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Human Resources Department, Risk Management Division, recommending the Board approve and authorize the Chair to sign perpetual Agreement for Services 3360 with York Risk Services Group, Inc. to provide administration services for worker’s compensation claims opened prior to September 1, 2018, with a term beginning November 1, 2018 and to be renewed automatically for successive one-year terms and a total not-to-exceed amount of $208,233 for the first year of service.
FUNDING: Workers’ Compensation Internal Service Fund
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DISCUSSION / BACKGROUND
York Risk Services Group, Inc., formerly Gregory A. Bragg and Associates, has been the County’s third-party administrator (TPA) for workers’ compensation claims since 1999.
On August 28, 2018, the Board approved the purchase of workers’ compensation coverage through a the Primary Workers’ Compensation (PWC) program offered through California State Association of Counties Excess Insurance Authority (CSAC-EIA) (Legistar Item # 18-1218). The effective date of coverage is September 1, 2018.
Under this program, El Dorado County is permitted to choose from among Third-Party Administrators with whom CSAC-EIA has negotiated contracts. As previously mentioned, Staff researched each TPA and selected York Risk Services Group (York). Under the PWC program, claims for injuries or illnesses dated on or after September 1, 2018 will be submitted to York for claims management.
However, workers' compensation covers medical treatment for a specific work-related injury or illness based upon the date of such injury or illness, for as long as that treatment is necessary, which could be many years. Because of this, all claims for industrial illnesses or injuries incurred prior to September 1, 2018, would be covered under the Excess Workers’ Compensation Self-Insured Retention level based on the date of injury. Such claims are commonly referred to as ''tail claims'' and will continue to be self-administered and self-defended b...
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