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TPA for Claims Administration Service <br />August 17, 2021 <br />Page 2 <br />1 <br />9 <br />4 <br />5 <br />The City recommends the approval of the aforementioned actions. <br />ENVIRONMENTAL IMPACT <br />There is no environmental impact associated with this action. <br />FISCAL IMPACT <br />Workers’ Compensation and General Liability TPA services are budgeted for FY 2021- <br />22. Funds are available in Human Resources Department Risk Management Division. <br />The Agreement has in place the annual fee structure of September 1 through August <br />31, for the current and upcoming three (3) fiscal years. The annual fee structure is <br />inclusive of and shall never exceed a three percent (3%) increase per-year, including <br />optional additional years. Fees for fiscal year 21/22 are already reflected in the current <br />approved budget. Subsequent years fees will be budgeted accordingly. <br />Year Accounting <br />Unit <br />Fund <br />Description <br />Accounting Unit, <br />Account Description <br />Amount <br />9/1/21-8/31/22 08209054- <br />62302 <br />Workers’ <br />Compensation <br />Contracted Vendor <br />Personnel Services $605,206 <br />9/1/22-8/31/23 08209054- <br />62302 <br />Workers’ <br />Compensation <br />Contracted Vendor <br />Personnel Services $623,363 <br />9/1/23-8/31/24 08209054- <br />62302 <br />Workers’ <br />Compensation <br />Contracted Vendor <br />Personnel Services $642,063 <br />9/1/24-8/31/25 08209054- <br />62302 <br />Workers’ <br />Compensation <br />Contracted Vendor <br />Personnel Services $661,325 <br />Year Accounting <br />Unit <br />Fund <br />Description <br />Accounting Unit, <br />Account Description <br />Amount <br />9/1/21-8/31/22 08009051- <br />62300 <br />Liability & <br />Property Ins <br />Fund <br />Contracted Vendor <br />Personnel Services $290,491 <br />9/1/22-8/31/23 08009051- <br />62300 <br />Liability & <br />Property Ins <br />Fund <br />Contracted Vendor <br />Personnel Services $299,206 <br />9/1/23-8/31/24 08009051- <br />62300 <br />Liability & <br />Property Ins <br />Fund <br />Contracted Vendor <br />Personnel Services $308,182 <br />9/1/24-8/31/25 08009051- <br />62300 <br />Liability & <br />Property Ins <br />Fund <br />Contracted Vendor <br />Personnel Services $317,428 <br />EXHIBIT(S) <br />1. Agreement Between City of Santa Ana and AdminSure, Inc. <br />2. 1st Amendment to the Agreement