Loading...
HomeMy WebLinkAboutR-96-0926J-96-1305 12/4/96 RESOLUTION N� A RESOLUTION, WITH ATTACHMENT(S), AUTHORIZING THE ISSUANCE OF A REQUEST FOR PROPOSALS (RFP), IN SUBSTANTIALLY THE ATTACHED FORM, SEEKING QUALIFIED FIRMS TO PROVIDE A STATE APPROVED WORKERS' COMPENSATION MANAGED CARE PROGRAM FOR CITY EMPLOYEES. WHEREAS, the State Legislature passed legislation in 1994 amending the Workers' Compensation Statute to require employers, such as the City of Miami, to provide a Workers' Compensation Managed Care Program for their employees; and WHEREAS, pursuant to Motion No. 96-633, adopted September 12, 1996, the City Commission instructed the City Manager to draft a Request For Proposals (RFP) for a Worker's Compensation Managed Care Program and further instructed the Manager to submit said RFP for Commission consideration; 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 thereto and incorporated herein as if fully set forth in this Section. Section 2. The City Manager is hereby authorized to issue a Request for Proposals, in substantially the attached form, seeking qualified firms to provide a State approved Workers' Compensation Managed Care Program for City employees. ATTACHMENT (S) 2"'.-CONTAINED CITY COMMISSION MEETING OF DEC 9 2 1996 -926 Resolution No. 96 Section 3. This Resolution shall become effective immediately upon its adoption. PASSED AND ADOPTED this 12th day of December—, 1996. J CAROLLO, MAYOR ATTEST: WALTER J. F A CITY CLERK PREPARED AND APPROVED BY: OLGA�'AMIREZ-SEI AS ASSISTANT CITY ATTOR141EY APPROVED AS TO FORM AND CORRECTNESS: e A: WI�N JONW, III CITY ATTO Y W 1314:csk:ORS -2- CITY OF MIAMI, FLORIDA REQUEST FOR PROPOSALS MANAGED CARE PROGRAM FOR WORKER'S COMPENSATION RFP 96-97-017: SPECIAL CONDITIONS 1. PURPOSE/SCOPE OF WORK: The purpose of this Request for Proposals (RFP) by the City of Miami ("City") is to seek a qualified firm ("Proposer") to provide a Managed Care Program on behalf of the City of Miami. The City of Miami has created and maintains a Self Insurance and Insurance Trust fund to provide a formal Self -Insurance program in accordance with Section 18-93 through 18-104 of the City of Miami Code. The Division of Risk Management located presently within the Department of Fire -Rescue is charged with the administration and claims handling of the Self -Insurance Program, which includes Worker's Compensation. The City shall not be responsible for any expenses incurred by the Proposer in preparing or submitting a Proposal. 2. MANDATORY PRE -PROPOSAL CONFERENCE: All Bidders must attend the mandatory Pre -Proposal Conference scheduled to take place at the City of Miami Riverside Center, 444 S.W. 2nd Avenue, 9th Floor, Miami, Florida 33130 on Tuesday, January 14, 1997 at 10:00 a.m. All requirements and specifications detailed in this Proposal will be discussed. Proposers who arrive more than one-half (1/2) hour late shall not be deemed as having met this mandatory requirement. All Proposers are requested to bring with him/her a complete Proposal package for discussion. IT IS MANDATORY THAT A REPRESENTATIVE(S) OF THE PROPOSER ATTEND IN ORDER TO QUALIFY TO PROVIDE A PROPOSAL. FAILURE TO ATTEND SHALL DEEM ANY PROPOSAL FROM THE SAME AS NON -RESPONSIVE. 3. MINIMUM QUALIFICATIONS: Proposers shall meet all of the following minimum qualifications. Failure to meet these minimum qualifications shall deem the Proposal non -responsive. 1. Have been in business for at least the past three (3) years. 2. Ability to meet and adhere to Florida State Statute 440.134 Workers' Compensation Managed Care Arrangement, and be approved by the Health Care Administration of the State of Florida to provide required services upon selection. The City shall possess the ability to select another proposer to provide said services should Proposal fail to be approved by the State of Florida. 3. Possess experience of a similar nature in the provision of a Managed Care Arrangement. 4. Ability to interface with the computerized tracking system of the City of Miami and Corporate Systems. S. Shall have no record of pending lawsuits or criminal activities, and have never been declared bankrupt. 96-926 [A RFP NO.96-97- 017 SPECIAL CuwDITIONS (CONT.) 4. ACCEPTANCE/REJECTION: The City reserves the right to reject any and/or all Proposals and to select the Proposal, which in the opinion of the City, will be in the best interest of, and/or most advantageous to, the City. The City also reserves the right to reject the Proposal of any Proposer who has previously failed in the proper performance of an award, or who is not in a position to fully perform under the terms of this RFP. The City reserves the right to waive any irregularities. and/or technical defects and may, at its discretion, re -advertise the RFP. 5. LEGAL REQUIREMENTS: This RFP is subject to all applicable federal, state, county and local laws, ordinances, rules and regulations that in any manner affect the Services covered herein. Lack of knowledge by the Proposer shall in no way be cause for relief from responsibility. 6. TERMS OF CONTRACT: The successful Proposer shall be required to enter into a contract for professional services with the City (the "Contract") which shall include, but not be limited to, the following terms: a) The term of the Contract 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 the Proposer at least thirty (30) days prior written notice. b) Extension of the term of the Contract 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 the Proposer. c) City shall have the right to terminate the Contract, for any reason whatsoever, at the sole discretion of the City. Should this occur, the City shall attempt to provide successful Proposer with sixty (60) days notice prior to termination. 7. DEFAULT: In the event the successful Proposer fails to execute the Contract, or fails to furnish required documentation, and/or fulfill any conditions of the RFP within the time stipulated for performance (or, if no time is stipulated, within 30 days following a request by authorized City personnel of any data it is required to provide), then the City may disqualify such successful Proposer and collect from said Proposer all reprocurement costs and expenses. Additionally, the successful Proposer may be debarred or suspended from future City bids/proposals. 8. ASSIGNMENT: The Contract shall not be transferred, conveyed, assigned, or disposed of, in whole or in part, without the prior written consent of the City, which may be withheld or conditioned, in the City's sole discretion. 9. CONTRACT AWARD AND CITY'S RIGHTS: A recommendation to enter into a Contract based on Proposals submitted shall be made by a Selection Committee. The City reserves the right to make the award to the Proposer submitting the Proposal which is the most advantageous and in the best interest of the City. The City of Miami is under no obligation to award this 2 9 6 - 926 [i REP NO.96-97- 017 SPECIAL G,,ADITIONS (CONT.) solicitation to the lowest proposer as award shall be made upon the evaluation criteria included within this solicitation. The City shall execute the Contract pursuant to action taken by the City Commission at a duly held meeting. The General Terms and Conditions, the Special Conditions, the Performance Specifications, the Proposer's response and documentation, Price Sheet, and the Purchase Order, shall be a part of the Contract between the successful Proposer and the City. It is anticipated that the City will enter into the Contract with the successful Proposer. The successful Proposer's failure to execute the Contract within thirty (30) days after the date of award by the City Commission shall entitle the City to rescind such selection unless the period for executing the Contract is extended or waived by the City in writing. While the City Commission may determine to enter into a Contract with a Proposer under this RFP, said Contract may be conditional on the subsequent submission of other documents as specified in the Special Conditions. The Proposer may be in default if any of these documents are not submitted in a timely manner and in the form required by the City. If the Proposer is in default, the City Commission may rescind its acceptance of the Proposer's offer and may determine to accept the offer from another responsive and responsible Proposer, or re -solicit Proposals. The City may also seek monetary restitution from the initially awarded Proposer as a result of damages or costs sustained as set forth in Section 7 above. The successful Proposer shall acquire no vested rights by virtue of its selection or recommendation by the Selection Committee. No rights at all shall accrue to the benefit of the successful Proposer until the Contract is executed by both parties. The City also reserves the right to waive any informalities, irregularities and technicalities in procedure at its sole discretion. The City reserves the right, before entering into the Contract, to require a Proposer to submit such evidence of its/his/her qualifications as it may deem necessary. The City may consider any information available to it with respect to financial, technical, and other qualifications and abilities of a Proposer, including past performance (experience) with other governmental agencies prior to executing the Contract. FAILURE TO PROVIDE ALL INFORMATION REQUESTED MAY BE CAUSE FOR REJECTION OF PROPOSAL. tn_ FFFc- The City is interested in a program which will generate savings over the current expenditures in the workers compensation area. The proposed fee structure should address the mechanism for achieving aminimum of 15% net savings with an escalating incentive bonus for savings exceeding the minimum and a penalty for a shortfall in the desired net savings. Please refer to Attachment A - Fact Sheet. Additional fee structures will be considered, with preference given to those which will generate significant savings to the City. Fee proposal shall be indicated and returned on the Fee Proposal Form. 3 ( 6) A 1i 1 UP NO. 96-97- 017 SPECIAL (%-,NDITIONS (CONT.) 11. VARIANCE: All Proposers must indicate any variance to the performance specifications, terms and conditions, no matter how slight. If variations are not stated in the Proposal, it shall be construed that the Proposal fully complies with the performance specifications, terms, and conditions. 12. CONFLICT OF INTEREST: Proposer covenants that no person employed or to be employed by it for the performance of services hereunder exercises any functions or responsibilities in connection with this RFP or has any personal financial interests, direct or indirect, with the City. The successful Proposer shall further covenant that, in the performance of the Contract, no person having a conflicting interest shall be employed. Any such interests in the part of the Proposer or its employees must be disclosed in writing to the City. Proposer is aware of the conflict of interest laws of the City of Miami; Dade County, Florida; and the State of Florida, and agrees that it shall fully comply in all respects with the teens of said laws. 13. FIRST SOURCE HIRING AGREEMENT: Ordinance No. 10032 implemented the City's "First Source Hiring Agreement" to foster the creation of new, permanent jobs for City of Miami residents. All recipients of contracts for goods/services from the City shall, to the greatest extent feasible, comply with the Ordinance's requirements by participating in this program. 14. AUDIT RIGHTS AND RECORDS RETENTION: The Proposer agrees to provide access to the City and/or its duly authorized representatives to any books, documents, papers, and records of the Proposer which are directly pertinent to this RFP, for the purpose of audit, examination, excerpts, and transcriptions, in accordance with standard auditing procedures of the City. In accordance with standard auditing procedures of the City, the successful Proposer shall maintain and retain any and all of the aforementioned records for three (3) years after expiration of the Contract, or of final payment by City under the Contract, or of the closing of all other pending matters, whichever occurs last. 15. CANCELLATION: The City shall have the right to terminate and cancel the Contract including elimination of the individual(s) and/or business enterprise(s) from consideration and participation in future City contracts, on the basis of having submitted deliberate and willful, false, or misleading information as to his; her, or its status as a Black, Hispanic and/or Minority/Women Business Enterprise (M/WBE). 16. TRAINING / ORIENTATION: Proposer shall be required to provide at least a basic training and/or orientation program to employees of the Risk Management Division and other City departments as necessary to learn how the City will operate in conjunction and coordination with the successful Proposer. Said training/orientation shall be conducted on dates and times acceptable to the City. 4 g °-vz6 r REP NO.96-97- 017 17. PERSONNEL: SPECIAL WNDITIONS (CONT.) Proposer shall provide all necessary qualified, licensed, and trained personnel to perform all the specifications reflected within this RFP. In addition, Proposer shall designate a manager to serve as the liaison between the City and the successful Proposer in servicing the Managed Care Arrangement. It is expected that any and all telephone calls by the City shall be returned within 24 hours, and successful Proposer shall immediately handle all inquiries of an emergency nature. All employees shall be deemed employees of the Proposer and not employees of the City of Miami. 1>3. MINORITY PROCUREMENT PROGRAM: Ordinance No. 10062, as amended, entitled the Minority and Women Business Affairs and Procurement Ordinance of the City of Miami, Florida sets forth "...a goal of awarding at least 51 percent of the City's total annual dollar volume of all expenditures for all goods and services, to Black, Hispanic and Women minority business enterprises on an equal basis." A minority business enterprise is defined as a business firm"...in which at least 51 percent of said enterprise is owned by Blacks, Hispanics, or Women and whose management and daily business operations are controlled by one or more Blacks, Hispanics or Women, having a net worth not in excess of $2,000,000 and twenty-five (25) or less employees." To achieve the goal established by this Ordinance, participation in providing goods and services to the City by minorities is being encouraged in a number of ways. All vendors doing business with the City are encouraged to include the participation of minority firms in their proposals. In evaluating Proposals, minority participation may be a factor. Failure to adequately involve minority firms may be a basis for rejecting a Proposal. Acceptable ways for minority participation in this Proposal are: 1. Joint venture with a minority firm(s). (Must be evidenced by a copy of joint venture agreement submitted with Proposal). 2. Utilizing minority firm(s) as subconsultant(s). 3. Other forms of minority participation, if properly documented. City will solely determine acceptability. Proposers may contact the City for copies of Ordinance No. 10062 and amendments. Additionally, a special information sheet has been provided to assist Proposers in presenting information concerning minority participation. Minority business firms are require to be certified with the City in order to be considered certified as a minority firm for the purposes of evaluation by the Selection Committee. The Procurement Office will provide the necessary forms and instructions upon request, and contact can be made with Ms. Anita Moore at (305) 416- 1913. Should a Proposer elect to joint venture, joint venture parties must provide at the time of Proposal submittal a copy of the executed joint venture agreement, evidencing the percentage of the work and/or dollar amount of contract to each joint venture party. In addition, all qualifying information to be provided by Proposal shall also be provided by the joint venture firm. Proposer shall include in response to this RFP its approach to attempt to meet the goals set forth in the aforementioned City ordinance. 96-.,926 i R!?P NO.96-97- 017 SPECIAL (..,,gDITIONS (CONT.) ALL PROPOSERS ARE URGED TO SUBMIT PROPOSALS FOR ANY GOODS OR SERVICES THAT THEY ARE ABLE TO SUPPLY, REGARDLESS OF MINORITY CLASSIFICATION. However, compliance with all requests for information regarding Minority Status or Participation is required.Proposer's cooperation is greatly needed to aid the City in achieving its goal. A certified affidavit of the extent to which the business enterprise has as one or more of its partners or principals persons who are Black, Hispanic, or Women shall be provided. Each Proposer shall also submit along with the Proposal an Affirmative Action Plan (AAP). Any significant equity participant, joint venture participants, or subcontractors (if any), shall also be required to submit such Plans. 19. NONDISCRIMINATION: Proposer agrees that it shall not discriminate as to race, sex, color, age, religion, national origin, marital status, or disability in connection with its performance under this solicitation. Furthermore, Proposer agrees that no otherwise qualified individual shall solely by reason of his/her race, sex, color, age, religion, national origin, marital status or disability be excluded from the participation in, be denied benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance. In connection with the conduct of its business, including rendition of services and employment of personnel, Proposer shall not discriminate against any person on the basis of race, color, religion, disability, age, sex, marital status or national origin. All persons having appropriate qualifications shall be afforded equal opportunity for employment. 20. OCCUPATIONAL LICENSE REQUIREMENTS Any person, firm, contractor or joint venture with a business location in the City, which is submitting a Proposal under this RFP, shall meet the County and City's Occupational License Tax requirements in accordance with Chapter 31.1, Article I of the City Charter. Proposer shall provide a copy of firm's current Occupational License or any other similar documentation regarding Proposer's establishment as a legal entity and authorized to provide said services. 21. INDEMNIFICATION: The successful Proposer shall defend, indemnify and save harmless the City of Miami and all its officers, agents, and employees from all suits, actions, or other claims of any character, name and description brought for or on account of any injuries or damages received or sustained by any person, persons, or property on account of any negligent act or fault of the successful proposer, or of any agent, employee, subcontractor or supplier in the execution of, or performance under, any contract which may result from the award of proposal. Successful proposer shall pay any judgments with cost which may be obtained against the .City of Miami growing out of such injury. 22. INSURANCE: The successful proposer shall be required, at its/his/her own expense, to furnish to the City of Miami Chief Procurement Officer within ten (10) days of notification of award, evidence that it has obtained as a minimum, the following insurance coverage which shall be in force and maintained throughout the duration of the contract. I 6 96-926 REP NO.96-97- 017 SPECIAL CONDITIONS (CONT.) Professional Liability Coverage for not less than $1,000,000.00 per occurrence. The City shall be furnished proof of coverage of insurance by Certificates of Insurance and shall be listed as an Additionally Insured if awarded subsequent Contract. Proposer shall demonstrate strict compliance to all requirements listed on the enclosed form "Insurance Requirements," and shall return the signed form with Proposal. 23. CAPITAL EXPENDITURES: Proposer understands that any capital expenditures that the Proposer makes, in order to perform the services required by the City specified in this RFP, is a business risk which Proposer shall assume. The City shall not be obligated to reimburse amortized or unamortized capital expenditures, any other expenses, or to maintain the approved status of the Proposer. If Proposer has been unable to recoup its capital expenditures during the time it is rendering such services, it shall not have any claim upon the City. 24. PRINCIPALS/COLLUSION: By submission of this Proposal, the Proposer shall declare that the only person or persons interested in this Proposal as principal or principals is/are named therein, and that no person other than therein mentioned has any interest in this Proposal or in the Contract that may ensue; that this Proposal is made without connection to any person, company or parties making a proposal; and that it is in all respects fair and in good faith without collusion or fraud. 25. RESOLUTION OF PROTESTS: Proposer's attention is directed to the attached Ordinance No. 11072 amending Section 18.56-1 of the City Code. In the event of protests, compliance with the procedures described therein is mandatory. 26. ANTITRUST PROVISION: At such times as may serve its best interest, the City reserves the right to advertise for, receive, and award additional Proposals for the herein described Services, and to make use of other competitively proposed governmental contracts for the purchase of the services as may be available. 27. DEBARMENT AND SUSPENSION: Proposer's attention is directed to the attached Section 18-56.4 of the City Code and certification which must be executed and returned with the Proposal, Forms, and Fee Proposal Form. 28. PROPOSAL SUBMISSION: The following documentation shall be included as a minimum in the Proposal and submitted to the City. Failure to provide all information and documentation required in this RFP may deem the Proposal to be non -responsive. A. Proposal: Proposer shall submit a Proposal expressing its interest in providing the services described herein. Each proposal must contain the following. Failure to provide all.requested documentation may deem the proposal as non -responsive: 7 �6-96 1i RFC' NO.96-97- 017 SPECIAL Cu,gDITIONS (CONT.) 1. Provide the firm's main and local office locations, and address(s) of offices(s) where the administrative services will be performed. 2. A detailed description of the Proposer's qualifications to provide Managed Care. Provide current copies of all required licenses to work in the State of Florida and local counties. Include any information regarding the training of Proposer's employees and the licenses held by the same. Specifically provide information regarding the individual to be assigned to the City of Miami's account. Include the Proposer's thorough knowledge of all State Statutes and other applicable laws governing this solicitation to show a complete understanding of the work to be performed: 3. Submit a detailed Letter of Interest specifying exactly how all services reflected in the Scope of Work will be accomplished. All items (#1-#14) in the Scope of Work shall be individually addressed in detail. Include a complete approach Proposer will take to meet all responsibilities expected of Proposer by the City. Include any and all information regarding affiliated physicians, other medical personnel, locations to provide said services, and other related information regarding the provision of such services for the City. 4.. Provide a general description of the firm, including its size, approximate number of personnel, and the areas of coverage. Include how Proposer will ensure worker's compensation coverage by City employees residing in Dade, Broward, Palm Beach, and Monroe Counties, among other locales. Include listing of all current providers within each of these locales, and his/her areas of practice. 5. Provide identification of personnel to be assigned to this project and location where work will be performed. Include the number of personnel employed by Proposer by race/ethnicity and gender. Include resumes of key personnel to be assigned to all levels of this project. Include the proposal team member who worked for the organization and the type of work performed. 6. Summary of the firm's current workload and ability to satisfy City requirements. Include the availability of all appropriate financial, personnel and other resources Proposer has in order to perform required services. 7. Provide a sample Risk Management Information System report format. Also indicate how Proposer expects to effectively interface his/her system with the present Claims Management System by the City and "Corporate Systems." 8. Provide a detailed list of experience of Proposer in the field of Managed Care. List must include at least three (3) similar types of projects preferably of comparable size and responsibility, for whom Proposer has provided such services within the past three (3) years. Include in detail any and all experience in the public sector and working with other governmental entities. 10. Any additional remarks/comments the Proposer wishes to make to elaborate on the proposal and indicate whether Proposer has what he/she considers as a better method of approach to the solicitation and a means to save the City additional costs. 11. Methodology for evaluating and determining savings as expected within the solicitation. Include in detail the mechanisms Proposer would use to track whether proposed savings goal has been met, and methods to meet those goals. Indicate if willing to accept the incentive or penalty as indicated should savings not result. 8 ri 6 9 2 6 REP NO.96-97- 017 SPECIAL CONDITIONS (CONT.) B. Letters of Reference : Provide as a minimum three (3) Letters of Reference on firm letterhead from whom Proposer has provided a similar service for the past three (3) years. These letters may be verified for authenticity and quality of performance. C. Proof of all required Insurance: Required to agree to requirement Proposer intends to comply with Insurance Requirements should award be made to Proposer. This includes Professional Liability Coverage for not less than $1,000,000.00 per occurrence. City to be listed as an Additional Insured upon, award. D. Fee Proposal Form: Complete and return the enclosed Form for the anticipated savings by the City for the engagement of Proposer on an annual basis. Failure to return this form will deem the Proposal submitted as non -responsive. E. Affirmative Action Policy: Provide all policies on affirmative action of Proposer. F. Minority/Women Business Participation: Proposer shall provide documentation that Proposer has been certified as a minority owned firm by the City of Miami. 29. METHOD OF SELECTION/SELECTION CRITERIA: A Selection Committee shall be appointed by the City of Miami Commission to evaluate the responses to the Request for Proposal. Proposers deemed responsive and responsible may be granted an interview by the Selection Committee thereafter. Upon the completion of the review and the interviews, the Committee shall rank the proposals and make recommendations to the City Commission. The City shall prepare and present a Professional Services Agreement to the City of Miami Commission for final approval. The City reserves the right to reject any and any and all submittals for any reason, and reserves the right to waive any defect and accept any proposal deemed to be in the best interest of the City. The City further reserves the right to negotiate with each Proposer. The evaluation criteria shall consist of the following: A. Proposer's Qualifications to provide managed care. (15%) B Responsiveness to the requirements of the RFP. (l 5%) C. Proposer's ability to provide quality managed Care Services. (20%) D. Past Performance of services to public and private employers of a similar size. (15%) E. Fee Proposal. (25%) F. Minority/Women Business Participation and Affirmative Action policies. (10%) 0 6, 926 r REP NO. 96-97- 017 SPECIAL WNDITIONS (CONT.) 30. SUBMISSION OF DOCUMENTS: The following Documents must be included in your response to this RFP and shall be submitted in a sealed Proposal Envelope, with the name and number of this RFP No. 96-97-017 (Refer to Section 31). a) Letter of Interest / Proposal as required in Section 28 above. b) Statement of Relevant Experience c) Current Copy of Occupational License or similar proof of legal establishment d) Proof of Insurance / Acknowledgment e) M/WBE Participation Compliance Form f) Minority/Women Business Affidavit g) Affirmative Action Policy/Plan h) Primary Office Location Affidavit i) Public Entity Crimes Affidavit j) Debarment and Suspension Certificate k) List of subconsultant(s), if applicable 1) At least three (3) Letters of Reference on Firm Letterhead m) Fee Proposal Form n) Proof that Proposer has all insurance required in Section 22. The following document must be provided with your response to this RFP in the yellow envelope provided and separate from the above required documentation. Completed Fee Proposal Form FAILURE TO SUBMIT ANY OR ALL OF THE ABOVE DOCUMENTATION MAY DEEM YOUR PROPOSAL TO BE NON -RESPONSIVE. 31. COPIES REQUIRED: Each Proposer is required to submit at least seven (7) complete copies of the Proposal in the manner described in Section 30 of this RFP. The City will not be responsible for any expense incurred by Proposer in preparing and submitting the Proposal. Sealed Proposals must be clearly marked with the following information indicated on the outside of the RFP envelope/package: "RFP No. 96-97-017 for "Managed Care Program for Worker's Compensation." Proposals shall be submitted no later than February 17, 1997 at 10:00 a.m. and shall be addressed and delivered to: City of Miami CITY CLERK'S OFFICE First Floor 3500 Pan American Drive Miami, Florida 33133 ALL PROPOSALS MUST BE SUBMITTED ON OR BEFORE THE ABOVE PROPOSAL OPENING DATE. ANY ENVELOPES WITH PROPOSALS RECEIVED AFTER THE STATED OPF,NTNG DATE AND TIME SHALL BE REJECTED AND WILL BE RETURNED UNOPENED. 10 6-926 RF.P NO.96-97- 017 SPECIAL CtiNDITiONS (CONT.) 32. INOUIRIES: Any questions regarding this Proposal should be directed in writing to the Chief Procurement Officer, 444 S.W. 2nd Avenue, 6th Floor, Miami, Florida 33130. Written responses will be compiled and shall be issued only in addendum format. Any questions regarding the process may be addressed to Ms. Pamela Burns at (305) 416- 1905. NO CHANGES IN THIS REQUEST FOR PROPOSALS SHALL BE VALID UNLESS EVIDENCED BY WRITTEN ADDENDUM FORM AND SENT TO ALL POTENTIAL PROPOSERS. 33. VENDOR REGISTRATION: It is the policy of the City that all prospective Bidders and/or Proposer's complete a "Vendor Application" indicating the commodities / services which the vendor can regularly supply to the City for inclusion on the City's vendor/bidder's list. Should a prospective bidder/proposer not be currently listed on the City's vendor/bidder's list, a Vendor Application will be enclosed with the Bid package. Vendors who have already submitted an application and secured a vendor number from the City are not required to submit a new vendor application. If a Bidder/Proposer submits a Bid or a "No Bid," a fully completed Vendor Application should be returned with the Bid documents or the "No Bid" form. Completed Vendor Applications will be added to the City's vendor/bidder's list. A Purchase Order will not be issued by the City unless the successful Bidder/Proposer has completed this application. For any questions, contact the Vendor Application Section at (305) 416-1906. RFP NO.96-97- 017 SPECIAL U NDITIONS (CONT.) CITY OF MIAMI, FLORIDA TENTATIVE RFP TIMETABLE RFP 96-97-017 MANAGED CARE PROGRAM FOR WORKER'S COMPENSATION ADVERTISED DATE FOR RFP DECEMBER 18, 1996 PRE -PROPOSAL CONFERENCE JANUARY 14, 1997 DUE DATE FOR RECEIPT OF PROPOSALS FEBRUARY 17, 1997 M EVALUATION/SELECTION COMMITTEE MEETING MARCH 5, 1997 INITIATION OF INTERVIEWS RECOMMENDATION FOR AWARD TO THE MARCH 13, 1997 MIAMI CITY COMMISSION NEGOTIATIONS TO COMMENCE WITH THE MARCH 14, 1997 AWARDED PROPOSER PROJECTED CONTRACT START DATE r 12 12 1i CITY OF MIAMI, FLORIDA REQUEST FOR PROPOSALS MANAGED CARE PROGRAM FOR WORKER'S COMPENSATION RFP-96-97-017: SPECIFICATIONS I. BACKGROUND: The City of Miami has created and maintains a Self Insurance and Insurance Trust fund to provide a formal Self -Insurance program in accordance with Section 18-93 through 18-104 of the City of Miami Code. The program is administered by the Self Insurance and Insurance Trust Committee created pursuant to Section 18-101 of the Code. The Self Insurance Program provides protection to the City for all property and casualty loss exposures, workers compensation claims and provides group health benefits to active and retired employees. The Division of Risk. Management within the Department of Fire -Rescue is charged with the administration and claims handling of the Self -Insurance Program which is divided into the following four sections: Workers Compensation, Tort Liability, Insurance and Group Health Benefits. This request for proposal however, is limited to the area of workers compensation and the implementation of a managed care program. At this time, the Division of Risk Management is comprised of twenty-one professionals and support staff. All adjusters are licensed in the State of Florida. Risk Management works closely with the City Attorney's Office in the negotiating and settlement of claims. Please refer to Attachment A for additional information. SELF-INSURANCE AND INSURANCE TRUST COMMITTEE The Self Insurance and Insurance Trust Committee is responsible for the administration of the Self -Insurance Program. The Committee is comprised of high level administrators from the City of Miami. The members are uniquely familiar with and committed to the Program. KFP No. 96-97-0I7 5, cCIFICATIONS (CONT.) SAFETY PROGRAM The City recognizes the importance of a strong safety program as the primary tool for mitigating loss. The City is currently in the process of restructuring the Safety Program in order to achieve a more cohesive centralized unit from which policies and strategies can be developed, implemented and enforced. The administration of the safety program is under the supervision of Risk Management. IV. LIGHT DUTY The City of Miami has managed Light Duty Programs within the Police, Fire and GSA Departments for many years. Currently, Risk Management has developed a Modified Duty Program to establish a pool of Light Duty employees for use in various City Departments. V. MINIMUM REQUIRED SCOPE OF SERVICES: The following are the minimum required services to be provided to the City as required in this solicitation. In addition, all proposals shall contain a detailed description of how all these services will be provided by the Proposer, along with any other proposed services, and all costs relating thereto. 1. 24 hour toll free telephone number service for reporting worker injuries 2. Completion of Statutory first report of injury(DWC 1), injured worker information/grievances and medical provider services 3. Channeling of injured workers to in -network and/or out -of -network providers approved by the City 4. Managing the lost time element of claims 5. Coordinating ancillary medical/disability management services 6. Preferred Provider Organization (PPO) network access 7. Medical Utilization Review, Professional Peer Review and provider appeal process B. Medical provider bill review and provider compliance 9. Out -of -network provider management 10. Telephonic medical case management, vocational assessments, job site evaluations and other vocational services 2 96®926 I RFP No. 96-97-017 Sr tXIFICATIONS (CONT.) 11. Mandatory reporting, all State mandated reports, required tax information for the Internal Revenue Service including 1099 with magnetic tape of 1099 to the IRS, special administrative reports such as the OSHA 200 and others as determined by the City 12. Interface with the City's on-line claims management system. 13. Prepare and submit the managed care application to the State of Florida with the assistance of the City of Miami. 14. The City of Miami will entertain a methodology through which the successful proposer will pay the providers medical bills and update the City's financial system. VI. FEES The City desires a program which will generate savings over the current expenditures in the workers compensation area. The fee structure should address the means for achieving a minimum of 15 % net savings with an escalating incentive bonus for savings exceeding the minimum and a penalty for a shortfall in the desired net savings. Other fee structures will be entertained, with preference given to those which will generate significant savings to the City. VII. COMPLIANCE WITH LEGAL REQUIREMENTS The proposer must comply with all statutory, regulatory and other requirements applicable to the provision of managed care services. 3 96 9 ATTACHMENT A RFP NO. 96-97-017 MANAGED CARE PROGRAM FOR WORKER'S COMPENSATION FACT SHEET APPROXIMATE NUMBER OF FULL-TIME CITY EMPLOYEES AT THE TIME OF THIS SOLICITATION: 3200 LOCATION OF RESIDENCES: DADE 2751 BROWARD 389 i MONROE 10 PALM BEACH 50 NUMBER OF NEW CLAIMS: 900 - 1000 approximately per year RATIO OF MEDICAL ONLY TO LOSS TIME: 407 MED. ONLY : 60% LOSS TIME MEDICALS PAID (2 YRS.) $ 1,600,000 f INDEMNITY PAID (2 YRS.) $ 800,000 I EXPENSES PAID (2 YRS.) $ 209,000 LEGAL COSTS ( 2 YRS.) $ 17,000 CLAIMS MANAGEMENT SYSTEM: The City of Miami utilizes an on-line claims processing system where all data is maintained, updated and payments are issued. The servicing company is Corporate Systems. The adjudication of Worker's Compensation medical bills and payments to the City's providers are performed through this system. On a monthly basis, Corporate Systems provides the City with a bank reconciliation tape and a tape to interface with the City's financial system. The successful proposer must provide a mechanism for interface with the current system. The proposer shall be responsible for the conversion of any data necessary should their proposed system not be compatible with the City's. Any procedures, equipment, and/or costs necessary to connect with the City's hardware and software shall be the Proposer's responsibility. �6 92 1 r CITY OF MIAMI, FLORIDA RFP NO.96-97-017 MANAGED CARE PROGRAM FOR WORKERS COMPENSATION FEE PROPOSAL FORM ALL PROPOSERS SHALL FULLY COMPLETE AND RETURN THIS FORM WITH THE RESPONSE TO THE RFP. PROPOSERS SHALL DESCRIBE IN DETAIL THE METHODOLOGY TO BE USED TO REACH THE ANTICIPATED 15% MINIMUM SAVINGS TO THE CITY. THIS DETAILED APPROACH SHALL BE PROVIDED AS PART OF PROPOSAL. FAILURE TO RETURN THIS FORM SHALL DEEM THE PROPOSAL NON -RESPONSIVE. ANTICIPATED SAVINGS TO THE CITY PER PROPOSAL SUBMITTED: % OR $ INDICATE WHETHER PROPOSER AGREES/DISAGREES TO ADHERE TO REQUIREMENT FOR THE PROVISION OF AN INCENTIVE BONUS TO PROPOSER FOR SAVINGS EXCEEDING THE MINIMUM: AGREES DISAGREES: INDICATE WHETHER PROPOSER AGREES/DISAGREES WITH THE PROVISION FOR A PENALTY TO BE PLACED UPON PROPOSER SHOULD A SHORTFALL OCCUR IN THE DESIRED NET SAVINGS TO THE CITY: AGREES: DISAGREES: LIMITATIONSNARIANCES TO THE ABOVE: NAME OF BIDDER: COMPLETE ADDRESS OF BIDDER: TELEPHONE NUMBER: FAX NUMBER: SOCIAL SECURITY OR FEDERAL EMPLOYEE ID NO.: OCCUPATIONAL LICENSE NO.: EXPIRES: (To be provided with Bid) i SIGNATURE: TITLE: DATE: i _i FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM AND ALL OTHER REQUIRED DOCUMENTS SHALL DEEM THE PROPOSAL NON -RESPONSIVE. 96 CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM TO : Honorable Mayor and Members DATE : DEC 4 1996 FILE of the City Commission SUBJECT : Resolution Authorizing 4e"� Workers' Compensation Managed Care UP FROM REFERENCES: dward Marq ez City Manager ENCLOSURES: RECOMMENDATION; It is respectfully recommended that the City Commission adopt the attached resolution authorizing the issuance of a Request for Proposals (RFP), in substantially the attached form, seeking services to provide a State approved Managed Care Program for Workers' Compensation for City employees. BACKGROUND: The State Legislature passed legislation in 1994 amending the Workers' Compensation Statute to require employers within the State meeting certain criteria to enter into a Managed Care Program for Workers' Compensation by January 1, 1997. The City of Miami is an employer who is required to comply. The attached UP has been developed by Risk Management to allow providers to submit proposals for the City to evaluate in an effort to comply with the State requirement.