NIGP 95392: Worker's Compensation

NIGP 95392 Worker's Compensation, an Item code, covers third-party administration (TPA) of workers' compensation claims, medical bill review services, comprehensive claims management, and related support functions that state and local governments purchase to administer self-insured or partially self-insured workers' compensation programs. State and local solicitations under this code request TPA firms to handle claims intake and processing, compensability determinations, indemnity and medical-only benefit payments, medical provider networks and bill review, case management, subrogation recovery, regulatory compliance (including Medicare Secondary Payer and OSHA reporting), and transition of legacy claims from prior administrators. Issuing bodies span large municipal governments, county boards and offices, school districts, state labor and workforce agencies, regional risk pools, and special districts; repeat buyers include the City of Phoenix, Atlanta Public Schools, San Antonio Independent School District, Greenville County South Carolina, and the State of Michigan. Recent RFP and IFB activity shows work solicited from cities (Phoenix, Austin, Orlando, Lubbock), counties (Monroe Florida, Greenville South Carolina, Sarasota Florida, Pinellas Florida, Butts Georgia, Washington Oregon), school districts (Atlanta Public Schools, San Antonio ISD, Springfield School District No. 19 Oregon, Cherokee County Georgia), state agencies (Michigan Department of Labor, State of Mississippi, State of Utah, State of Illinois), and cooperative purchasing entities (Cooperative Insurance Services Oregon).

Geographic activity spans Florida (Monroe, Sarasota, Pinellas counties), Texas (Austin, San Antonio, Lubbock), Georgia (Phoenix suburb, Atlanta, Fulton County, Butts, Cherokee counties), Oregon (Washington County, Springfield district, CIS regional pool), Michigan, Mississippi, and Utah. Representative recent opportunities include the City of Phoenix RFP RFPPS270005 (July 31, 2026 response date) seeking TPA services for 14,000 benefit-eligible employees with on-site staffing requirements and performance guarantees including $200–$5,000 per-instance penalties; the State of Michigan Department of Labor RFP 1711-26-R-IFBD-00005-V03 (July 17, 2026) requesting medical bill review services covering 2,100–4,400 bills annually across three funds with mandatory WDCA certification and seven-business-day turnaround; the City of Austin RFP 5800 SLW3033 (July 23, 2026) procuring comprehensive TPA services with strict AI prohibitions in claims determinations and performance-based oversight rating minimums of 95 percent; and Atlanta Public Schools RFP 2612180226PAR (April 3, 2026) seeking TPA administration for approximately 32 lost-time and 238 medical-only annual claims with interface to the district's QISS system. Most TPAs are required to hold state licensure (Arizona, Florida, Michigan WDCA), maintain professional liability insurance from $500,000 to $3 million per occurrence, assume responsibility for claim transitions at no additional fees, and guarantee firm pricing for contract Year 1. Vendors compete on experience with public-sector clients, staffing qualifications and caseload capacity, reporting technology, and pricing structures ranging from fixed annual fees to per-claim billing with performance guarantees.