1-SLCI27041.pdf
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- Attached to
- Salt Lake City Request for Information SLCI27041 Workers Compensation Third Party Administrator Services
- Solicitation number
- SLCI27041
- Issued by
- Utah
About this file
This is a Request for Information (RFI) issued by Salt Lake City Corporation regarding workers compensation third party administrator (TPA) services. The City, which employs approximately 3,100 full-time equivalent employees, is seeking information from qualified vendors to evaluate potential costs and service offerings for TPA administration. The RFI is strictly for information-gathering purposes and does not constitute a solicitation, commitment to purchase, or binding contract. The City currently maintains a contract with an occupational medicine clinic for initial and follow-up care including physical therapy. Vendor responses are limited to 30 pages and should address 12 specific categories of inquiry regarding service delivery, staffing, fee structures, technology capabilities, and performance metrics.
The City's historical workers' compensation data spans ten fiscal years (2015-2025), demonstrating an average of approximately 450 total claims annually with paid amounts ranging from $704,048 to $1,609,183 and incurred costs ranging from $898,052 to $1,849,113. Vendor information requested includes invoicing methods and implementation fees, personnel assignments and staffing composition, service bundling versus unbundled offerings, data management and retention fees, technology capabilities for claims flagging, performance guarantees tied to claim closure rates, in-house versus outsourced service components, PPO network details and bill-review savings, and transitional return-to-work strategies. Responses to this RFI are protected under Utah Code Section 63G-2-305, and vendors are not required to submit a Claim of Confidentiality.
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SLCI27041 Request for Information (RFI)
Salt Lake City Corporation
Workers Compensation Third Party Administrator Services
Salt Lake City Corporation (City) is seeking information from qualified vendors regarding workers compensation third party administrator services. The goal is to learn more about potential costs to the City. This RFI is for information-gathering purposes only and does not constitute a solicitation or commitment to purchase.
Background
The City provides a full range of municipal services and has approximately 3,100 full-time equivalent employees. The City presently has a contract with an occupational medicine clinic for initial and follow-up care including physical therapy. The following is a historical summary of the City's workers' compensation claims for the last ten (10) fiscal years.
Claims Counts by Fiscal Year
Fiscal Year Closed Open Total Paid Incurred
2015 345 4 349 $1,168,983 $1,254,118
2016 357 8 365 $1,076,057 $1,173,596
2017 261 52 313 $704,048 $1,031,103
2018 261 2 263 $1,260,413 $1,638,803
2019 340 4 344 $1,609,183 $1,655,879
2020 707 4 711 $1,169,145 $1,211,147
2021 558 13 571 $1,466,845 $1,849,113
2022 487 31 299 $948,999 $1,511,216
2023 501 2 503 $887,227 $898,052
2024 534 3 537 $1,233,322 $1,574,082
2025 581 8 589 $1,246,070 $1,576,959
Vendor Information Requested
Please limit your response to 30 pages. Please provide responses to the following:
1. How are your services invoiced? Can you provide a range of estimated implementation fees/costs?
2. How many personnel would be assigned to an account this size, are all personnel included in the administration fees? Does personnel include a dedicated adjuster?
3. What services are included in the base and/or administrative fee vs. what is unbundled (e.g., nurse case management, litigation, bill review)?
4. Which tasks, services, or reports are charged in addition to a base and/or administrative fee?
5. Which services do you provide in house and which do you outsource? How does this affect pricing?
6. Do you offer in-house triage or 24/7 telemedicine programs? If so, is that a separate fee?
7. What are the fees for the transfer of data to another provider? What are the fees to store data? What are the fees to use TPA software? How is data destroyed and what is the fee for said destruction? How is retention set and what is the fee for standard Workers’ Comp. retention?
8. Does your technology contain a model to flag complex, high exposure, or potentially fraudulent claims?
9. Do you offer performance guarantees in your contract tied to claim closure rates or financial outcomes?
10. Are your nurse case managers, utilization review clinicians, and medical directors in-house or outsourced?
11. Please detail information about your Preferred Provider Organization (PPO) networks and your average net savings after all bill-review fees.
12. What tools, guidelines and transitional strategies do your adjusters use to achieve timely return to work outcomes?
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