Workers' Compensation Third Party Administration

Description

The County of Tuolumne, hereinafter referred to as “County”, is soliciting proposals from qualified third-party administrators, hereinafter referred to as “TPA”, for claims administration of the County’s Workers’ Compensation Program. The County is seeking a strong, long-term partnership with a TPA to manage its Self-Insured Workers’ Compensation claims. It is the intent of the County to contract with a qualified firm to provide claims administration and medical cost containment services for the period beginning July 1, 2024, through June 30, 2026 with an option for two (2) two (2) year extensions. The County is seeking proposals for bundled and unbundled services, whichever is determined to be in the best interest of the County.The County requires a TPA partner who demonstrates an innovative and effective claims management process that is streamlined, user-friendly, and that allows for exceptional customer service to the County and its staff served through the Workers’ Compensation program. Customer service includes the provision of consistently correct claims management and appropriate internal oversight for checks and balances, consistent direct dissemination of communication via reporting, updated technological capabilities, timely dissemination of information to the County’s Human Resources-Risk Management office (HR-RM) and employees served through the Workers’ Compensation program. Competitive rates and fees and the ability and willingness to comply with PRISM’s Claims Administration Standards are also desired.  The proposing TPA’s staff should have proper licensing to perform claims administration services. The proposing TPA should demonstrate a strong regional presence in the County’s surrounding areas and maintain the staff necessary to perform the claims administration services requ