Leave Management Administration Services

The Vendor is required to provide to perform a full range of services related to the administration of leave programs through service and technology support.
- Internal support departments include finance and budget, information technology, human resources, legal, and administrative services.
- The primary objective is to ensure the effective administration of county’s leave programs through service and technology support.
- Maintain a high level of overall customer service for the employees, management and human resources staff of the county
- Provide seamless and comprehensive FMLA and other leave policy eligibility determination support and accurate compliance with all leave regulations and policies
- Reduce administrative expense and burden
- Reduce litigation exposure through compliance and procedural consistency
- Utilize an effective tracking/reporting methodology and supporting system
- In compliance with relevant laws, regulations and policies, partner with the county to implement effective strategies and solutions to identify, address and resolve abusive utilization of leave.
- The assumption of all employees currently on an approved leave of absence and the commencement of administration of leave policies as of the agreed-upon program implementation date
- Claim administration
• Ability for employee and/or their supervisor to request leave or report usage electronically or by phone
• Issuance of initial leave package to employee
• Ability to provide a secure and dedicated system to receive phi and related documents from medical providers and the employee
• Determination of employee leave eligibility
• Preparation of approval and denial notifications to employees
• Verification of medical certifications
• Notifications to employer and employee of relevant dates and deadlines
• Detailed case management
• Efficient claim processing in compliance with DOL mandates and guidelines
• Advise/counsel on non-compliance and leave abuses, and action plans to address them
• Timely and effective communication with management and employees on leave issues
• Customer service, call center and/or help desk support
• Coordination with other county leave-related benefits
• Facilitate second and third medical opinions by maintaining access to relevant healthcare providers in the local area willing to provide those services
- Claim tracking, documentation and reporting
• Automated tracking of all employee requests for leaves based upon their authorized work schedule
• Tracking of leave utilization including recertification, intermittent, refusal of forced ot, etc.
• Complete documentation of each claim, including all communication with employees
• Ability to track FMLA leave concurrently with other leaves
• Ability to track reductions in lost time for cost control
• Alert the county to intermittent absences that exceed frequency and duration as per medical certification; provide options and strategies to request recertification’s as necessary and resources to help reduce intermittent leave
• Accurate, detailed and timely reporting – monthly, quarterly and ad hoc as requested on employee leave usage, program results, ROI, etc.
• Data backup, security and recovery plans
- Customer service and communications
• Provide courteous, professional and prompt service while treating all employees fairly and equitably; provide all written notices required by law
• Meet with county representatives annually to review program accomplishments and areas for improvement
• Make appropriate staff available to testify at administrative hearings and/or participate in other proceedings as required
• Develop and/or provide a survey, as agreed upon with county, to gather feedback from employees on their customer experience; work with the county to develop and implement plans for service improvements as determined necessary by the county
• Provide communication tools and other materials to promote and educate employees on services including posters, contact cards, customized brochures, etc.
• Provide training to appropriate county staff on processes, procedures, capabilities of the provider and changes to leave policies and laws affecting such policies; provide updates to applicable laws and regulations and changes to business processes, etc.
• Administer return-to-work processes and procedures in coordination with employees, managers and HR staff as appropriate.
- Claims management system
• Maintain a comprehensive claims management system and conduct audits of claim file data to assure accuracy and completeness; provide the county with reliable, secure online or web access to the system. 
• The system should be accessible 24 hours a day, 7 days a week and include remote access capabilities.
• Help desk resources must be available during normal business hours and provide responses to inquiries within one business day.
- Account management
• Assign a dedicated account manager with responsibility and authority to take necessary steps ensuring that county expectations are met and to solve professional performance, service, invoicing and other issues that may arise.
• Assign a team of leave administration staff sufficient to service the county’s volume of claims and activity and knowledgeable about county operations and processes.
• The county will conduct periodic reviews to ensure that claim handling is managed in a proficient and efficient manner and will share audit results with the service provider.
- Contract Period/Term: 2 years
- Questions/Inquires Deadline: July 18, 2025