Workers Compensation Claims Third Party Administrator Services

The vendor is required to provide workers compensation claims third party administrator services include, but are not limited to, the following:
•    Thoroughly investigate all claims made against city through appropriate claim procedures as necessitated by the severity of the injury and ensures correct payment of medical and time loss claims. 
•    Recommend surveillance or activity checks as deemed appropriate and arrange same upon prior approval of city. 
•    Provide cost containment services, including medical fee reductions and provide quarterly report of cost containment services. 
•    Assist the city in preparing the defense of litigated or administratively contested claims. 
•    Attend trials and settlement conferences as appropriate. 
•    Develop and maintain an investigative file on each claim in accordance with an approved format by city. 
•    Files are to be readily available for city review and shall be well documented and up-to-date. 
•    Notify excess insurance carriers of claims and or occurrences at predetermined levels required by excess insurers. 
•    Provide information and status of claims as requested by the excess insurance carrier. 
•    Develop and maintain a claims database to be used in the administration of the claims and to generate reports to city. 
•    Within 15 days following the end of each quarter, provide city with a report to account for individual claims and aggregate loss experience analysis. 
•    This report shall show the status of each open claim and experience year-to-date of all claims. 
•    The capability of providing data necessary to prepare financial and statistical reports on losses or claims. 
•    Within 24 hours, respond to inquiries from employees regarding the status of their claim. 
•    Provide assistance as necessary to city staff for proper procedural handling of claims. 
•    Provide claim materials as deemed appropriate by city staff.
•    Identify and investigate all subrogation possibilities for potential recovery including investigation evaluation and negotiation of subrogation cases. 
•    Attend periodic meetings (generally 3-4 months apart) with city staff to review and strategize pending and threatened claims. 
•    Prepare administrative reports required by the state. 
•    Monitor the compliance of city's employer reporting requirements and record keeping requirements and advise city staff on any deficiencies in city's overall self-insured compliance matters. 
•    Prepare and assist city staff with all appropriate responses to audits and inquiries of all regulatory agencies.
•    Provide competent and qualified loss control services on request.

- Contract Period/Term: 1 year
- Questions/Inquires Deadline: October 28, 2025