The third party administration and managed care services to be provided by the TPA shall include the following: 1. Reviewing all the City’s claim forms submitted by the City of Orange and providing complete handling of all loss adjustments, and medical case management in compliance with industry standards; 2. Having the TPA’s key local personnel conduct service calls, as needed, to the City for the purpose of establishing lines of communication and reporting procedures; 3. Establishing and maintaining estimated reserve figures for each claim file and consulting with the City with respect to payment of any claim; 4. Furnishing claim forms necessary for proper claims administration, in accordance with the Tort Claims Act, Title 59, of New Jersey Statutes; 5. Maintaining claim files for each reported claim throughout the life of the claim and to retain all closed files for a period of three (3) years following closing of the file, or as otherwise required by applicable law or regulation; 6. Transmitting to the City, on a weekly basis, a list of all medical/indemnify benefits and allocated expenses and/or all claim expenses, awards, etc., to be paid; 7. Issuing checks in payment of benefits and allocated expenses. Said checks to be paid from an account maintained by the City at a bank of its choice and any fee or charges in connection with said account shall be the responsibility of the City.
