Worker Compensation and Liability Third Party Claims Administration Services

The vendor is required to provide worker compensation and liability third-party claims administration services for include:
- Workers’ compensation program
•    Deliver fair, equitable, and efficient claims processing
•    Collaborate effectively with city HR and risk management staff
•    Minimize overall risk exposure to the city
•    Promote cost-effective, quality care through local provider partnerships
•    Maintain compliance with the state workers’ compensation act and industry best practices
•    Prioritize employee health and medical recovery outcomes
•    Support workplace safety, return-to-work programs, and loss prevention efforts
- General liability program
•    Administer liability claims in a fair, consistent, and timely manner
•    Ensure clear communication and coordination with city HR and risk management staff and legal counsel
•    Manage claims to reduce financial exposure and protect city resources
•    Apply best practices in investigation, evaluation, negotiation, and settlement of claims
•    Provide litigation management support, including coordination with outside counsel
•    Deliver robust reporting and analytics to support transparency, cost controls, and trend analysis
•    Promote proactive risk identification and mitigation strategies
- Current administrative process
1. Claims payment and reporting:
•    The city funds a zero-balance account, through which the contractor (TPA) issues benefit payments and payments to providers and vendors. 
•    Weekly, the contractor submits:
o    A check register and loss run to the city’s HR and risk department (typically on the first business day of the week). 
o    An invoice to the city’s finance department for zero-balance account reconciliation.
2. Year-end reporting:
•    Responsible for generating and distributing IRS forms 1099-misc to all applicable vendors. 
•    All data processing and reporting services should be fully included in any submitted proposal.
- Partial to full engagement
1. Workers’ compensation services:
•    Claims intake and investigation
•    Benefit determination and payment
•    Medical case management and bill review
•    Subrogation and recovery efforts
•    Excess carrier notifications
•    Legal coordination and litigation support
•    Compliance with all applicable federal and state laws
•    Claim reporting and data analytics
2. Liability claims services (general, auto, professional, etc.):
•    Incident intake and investigation
•    Liability evaluation and settlement negotiation
•    Excess carrier notifications
•    Litigation coordination
•    Reserve setting and financial reporting
•    Recovery and subrogation tracking
•    Support for internal reporting and audits.

- Contract Period/Term: 5 years
- Questions/Inquires Deadline: September 24, 2025