Okaloosa County Sealed Solicitation
Title: Third-Party Administration (TPA) of Property, Liability & Workers' Compensation Claims
Deadline: 9/26/2023 3:00 PM (UTC-06:00) Central Time (US & Canada)
Status: Deadline Expired
Solicitation Number: RFP RM 79-23
Description: It is the County’s intention to provide both equitable and efficient service in processing every claim presented to us. The County controls costs by aggressively managing claims. The Risk Management staff actively participates in investigations, depositions, hearings and trials. The County believes that a cooperative effort between the Risk
Management Department and the third-party administrator is the most cost effective way to manage claims. The Risk Management Department is looking for excellent communication in partnership with the employer/employee in order to get the injured worker back to work as soon as possible.
Documents:
| Documents as of 9/1/2023 |
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Addition 1
Posted: 9/7/2023
Type of Addition: Addendum
Overview: See attached addendum 1 and excel files
Deadline: 9/26/2023 3:00 PM
Solicitation #: RFP RM 79-23
Documents:
Addition 2
Posted: 9/15/2023
Type of Addition: Addendum
Overview: See addendum 2 attached.
Deadline: 9/26/2023 3:00 PM
Documents:
Addition 3
Posted: 9/20/2023
Type of Addition: Addendum
Overview: Addendum 3 attached.
Deadline: 9/26/2023 3:00 PM
Solicitation #: RFP RM 79-23
Documents:
Question 1
Posted: 9/6/2023
Question: 1. A excel loss run of all claims, for the last three to five years, including as many of the below data fields as possible. • State of Jurisdiction • Year of Loss • Date of Loss • Coverage • Claim # • Claim Type • Status • Total Paid • Outstanding Reserve • Total Incurred • Paid (Expense) • Paid (Indemnity) • Paid (Legal) • Paid (Med) • Paid(Other) • Reserve (Expense) • Reserve (Indemnity) • Reserve (Legal) • Reserve (Med) • Reserve (Other) • Incurred (Expense) • Incurred (Indemnity) • Incurred (Legal) • Incurred (Med) • Incurred (Other) • Suit Filed (Y/N) • Nurse Assigned (Y/N) • Job Title • NCCI Job Code 2. A transaction report for the last 12 months including all payments and the information below for each. • Payee • Amount charged • Amount paid • Payment class • Payment sub-class • Date of payment 3. Annual claim estimates for the following lines of coverage: Workers Compensation • Medical Only • Indemnity Auto/GL • General Bodily Injury • General Property Damage • Auto Bodily Injury • Auto Property Damage • Auto Physical Damage • Professional Liability • Sexual Misconduct • Property
Response: See attached.
Question 2
Posted: 9/15/2023
Question: 3.7 Ownership of claim files Can we get clarification if the 10 day request threshold is for a request for specific files, or is this the expected turnaround time for producing ALL of their claim data upon request? 3.8 Audit of Files and Procedures Files - Since this part of the request pertains to the audit of the claim files, you might want to inquire from TPA claims if they have any concerns. Procedures - Can we get some clarification on their definition of "procedures"? .
Response: See addendum 2 attached.
Question 3
Posted: 9/15/2023
Question: 3.20.3 - RESPONDENT shall provide COUNTY staff with access to its electronic claims information systems for the purposes of managing the COUNTY'S in-house administered claim files. Are you asking for access to the claim center we use? We don't lease system access to self administer you files.
Response: See addendum 2 attached.
Question 4
Posted: 9/15/2023
Question: Could you provide us with WC Medical Paid in 2019, 2020, 2021, 2022, and expected for 2023, Could you clarify whether the medical paid numbers provided were only WC?
Response: See addendum 2 attached.
Question 5
Posted: 9/15/2023
Question: Can you advise under the annual number of claims report if we can break out auto into BI and PD claims, GL can be broken out into BI, PD, RO claims,
Response: See addendum 2 attached.
Posted: 9/7/2023
Type of Addition: Addendum
Overview: See attached addendum 1 and excel files
Deadline: 9/26/2023 3:00 PM
Solicitation #: RFP RM 79-23
Documents:
Posted: 9/15/2023
Type of Addition: Addendum
Overview: See addendum 2 attached.
Deadline: 9/26/2023 3:00 PM
Documents:
Posted: 9/20/2023
Type of Addition: Addendum
Overview: Addendum 3 attached.
Deadline: 9/26/2023 3:00 PM
Solicitation #: RFP RM 79-23
Documents:
Posted: 9/6/2023
Question: 1. A excel loss run of all claims, for the last three to five years, including as many of the below data fields as possible. • State of Jurisdiction • Year of Loss • Date of Loss • Coverage • Claim # • Claim Type • Status • Total Paid • Outstanding Reserve • Total Incurred • Paid (Expense) • Paid (Indemnity) • Paid (Legal) • Paid (Med) • Paid(Other) • Reserve (Expense) • Reserve (Indemnity) • Reserve (Legal) • Reserve (Med) • Reserve (Other) • Incurred (Expense) • Incurred (Indemnity) • Incurred (Legal) • Incurred (Med) • Incurred (Other) • Suit Filed (Y/N) • Nurse Assigned (Y/N) • Job Title • NCCI Job Code 2. A transaction report for the last 12 months including all payments and the information below for each. • Payee • Amount charged • Amount paid • Payment class • Payment sub-class • Date of payment 3. Annual claim estimates for the following lines of coverage: Workers Compensation • Medical Only • Indemnity Auto/GL • General Bodily Injury • General Property Damage • Auto Bodily Injury • Auto Property Damage • Auto Physical Damage • Professional Liability • Sexual Misconduct • Property
Response: See attached.
Posted: 9/15/2023
Question: 3.7 Ownership of claim files Can we get clarification if the 10 day request threshold is for a request for specific files, or is this the expected turnaround time for producing ALL of their claim data upon request? 3.8 Audit of Files and Procedures Files - Since this part of the request pertains to the audit of the claim files, you might want to inquire from TPA claims if they have any concerns. Procedures - Can we get some clarification on their definition of "procedures"? .
Response: See addendum 2 attached.
Posted: 9/15/2023
Question: 3.20.3 - RESPONDENT shall provide COUNTY staff with access to its electronic claims information systems for the purposes of managing the COUNTY'S in-house administered claim files. Are you asking for access to the claim center we use? We don't lease system access to self administer you files.
Response: See addendum 2 attached.
Posted: 9/15/2023
Question: Could you provide us with WC Medical Paid in 2019, 2020, 2021, 2022, and expected for 2023, Could you clarify whether the medical paid numbers provided were only WC?
Response: See addendum 2 attached.
Posted: 9/15/2023
Question: Can you advise under the annual number of claims report if we can break out auto into BI and PD claims, GL can be broken out into BI, PD, RO claims,
Response: See addendum 2 attached.