Agenda Item
i. RFP 22-462, Renewal of the DeKalb County School District’s (“District”) Workers’ Compensation Third Party Administrator Services Contract with Brentwood (Renewal Year 3 of 5) (Not to exceed $494,523)
Summary: Presented by: Mr. H. Eric Hilton, Chief Legal Officer, Division of Legal Services, 678-676-0159
Request: It is requested that the Board of Education approve the renewal of the District’s Third-Party Administrator Services Contract with Brentwood Services Administrators (“Brentwood”), for an amount not to exceed $494,523 in fixed claim costs, excluding bill review fees that are billed monthly based on volume.
Why: The contract renewal with Brentwood will enable the District to continue the efficient provision of adjuster services for new and longstanding workers’ compensation claims.
Details: This item requests that the DeKalb County Board of Education (“Board”) approve the contract renewal for the District’s Workers’ Compensation Third Party Administrator Services with Brentwood. On July 13, 2021, Brentwood was selected after a competitive RFP process. That process sought expertise to minimize the number of claims per year and to reduce the overall cost of the District’s workers’ compensation program. RFP 22-462, Workers’ Compensation Third Party Administrative Services, was placed for bid on March 18, 2021. The companies that submitted proposals in response to the solicitation were Brentwood, Broadspire Services (“Broadspire”) and USIS.
Broadspire’s cost proposal was $703,272 a year plus $10,000 for data consolidation and $3,000 for initial set up. USIS submitted a cost proposal of $564,250 a year plus $5,000 for electronic file conversion. In addition, a 12.5% fee would be charged by Broadspire for any subrogation recovery.
The review committee decided that the vendor that would provide the best quality and customized claim services at a competitive price was Brentwood. Previously, in 2013 and again in 2016, Brentwood was also selected as a result of a competitive RFP process.
At its business meeting on September 13, 2021, the Board approved a new contract for the District’s Third-Party Administrator Services with Brentwood for an amount not to exceed $466,000.00 in fixed claim costs, subject to a two percent annual increase, excluding bill review fees that are billed monthly based on volume. Ultimately, Brentwood was awarded the contract because of the quality of service it provides in addition to the company’s willingness to furnish customized claim services at a competitive price.
At its business meeting on August 10, 2022, the Board approved the renewal of the contract for the District’s Third-Party Administrator Services with Brentwood. The renewal amount was $475,320.00 in fixed claim costs, subject to a two percent annual increase, excluding bill review fees that are billed monthly based on volume.
At its business meeting on July 10, 2023, the Board approved the renewal of the contract for the District’s Third-Party Administrator Services with Brentwood. The renewal amount was $484,826.40 in fixed claim costs, subject to a two percent annual increase, excluding bill review fees that are billed monthly based on volume.
Brentwood has effectively helped the District process new and longstanding workers’ compensation claims. Brentwood provides the District with medical bill review services that result in cost reduction through the utilization of their networks, and application of the Georgia Workers’ Compensation fee schedule. Moreover, Brentwood provides the District with two claims adjusters, a claims assistant, and a claims supervisor. Although not assigned solely to the District, Brentwood provides the District with access to a claims manager to assist with various matters. In addition to the staff provided by Brentwood, the District employs three full time workers’ compensation claim adjusters. Also, at no additional cost, Brentwood furnishes the District with access to SUCCEED, which is a web site that dispenses loss prevention recommendations.
In addition, at no cost to the District, Brentwood has converted existing claims data to the Brentwood claims system. This conversion enables the District to utilize the Brentwood claims system and allow Brentwood to issue claim related workers’ compensation checks, and liability checks, to claimants, employees, physicians and vendors. The transfer of the check issuance process from the District’s Accounts Payable Department to Brentwood ensures continual check issuance in the event District offices are closed due to a pandemic or natural disaster.
Further, another service provided by Brentwood is the Medicare Section 111 Reporting. This is an automated process through Brentwood’s ClaimsXpress System. A weekly data feed is provided to ExamWorks who reports to Medicare on the District’s behalf. The District is a mandatory reporter under Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007. The Medicare Secondary Payer (“MSP”) policy is designed to ensure that the Medicare Program does not pay for healthcare expenses for which another entity is legally responsible.
Financial impact: This is a budgeted expense within the Risk Management budget. The cost is paid in quarterly installments. Medical bill review costs will be paid monthly based on volume from the workers’ compensation claims budget. The account charge code from which the expense will be paid is 100.2500.530000.15311.7490.9990.8010.080.0000.
Contact: Mr. H. Eric Hilton, Chief Legal Officer, Division of Legal Services, 678-676-0159
Mr. Glinton R. Darien, Jr., Director of Legal Affairs, Division of Legal Services, 678-676-0403
Status: Approved by Office of Legal Affairs
Pharmacy Program Performance
Medispan Prescription Pharmacy Total Total Total
Source Code Count Spend Fee Schedule Fee Schedule Savings $ Fee Schedule Savings %
Brand 90 $91,549.29 $105,110.46 $13,561.17 14%
Generic 1,057 $67,905.20 $158,268.09 $90,363.14 49%
Grand Total 1,147 $159,454.49 $263,378.55 $103,924.31 46%
Prescription Pharmacy Total Pharmacy
Year 2023
Count Spend Fee Schedule by $ Savings
Qtr1 Qtr1 338 $43,223.20 $71,319.48 $28,096.28
Qtr2 Qtr2 308 $48,415.84 $79,328.10 $30,912.51
Qtr3 Qtr3 212 $35,542.84 $54,879.20 $19,336.36
Qtr4 Qtr4 289 $32,272.61 $57,851.77 $25,579.16
Grand Total Grand Total 1147 $159,454.49 $263,378.55 $103,924.31
Pharmacy Cost Drivers
Drug Name Prescription Pharmacy Total Savings Savings
Count Spend Fee Schedule By $ By %
LAMICTAL TAB 100MG 26 $50,973.50 $58,368.81 $7,395.31 13%
LIDOCAINE PAD 5% 113 $20,801.06 $37,201.65 $16,400.59 43%
VIMOVO TAB 500-20MG 7 $18,244.17 $20,881.00 $2,636.83 13%
EMGALITY INJ 120MG/ML 11 $9,271.08 $10,643.48 $1,372.40 13%
LIDOCAINE OIN 5% 13 $6,306.30 $43,600.77 $37,294.47 82%
SYNVISC ONE INJ 8MG/ML 2 $5,752.40 $6,582.88 $830.48 13%
MOVANTIK TAB 25MG 13 $5,296.12 $6,365.83 $1,069.71 17%
MELOXICAM TAB 15MG 62 $4,186.58 $8,502.65 $4,316.07 50%
CELECOXIB CAP 200MG 30 $3,327.92 $5,742.42 $2,414.50 43%
NAPROXEN TAB 500MG 111 $3,146.62 $6,101.84 $2,955.22 48%
Grand Total 388 $127,305.75 $203,991.33 $76,685.58 43%
Doctor Name Prescription Pharmacy Total Savings Savings
Count Spend Fee Schedule By $ By %
26 $50,973.50 $58,368.81 $7,395.31 13%
27 $20,513.00 $24,757.62 $4,244.62 37%
62 $11,759.55 $16,968.78 $5,209.23 43%
11 $9,271.08 $10,643.48 $1,372.40 13%
35 $8,642.08 $47,132.32 $38,490.24 41%
26 $4,162.11 $9,029.27 $4,867.16 55%
27 $4,008.90 $6,149.15 $2,140.25 37%
57 $3,541.41 $6,322.34 $2,780.93 47%
46 $3,400.54 $5,953.12 $2,552.58 47%
57 $2,994.56 $5,716.06 $2,721.75 48%
374 $119,266.73 $191,040.95 $71,774.47 42%
CONFIDENTIAL: Property of Workforce Ancillary Management, Inc. Any files transmitted may contain legally privileged and/or confidential information, including information protected under
the Health Insurance Portability and Accountability Act (HIPAA), and is intended only for the use of the individual and/or entity to which it is addressed. If you are not the intended recipient,
you are hereby notified that disclosure, copying, use, or distribution of the information included in this email is strictly prohibited. If you have received this message in error, please notify the
sender, permanently delete the message from your inbox, and destroy any printed copies.