The vendor is required to provide the third-party administrator (TPA) for the county’s workers’ compensation claims program services.
- The county is seeking to obtain a single, experienced, professional workers’ compensation claims service company to provide claims administration and data management services for workers compensation claims.
- Requirements
• Key personnel - offeror must provide a program manager with either:
o 10 years cumulative experience in relevant claims with 3 years specific to state workers’ compensation; or
o 5 years state specific workers’ compensation claims experience
• Claims handling services - provide customary and appropriate handling for each claim, including, but not limited to investigation, adjusting, preparing and issuing medical and indemnity payments to claimants, setting appropriate claim reserves, investigation and pursuit of subrogation on behalf of county.
• Strategic planning - provide periodic claims and stewardship meetings to review the account.
• Cost saving initiatives - identify and recommend creative cost saving initiatives.
• Compliance assistance - complete and timely file all forms required to be used in the adjustment of workers' compensation claims by the state bureau of workers' compensation (the "bureau") and the state workers' compensation act (the "act").
• Employee communications - provide on-line access of third-party administrator (TPA) claim data to the county.
• Provide an on-line claim submission method.
• Excess insurance carrier (EIC) - provide written notification and periodic updates on claims which meet the excess insurance reporting requirements to insure coverage by the excess insurance carrier.
• Ongoing support services- field and respond to claims handling communication from human resources point of contact, finance, solicitor, work comp attorney, insurance broker, to include, but not limited to claim issues, exclusions, waiting periods, subrogation, regulatory compliance issues (self-insurance regulations).
• Risk management information reports - provide monthly standard reports, which may include loss runs, reserve analysis, medical payment detail, experience reports (loss summary by loss line).
• Self-insurance application - provide claim data and/or completed bureau forms necessary to complete the application.
- Questions/Inquires Deadline: June 05, 2025