UNSPSC 78142101: Claim management

Coordination and management of logistics related claims against suppliers / authorities in an outsourced model.

UNSPSC 78142101 Claim management is a Commodity code that encompasses third-party administration (TPA) and claims adjustment services state and local governments procure to manage workers' compensation, auto liability, health, and pharmacy benefit claims. Recent solicitations show governments outsourcing the full lifecycle of claim processing—from intake and liability determination through indemnity payment, subrogation recovery, and settlement negotiation—rather than managing claims in-house. The code captures both specialized claim administration services (workers' compensation TPAs handling disability benefits and medical cost control) and broader claims support work (claim audits, revenue cycle recovery services, and claims editing systems that improve payment accuracy). Issuing bodies span city risk management offices, county human resources departments, school district self-insurance programs, state agencies managing workers' compensation assigned claims, and regional health plans administering Medicaid and public-employee benefits. Cities and counties dominate the market, with repeat procurement activity from jurisdictions managing multi-thousand-employee workforces; the City of Phoenix, City of Orlando, Pinellas County, Chatham County, and Atlanta Public Schools each posted workers' compensation TPA solicitations in the past four months.

Recent activity concentrates in Florida, Georgia, Oregon, Utah, Texas, and Colorado, with secondary activity in Arizona and South Dakota. The City of Phoenix posted RFP RFPPS270005 on July 2, 2026 (due July 31, 2026) for worker's compensation third-party administration covering approximately 14,000 employees, with mandatory Arizona licensure and $200–$5,000 per-instance performance penalties; the State of Oregon Department of Consumer and Business Services Workers' Compensation Division issued RFP S-44000-00017296 (due July 30, 2026) for assigned claims processing agent services with an estimated $70 million contract value over a cumulative ten-year term and a December 1, 2026 start date. The City of Orlando's RFP 26-0265 (due April 24, 2026) sought third-party administration for 87 open firefighters' workers' compensation claims under a three-year initial term with options to extend through year ten; Salt Lake City's SLCI26001 (due May 12, 2026) targeted claims adjustment services for utility property damage and auto liability with five-year initial term and potential seven-year extensions. Chatham County issued separate RFPs in March 2026 for health claims audits and auto liability TPA services, each reflecting the fragmented claims-management market in which jurisdictions outsource distinct claim functions independently. Set-aside activity includes DBE participation requirements (City of Phoenix), M/WBE good-faith-effort documentation (Chatham County, Atlanta Public Schools, Salt Lake City), and HUB subcontracting plans (University of Texas System RFP 720-2604 for claim preparation services, with 0.25% participation goal).