The vendor required to provide workers compensation (WC) third-party administration (TPA) for the county risk management worker’s compensation program (WC program), including tail claims.
- Provide all personnel, labor, materials, supervision, travel, facilities, software, and equipment to provide TPA services in compliance with the all services required shall also include services requested and required by the office as a separate entity under the same umbrella.
- Provide a toll-free or local area code (727) number for member services.
1. Transition duties
• Provide the necessary support, including it support, insight, guidance, and assistance to ensure a smooth conversion for all the county's WC claims, which include claims involving sheriff’s employees.
• Office will participate and use this contract for its WC claims.
• Transition duties require that the electronic data, including historical data, be transitioned to the contractor and stored in a manner in which the contents are readily identifiable by type of document and date the document was created, not the date it was transitioned, in order to ensure proper and timely responses to requests for documentation by the county attorney, participants in the county WC system, and WC claimants.
• Provide a mutually agreeable written transition schedule for both county and office claims.
• Provide a work plan that lays out an effective strategy for service transition and the data conversion.
• Ensure claim conversions are accurate with respect to data integrity, including but not limited to data mapping, historical financial transactions, and payment history and classification.
2. Administrative and managerial
• The contractor must analyze, verify, and make payment of state fines and assessments, if appropriate.
• The county, including all reports and data necessary, for filing annual certification of the county's safety program and drug-free workplace programs by October 31st of each year
• Provide the county with annual documentation of the contractor's state of certification as a qualified servicing entity for self-insureds.
• Provide WC claims data in the format requested by the county's actuary by October 15 of each year and provide any supplemental data as requested by the actuary.
• Provide responsive and professional account management, administrative services, information technology services, 1099 filing, subrogation and recovery services, special investigative unit (SIU) services to investigate fraud, and any other professional services per industry standards and claims handling best practices.
• Provide prescription, bill review, and payment services in a manner that allows the county to realize optimum savings.
• Provide documentation and summarize your firm's emergency management plan to ensure the continuity of services after a catastrophic event that affects your operations
3. Claims management, adjusting, investigation, and reporting
• Provide professional WC claims administration, including: telephonic and field investigation, statements, photos, settlement evaluation, medical care management referrals, scheduling· of appointments, tests and notifications of same, medical cost containment, medical bill review and payment in accordance with state WC fee schedule and any additional discounts that may be due from the county’s preferred bay care provider and the TPA's provider network and any further discounts negotiated independently by the county.
• Determine and make payment of indemnity benefits due and owing, and provide electronic reporting of both indemnity and medical payments to the state.
• The contractor must maintain and administer one or more bank accounts for the payment of claims.
• County will remit payment to the contractor via ach or wire transfer weekly for claims paid.
• Provide a weekly payment report in microsoft excel or other county-approved format by 10:00 a.m. et on Monday mornings indicating all claimants on a light duty or no duty status and any WC claims that have changed in the past 2 weeks from light duty or no duty to full duty.
• The contractor must pay outside counsel and other contractual fees in accordance with the time frames set forth in the act.
• Claim from either an electronic telephonic reporting service or the county department and create claim files in the contractor's RMI system for each claim and maintain the file for the duration of the agreement.
• Investigate WC claims for compensability, validity and liability for subrogation purposes and provide field adjusters and investigations when necessary.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: January 13, 2026
