This RFP seeks a vendor to provide comprehensive workers' compensation third party administrator (TPA) services. The selected firm will manage all aspects of workers' compensation claims administration, including claims handling, medical management, return-to-work coordination, regulatory reporting, and related support functions. A focus on effective and transparent communication is required to ensure timely, accurate, and solution-driven claims resolution.

Key responsibilities include full-service end-to-end claims management, oversight of the transition from the outgoing TPA including import of historical files, management of care coordination, timely return-to-work facilitation, and ongoing collaboration with medical providers, legal consultants, and investigators. The vendor must ensure proactive, responsive claims handling, maintain compliance with all regulatory requirements, conduct annual reviews of open claims, manage Utilization Review (UR) processes, establish and maintain claim reserves, and document all settlement negotiations and agreements.

The TPA is also required to support cost control, ensure high-quality service delivery, and promptly address any issues. All administrative support and record-keeping must comply with relevant regulations while promoting efficiency and transparency.