NIGP 95392: Worker's Compensation

NIGP 95392 Worker's Compensation, an Item code, encompasses third-party claims administration, medical case management, bill review, and related services that state and local governments procure to manage their self-insured or partially insured workers' compensation programs. Recent opportunities show state departments, counties, school districts, cities, and special-purpose entities soliciting comprehensive TPA services covering claims processing, benefit determinations, medical provider management, regulatory compliance, and often ancillary services such as pharmacy benefit management, bill auditing, utilization review, and Medicare Secondary Payer reporting. State of South Dakota issued RFP #26RFP19880 for third-party claims administration covering approximately 18,300 full-time equivalent employees, due November 25, 2026, requiring SOC 2 Type II compliance or FedRAMP certification, HIPAA adherence, 24/7 injury reporting capability, and itemized cost proposals across administration fees, implementation, claims processing, reporting, and safety/loss control services. The City of Phoenix solicited worker's compensation TPA claims management services under a five-year agreement effective July 1, 2027, requiring comprehensive administration for approximately 14,000 benefit-eligible employees, with DBE-N small-business participation plan compliance, all-inclusive pricing, performance guarantees with penalty structures, and onsite staffing requirements. Monroe County, Florida sought TPA services for approximately 1,320 employees through July 16, 2026, with evaluation weighted toward pricing (25 points), adjuster experience (20 points), and local business preference (up to 10 points). Greenville County, South Carolina issued RFP #26101 requiring ten years' minimum experience and professional certifications (CPCU, ARM, AIC), with proposals due May 8, 2026.

Geographic activity spans South Dakota, Arizona (Phoenix and Tucson), Florida (Miami-Dade, Monroe, and Tampa Bay regions), Texas (Austin and San Antonio), South Carolina, Michigan, Ohio, Georgia, and Oregon. Recent solicitations show state procurement offices and county risk-management divisions as primary issuing bodies, with school districts and municipalities also active. The City of Austin, Texas solicited TPA services covering medical-only, indemnity, fatality, and hearing loss claims with 532 new incident claims projected annually and current inventory averaging 788–926 open claims monthly, with local business and small business preferences potentially adding up to 10 points each to evaluation scores. Los Angeles County requested proposals for comprehensive workers' compensation claims TPA services effective July 1, 2027, with Certified Business Enterprise (CBE) mandatory compliance. Salt Lake City issued an RFI (SLCI27041, due November 9, 2026) to gather vendor input on service delivery, fee structures, technology capabilities, and performance metrics for approximately 3,100 full-time equivalent employees with historical annual claims averaging 450 across a ten-year period. Northside Independent School District in San Antonio issued two separate solicitations—RFP2026128 for TPA and related services (due October 22, 2026) and RFP2026099 for excess workers' compensation coverage (due October 7, 2026)—noting that all vendors must respond to new RFPs or risk continued business opportunity. The code sees consistent activity from state agencies, mid-size counties, and municipal governments managing claims volumes ranging from 450 to 1,186 annually, with multi-year contract terms (typically three to five years) and renewal options driving recurring procurement cycles.