertisement. INSTRUCTIONS: Please type and attach a copy of the advert' m nt with thisr i i i n. 1. Department: 2. Division: 3. Account Code number: 4. Is this a confirmation: ❑ Yes ❑ No 5. Prepared by: 6. Size of advertisement: 7. Starting date: 8. Telephone number: 9. Number of times this advertisement is to be published: 10. Type of advertisement: ❑ Legal ❑ Classified ❑ Display 11. Remarks: 12. Publication Date(s) of Advertisement Invoice No. Amount --t > r- M Fri -�syYm ,J ` Z 14D 13. ❑ Approved ❑ Disapproved Department Director/Designee Date Approved for Payment Date C IGS/PC 503 Rev. 12/89 1 Routing: Forward White and Canary to G.S.A. (Procurement Management) and retain Pink copy. DISTRIBUTION: White - G.S.A.; Canary - Department