Common use of Compensation Services Clause in Contracts

Compensation Services. Sedgwick will provide the following services to each Participant in good standing as defined in Section 3 provided, however, it is specifically understood and agreed that Sedgwick shall not be obligated to take any action(s) which constitutes, at any time, the practice of law or medicine in Ohio: • Provide an outline of recommended internal procedures for the processing of claims and payroll reports. • Maintain records of claims and awards at the SP Administrator’s discretion during the period of time in which this Agreement is in effect. • Consult with Participant on claim management and/or cost control techniques to initiate appropriate action in workers’ compensation matters. • File requests for cost relief such as handicap reimbursement and military-service-related disabilities, if deemed appropriate by the SP Administrator and supported by appropriate medical documentation. • Attend hearings before the OBWC and Ohio Industrial Commission when necessary and permitted under the pertinent state regulations. • Assist in developing a defense, where possible, for workers’ compensation claims brought against Participant when deemed appropriate by the SP Administrator and contested by the Participant. • Review, upon Participant’s written request, OBWC audit reports and manual classification changes for NFIB/Ohio SP Participant and file request(s) for correction as necessary. • File request(s) for correction of duplicate or erroneous awards and reserves to reduce the cost used in Participant’s actuarial experience when identified. • Review, when submitted by Participant, workers’ compensation payroll report calculations based on information provided by Participant. • Review Participant’s annual experience rating and verify the annual premium rates. • Evaluate the Participant’s actuarial experience for eligibility into the NFIB/Ohio Group Rating Program.