LWP Claims Solutions, Inc. 1 Service Provider Agreement Version 10-15-25
SERVICE PROVIDER AGREEMENT
This SERVICE PROVIDER AGREEMENT (“Agreement”) is entered into this ____ day of _________ 2026 (“Effective Date”), by and between the CITY OF ALAMEDA, a municipal corporation (“the City”), and LWP Claims Solutions, Inc., a California corporation, whose address is 35 Miller Ave., #214, Mill Valley, CA 94941 (“Provider”), in reference to the following facts and circumstances:
RECITALS
A. The City is a municipal corporation duly or ganized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the statutes of the State of California and the Charter of the City.
B. The City is in need of the following services: Workers’ Compensation adjusting and administrative services.
C. With the written approval of the City Attorney, City staff selected the service provider on a sole source basis due to the specialized nature of the claims processing services that the City requires, the Provider’s familiarity with the City’s worker’s compensation procedures, and the Provider’s strong track record of performance over the past five years.
D. Provider possesses the skill, experience, ability, background, certification and knowledge to provide the services described in this Agreement on the terms and conditions described herein.
E. Whereas, the City Council authorized the City Attorney to execute this agreement on ___________________.
F. The City and Provider desire to enter into an agreement for Workers’ Compensation adjusting and administrative services, upon the terms and conditions herein.
AGREEMENT
NOW, THEREFORE, in consideration of the fo rgoing, which are incorporated herein by reference, and for good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the City and Provider agree as follows:
1. TERM:
The term of this Agreement shall commenc e on the 1st day of July 2026, and shall terminate on the 30th day of June 2031, unless terminated earlier as set forth herein.
2. SERVICES TO BE PERFORMED:
Provider agrees to do all necessary work at its own cost and expense, to furnish all labor, tools, equipment, materials, except as otherwis e specified, and to do all necessary work included in Exhibit A as requested. Provider acknowledges that the work plan included in Exhibit A is tentative and does not commit the City to request Provider to perform all tasks included therein.
June
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3. COMPENSATION TO PROVIDER:
a. By the 7th day of each month, Provider shall submit to the City an invoice for the total amount of work done the previous month.
b. Pricing and accounting of charges are to be according to the fee schedule as set forth in Exhibit B and incorporated herein by this reference.
4. TIME IS OF THE ESSENCE:
Provider and the City agree that time is of the essence regarding the performance of this Agreement.
5. STANDARD OF CARE:
Provider shall perform all services under th is Agreement in a skillful and competent manner, consistent with the standards generally recognized as being employed by professionals in the same discipline in the State of California. Provider represents that it is skilled in the professional calling necessary to pe rform all services contracted for in this Agreement. Provider further represents that all of its employees and subcontractors shall have sufficient skill and experience to perform the duties assigned to them pursuant to and in furtherance this Agreement.
Provider further represents that it (and its employees and subcontractors) have all licenses, permits, qualifications, and approvals of wh atever nature that are legally required to perform the services (including a City Business License , as needed); and that such licenses and approvals shall be maintained throughout the term of this Agreem ent. As provided for in the indemnification provisions of this Agreement, Provider shall pe rform (at its own cost and expense and without reimbursement from the City) any services necessa ry to correct errors or omissions which are caused by Provider’s failure to comply with the standard of care provided for herein. Any employee of the Provider or its sub-providers who is determined by the City to be uncooperative, incompetent, a threat to the adequate or timely completion of any services under this Agreement, or a threat to the safety of persons or propert y (or any employee who fails or refuses to perform the services in a manner acceptable to the City ) shall be promptly removed by the Provider and shall not be re-employed to perform any further services under this Agreement.
6. INDEPENDENT PARTIES:
Provider hereby declares that Provider is engaged as an independent business and Provider agrees to perform the services as an independent contractor. The manner and means of conducting the services and tasks are under the control of Pr ovider except to the extent they are limited by statute, rule or regulation and the express terms of this Agreement. No civil service status or other right of employment will be acquired by virtue of Provider’s services. None of the benefits provided by the City to its employees, including but not limited to unemployment insurance, workers’ compensation plans, vacation and sick leave, are available from the City to Provider, its employees or agents. Deductions shall not be made for any state or federal taxes, FICA payments, PERS payments, or other purposes normally asso ciated with an employer-employee relationship from any compensation due to Provider. Paymen ts of the above items, if required, are the responsibility of Provider. Any personnel performing the services under this Agreement on behalf
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of Provider shall also not be employees of City and shall at all times be under Provider’s exclusive direction and control.
7. IMMIGRATION REFORM AND CONTROL ACT (IRCA):
Provider assumes any and all responsibility for verifying the identity and employment authorization of all of its employees performing work hereunder, pursuant to all applicable IRCA or other federal, or state rules and regulations. Provider shall indemnify, defend, and hold the City harmless from and against any loss, damage, liability, costs or expenses arising from any noncompliance of this provision by Provider.
8. NON-DISCRIMINATION:
Consistent with the City’s policy and state and federal law that harassment and discrimination are unacceptable conduct, Provider and its employees, contractors, and agents shall not harass or discriminate against any job applicant, City employee, or any other person on the basis of any kind of any statutorily (federal, state or local) protected class, including but not limited to: race, religious creed, color, national origi n, ancestry, disability (both mental and physical) including HIV and AIDS, medical condition (e.g. cancer), genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, pregnancy, political affiliation, military and veteran status or legitimate union activities. Such non-discrimination shall include but not be limited to all activities related to initial employment, upgrading, demotion, transfer, recruitment or recruitment adver tising, layoff, or termination. Pr ovider agrees that any violation of this provision shall constitute a material breach of this Agreement.
9. HOLD HARMLESS:
a. To the fullest extent permitted by law, Provider shall indemnify, defend (with counsel acceptable to the City) and hold harmless the City, its City Council, boards, commissions, officials, employees, agents a nd volunteers (“Indemnitees”) from and against any and all loss, damages, liability, obligations, claims, suits, judgments, costs and expenses whatsoever, including reasonable attorney’s fees and costs of litigation (“Claims”), arising from or in any manner connected to Provider’s performance of its obl igations under this Agreement or out of the operations conducted by Provider even if the City is found to have been negligent. If the Claims filed against Indemnitees allege negligence, recklessness or w illful misconduct on the part of Provider, Provider shall have no right of reimbursement agai nst Indemnitees for the costs of defense even if negligence, recklessness or willful misconduct is not found on the part of Provider.
Provider shall not have any obligations to indemnify Indemnitees if the loss or damage is found to have resulted solely from the negligence or the willful misconduct of the City. The defense and indemnification obligations of this Agreement ar e undertaken in addition to, and shall not in any way be limited by, the insurance obligations contained in this Agreement. b. As to Claims for professional liability only, Provider’s obligation to defend Indemnitees (as set forth above) is limited as provided in California Civil Code Section 2782.8. c. Provider’s obligation to i ndemnify, defend and hold harmless Indemnitees shall expressly survive the expiration or early termination of this Agreement.
10. INSURANCE:
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a. On or before the commencement of the terms of this Agreement, Provider shall furnish the City’s Risk Manager with certificat es showing the type, amount, class of operations covered, effective dates and dates of expiration of insurance coverage in compliance with Sections
10.b. (1) through (5). The Certificate Holder shou ld be The City of Alameda, 2263 Santa Clara, Ave., Alameda, CA 94501. Such certificates, which do not limit Provider’s indemnification, shall also contain substantially the following statement:
“Should any of the above insuran ce covered by this certificate be canceled or coverage reduced before the expiration date thereof, the insurer affording coverage shall pr ovide thirty (30) days’ advance written notice to the City of Alameda. Attention: Risk Manager.” Provider shall maintain in force at all times during the performance of this Agreement all appropriate coverage of insurance required by this Agreement with an insurance company licensed to offer insurance business in the State of Califor nia with a current A.M. Best’s rating of no less than A:VII or Standard & Poor’s Rating (if rated) of at least BBB unless otherwise acceptable to the City. Provider shall deliver updated insurance certificates to the City at the address described in Section 17.f. prior to the expiration of the ex isting insurance certificate for the duration of the term of Agreement. Endorsements naming th e City, its City Council, boards, commissions, officials, employees, agents, and volunteers as additional insured shall be submitted with the insurance certificates.
____ _______
Provider Initials
b. COVERAGE REQUIREMENTS:
Provider shall maintain insurance coverage and limits at least as broad as:
(1) Workers’ Compensation:
Statutory coverage as required by the State of California, as well as a Waiver of Subrogation (Rights of Recovery) endorsement. (2) Liability:
Commercial general liability coverage in the following minimum limits:
Bodily Injury: $1,000,000 each occurrence
$2,000,000 aggregate - all other
Property Damage: $1,000,000 each occurrence
$2,000,000 aggregate
If submitted, combined single limit policy with per occurrence limits in the amounts of $2,000,000 and aggregate limits in the amounts of $4,000,000 will be considered equivalent to the required minimum limits shown above. Provider shall also submit declarations and policy e ndorsements pages. Additional Insured Endorsement naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers is required. The Additional Insured
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Endorsement shall include primary and non-contributory coverage at least as broad as the CG 2010.
(3) Automotive:
Comprehensive automobile liability coverage (any auto) in the following minimum limits:
Bodily injury: $1,000,000 each occurrence
Property Damage: $1,000,000 each occurrence
or
Combined Single Limit: $2,000,000 each occurrence
Additional Insured Endorsement naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers is required. (4) Professional Liability:
Professional liability insurance which includes coverage appropriate for the professional acts, errors and omissions of Provider’s profession and work hereunder, including, but not limited to, technology professional liability errors and omissions if the services being provide d are technology-based, in the following minimum limits:
$2,000,000 each claim
Technology professional liability errors and omissions shall include, or be endorsed to include, proper ty damage liability coverage for damage to, alteration of, loss of, or destruction of electronic da ta and/or information “property” of the City in the care, custody, or control of Provider. If not covered under Provider’s liability policy, such “property” covera ge of the City may be endorsed onto Provider’s Cyber Liability Policy as covered property as follows: cyber liability coverage in an amount sufficient to cover the full replacement value of damage to, alteration of, loss of, or destruction of electronic data and/or information “property” of the City that will be in the care, custody, or control of Provider. (5) Cyber Liability:
Coverage shall be sufficiently broad to respond to the duties and obligations as are undertaken by Provider in this Ag reement and shall include, but not be limited to, claims involving infringement of intellectual property, copyright, trademark, trade dress, invasion of privacy violations, information theft, damage to or destruction of electroni c information, release of pr ivate information, alteration of electronic information, extortion and network security. The policy shall provide coverage for breach response costs as well as regulatory fines and penalties as well as credit monitoring expenses with limits sufficient to respond to these obligations with the following minimum limits:
$2,000,000 per occurrence or claim.
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As to commercial general liability and automob ile liability insurance, such insurance will provide that it constitutes primary insurance with respect to claims insured by such policy, and, except with respect to limits, that insurance applies separately to each insured against whom claim is made or suit is brought. Such insurance is not additional to or contributing with any other insurance carried by or for the benefit of the City.
c. SUBROGATION WAIVER:
Provider hereby agrees to waive rights of subrogation that any insurer of Provider may acquire from Provider by virtue of the pa yment of any loss. Provider agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether the City has received a waiver of subrogati on endorsement from the insurer. The Workers’ Compensation policy shall be endorsed with a waiver of subrogation in favor of the City for all work performed by Provider, its employees, agents and subcontractors. d. FAILURE TO SECURE:
If Provider at any time during th e term hereof should fail to secure or maintain the foregoing insurance, the City shall be permitted to obtain such insurance in Provider’s name or as an agent of Provider and shall be compensated by Provider for the costs of the insurance premiums at the maximum rate permitted by law and computed from the date written notice is received that the premiums have not been paid.
e. ADDITIONAL INSUREDS:
The City, its City Council, boards, commi ssions, officials, em ployees, agents, and volunteers shall be named as additional insured(s) under all insurance coverages, except workers’ compensation and professional liability insurance. The naming of an additional insured shall not affect any recovery to which such additional insured would be entitled under this policy if not named as such additional insured. An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of any nature on this policy or any extension thereof. Any other insurance held by an additional insured sh all not be required to contribute anything toward any loss or expense covered by the insurance provided by this policy.
Additional Insured coverage under Provider’s pol icy shall be primary and non-contributory and will not seek contribution from the City’s insurance or self-insurance. Any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be available to the additional insured(s). f. SUFFICIENCY OF INSURANCE:
The insurance limits required by the City are not represented as being sufficient to protect Provider. Provider is advised to consult Provider’s insurance broker to determine adequate coverage for Provider. The coverage and limits shall be (1) the minimum coverage and limits specified in this Agreement; or (2) the broader coverage and maximum limits of the coverage carried by or available to Provider; whichever is greater. g. EXCESS OR UMBRELLA LIABILITY:
If any Excess or Umbrella Liability policies are used to meet the limits of liability required by this Agreement, then said policies shall be true “following form” of the underlying policy coverage, terms, conditions, and provisions and shall meet all of the insurance requirements stated in this Agreement, including but not limited to, the additional insured, SIR, and primary insurance
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requirements stated therein. No insurance policies maintained by the indemnified parties or Additional Insureds, whether primary or excess, and which also apply to a loss covered hereunder, shall be called upon to contribute to a loss until all the primary and excess liability policies carried by or available to the Provider are exhausted. If a Provider is using an Excess Liability policy to supplement any insurance co verage required by this Agreem ent, they must submit the Excess Liability policy in full.
11. CONFLICT OF INTEREST:
Provider warrants that it is not a conflict of interest for Provider to perform the services required by this Agreement. Provider may be required to fill out a conflict of interest form if the services provided under this Agreement require Provider to make certain governmental decisions or serve in a staff capacity as defined in Title 2, Division 6, Section 18700 of the California Code of Regulations.
12. PROHIBITION AGAINST TRANSFERS:
a. Provider shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or i ndirectly, by operation of law or otherwise, without prior written consent of the City Manager. Provider shall submit a written request for consent to transfer to the City Manager at least thirty (30) days in advance of the desired transfer. The City Manager or their designee may consent or reject such request in their sole and absolute discretion. Any attempt to do so without said consent shall be null and void, and any assignee, sublessee, hypothecate or transferee shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. However, claims for money agains t the City under this Agreement may be assigned by Provider to a bank, trust company or other financial institution without prior written consent. b. The sale, assignment, transfer or othe r disposition of any of the issued and outstanding capital stock, membership interest, partnership interest, or the equivalent, which shall result in changing the control of Provider, shall be construed as an assignment of this Agreement.
Control means fifty percent or more of the voting power of Provider.
13. APPROVAL OF SUB-PROVIDERS:
a. Only those persons and/or businesses whose names and resumés are attached to this Agreement shall be used in the performance of this Agreement. However, if after the start of this Agreement, Provider wishes to use sub-providers, at no additional costs to the City, then Provider shall submit a written request for consent to add sub-providers including the names of the sub- providers and the reasons for the request to the City Manager at least five (5) days in advance. The City Manager may consent or reject such requests in their sole and absolute discretion. b. Each sub-provider shall be required to furnish proof of workers’ compensation insurance and shall also be required to carry general, automobile and professional liability insurance (as applicable) in reasonable conformity to the insurance carried by Provider. c. In addition, any tasks or services perform ed by sub-providers shall be subject to each provision of this Agreement. Provider shall include the following language in their agreement with any sub-provider: “Sub-pr oviders hired by Provider agree to be bound to Provider and the City in the same manner and to the same extent as Provider is bound to the City.”
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d. The requirements in this Section 13 sha ll not apply to persons who are merely providing materials, supplies, data or information that Provider then analyzes and incorporates into its work product.
14. PERMITS AND LICENSES:
Provider, at its sole expense, shall obtain and maintain during the term of this Agreement, all appropriate permits, certificates and licenses, including a City business license that may be required in connection with the performance of the services and tasks hereunder.
15. REPORTS:
a. Each and every report, draft, work product, map, record and other document produced, prepared or caused to be prepared by Provider pursuant to or in connection with this Agreement shall be the exclusive property of the City.
b. No report, information or other data given to or prepared or assembled by Provider pursuant to this Agreement shall be made available to any individual or organization by Provider without prior approval of the City Manager or their designee. c. Provider shall, at such time and in such form as City Manager or their designee may require, furnish reports concerning the status of services and tasks required under this Agreement.
16. RECORDS:
a. Generally, the City has the right to c onduct audits of Provi der’s financial, performance and compliance records maintained in connection with Contractor’s operations and services performed under the Agreement. In the event of such audit, Contractor agrees to provide the City with reasonable access to Contractor’s employees and make all such financial (including annual financial statements signed by an independent CPA), performance and compliance records available to the City. City agrees to provide C ontractor an opportunity to discuss and respond to any findings before a final audit report is filed.
b. Provider shall maintain complete and accurate records with respect to the services, tasks, work, documents and data in sufficient detail to permit an evaluation of Provider’s performance under the Agreement, as well as mainta in books and records rela ted to sales, costs, expenses, receipts and other such information requ ired by the City that relate to the performance of the services and tasks under this Agreement (collectively the “Records”). c. All Records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Provider shall provide free access to the Records to the representatives of the City or its designees during regular business hours upon reasonable prior notice. The City has the right to examine and audit the Records, and to make copies or transcripts therefrom as necessary, and to allow inspection of all proceedings and activities related to this Agreement. Such Records, together with supporting documents, shall be kept separate from other documents and records and shall be maintained by Provider for a period of three (3) years after receipt of final payment.
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d. If supplemental examination or audit of th e Records is necessary due to concerns raised by the City’s preliminary examination or audit of record s, and the City’s supplemental examination or audit of the records discloses a failure to adhere to appropriate internal financial controls, or other breach of this Agreement or failure to act in good faith, then Provider shall reimburse the City for all reasonable costs an d expenses associated with the supplemental examination or audit.
17. NOTICES:
a. All notices shall be in writing and delivered: (i) by hand; or (ii) sent by registered, express, or certified mail, with return receipt requested or with deliver y confirmation requested from the U.S. postal service; or (iii) sent by overnight or same day courier service at the party’s respective address listed in this Section.
b. Each notice shall be deemed to have been received on the earlier to occur of: (x) actual delivery or the date on whic h delivery is refused; or (y) three (3) days after notice is deposited in the U.S. mail or with a courier se rvice in the manner described above (Sundays and City holidays excepted).
c. Either party may, at any time, change its notice address (other than to a post office box address) by giving the other party three (3) days prior written notice of the new address. d. All notices, demands, requests, or approvals from Provider to the City shall be addressed to the City at:
City of Alameda
City Attorney’s Office
2263 Santa Clara Ave, Room 280
Alameda, CA 94501
ATTENTION: Risk Manager
Ph: (510) 747-4777
e. All notices, demands, requests, or approvals from the City to Provider shall be addressed to Provider at:
LWP Claims Solutions, Inc.
35 Miller Ave. #214
Mill Valley, CA 94941
ATTENTION: Judy Adlam
Ph: (415) 384-0370
f. All updated insurance certificates from Provider to the City shall be addressed to the City at:
City of Alameda
City Attorney’s Office
2263 Santa Clara Ave, Room 280
Alameda, CA 94501
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ATTENTION: Risk Manager
Ph: (510) 747-4764
18. SAFETY:
a. Provider will be solely and completely responsible for conditions of all vehicles owned or operated by Provider, including the safety of all persons and property during performance of the services and tasks under this Agreement. This requirement will apply continuously and not be limited to normal working hours. In addition, Provider will comply with all safety provisions in confor mance with U.S. Department of Labor Occupational Safety and Health Act, any equivalent state law, and all other applicable federal, state, county and local laws, ordinances, codes, and any regulations that may be detailed in other parts of the Agreement. Where any of these are in conflict, the more stringent requirements will be followed. Provider’s failure to thoroughly familiarize itself with the aforementi oned safety provisions will not relieve it from compliance with the obligations and penalties set forth herein. b. Provider will immediately notify the City within 24 hours of any incident of death, serious personal injury or subs tantial property damage that occurs in connection with the performance of this Agreement. Provider will promptly submit to the City a written report of all incidents that occur in connection with this Agreement. This report must include the following information: (i) name and address of injured or deceased person(s); (ii) name and address of Provider’s employee(s) involved in the incident; (iii) name and address of Provider’s liability insurance carrier; (iv) a detailed description of the incident; and (v) a police report.
19. TERMINATION:
a. In the event Provider fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder, Provider shall be deemed in default in the performance of this Agreement. If such default is not cured within two (2) business days after receipt by Provider from the City of written notice of default, specifying the nature of such default and the steps necessary to cure such default, the City may thereafter immediately terminate the Agreement forthwith by giving to Provider written notice thereof. b. The foregoing notwithstanding, the City shall have the option, at its sole discretion and without cause, of terminating this Agreement by giving seven (7) days’ prior written notice to Provider as provided herein.
c. Upon termination of this Agreement either for cause or for convenience, each party shall pay to the other party that portion of compensation specified in this Agreement that is earned and unpaid prior to the effective date of termination. The oblig ation of the parties under this Section 19.c. shall survive the expiration or early termination of this Agreement.
20. ATTORNEYS’ FEES:
In the event of any litigation, including administrative proceedings, relating to this Agreement, including but not limited to any actio n or suit by any party, assignee or beneficiary against any other party, beneficiary or assignee, to enforce, interpret or seek relief from any provision or obligation arising out of this Agreement, the parties and litigants shall bear their own attorney’s
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fees and costs. No party or litigant shall be entitled to recover any attorneys’ fees or costs from any other party or litigant, regardless of which party or litigant might prevail.
21. HEALTH AND SAFETY REQUIREMENTS.
Provider acknowledges that the C ity shall have the right to impose, at the City’s sole discretion, requirements that it deem s are necessary to protect the health and safety of the City employees, residents, and visitors. Provider ag rees to comply with all such requirements, including, but not limited to, mandatory vaccinati ons, the use of personal protective equipment (e.g. masks), physical distancing, and health screenings. Provider also agrees to make available to the City, at the City’s request, records to demonstrate Provider’s compliance with this Section.
22. COMPLIANCE WITH ALL APPLICABLE LAWS:
During the term of this Agreement, Provider shall keep fully informed of all existing and future state and federal laws and all municipal ordinances and regulations of the City of Alameda which affect the manner in which the services or tasks are to be performed by Provider, as well as all such orders and decrees of bodies or tribuna ls having any jurisdiction or authority over the same. Provider shall comply with all applicable laws, state and federal and all ordinances, rules and regulations enacted or issued by the Cit y. Provider shall defend, indemnify, and hold City (including its officials, directors, officers, empl oyees, and agents) free and harmless from any claim or liability arising out of any failure or alleged failure to comply with such laws and regulations pursuant to the indemnification provisions of this Agreement.
23. CONFLICT OF LAW:
This Agreement shall be interpreted under, and enforced by the laws of the State of California without regard to any c hoice of law rules which may dir ect the application of laws of another jurisdiction. The Agreement and obligations of the parties are subject to all valid laws, orders, rules, and regulations of the authorities having jurisdiction over this Agreement (or the successors of those authorities). Any suits brought pursuant to this Agreement shall be filed with the courts of the County of Alameda, State of California.
24. WAIVER:
A waiver by the City of any breach of any term, covenant, or cond ition contained herein shall not be deemed to be a waiver of any subs equent breach of the sa me or any other term, covenant, or condition contained herein, whether of the same or a different character.
25. INTEGRATED CONTRACT:
Subject to the language of Secti on 30, the Recitals and exhibits are a material part of this Agreement and are expressly incorporated here in. This Agreement represents the full and complete understanding of every ki nd or nature whatsoever betwee n the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be held to vary the provisions hereof. Any modification of this Agreement will be effective only by written execution signed by both the City and Provider.
26. PREVAILING WAGES:
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Provider is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq. as well as California Code of Regulations, Title 8, Section 1600, et seq., (“Prevailing Wage Laws”) which require the payment of prev ailing wage rates and th e performance of other requirements on “public works” and “maintenance” projects. Provider agrees to fully comply with such Prevailing Wage Laws if the services are be ing performed as part of an applicable “public works” or “maintenance” project as defined by the Prevailing Wage Laws and if the total compensation is $1,000 or more. City, upon Provider’s request, shall provide Provider with a copy of the prevailing rates of per diem wages in effect at the commencement of this Agreement.
Provider shall make copies of the prevailing rates of per diem wages for each craft, classification, or type of worker needed to execute the servi ces available to interested parties upon request; and shall post copies at the Provider’s principal place of business and at the project site. Provider shall defend, indemnify, and hold the City (its elected officials, office rs, employees, and agents) free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws.
27. CAPTIONS:
The captions in this Agreement are for convenience only, are not a part of the Agreement and in no way affect, limit or amplify the terms or provisions of this Agreement.
28. COUNTERPARTS:
This Agreement may be executed in any numbe r of counterparts (including by fax, PDF, DocuSign, or other electronic means), each of which shall be deemed an original, but all of which shall constitute one and the same instrument.
29. SIGNATORY:
By signing this Agreement, signatory warrants and represents that they executed this Agreement in their authorized capacity and that by their signature on this Agreement, they or the entity upon behalf of which they acted, executed this Agreement.
30. CONTROLLING AGREEMENT:
In the event of a conflict between the terms and conditions of this Agreement (as amended, supplemented, restated or othe rwise modified from time to time) and any other terms and conditions wherever contained, including, without limitation, terms and conditions included within exhibits, the terms and conditions of this Agreement shall control and be primary.
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IN WITNESS WHEREOF, the parties have each caused this Agreement to be duly executed on its behalf as of the Effective Date.
LWP CLAIMS SOLUTIONS, INC. CITY OF ALAMEDA
a California corporation a municipal corporation
Judy Adlam Yibin Shen
CEO City Attorney
SheriLynn Erickson
CFO
APPROVED AS TO FORM:
City Attorney
Michael Roush
Special Counsel
R
E
LWP Claims Solutions, Inc
Workers’
Workers’ Compensation Claims Management
City of Alameda
Proposal for Services - Renewal
Judy Adlam
President & CEO
March 17, 2026
Workers’
Delivering
What We Promise
[email protected] | 35 Miller Ave. #214, Mill Valley, CA 94941 | 415-384-0370
y,//d
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
March 11, 2026
Susie Kim
Lisa Cooper
Yibin Shen
City of Alameda
Delivered via email to: [email protected], [email protected], [email protected] All,
Thank you for the opportunity to present a renewal proposal for Workers’ Compensation Claims services. We remain honored to be your claims partner and are committed to meeting and exceeding your expectations.
Be assured that in the upcoming years, we will work even harder than during these first five years to deliver outstanding results and service. We will continue to work diligently to earn your business each and every day, and to demonstrate our commitment to be a “partner” rather than an “administrator.” We look forward to another productive year and are confident that we can make additional improvements in containing your claims costs. We promise to look for creative ways to resolve your claims, and to support your operations and those of your members. And above all else, we remain committed to “Delivering What We Promise!”
Sincerely,
Judy
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Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
Executive Summary
LWP is honored to be the City of Alameda’s Workers’ Compensation claims partner since 2021. We are confident that we can continue to deliver strong results while easing the process for the City and for your employees. We recognize that the City requires a partner with a good understanding of the principles that differentiate excellence in Workers’ Compensation from mediocrity and require a partner who can deliver. LWP is that partner!
Our exclusive focus on Workers’ Compensation claims co upled with our results-oriented culture allow us to balance the need for customization with the discipline to execute our Best Practices and deliver superior results.
We are confident that we can continue to deliver services that provide you with a distinct financial advantage. In addition to providing the programs currently in place for the City, LWP is committed to providing access to new programs and strategies that are developed to meet the ever-changing Workers’ Compensation environment. We recognize that ongoing success requires the following:
Maintaining the best staff for the City
Managing the Programs: (including the Clinical Component, Medical Provider Network, Disability Management, Litigation Support, Recovery, and Special Investigations) Disciplined Execution of Best Practices
Effective Cost Containment Strategies
Client Support
We expect to continue to refine our service offerings an d to continue to customize and tailor our services by working with you to identify particular areas of need.
Maintaining the best staff for the City
At LWP, we recognize that identifying the right staff for any particular client is part art, part science. LWP takes very seriously the process of matching the proper Examiner with the client. We consider Client culture and objectives
Relevant experience
Examiner’s caseload (both new loss volume and pending) Feedback from the client
Staff supporting the City
Amber Davis serves as the Claims Director /Account Manager.
In her role, she ensures that our programs and protocols meet the City’s needs and are followed.
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
Amber joined LWP in 2003 as a Workers’ Compensation Examiner, having adjusted workers’ compensation claims since January 2000. She is a graduate of the Ricks College with Associate in Arts & Science. She holds the California Self Insured Certificate since 2003. She is a Certified Adjuster under the California Insurance Code and the California Code of Regulations. Amber was promoted to Claims Supervisor in 2008, Claims Manager in 2013 and Claims Director in 2022. She oversees all staff the support our public agency clients, and all public pools.
The City is further supported by a team comprised of the following staff:
1 Claims Supervisor – partially dedicated
1 Claims Examiner - partially dedicated
1 Future Medical Examiner- partially dedicated
1 Claims Assistant – partially dedicated
Additional support (to include mail room, scanning, check printing, bill payment, trust fund replenishment and balancing and loss reporting) will be provided by our Centralized Services Team) Managing the Programs
We believe in continually refining our approach to stay ah ead of the ever-changing external legislative, judicial and clinical factors that can drive costs up. Our current approach to the major claims programs includes:
The Clinical Component
At LWP, we believe that excellence in clinical management is the best way to shorten disability durations and speed both return-to-work and claims closure. Our track record for excellent outcomes is the result of our focus on aggressive up-front medical treatment, a reliance on evidence-based protocols and very aggressive return-to- work efforts. We subscribe to the sports medicine philosophy of medical treatment. We advocate immediate diagnostics and early aggressive treatment to shorten the treatment timetables and keep the injured worker focused on recovery and return to work. Additionally, we know that passive treatment and delays can also lead to dependence on pain medications and the resulting “disability” syndrome. We are willing to “think outside the box” when treatment alternatives are presented that have a likelihood of a productive return to work.
Some of our differentiators include:
UR plan that accommodates adjusters approving needed treatments without delay – roughly 93% of all treatment requests are approved by the Examiner without the delay and expense of Utilization Review Diagnostic testing program that gives us access to preferential testing appointments at various providers at discounted rates
Two-pronged approach to preventing prescription drug overutilization (including Pharmacy Benefit Network that includes first-fill, and physician peer-to-peer wean down support) Very judicious use of Nurse Case Managers with many assignments limited to one-time tasks Amber Davis
Director of Claims
Public Entities
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
Medical Provider Network
LWP offers a proprietary Medical Provider network that is currently in use by the City.
Our network, developed by Signature Networks Plus, offers clients a very distinct advantage, both in quality of care and in cost. The network is offered in two forms- one including Kaiser and one excluding Kaiser, with all other features of the networks being identical. Some advantages to our network include:
Statewide Network developed by industry leading network developers Providers were carefully chosen based on extensive data that measures outcomes (return-to-work and treatment durations)
Need for utilization review is significantly reduced by the quality of physicians (saving time and expense) Significantly deeper discounts than most MPNs
No access fee (client pays only the PPO % of savings BELOW fee schedule without any separate access fee.)
Litigation rates are reduced through use of a good network
We continually review the effectiveness of the providers and always welcome input from the City.
Disability Management
LWP is committed to proactive disability management that is focused on early and sustained Return-to-Work. We recognize the need for early aggressive medical treatment so as to minimize disability and facilitate case resolution. We know that claims resolve quicker when the injured worker is returned to work. While an injured worker is disabled, we contact the treating physicians frequently. During the call, we attempt to coordinate release to full duty or, failing that, a return to modified or alternate work. Our staff is trained to probe for information about what an employee is physically ABLE to do, rather than accepting “unable to return to work” as a status. We focus on activities of daily living to determine whether we can work with the employer to create modified duties based on those abilities.
Litigation Support
LWP believes in aggressive litigation management focused first on avoiding the process and then limiting the use of counsel to task assignments when appropriate. As a result, our clients enjoy litigation rates that are considerably below the state average. We believe, and have proven, that prompt and appropriate file handling reduces the number of claims that go into litigation. By involving the injured worker and employer as key members of the claim management team, conflicts and disputes are avoided and/or minimized.
Our litigation management strategies include:
Referrals to counsel are limited, and when needed, are issue-specific Litigation budgets are required of counsel
All case activity requires the examiner’s approval
LWP examiners maintain control of the file at every step of the process LWP examiners are trained to manage basic legal issues without attorney involvement LWP recommends litigation claim reviews to review all litigated cases with the attorney(s), client and claims staff.
Through these practices we have been able to successfully control our clients’ allocated loss adjustment expenses and the impact that litigation has on average claim duration. When litigation commences, we evaluate the case
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
for resolution at every step of the process. We will contin ue to work with the City to ensure our litigation management program fits your EXACT needs.
Recovery Support
LWP pursues recovery on behalf of the City, that includes:
x Subrogation
x Excess recovery
x Contribution
It is our philosophy to aggressively pursue all types of recovery on behalf of the City. We are confident we can continue to support the City in any recovery opportunities that arise.
Special Investigations Unit (SIU)
Our approach to SIU is consistent with our approach in all other areas. We do not paint all injured workers with a broad brush. We strive for balance, knowing that fraud mu st be taken very seriously, yet also recognizing that unfounded accusations and mistrust lead to unnecessary litigation and expense.
Our staff receives regular training in how to identify potential fraud without becoming suspicious of honest and well-meaning injured workers. We utilize a list of Key Fraud Indicators that assist the Examiner in identifying claims that may require additional investigation. Whenever red flags are identified, the Examiner will immediately contact the Employer to discuss and agree on an appropriate plan of action.
On occasion, the SIU investigation raises issues that do not rise to the level of prosecution, but which could still result in expedited return-to-work. Often, surveillance films can be shown to a treating physician that will result in the physician releasing the injured worker to return to modified or full duty. Films that show some moderate activity can be successfully used to prompt a release from care or return to work even if they are not sufficient for an SIU prosecution.
Disciplined Execution of Best Practices
LWP has a proven track record for disciplined execution. We have documented those practices that we are confident facilitate achievement of outstanding results. We will continue to work wi th the City to ensure we understand the City’s specific requirements, and that we hold ourselves to those standards.
We measure and monitor our Examiners’ performance to be sure that the agreed Best Practices are utilized. We know that the difference between excellence and mediocrity is in the blocking and tackling that occurs each and every day. Yet, we also recognize that even tried and true techniques are not always the best course for any particular claim. Our Examiners are empowered to evaluate the circumstances of a claim and to consider an alternate course of action that is likely to lead to a better result for a particular claim. We want our Examiners to “do the right thing,” rather than merely “doing things right.” If at any time, the Examiner proposes an alternative strategy, this will be discussed with the client prior to embarking on an alternative path.
At LWP, we recognize that our core responsibility is to investigate, adjust and settle claims.
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
LWP has extensive protocols to ensure that we determ ine eligibility for, and then process both medical and indemnity benefits in a timely manner.
Included in our core responsibility is timely payment of benefits and notices to employees. Through careful hiring and training practices working hand in a hand with a claims system specifically designed to move claims toward conclusion while complying with all regulations we are able to effectively meet this responsibility. Our unique approach to supervision and management also ensure compliance with the California Labor Code.
Integral to our approach to claims handling is client involvement. The City maintains final control of each item requested. Communications have been established to ensure that you are always aware of claim status and approval is sought when appropriate.
LWP’s contact is focused on determining what activities the employee is ABLE to perform. We do not accept “unable to work” as a status. We look for the activities that CAN be performed, including activities of daily living.
We then work with the Employer to determine whether temporary modified work can be available to keep the employee at work.
LWP has a proven track record for disciplined execution. We go well beyond the legal requirements in order to ensure that we accomplish the goal of minimizing the disruption both to the injured worker and to the employer that is caused by an industrial injury. We want our Examiners to “do the right thing,” rather than merely “doing things right.”
We have documented those practices that we are confident facilitate achievement of outstanding results. We measure and monitor our Examiners’ performance to be sure that our Best Practices are utilized. We know that the difference between excellence and mediocrity is in the blocking and tackling that occurs each and every day.
Yet, we also recognize that even tried and true techniques are not always the best course for any particular claim.
Our Examiners are empowered to evaluate the circumstances of a claim and to document and pursue a course of action that is likely to lead to a better result for a particular claim.
LWP will continue to manage the claims according to the City’s handling guidelines. The life of an indemnity claim is represented by the graph below;
Indemnity Claim Timeline
CLAIM REPORTED
TO LWP
SUPERVISOR
REVIEWS AND
ASSIGNS CLAIM
3 POINT CONTACT
MADE
INITIAL RESERVES
SET
PLAN OF ACTION
CREATED
SUPERVISOR
REVIEW
FIRST CASE
RESOLUTION
DIARY
PLAN OF ACTION
REVIEWED
SUPERVISOR
REVIEW
SUPERVISOR
REVIEW
Day 1 Day 1 24 hours Day 5 Day 14 Day 28 Day 30 Every 45 Days Day 90 Every 90 Days
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
LWP sets up a claim and begins the three-point contact process immediately upon receipt of ANY notice of a claim.
LWP Examiners are required to make three-point contact on all Indemnity claims within 24 hours of receipt, with the first contact always being the employer. If voice-to-v oice contact is not achieved, the Examiner will continue efforts to reach the parties until accomplished.
Once the three-point contact in completed the claim begins a cycle of processing that is continually focused towards closure.
During the initial case evaluation and no later than five business days from the date the claim is originally reported to us, the Claims Examiner establishes a reserve that reflects the likely cost of the case based on the available factual and medical information. Subsequent reserve chan ges are made within five business days of receipt of any additional information supporting a reserve adjustment. It is our philosophy to ensure that the reserves represent the likely outcome based on available information. The Examiner will review reserves every 30 days in addition to reevaluating them every time new information is received.
Our supervisors review reserves each time they touch a file. After assigning the claim and providing initial direction to the Examiner, they first see the reserves at their 28 day review, and then subsequently at each touch point and on each oversight diary. Supervisors maintain oversight diaries no longer than 90 days apart, and more frequently for files with significant issues. Additionally, they must approve all reserve changes that meet the client thresholds as well as reviewing the reserves in preparation for each client claim review. Beginning with this review and continually through the life of the claims the supervisor and adjuster will work at each touch of the claim to move toward closure.
Our protocols include regular plan of action updates. For each claim issue, the Examiner will enter a status update as well as a Plan for the Steps necessary to resolve that issue. The scheduled review and update of this plan will allow the BCJPIA to immediately review the status of the claim at any time through online access.
Continued review by the examiner and the supervisor is maintained through the use of our diary system. Each time a diary is worked another will be set. We consider resolution of the claim at each touch and are constantly working to return the injured worker to work and close the claim.
Claim
Reported
Assigned to
adjuster
3 point
contact
completed
3p o i n t
c Medical and disabilty
managment / Reserves
set or reviewed
Plan of action is created
or updated
Supervisor reviews the
file
Ongoing contact with
employer, employee and
doctor
Interal audit continually
reviews files for
compliance
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
Effective Cost Containment Strategies
LWP has a proven track record for “doing the right thing”, rather than merely “doing things right”. Our focus is always on the successful outcome, rather than on the savings that can be generated by a single short-sighted transaction.
We maintain extensive cost-containment programs that are designed to first provide access to the best care available, and secondly, to offer cost savings where available. We review our claims and cost containment results regularly to look for patterns that may allow us to fine tune our Best Practices in order to maximize the impact that cost-containment techniques have in the right situations while minimizing the costs and time that can be spent chasing savings that can be less than the cost of the process. Plainly stated, we will not spend a dollar to try to save fifty cents.
LWP’s cost containment program, branded as “SPHERE Solutions,” is flexible and can be adapted to meet the unique needs of the client. We offer a menu of services, as well as interfacing with providers chosen directly by the client. Each service can be customized for each client.
Utilization Review
One of the distinguishing features of LWP’s UR program is our judicious use of UR. As with all other things, LWP does not believe that more is necessarily better. In fact, unnecessary UR can serve to alienate treating physicians and injured workers and drive up employers’ costs. We continually monitor each Examiner’s utilization to look for training opportunities. Examiners are encouraged to approve diagnostics and treatment that are very unlikely to be denied or modified. This can even include approving surgeries based on positive objective diagnostic findings.
This approach is also consistent with our sports medicine philosophy to ensure aggressive, up-front medical care in order to speed the process from diagnosis to recovery.
Nurse Case Management
It is our philosophy to utilize nurse case management on a case-by-case basis. We be lieve that Case Managers can be an invaluable resource in the right situations. But indiscriminate use drives up claim costs while also diluting the nurse’s effectiveness on the right cases. More is not necessarily better.
Field case management is generally reserved for those claims that are more severe or where face-to- face intervention with both the employee and treating doctor will serve to facilitate an early return to work and recovery. Most field case management assignments are ta sk-specific, with the field case manager assigned to attend a medical appointment or meet with an injured worker and their family, after which they close their assignment until/unless requested to take any additional action.
We recommend case management services be implemented when a need is identified and should end when they are no longer impacting the return-to-work efforts or ultimate claim outcome. The specific guidelines are tailored to each client to be consistent with their return-to-work program.
Medical Bill Review
At LWP, we believe that the most important component of bill review is identifying the best network for a client.
Our clients can access both national and customized networks, and networks can be stacked in order to maximize
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
savings. In order to provide extensive flexibility, we have built an internal system that adds a significant layer of quality control that sits on top of a bill review company’s software. By using this approach, we are able to offer our clients a full assortment of network options while still ensuring accuracy of reviews and payments and consistency across networks and providers. We have a fully integrated interface with accuro.
Medical Provider Network
LWP offers our client’s access to a proprietary Medical Provider network that we believe offers a very distinct advantage, both in quality of care and in cost. The network is offered in two forms- one including Kaiser and one excluding Kaiser, with all other features of the networks being identical. Some advantages to our network include:
Network developed by industry leading network developers Providers were carefully chosen based on extensive data that measures outcomes (return-to-work and treatment durations)
Need for utilization review is significantly reduced by quality of physicians (saving time and expense) Significantly deeper discounts than most MPNs
No access fee (client pays only the per-bill bill review fee, which includes MPN access) Simplified enrollment
Prescription Drug Management
LWP has implemented an aggressive, multi-pronged appr oach to controlling Pharmacy Costs. Our program includes the following:
Pharmacy Benefit Network (PBN) – LWP has a strategic partnership with Optum for pharmacy services. Optum’s extensive network and pharmacy cards provide accessibility and ease of use for the injured employees. The network pricing and utilization review allows LWP to monitor medical use and control claim costs for our clients.
Features include:
No prescriptions can be filled in physicians’ offices First Fill cards provided to employer
Home Delivery service available
Brand to generic channeling
Both network discounts and out-of-network retrospective reviews Robust database checks for drug interactions, non-formulary prescriptions, over-utilization and prescriptions filed by multiple physicians
Clinical Oversight- One of the strongest advantages to this program is Optum’s clinical oversight. A team of pharmacists review our utilization and identify claims that they feel might benefit from roundtable discussions.
Those discussions include the claims team and the clinicians who develop strategies for wean down, detox and transition to alternative medications.
Peer-to-Peer Physician Intervention- LWP has partnered with Optum to offer peer-to-peer physician coaching for treating physicians who are uncomfortable with the wean-down and detox process. They focus on educating physicians on safe methods of weaning, utilizing drug replacement strategies and detox methods.
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
Expedited Diagnostic Testing
For diagnostic services, LWP currently has a strategic partnership with One Call Medical and with HomeLink. The benefits of this arrangement are twofold - (1) prefer ential expedited appointments to speed diagnosis and treatment and (2) reduced fees for these services. Most tests can be scheduled within 24 hours to avoid the protracted delays that interfere with return-to-work and healing. There is no separate pricing for this program.
Charges will be no higher than fee schedule, without any additional administrative charge.
Upon receipt of referral, our partner will contact the injured employee to schedule the diagnostic test at a network facility. Reports are sent to the claims examiner immediately following the diagnostic test.
Durable Medical Goods
LWP has strategic partnerships with One Call Medical and with HomeLink for Durable Medical Goods. We channel to these providers in order to effectively track utilization as well as accessing discounted prices for durable goods.
Transportation and Translation Program/Network
LWP has a strategic partnership with One Call Medical. Their Relay-Ride program has resulted in very substantial savings by using an on-demand Lyft transportation mode l. Their proprietary software allows them to schedule and communicate with drivers and injured workers in real time, offering the injured employee seamless services at a much-reduced cost.
Translation services include the availability of language-line telephone translation in all languages, as well as on- site face to face translators for meetings, depositions and medical appointments.
Physical Therapy
LWP has formed strategic partnerships with One Call Medical and with HomeLink to offer access to their Physical Therapy Network. The benefits of utilizing a network are:
Removes the financial incentive for physicians to over-prescribe, since the therapy will be performed at a facility in which the physician has no financial interest Consistency of reporting
Discounted fees (8% below fee schedule for Concentra, 16% below fee schedule for other providers)
Clinic Management Program
LWP’s managers work directly with medical clinics to improve their reporting practices when needed. We visit the business managers at those clinics to reinforce the necessity of providing timely and comprehensive reports that address our very specific requirements, including our requirement to comment on allowable activities of daily living when reporting any work restrictions. LWP has experienced improved reporting from some clinics following their understanding that patients will be directed to other clinics if we cannot obtain the information needed to support our clients.
Client Support
Proactive service coupled with responsiveness to clients’ needs is the hallmark of LWP’s service model. We have 32 years’ experience managing claims for self-insured clients and recognize that workflows and logistics are a very important component in successful program support. We know that
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
Coordinated Account Management
Strong Communication with the City
Client Access and Reporting
Coordinated Account Management
The City is supported by Amber Davis, our Director of Claims- Public Agencies. She remains available at any time to discuss issues and coordinate communications. Although the client is encouraged to communicate directly with our Assistant Claims Manager, Supervisor and Examiners, Amber will also be available to coordinate that communication at any time.
Amber joined LWP in 2003 as a Workers’ Compensation Examiner, having adjusted workers’ compensation claims since January 2000. She is a graduate of the Ricks College with Associate in Arts & Science. She holds the California Self Insured Certificate since 2003. She is a Certified Adjuster under the California Insurance Code and the California Code of Regulations. Amber was promoted to Claims Supervisor in 2008, Claims Manager in 2013 and Claims Director in 2022. She oversees all staff the support our public agency clients, and all public pools.
Strong Communication with the City
Building on our track-record for building strong and enduri ng relationships, we remain open to tralining all our communications to meet the City’s specific needs and preferences. We are happy to continue using the protocols in place, but are also happy to revisit any of the protocols that th e City might be interested in updating. Some noteworthy features of our communications approach include:
Regular Communications with All Parties: At LWP, we believe that regular communication with all parties is essential in ensuring a superior result. We know that lack of information and failure to follow through leads to much of the litigation in Workers’ Compensation. LWP clients enjoy very low litigation rates due to the disciplined follow through that our Examiners deliver. We firmly believe that involving the Injured Worker in the process prevents misunderstandings and drives down litigation. We are committed to keeping all parties informed, to checking in regularly and to ensuring that an Injured Worker knows what to expect, and when.
We expect to have very frequent communications with the City’s team and staff. We feel that it is very important to involve our clients in both routine and high-level issues to ensure the maximum level of claims management is being provided. Successful claim outcomes can be traced very specifically to teamwork between the employer and the administrator.
Communications with our clients is done through a combination of email, telephonic and face-to-face means. You are welcome to reach out to our management and claims team at any time. All remain available to assist with issues, large and small. Additionally, we expect to provide regular reports that detail the status of various issues.
You can expect regular calls from our management and meetings at whatever frequency is preferable to you.
Amber Davis
Director of Claims
Public Entities
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
User Friendly Reporting: LWP maintains very robust reporting capa bilities. We deliver reports via several methods:
Regularly scheduled reports are emailed to clients
Client access to templates
Customized reports prepared by LWP staff
Stewardship reports
Scheduled Reports: We continue to provide those reports that have been requested by the City. We are always happy to review those reports and to develop any additional reports that the City would find helpful. Reports can then be automatically distributed to you on any schedule that his helpful, whether daily, weekly, monthly or quarterly.
Customized reports prepared by LWP staff: LWP also maintains staff with expertise in creating customized reports.
The City will have unlimited access to our staff and ca n request ad-hoc or customized reports at any time. We employ a team of analysts with very advanced capabilitie s in order to assist clients with advanced reporting and analysis needs.
Stewardship Reporting: LWP commits to providing Stewardship reporting that includes metrics that are of particular interest to the City. We will offer some metrics based on our observations, and then will tailor the reports to meet your specific suggestions. We can mimic a format already used or can collaborate on the development of new reports in order to meet your needs.
System Access: LWP offers the City access to Origami Risk. Through this access, you will be able to:
View individual claim details
Run reports
View a dashboard with selected metrics
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
Proposed Pricing
Claims Administration - Life of Contract Claims Administration and Managed Care Annual Claims Fee
July 1, 2026 – June 30,2027 $240,631
July 1, 2027 - June 30, 2028 ` $247,850
July 1, 2028 – June 30, 2029 $255,285
July 1, 2029 – June 30, 2030 $264,220
July 1, 2030 – June 30, 2031 $273,467
Services will be billed monthly at 1/12th of annual fee.
Services Included in Claims Administration Fee
Claims Administration Designated Account Manager
Claim Review Meetings Litigation Management
Reporting to Excess Reinsurer
Additional Services
Annual Administration Fee $5,000
Bank Charges (Does not include outgoing ACH) Included
Storage Fees Included
On-Line 5020 Reporting Included
Loss Reports Included
On-Line System Access - up to 4 users Included - $250 per year per user in excess of 4 users
Trust Accounting Included
Preparation and filing of 1099's Included
Preparation of SIP reports Included
FROI/SROI Reporting Included
y,//d
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
Medicare Reporting Included
Ebill Included
Bill Review Fee
Standard Medical Bill Review Fee Schedule
Reductions
$9.00 per bill plus PPO Reduction
Inpatient or outpatient hospital or surgery center $300 per bill plus PPO Reduction Should hospital inpatient, outpatient, or
ambulatory surgery center charges be less than
or equal to $300 the standard bill review fee
and PPO network discount shall apply
PPO Reduction 24% of Reduction below Fee Schedule for all network except Anthem, Anthem 27% of
Reduction below Fee Schedule
Bills not subject to Fee Schedule 24% of Reduction
Managed Care Programs
Case Management
Telephonic Case Management $104 per hour
Field Case Management $110 per hour + incidentals (including mileage, phone, tolls, parking, etc.)
Utilization Review
Adjuster Review No Charge
Tier 1 - Nurse Review $120 Flat Fee
Includes 3 medical request in a single review, set up, phone calls to physician, email notices to adjuster and letters to all parties including network providers. Fee applies to reviews approved by nurse or escalated to physician.
Tier 2 - Physician Review $235 plus nurse charge
Includes 3 medical request in a single review.
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
Reconsideration $235 flat fee up to 3 medical requests per referral
Pharmacy Review $385 plus nurse charge
Includes unlimited medical request in a single review.
Pharmacy Reconsideration: $385 flat fee
Medical Provider Network Access (LWP Network)
PPO fee for savings below fee schedule and negotiations 24%
There is no separate charge for medical provider access to LWP's proprietary network. Percentage of savings below fee schedule is the only charge.
Specialized Network Access (bill review charges do not apply) Durable Medical Goods $5 per bill network access fee
Expedited Diagnostic Testing $5 per bill network access fee Physical Therapy Network $5 per bill network access fee Pharmacy Benefit Network $5 per bill network access fee
These charges apply only if LWP's programs are utilized.
Other Services Fee
Investigation
Investigative Services $95 per hour SIU Related Services $105 per hour Background Investigation $375 flat rate Social Media Investigation $375 flat rate Background + Social Media Packaged at Discount $550 flat rate Medical Canvass $525 flat rate VeriFive Package of 5 services for claim verification at a $800+ Discount $1,550 flat rate x VeriFive Package includes 1. Background; 2. Social Media; 3. Medical Canvass; PLUS 4. SIU Review + Strategy Development; and 5. Recorded Virtual Statements inclusive of Evidence-Based Questions. Includes two statements; additional fees apply for add-on services.
Renewal Proposal- City of Alameda
Submission Date – March 11, 2026
April
Plus expenses which can include, but are not limited to: mileage, database fees, DMV fees, court search fees, records, certified copies, tolls, parking, evidence storage, and transcription.
LWP has negotiated rates below standard industry rates on all investigative services including field investigations, SIU related services, and desktop services including background, social media, medical canvass, and other applicable investigative tools.
Indexing
Index and OFAC Reporting (ISO Fee passed through) $25 per claim (2026 fee - reviewed annually) Subrogation
15% of gross recovery
Fee shall not apply to cases where file is referred to subrogation attorney for handling and shall apply only to cases where recovery is negotiated by LWP staff. Fee shall still apply to cases where counsel is employed ONLY to draft releases, but where LWP did all negotiations.
LWP makes every effort to keep pricing as consistent as possible. Managed Care and Cost Containment pricing is subject to change with notice. Pricing is governed by annual notices, sent each December.
Pricing above constitutes 2026 pricing, consistent with the 2025 notices.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
(A/C, No):
FAX
E-MAIL
ADDRESS:
PRODUCER
(A/C, No, Ext):
PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be e ndorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A st atement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO D INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $
$
$PROPERTY DAMAGE
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DESCRIPTION OF OPERATIONS below
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CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
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