Third Party Administration Services

The Vendor is required to provide for third-party administration (“TPA”) of all current and future assigned liability claims (“Claims”) for the County’s self-insurance plan (“Plan”).
- Claims Administration Services
•    Perform all services required to process, supervise, and administer all claims;
•    Investigate, examine, and adjust or resist payment of claims as authorized by county;
•    Pursue, with county's consent, subrogation and loss recoveries following payment of claims;
•    Periodically review and report to county and required agencies on the status of claims, including reporting on serious claims to excess insurers;
•    Furnish forms required for the proper reporting and administration of claims;
•    Establish and maintain files in connection with each claim, which files are the property of county and must be returned to the county at the expiration or termination of the contract.
•    Issue drafts or checks in payment of claims and allocated loss adjustment expenses on the county's behalf as authorized by the county;
•    Pay claims not otherwise covered by the plan on the county’s behalf as authorized by the county; and
•    Retain and store, at county's or the county’s excess insurers’ request, closed files in their existing state at the time closed, for a period of six (6) years from the date closed.
•    The respondent will accept and act on all open/pending claims from the current vendor. Currently, there are one hundred and eighty-eight (188) open claims. Retain defense counsel to handle any lawsuit or hearing involving the subject exposures, if requested by the county; and
•    Monitor and periodically report to county on the status of claims referred to defense counsel.
- Medical Control.
•    Maintain a roster of consulting physicians for treatment of industrial or casualty accidents on a first aid and specialized basis;
•    Establish and maintain liaisons with the treating physicians for claims; and
•    Monitor medical treatment and bills for claims and refer same for audit where deemed necessary.
- Provide license information for all employees who will be working on the County account.
- Provide hours of operations, such hours must at a minimum match the County’s core working hours of 9:00 a.m. – 4:45 p.m. (Eastern time zone), Monday through Friday. The TPA shall be on-call outside of regular business hours, only rarely, if a Claim warrants it.
- Consultant shall assign a dedicated Principle Adjuster to the County’s account, not a team or group of adjusters. Consultant shall ensure that the Principle Adjuster be available 24/7/365 and have a designated backup licensed adjuster.
- Consultant must adapt their services and systems to comply with present and future County forms including, but not limited to, claim vouchers and supplemental vouchers.

- Contract Period/Term: 3 years
- Questions/Inquires Deadline: October 20, 2025