Workers Compensation Services

The Vendor is required to provide workers compensation services include:
• Investigate, determine liability, adjust, and subrogate every open reported injury in accordance with the state workers’ compensation act.
• Assign bilingual (English & Spanish) and shall contact injured workers within 24 hours of receipt of the employer’s first report of injury.
• Administer all “run-off” claims reported as of October 1, 2025.
• Arrange file reviews with city worker’s compensation analyst and city safety coordinator, quarterly and semi-annual, with city insurance liability and insurance broker, city attorneys, and risk manager.
• Notify the city within 3 days when any previously closed claim is reopened and provide the rationale for reopening.
• Closely monitor temporary disability and permanent disability cases and advise the city in writing of such claims.
• Actively communicate daily (phone/fax/email) with city worker’s compensation analyst to review new claims (as needed) and discuss the possibility of modified assignments for employees continuing temporary disability.
• Follow up on all doctor releases, if information between doctors’ conflicts with the return to work of the employee, a prompt follows up to doctor(s) must be conducted so that communication is administered, and a plan of action is carried for the employee’s return to work, if obtainable.
• Obtain nurse case managers that are bilingual, can visit with the employee and attend doctors’ visits, if need too. 
• City should be informed with reports from the nurse case manager and approval for such services.
• Closely monitor physicians and their contact personnel, establish a working relationship, and inform the city the conduct, efficiency, and overall proficiency of their organization. 
• In every effort, attempt to utilize local specialist(s) for cost containment purposes. 
• Maintain close liaison with selected doctors and ensure maximum efficiency in the management of claims by practicing proactive case management and aggressive return-to-duty when clinically feasible.
• review city’s worker’s compensation program, to include policies and provide directives or recommendations, if needed.
• Utilize any analytical report that may be provided by other insurance carriers regarding trends in work-related injuries.
• Provide medical management of all cases, ensure pharmacy management is cost-effective and appropriate and provides the utmost efficiency with local providers to our employees; establish a professional relationship to ensure prompt distribution of medications, when needed.
• Set appropriate reserves and review for adequacy at least every 60 days.
• For rapid accommodations and cost containment, look for local providers of RME equipment. 
• If equipment will be more than $1,000, city must be informed.
• Provide up-to-date monthly reports regarding trends, physicians, costs, and open claims within a
24-hour period, when requested.
• Participate and provide yearly training in the current workers’ compensation program to departments/employees.
• Capacity to store and maintain all files pertaining to the previous third-party administrator.
- Contract Period/Term: 1 year
- A Non-Mandatory Pre-Proposal Conference Date: July 3, 2025
- Questions/Inquires Deadline: July 14, 2025