Third Party Administrator Services

The Vendor is required to provide for the services of a third-party administrator (TPA) contractor to aggressively and professionally manage its workers’ compensation, general/auto liability and subrogation claims management.
- As part of the transition process, all general liability present claims and claims in the discovery phase of litigation will be transferred to the new Third-Party Administrator (TPA).
- This approach is intended to preserve consistency in communication with claimants, injured workers, and their legal representatives, and to avoid disruption in the final stages of claim resolution or medical management.
- Claims that are nearing settlement, defined as those where a settlement offer has been extended and is approaching the upper limit of the authorized settlement authority.
- Workers’ Compensation (WC) claims will be transitioned based on claim status and complexity.
- Medical-only and inactive WC claims will be transferred to the new TPA during the implementation period.
- Claims where settlement negotiations are underway and a proposed settlement is pending within the authorized authority.
- Assume liability for fines/penalties due to late filings or payments as a result of audit or during the normal course of business and/or review.
- Identify claims subject to second injury relief or subrogation.
- Maintain a claim file for each reported claim containing all pertinent data.
- Audit all medical bills for conformity to state fee schedules and appropriateness of treatment.
- must ensure that all payments are issued on time and in full compliance with applicable laws and regulations.
- Ensure payments are issued timely and in compliance with applicable laws; assume liability for fines/penalties from late or non-compliant payments.
- Maintain accurate data with audit trails, including claim turnaround time, quality control, duplicate/ineligible claim detection, charge review/reduction, and index scans.

- Contract Period/Term: 3 years
- Pre-Proposal Conference Date: October 28, 2025
- Questions/Inquires Deadline: October 30, 2025