RFP for Workers' Compensation Services

Description

REQUEST FOR PROPOSAL WORKERS’ COMPENSATION CLAIMS ADMINISTRATION SERVICES I. OBJECTIVES California Housing Workers’ Compensation Authority, hereinafter referred to as CHWCA, is soliciting proposals from qualified third party administrators, hereinafter referred to as the TPA, for administration of CHWCA’s self-insured workers’ compensation program. CHWCA requires a vendor who demonstrates an innovative and effective claims management process that is streamlined and user-friendly, has a strong emphasis on exceptional customer service, solid reporting capabilities, effective and advanced technological capabilities, proactive and consistent management of employee/claimant occupational absences, competitive rates and fees, and the ability and willingness to commit to complying with CHWCA’s performance standards, and possess the flexibility and willingness to adapt to CHWCA’s evolving operational needs. II. BACKGROUND CHWCA is a self-insured group currently comprised of California Public Housing Authority members located throughout the state of California. CHWCA began pooling for workers’ compensation risk coverage on January 1, 1991. CHWCA currently maintains a self-insured retention of $750,000. CHWCA contracts with Sedgwick to provide administrative, finance, risk management, safety and loss prevention, and workers’ compensation oversight services. Administration includes services of a Workers’ Compensation Program Manager (WCPM) to ensure the competent and consistent handling of claims by the TPA. CHWCA’s WCPM is responsible for the management of CHWCA’s workers’ compensation program, including administration of the TPA agreement and coordination of all aspects of the workers’ compensation program with the TPA. This includes general oversight of the workers’ compensation program, file reviews, training, and other services as requested by CHWCA. CHWCA’s total expected payroll (salaries) for calendar year 2026 is $223,246,404. CHWCA consists of 28 members which employ approximately 2,507 employees consisting of both full-time and part-time employees. Innovative Claims Solutions (ICS) currently administers the workers’ compensation program. As of May 31, 2026, there are 234 open claims that includes 160 indemnity claims, 43 future medical, and 31 medical only claims. Also attached is a copy of the Self-Insured Plans Annual Report (one page only with claims data) dated August 21, 2025 (Attachment A).