Workers’ Compensation Third Party Administration and Managed Care Cost Containment Services

The agency is seeking a vendor to provide workers’ compensation third party administration and managed care cost containment services for its self-insured workers' compensation program. The selected vendor will manage all new and existing claims, which includes establishing and maintaining accurate claims reserves for all anticipated benefits and related cost exposures on each claim. The project requires the vendor to review medical bills, medical reports, records, and documentation of alleged wage loss prior to settlement negotiations to ensure causal relationship and reasonableness of treatment. The scope of work covers medical management, utilization review, and the management of workers’ compensation trust fund checking accounts. The agency requires the maintenance of an effective claim electronic data security system with adequate access and integrity controls, alongside a computerized claims management system and a continuity program for uninterrupted operations. Representatives from the vendor must also attend workers’ compensation hearings and mediations as requested by the agency. Eligible bidders must be onshore organizations based in the United States. The performance of the work can take place either onsite or offsite. The agency is looking for proposals to determine the budget, and the resulting contract period will run for three years. Bidders must submit all questions no later than June 12, 2026, and the final response can be submitted digitally via email or online.