PCBDD Insurance - Portage County Board of Developmental ...

Portage County Board of Developmental
Disabilities
Portage County Board of
Developmental Disabilities
2606 Brady Lake Road
Ravenna, Ohio 44266
1

PROPOSAL REQUIREMENTS
1. Portage County Board of Developmental Disabilities requires that your company/programs proposals are
receive at Love Insurance Agency 34920 Ridge Road Willoughby, Ohio 44094 no later than April 30, 2013
at 3 pm for the specified coverage. Proposals may be optionally delivered electronically copy to
phickey@loveinsurance.com no later than the above date and time.
Coverage:
I. Commercial General Liability including Professional Liability
II. Fiduciary Liability, Including Employee Benefits Liability
III. Employers Liability
IV. Educational Legal Liability
V. Employment Practices Liability
VI. Automobile Liability and Physical Damage Coverage
VII. Property Coverage
VIII. Inland Marine Coverage
IX. Electronic Data Processing Coverage
X. Crime/Employee Dishonesty Coverage
XI. Equipment Breakdown Coverage
XII. Violence Coverage
XIII. Umbrella/Excess Liability
XIV. Cyber Coverage
XV. Environmental Coverage
2. Provisional Time Line for the RFP
a) RFP released March 12
b) All questions or request for applications/surveys due March 24
c) Replies to any questions or applications will be forward by April 1
d) Quotes due Tuesday April 30 by 3 pm. This is firm not provisional.
e) Analysis of proposals/additional negotiations by May 8
f) Recommendation to the board by May 15
g) Board Meeting Approval May 22
h) Binding of Coverage July 1
This is a Request for Proposals. Proposals will not be shared with other proposers until after the board approval.
Portage County Board of Developmental Disabilities under the rules of this RFP may negotiate with various
proposers if it believes it in its best interest to do so.
3. Portage County Board of Developmental Disabilities will make every attempt to reply to reasonable
information requests. All such requests are to be directed to:
Patrick M. Hickey
877-859-3073
phickey@loveinsurance.com
Mr. Hickey is acting as agent for the Portage County Board of Developmental Disabilities and will assist the board
with in determining its final decision. He will receive no compensation from Portage County Board of
Developmental Disabilities. He will be compensated through normal commission paid to agents. Please see
commission disclosure further down in the bid specifications.
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4. You may submit your proposal at any time before the due date. All proposals must be submitted electronically
using the attached proposal forms to phickey@loveinsurance.com. Contents of the proposal will not be
disclosed to other proposers until after the award is made. It is your responsibility to assure electronic delivery.
Other documents, specimens, brochures may be submitted by mail to Portage County Board of Developmental
Disabilities 2606 Brady Lake Road Ravenna, Ohio 44266 by the due date.
5. Each proposal must be submitted on the enclosed Proposal Forms and must contain the full name or
names of the parties making the proposal and all persons interested therein. Proposers shall state in their
proposals the names of their Insurance Company or Companies and/or Program in which they propose to
provide the coverage. Proposers shall note any differences between coverage as requested in the
Request for Proposals and their Proposal.
6. Failure to meet the coverage as requested in the Request for Proposals contained herein may be cause for the
rejection of a proposal.
7. Each prospective proposer shall furnish one (1) specimen policy of the Company for each form of
coverage to be written, including all endorsements as constitute the entire contract. Each proposal must also
contain a detailed listing of the proposed coverage. Any exceptions to the coverage as requested in the
Request for Proposals must be noted in the proposal and explained in detail on an attachment thereto.
Portage County Board of Developmental Disabilities reserves the right to consider such exceptions before
awarding the contract. If an attachment is not received with the Proposal Forms, the copy of the specimen
policy or policies submitted with the proposal will be assumed to be identical to the specifications with respect
to coverage. Failure to comply with the terms of this paragraph may be cause for the rejection of a proposal.
8. The effective date of the policy or policies must be 7/1/2013 unless otherwise directed by Portage County
Board of Developmental Disabilities or its’ designate. Each proposer is requested to quote on the entire
insurance program. The proposer shall indicate whether premium audits will be required.
9. The policy or policies contained therein must provide that if Portage County Board of Developmental
Disabilities should cancel such policy or policies, the cancellation provision and any pro-rate premium shall
apply only to the current policy year and not to additional years remaining under the policy. Insurance program
must not require Portage County Board of Developmental Disabilities to provide a notice of cancellation or
termination of more than 60 days. Proposer also agrees to provide a minimum of 60-days’ notice of
cancelation also.
10. All insurance shall be written with a responsible company or companies, each of which is qualified and/or
licensed in the State of Ohio or a program organized under Chapter 2744 of the Ohio Revised Code. Surplus
lines companies are not desired, but should be on the Ohio Department of Insurance’s “approved list”. The
insurance company or companies must be listed in the latest edition of Best‘s Insurance Guide and Key
Ratings and a copy of the page with the proposed insurer must be included. All carriers must carry a current
AM Best rating of "A-“ or better. The financial condition of the company or companies must carry an AM Best
rating of “VII” or better.
11. Programs organized under Chapter 2744 of the Ohio Revised Code (ORC) with assessment features will
not be considered. A current audited financial statement or a link to the audited financial statement from the
program’s website must be provided. All reinsurance information must be identified including all reinsurance
companies and either audited financial statements or AM Best ratings. Proposers must include a copy of the
program’s membership agreement and governing documents. Proposers must include the number of members
of the “ORC Chapter 2744” program.
12. The insurance company or program submitting a proposal must provide evidence of the ability to provide
effective local claim administration and services to the Portage County Board of Developmental Disabilities.
The proposal shall include a synopsis of the proposers operations, a list of Ohio school accounts written by the
proposer, and a Certificate of Insurance verifying errors and omissions insurance coverage for the proposer in
the minimum amount of $2,000,000.
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13. Successful proposers are required to disclose the commission paid. Describe any contingent commission
arrangements or other compensation plans that you or your company program gives in addition to your
standard commission.
14. The following standard provisions are required for all policies:
a. Amended Notice of Cancellation and/or Non-renewal
“It is hereby understood and agreed all policy terms and conditions relating to cancellation and
non-renewal of coverage are amended to provide: Sixty (60) days prior written notice of
cancellation or non-renewal of coverage to the insured. Non-payment of premium is an exception.”
b. Knowledge of Occurrence Endorsement
“It is hereby understood and agreed that knowledge of a loss or accidents, servants, or employees
of the insured shall not in itself constitute knowledge by the insured unless the insured shall have
received notice of the loss or accident from its agents, servants, or employees.”
c. Unintentional Errors and Omissions Endorsement
“It is agreed the failure of the Named Insured to disclose all hazards or occurrences as of the
inception of this policy will not prejudice the insured’s rights of coverage under this policy provided
the error or omission was not intentional.
15. The current program is occurrence on all but Employee Benefit/Fiduciary Liability and School Leaders
Errors and Omissions (D&O coverage) which are claims made. Prior to 5/1/2008 the BDD was covered on a
claims made program for all liability coverage. Thus, Prior acts coverage is needed from 7/1/2002 to 5/1/2008
for all liability coverage and to 7/1/13 for Employee Benefit/Fiduciary Liability and School Leaders Errors and
Omissions (D&O coverage.) Proposals are to provide prior acts coverage for these time periods.
16. Proposals submitted or received shall impose no liability or obligation upon Portage County Board of
Developmental Disabilities and Portage County Board of Developmental Disabilities reserves the right to
request future quote proposals or negotiate at its discretion.
17. Portage County Board of Developmental Disabilities reserves the right to reject any or all quotes; to waive
any and all irregularities in a quote; and to accept that the quote or combination of quotes which, in its
judgment, is/are the most favorable to Portage County Board of Developmental Disabilities.
18. In reviewing the quotes and awarding the contract, Portage County Board of Developmental Disabilities
reserves the right to consider all elements related to the quote, including, but not limited to, the rating and
financial condition of the prospective insurance company or program; the responsibility and experience of the
proposer, its agents, and representatives; and the services to be provided by the insurance company, the
proposer, and its agents or representatives.
19. Every proposal should be made on the Proposal Forms attached hereto with attachments of the
company/program fees necessary to explain their coverage/program.
20. The successful proposer shall deliver the policy or policies of insurance or binders for such policy or
policies of insurance covering the hazards named herein to Portage County Board of Developmental
Disabilities within sixty (60) days following the notice of the award of the contract or the effective date of
coverage, whichever comes first.
21. Should a proposer find discrepancies in or omissions from this Request for Proposals or should a proposer
have questions concerning their meaning, he/she may submit comments or questions to the above contact.
We will attempt to answer such questions or comments within a reasonable period of time and will send a copy
of any such response to all prospective proposers on record.
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22. Quotes may be withdrawn up to delivery upon written notice to Portage County Board of Developmental
Disabilities.
23. Proposals must remain valid until July 1, 2013.
24. Each proposer must comply with all requirements of law pertaining to contracts with Portage County Board
of Developmental Disabilities. It is the responsibility of the proposer to be in compliance.
25. “ORC Chapter 2744” programs must provide (or post on their website) financial statements audited in
accordance with auditing standards generally accepted in the United States of America and the standards
applicable to financial audits contained in Government Auditing Standards. Financial statements should
include formal actuarially determined Loss and Loss Adjustment Expense Reserves (including IBNR).
26. “ORC Chapter 2744” program must confirm that an independent actuarial opinion is performed, the name
of the actuarial firm, and the date of the most recent report.
27. “ORC Chapter 2744” programs must complete the chart provided on the Proposal Checklist to
demonstrate financial stability and adherence to financial benchmarks established by the National Association
of Insurance Commissioners (NAIC).
28. It is the desire of Portage County Board of Developmental Disabilities to award the entire insurance package
to one proposer.
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29.
PROPOSAL CHECKLIST
Please complete the following information per the Proposal Requirements. This Proposal Checklist is required as
part of the Proposal Submission.
Item #3 – Completed Proposal Forms:
General Information
Proposal Summary Sheet
Proposal Form
Item #5 - Specimen Policies including endorsements for all coverage quoted
All exceptions to Request for Proposals are clearly noted
Item #8 – Documentation of AM Best’s Rating of company (ies) proposed
Item #9 – “ORC Chapter 2744” Program Requirements
Assessments or Dividend schedule, if applicable
Current Audited Financial Statement or a link to the Financials on program’s website
All Reinsurers and their AM Best Rating or Current Audited Financials
Program Membership Agreement
Members of the “ORC Chapter 2744” program
Item #10 –Errors & Omissions Certificate of Insurance - $2,000,000 Limit
Synopsis of Company/program’s operations
Errors & Omissions Certificate of Insurance - $2,000,000 Limit
List of Ohio similar accounts/clients
Item #12 – Standard Policy Provisions include:
Amended Notice of Cancellation and/or Nonrenewal
Knowledge of Occurrence Endorsement
Unintentional Errors and Omissions Endorsement
Item #23 – “ORC Chapter 2744” program – Independent Actuarial Report Performed
Name of Actuarial Firm;
Date of most recent report:
6

PROPOSAL CHECKLIST
Item #24 – “ORC Chapter 2744” programs must complete the following chart to demonstrate financial stability
and adherence to financial benchmark established by the National Association of Insurance Commissioners
(NAIC).
* If surplus is not 10 times greater than Self Insured Pool Retention then describe pool’s risk philosophy and strategy.
Year Pool Self insured
Retention
Audited Surplus* Current Assets Liabilities Pool Stop Loss
Aggregates
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Additional Requested Items:
Agent Commission Disclosure
Executive Summary
Coverage Structure & Recommendation(s)
Company/Program Scope of Services
Company/Program Service Enhancements – Description
Company/Program Service Team (Including Bios)
References (List of similar accounts insured.)
Risk Management Services Questionnaire (1 through 9)
Claim Service Questionnaire (1 through 14)
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GENERAL INFORMATION
Please complete a copy of this form for EACH insurance company within your insurance group that is being proposed or for
your insurance program.
INSURING COMPANY/Program
Insurer:
Address 1:
# of Ohio Schools currently insured:
Phone:
Fax:
Address 2:
City: State: Zip:
Coverages provided by the insurance company. Insert an “X” as applicable
Commercial General Liability and Professional
Liability
Sexual Abuse and Molestation Liability
Fiduciary Liability
Employee Benefits Liability
Employers Liability
Educational Legal Liabilitay
Employment Practices Liability
Automobile Coverage
Excess Liability
Umbrella Liability
Property Coverage
Inland Marine Coverage
Electronic Data Processing Coverage
Crime Coverage
Employee Dishonesty Coverage
Equipment Breakdown Coverage
Flood Coverage
Earthquake Coverage
Violence Coverage
Cyber Coverage
Environmental Coverage
8

PROPOSAL SUMMARY SHEET
These sheets must be completed and returned with each Proposal. Place this form on top of your submission.
Insurer:
Best Rating:
Please summarize your quote according to the following form. If you submit quotes from more than one insurer, a
copy of this form must be submitted for each insurer. If you quote items that are not covered in the Quote
Specifications, summarize them in the comments section below.
Minimum Coverage Requested
I. Commercial General Liability and
Professional Liability
II.
III.
IV.
Fiduciary Liability, including
Employee Benefits Liability
Employers Liability
Educational Legal Liability
V. Employment Practices Liability
VI.
Automobile Coverage
VII. Property Coverage 100% of Values =
VIII. Inland Marine Coverage Total Values =
IX. Electronic Data Processing Coverage Total Values =
X. Crime Coverage
XI.
XII.
XIII.
XIV.
XV.
Employee Dishonesty Coverage
Equipment Breakdown Coverage 100% of Values =
Violence Coverage
Excess Liability
Cyber Coverage
Environmental Coverage
(Your) Limits
Total Premium:
Your Premium
Agreement
My company/program agrees to provide all insurance policies proposed in the attached proposal. We agree to
provide a complete set of policies and endorsements to the insured within sixty (60) days from contract award
and appropriate binders by July 1.
Signed by:
Title:
Print Name:
Date:
9

PROPOSAL FORM
Proposal Form Instructions: Answer YES or NO to each coverage topic or enter your coverage limit or deductible
proposed. Attach explanations where necessary. Please note on liability coverage, current program is occurrence
but provides prior acts coverage from 7/1/2002 to 5/1/2008. Proposals should provide prior acts coverage for this
time period.
Coverage Current Limits Proposer Limits Premium
I. Commercial General Liability and Professional
Liability
A. Liability Limits [Occurrence Limit] $5,000,000
B Liability Limits [Aggregate Limit] $7,000,000
C
Other Coverage Terms
Sexual Abuse and Molestation Included
Law Enforcement Liability Included
Defense Costs
In addition to
Limit
Unaudited Policy Included
Personal and Advertising Injury Included
Products & Completed Operations Included
Booster/Parent Groups as Additional Insureds See Exhibit I
D. Additional Insureds See Exhibit I
II.
Retroactive Coverage
Fiduciary Liability, Including Employee Benefits Liability
2/1/2002 to
7/1/2008
A. Liability Limits [Occurrence Limit] $5,000,000
B Liability Limit [Aggregate Limit] $7,000,000
C. Deductible $2,500
D. Defense Costs Included in Limit
E. Employee Benefits Liability Included
F Coverage separate from GL Included
G. Claims Made Coverage Form
Fiduciary Liability Retro Date 2/1/2001
Employee Benefits Liability Retro Date 2/1/2002
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Coverage Current Limits Proposed Limits Premium
III.
Employers Liability
A. Bodily Injury by Accident- Each Accident $5,000,000
B. Bodily Injury by Disease $5,000,000
C. Bodily Injury by Disease – Each Employee $5,000,000
D. Deductible $0
E. Defense Costs In Addition to
Limit
F A sublimit of the GL? Yes/No
Prior Acts Coverage – Retro Date 7/1/02-5/1/08
IV.
Educational Legal Liability
A. Errors &Omissions Injury [Occurrence Limit] $5,000,000
B. Errors & Omissions Injury [Aggregate Limit] $7,000,000
C. Declaratory, Equitable, Injunctive Relief Defense
[Aggregate Limit]
$100,000
D. Deductible $2,500
E. Defense Costs Outside Limit
F. Coverage Form Claims Made
G. Prior Acts Coverage - Retro Date 2/1/2002
V. Employment Practices Liability
A. Liability Limits [Occurrence Limit] $5,000,000
B. Liability Limits [Aggregate Limit] $7,000,000
C. Deductible $2,500
D. Defense Costs Outside Limit
E. Coverage Form Claims Made
F. Prior Acts Coverage – Retro Date 7/1/02-5/1/08
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Coverage Current Limits Proposed Limits Premium
VI.
Automobile Coverage (Schedule of Automobiles is attached)
A. Automobile Liability (Symbol 1) $5,000,000
B. Uninsured/Underinsured Motorist Coverage $250,000
C. Medical Payments $5,000
D. Comprehensive Deductible
Buses $1,000
All Other Automobiles $250
E. Comprehensive Max Per Event Deductible $1,000
F. Collision Deductible
Buses $1,000
All Other Automobiles $500
G. Other Coverage
Fleet Coverage – Unaudited Policy Included
Non-Owned & Hired Automobile Liability $5,000,000
Hired Car Physical Damage $75,000
Employees as Insureds for Primary Non-Owned
Automobile Liability
Included
School Bus Passenger Personal Liability $25,000
School Bus Medical Payments $5,000
School Bus Towing & Labor Indicate Limit
Lease Gap Coverage Included
Pollution Liability Coverage Included
Retro Coverage on Auto 7/1/02-5/1/08
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Coverage Current Limits Proposed Limits Premium
VII.
Property Coverage
Property insurance to cover all buildings and contents, property in the open and improvements and
betterments. Coverage shall be provided on a BLANKET form of coverage (all locations) per the attached
Property Schedule with no requirement to build on the same premises.
A. Blanket Limit $20,421,355
B. Deductible $1,000
C. Coinsurance None
D. Agreed Amount Included
E Causes of Loss Special Form
F. Valuation Replacement
G Earthquake Coverage $5,000,000
Deductible
5% subject to
$25,000
minimum.
H Flood Coverage $5,000,000
Deductible $25,000
I
Additional Coverage/Extensions
Account Receivables $100,000
Backup of Sewer & Drains $100,000
Business and Rental Income $250,000
Debris Removal Included
Extra Expense $1,000,000
Fire Protection Devices $25,000
Foundations Included
Loss of Refrigeration $25,000
Newly Acquired/Constructed Buildings
Buildings – 90 Days $1,000,000
Personal Property – 90 Days $1,000,000
Off Premises Service Interruption $250,000
Ordinance or Law Coverage
20% of Bldg.
$500,000 Max
Paved Surfaces $200,000
Personal Effects of Others $50,000
Transit $200,000
Valuable Papers and Records $100,000
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Coverage Current Limits Proposed Limits Premium
VIII.
Inland Marine (Schedule is attached)
A. Blanket Equipment Limit
B. Audio-Visual Equipment $53,000
C. Miscellaneous Equipment $87,000
D. Deductible $1,000
E. Causes of Loss Special
F. Valuation Replacement
Cost
IX.
Electronic Data Processing (EDP)
A. Blanket Hardware Limit $378,000
B. Electronic Media Limit $65,000
C. Extra Expense Limit Included in
Property Extra
Expense
D. Transit Limit Included in
property transit
limit
E. Deductible $1,000
F. Causes of Loss Special
G. Valuation
Hardware Replacement
Software Reconstruction
X. Crime
A. Employee Dishonesty Coverage $100,000
Includes “Faithful Performance” Included
B. Forgery and Alteration Coverage and Money
Orders and Counterfeit Paper Currency
$50,000
C. Computer Fraud Coverage and Funds Transfer $50,000
D. Monies and Securities $25,000
Inside Premises $25,000
Outside Premises $25,000
E. Deductible $1,000
Retro Date on Crime 7/1/02-5/1/08
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Coverage Current Limits Proposed Limits Premium
XI.
Equipment Breakdown (Boiler and Machinery) Coverage
A. Limit per Any One Accident $20,421,355
B. Coverage Locations See Statement
of Values
C. Deductible
Property Damage $1,000
Utility Interruption 5 days
D. Coverage From Comprehensive
E. Jurisdictional Inspections Included
F. Recovery (Repair or RC) Included
G. Joint Loss Agreement Included
All Boiler Extension Sub Limits $250,000
XII.
Violence Coverage
A. Aggregate Limit $1,000,000
B. Violent Act Limit $1,000,000
C. Death Benefit per Person Limit $25,000
Death Benefit Aggregate Limit $1,000,000
D. EMT Charges Aggregate Limit $5,000
E. Medical Expense Aggregate Limit $25,000
F. Sub-Limits
Group Trauma Counseling $25,000
Extra Security $25,000
Substitute Teachers $25,000
Extra Student Transportation $10,000
G. Covered Persons
Student Included
Employee Included
Elected or Appointed Board Member Included
Graduate Teaching Assistant Included
Student Teacher Included
Authorized Volunteers Included
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Coverage Current Limits Proposed Limits Premium
XIII.
Excess/Umbrella Liability
A. Coverage Type (Follow Form Excess or
Umbrella)
Please indicate
B. Liability Limits [Occurrence Limit] $4,000,000
unless covered
in primary
C. Liability Limits [Aggregate Limit]
D. Self-Insured Retention $10,000
E. Underlying Coverage:
Commercial General Liability and Professional
Liability
Included
Sexual Abuse and Molestation Included
Law Enforcement Liability Included
Professional Liability Included
Fiduciary Liability Included
Employee Benefits Liability Included
Employers Liability Included
Educational Legal Liability Included
Employment Practices Liability Included
Automobile Liability Included
F. Coverage Form
G. Prior Acts Coverage – Retro Date 2/1/2002
H. Defense Costs Outside Limits
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Coverage Current Limits Proposed Limits Premium
XIV.
Cyber Coverage as below is provided in current program. While
not required, we prefer you offer a quote or an alternative.
Third Party Liability
A. Information Security and Privacy Liability –
Aggregate Limit
B. Privacy Notification Costs –
Aggregate Sub-Limit
C. Regulatory Defense and Penalties –
Aggregate Sub-Limit
D. Website Media Content Liability –
Aggregate Sub-Limit
$2,000,000
$500,000
$2,000,000
$2,000,000
First Party Computer Extensions
E. Cyber Extortion Loss – Aggregate Sub-Limit $2,000,000
F. Data Protection and Business Interruption –
Aggregate Sub-Limit
G. Business Interruption – Hourly –
Aggregate Sub-Limit
H. Business Interruption – Forensic Expense –
Aggregate Sub-Limit
I. Dependent Business Interruption –
Aggregate Sub-Limit
$2,000,000
$25,000
$25,000
$100,000
J. Self-Insured Retention $100,000
Waiting Period 8 Hours
XV.
Environmental Coverage as below is provided in current program. While not
required, we prefer you offer a quote or an alternative.
A. Pollution Liability – Aggregate Limit $1,000,000
B. Fungi and Legionella – Aggregate Sub-Limit $200,000
C. Self-Insured Retention
Per Pollution Condition $100,000
Underground Storage Tanks $750,000
Services
Premium
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XVI.
Risk Management Service
A. If Risk Management is not included as part of the proposed program, please provide
the fee for the services.
B. Please provide a description of services that will be provided in the Risk Management
Services Questionnaire section of this RFP.
XVII.
Claim Service
A. Please provide a description of the claim services provided in the Claim Service
Questionnaire section of this RFP.
TOTAL ANNUAL PREMIUM
Please provide your Company Commission or Fee
Describe all commission, fees, contingent commission and other compensation that
your company or your program pays as part of placing the insurance with you.
Agency Compensation
I have disclosed all compensation the company/program will pay for placing the insurance policies in the attached
proposal for Portage County Board of Developmental Disabilities.
Signed by:
Print Name:
Title:
Date:
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SERVICES QUESTIONNAIRE
Risk Management or Loss Control Services
1. Please specify the location of the office providing services to the district and specify whether
these are carrier or agency service personnel.
2. How much lead time is typically needed to set up a risk management visit?
3. Please specify the discipline specific certifications maintained by the staff that will be providing
risk management services to our entity.
4. Please describe the type of risk management resource material that will be provided to our
entity. Are they industry specific?
5. What type of risk management training is provided and/or available to our entity? Where are the
training sessions held? Please provide examples of training sessions you provided in the past to
an Ohio Board of Developmental Disabilities.
6. What is your risk management fee structure? What are the fee tiers of risk management
services? How much is included in the quoted premium for this request for proposal?
7. Please describe your overall approach to risk management. What do you intend to accomplish?
8. What can our entity expect to receive at the conclusion of your risk management visit? What is
your follow up mechanism?
9. Please list below a minimum of three Ohio public school and public entity risk management
references. These references should preferably be service by the same individuals who would
be servicing us.
19

Claim Service
1. Will the cost of servicing claims be included in the quoted premium? If not, describe how claim
servicing fees will be determined and charged.
2. Who will service our claims, the insurance company, a third party administrator (TPA) or your
agency? If insurance company adjusters service the claims, please skip to question #3.
If a TPA will service claims:
a. Does quoted premium reflect a discount since claim servicing is separate?
b. What is the approximate cost per year the TPA will charge based on our claim history?
Answers to the following questions should apply to the adjusters and the specific claim processing
location that would actually handle our claims.
3. How many claims processing locations do you operate in Ohio?
4. Provide the address of the location that would process our claims?
5. How many people are employed full-time in the above office?
6. Please indicate the size of this location in the following terms:
• # Ohio Public Schools this office services
• # Ohio Public Entities (non-schools) this office services
• # Contracted accounts served
• # Accounts served
• # Claims opened each month
• # Claims processed each month
7. Please furnish the following information regarding the claims manager at this claims adjusting
location from which our entity’s claims will be processed.
• Name
• Years of employment with your firm
• Years of experience in insurance industry.
• Years of experience with public school claims handling for auto, general and
professional liability
• Professional designations and/or degrees earned
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8. Please furnish the following information regarding the claim representative(s) at this claim
adjusting location who would handle our claims.
• Name
• Years of employment with your firm
• Years of experience in insurance industry
• Years of experience in claims administration for auto, general and professional liability
• Years of experience in public entity claims administration for auto, general and
professional liability
• Professional designations and/or degrees earned
9. Please provide an organization chart for the specified claims processing location. Please include
a block for each separate function included in the operation including any special units that exist.
Label each unit with its function, number of employees, and name of unit if it has one. If there are
several claims processing units, please indicate the unit that would process our claims.
10. Describe this office’s expertise servicing Ohio public schools and public entities.
11. List all Ohio public school clients/entity clients, including Boards of Developmental Disabilities,
which this office handles.
12. Describe any additional special programs or areas of emphasis that you think would be beneficial
in helping us to understand your adjusters’ level of public entity claim expertise.
13. Please attach copies of all standard forms or claim handling requirement used in your handling
process.
14. Please list below a minimum of three Ohio public school and public entity claim references.
These should be public employers with contracted/self-funded plans for which this claim
processing location pays claims.
21

EXHIBITS
The following Exhibits are attached to this Request for Proposal:
Exhibit I
Exhibit III
Most Recent Property Appraisal or Property Schedule to include:
• Property Descriptions
• Building – Replacement Values
• Contents – Replacement Values
• Property in the Open (bleachers, flag poles, press box, etc.) – Replacement Values
• Computer Equipment – Replacement Values
• Music Equipment – Replacement Values
• Audio Visual Equipment – Replacement Values)
Automobile/Bus Schedule and Driver Summary to include:
Year, Make, Model, Cost New. Please include the number of seats for each Bus.
Driver’s Information
Exhibit IV
5 Years of Loss Runs
Please see Proposal Requirements for any requests you have to meet your submission requirements.
Most recent audit can be found at http://www.co.portage.oh.us/auditor_pdfs/Portage_County_11‐Portage.pdf.
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