The vendor is required to provide claims administration services for the authority’s self-insured workers’ compensation program.
- This includes handling claims administration, cost control, compliance with relevant laws, and providing necessary reports and consultation.
- The services shall align with industry standards and adapt to any statutory or regulatory changes.
- Additionally, this includes bundled services that integrate claims management, compliance monitoring, and cost-containment strategies to ensure a comprehensive and efficient approach to workers' compensation administration.
• Self-insured since: 2/1/77
• Excess carrier: safety national casualty corporation
• Self-insured retention: $750,000
• Number of employees projected for 11/1/2025: 1,349
• Three (3)-year average claims data (FY 2022-2024):
○ New claims: 159
○ Claims pending: 262
○ Claims cost: $4,753,803
○ Outstanding reserves: $8,923,551
- The third-party administrator (administrator) shall manage and resolve workers’ compensation claims.
- Administrator shall represent agency in all matters related to the investigation, adjustment, processing, supervision and resolution of workers’ compensation claims against agency.
- Administrator shall, at no additional cost, deliver to agency all claims, reports, files, and data backups related to agency self-insured workers' compensation program within ten (10) business days following the termination of this agreement.
- These materials must be provided in a secure format compatible with administrator's computer system, along with information regarding the format used.
- Manage data conversion and ensure compatibility with origami risk platform.
- Administrator shall determine compensability of injuries and illnesses in accordance with state department of industrial relations workers’ compensation laws.
- All assignments for obtaining written or recorded statements of the injured employee or witnesses must be completed within thirty (30) days of receipt of claim.
- Administrator shall actively seek refunds for any overpayment of benefits.
- Administrator’s claims management staff including examiners shall attend all meetings at agency including but not limited to agency periodic facility tours, quarterly claims reviews, and quarterly claims team meetings.
- Contract Period/Term: 5 years
- On-Site Pre-Proposal Conference Date: May 20, 2025
- Questions/Inquires Deadline: May 22, 2025