The Vendor is required to provide to obtain a Claims Administration/ Risk Management Information System (RMIS) that shall support all claims and risk management functions, to include but not limited to reporting business and risk analysis for agency.
- RMIS system shall be a hosted solution.
- System capabilities must address:
• Liability Claims
• Safety
• Risk assessment, analysis, mitigation, transfer
• Workers' Compensation Claims
• Information and reporting management
• Data transfer, interface and integration
• Predictive modeling
- The RMIS shall provide improved claims handling, data repository and reporting functions to facilitate more effective management of risk. That shall enhance analytical, data management and data mining capabilities to enable all risk-related functions to align for 'Total Cost of Risk' control.
- The RMIS shall provide the ability to meet the following requirements and objectives:
• Claims administration and management functions for a self-insured and self-administered entity. The system must be scalable for changes in claim volume and the flexibility if agency moves to a third-party administrator (TPA) model instead of self-administration
• Provide pre-loss activities, the identification and reporting of safety trends and the effectiveness of safety programs
• Provide risk treatment analysis, including risk transfer, retention or other financing.
• Provide support for the annual actuarial studies to validate the required reserves and future funding needs of the entire self-insured program. Must be able to run paid and incurred loss triangle reports to support the annual actuarial study.
• Provide true occurrence reporting (consideration of all losses and recoveries of a single event).
• Provide 'cost of risk' reports to measure department and/or location performance.
• System that allows the opening of new ways to interpret data such as elevating 'causes' to 'actionable items'.
• System that allows the scheduling courses, enrolling employees, and giving course credit through this learning to avoid risk factors.
• The RMIS shall schedule, track, and analyze such training in order to measure its effect on operator behavior.
• Maintain the records and track the assessments of the drivers, properties and other safety hazards materials pursuant.
• Set alerts and notifications as to when safety levels are exceeded.
• Must include easy-to-submit paperless forms that can be submitted while online by named users anywhere from the field for all the incidents/accidents that occur to include incident reports & employer’s first report of injury.
- The system's Claims Management capabilities shall not be limited to only these lines of coverage; however, under this Contract, the system shall perform the follow items:
• Workers' Compensation
• General Liability
• Auto Liability (Property Damage)
• Employment Practices Liability
• First Party Property
• Self-Insured Retention Claims
- Automate the process of assigning claims to adjusters with notifications; manage the needs of supervisors to monitor and distribute claim loads accordingly and report individual adjuster caseloads on real time basis; prevent duplicate claim set up.
- Link coverage for policy periods with reported claims and provide necessary functionality to manually assign claims to appropriate policies; provide alerts/prompts when claim values reach specific points, thresholds or other circumstances (e.g. 50% of self-insured retention (SIR), specific types of injuries or conditions)
- Enhance workflow by providing a media management module capable of image capture, voice-based data capture and transcription, image/video storage, and storage of documents as attachments, capable of capturing all media in agency current claim files thereby allowing agency claims personnel to operate in a paperless environment.
- The media management module shall provide the ability to search using Optical Character Recognition (OCR).
- The media management module shall allocate a document to a specific claim and automate that allocation process.
- The media management module shall be able to handle extremely high volumes of scanned documentation on a daily basis.
- Improve the efficiency of claims processing by providing robust, secure and User-friendly 'claim notes' capability that accommodates viewing, sorting, printing, searching, provides date and User information, and serves as an audit trail; provides similar 'diary system' that assigns tasks, and sorts and prints claim data by various categories and multiple diary dates.
- The system will pre-populate information from the claims file onto the forms when they are utilized.
- Provide a template and or worksheet that can be used to facilitate the setting of reserves, automate processing and populate claim records, accordingly, provide an audit trail, or capture all reserve 'buckets' (e.g. medical, indemnity, expense, and subrogation).
- Provide adjusters with the ability to process recurring payments on individual files as well as process payments against PO accounts.
- Provide the ability to select an alternate mailing address for vendors within the SAP system.
- Provide robust and User-friendly functionality including but not limited to policy tracking, program structures, links policies with claims for erosion of limits/SIR, document attachment, text searching, financial data, premium allocation, captive insurance documentation, self-insurance plan information, program modeling for cost impact of retention. Manage certificates of insurance (primarily incoming) capture, store, retrieve, track dates, alerts, create form letters, etc.
- Provide data management functionality that includes point-in-time reporting, searchable metadata, complete audit trails for data elements, data dictionary.
- Contract Period/Term: 3 years
- Pre-Proposal Meeting Date: December 23, 2025
- Questions/Inquires Deadline: December 29, 2025
