2026_RFP_Liability_Claims_Adjusting_Services.pdf
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- Attached to
- Liability Claims Adjusting Services RFP
- Solicitation number
- 2026-RFP-0086
- Issued by
- Sacramento County, San Francisco City, California
About this file
Liability Claims Adjusting Services RFP Summary
This is a Request for Proposals issued by Sacramento County's Department of Personnel Services Risk Management Office seeking a qualified Third-Party Administrator (TPA) to provide comprehensive liability claims adjusting and administration services. The County is self-insured for liability with a self-insured retention of $2,000,000 for general liability and full self-insurance for medical malpractice claims, with excess coverage up to $35,000,000 provided through PRISM. The scope of services includes claims investigation, evaluation, litigation management, settlement negotiations, legal administration, subrogation and recovery services, Medicare reporting, records management, and financial oversight of liability claims. The County currently manages approximately 750 new claims annually with 96 new litigated claims per year and maintains an inventory of 1,391 open claims. The anticipated contract period is July 1, 2027, through June 30, 2030, with an option to extend for up to three additional years at the County's sole discretion. The current TPA agreement expires June 30, 2027. Bidders must submit responses with a table of contents, executive summary, qualifications, detailed approach, exceptions, and two cost proposals (time and expense basis and flat fee).
Bidders must meet minimum qualifications including at least 10 years of experience administering claims for California public entities, maintain an office within Sacramento County or within 35 miles driving distance of the County Administration building, hold a California licensed adjusting firm license, and provide at least three references. The principal adjuster assigned must have minimum 10 years of experience with California public entities including law enforcement and employment practices claims, while additional adjusters must have minimum 5 years of experience. Proposal evaluation will be weighted across five criteria: overall responsiveness (15 points), qualifications and technical capability (20 points), approach and methodology (30 points), conformance to RFP expectations (10 points), and relative cost (25 points). The County maintains a checking account (imprest fund) with maximum balance of $100,000 that the TPA will manage as a signatory, with monthly replenishment based on submitted documentation. Attorneys' fees and allocated expenses remain the responsibility of the County and should not be included in TPA fees.
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REQUEST FOR PROPOSALS
LIABILITY CLAIMS
ADJUSTING SERVICES
DEPARTMENT OF PERSONNEL SERVICES
RISK MANAGEMENT OFFICE
SECTION 1 - INTRODUCTION
1.1 INTENT OF THE REQUEST FOR PROPOSAL
It is the intent of this Request for Proposal (RFP) to secure the services of a qualified Third-Party Administrator (TPA) to provide liability claims adjusting services for the County of Sacramento (County). Interested and qualified TPAs capable of providing the required services who meet the minimum requirements are invited to submit responses.
The Bidder is expected to work in conjunction with County personnel in determining the best strategy for each potential and active claim, to maintain a proactive system of reporting claim status, action planning, diary action, and follow follow-through that expedites claim resolution and minimizes cost.
The RFP describes the required scope of services and the minimum information that must be included in the response. Bidders’ response must adhere to all the requirements outlined in the RFP as well as the Public Risk Innovation, Solutions, and Management (PRISM) Liability Claims Administration Standards (Attachment 1) and PRISM Defense Counsel Standards (Attachment 2). This RFP is for the selection of professional services, and the County reserves the right to reject any proposals for any reason.
The County Risk Manager shall administer any contract which may be awarded through this competitive bid process. The County’s current TPA agreement expires June 30, 2027.
Anticipated contract period is July 1, 2027, to June 30, 2030, with an option to extend the contract for up to three additional years at the County’s sole discretion.
1.2 BACKGROUND INFORMATION
Sacramento County was incorporated in 1850. The County is one of the original 27 counties of California. The County Charter was established in 1933. The County encompasses approximately 994-square miles, and current population is approximately
1.6 million residents. County maintains 2,232 miles of roadway. The County’s regional park system has 15,000 acres of land, including 30 parks, 4 golf courses, and miles of trails and waterways. Airports oversees 4 airports (Sacramento International Airport, Mather, Executive and Franklin Field).
The County has more than 12,000 employees, with an estimated payroll of $1.5 billion.
There are 36 different departments and special districts that provide a variety of services to County citizens. The functions which these employees perform include water plant operation and maintenance, equipment operation and maintenance, motor vehicle maintenance and repair, janitorial services, animal care services, refuse collection, office/clerical, professional, medical, administrative, and managerial services, law enforcement and detention facility operation, building, facility and other field operations, airports, parks, road maintenance and repair as well as various social services.
The County is self-insured for its liability exposure pursuant to the California Tort Claims Act. The County currently has a self-insured retention (SIR) of $2,000,000 for general liability and is currently fully self-insured for medical malpractice claims. Excess coverage of up to $35,000,000 inclusive of the self-insured retention is provided through PRISM, a member-directed public agency risk sharing pool. While County staff manage the program, claims administration has been performed by an TPA under contract. TPA has claims settlement authority of up to $7,500. The County Risk Manager has settlement authority of up to $20,000. The Deputy County Executive has settlement authority of up to $50,000. The Board of Supervisors must approve all other settlements.
The County averages approximately 750 new claims per year based on the last 10 years.
Average new litigated claims per year is 96 based on the last 5 years. The County’s current inventory is 1,391 open claims, 389 of which are litigated.
The current TPA also provides recovery/subrogation services to the County. This includes pursuing the third parties responsible and/or their insurance carrier for recovery of damage sustained to County property as well as first party recoveries through the County’s applicable insurance policies. With County approval, the TPA may pursue recovery through either small claims or by filing a civil complaint (limited or unlimited as appropriate) against the responsible party(ies). The County averages 150 new claims and recoveries of $733,000 annually based on the last 5 years. The Department of Finance, Revenue Recovery Division, may also be tasked to perform collection activities for County departments and we may refer files to Revenue Recovery to collect what is owed by the party responsible should they fail to reimburse the County.
Liability claims received on or after 1/1/25 are being maintained in a paperless environment, Ventiv, which has been managed by the County. The County plans to transfer claims files stored in Ventiv to the TPA’s claims system. Paper files are the master for anything received prior to 1/1/25. The paper master claims files are stored off site and TPA will need to coordinate with the offsite storage to retrieve any needed files. County currently pays storage fees for paper files.
The TPA selects and contracts with outside counsel for defense of claims; however, County retains ultimate discretion. Per County Code 2.09.320, decisions by the County relating to the management and conduct of the defense of claims shall be provided exclusively by the Board of Supervisors or County Counsel. Attorney bills are reviewed by TPA for appropriateness, accuracy, and adherence to standards. Once approved by TPA the bills are sent to County for payment processing.
The County maintains an imprest account through an outside bank so the County’s third-party Claims Program administrator can issue liability claim settlements that fall within their prescribed authority. The account is replenished monthly, and the maximum balance is $100,000.
1.3 REQUIREMENTS
1.3.1 Assigned Personnel
The Bidder shall provide the County with sufficient qualified personnel to efficiently and effectively meet the responsibilities as defined in the RFP. Bidder should state the number of claims adjusters proposed for this contract and outline their experience. Additionally, the total maximum number of County claims assigned per adjuster must be provided. If the claims adjuster is assigned to more than one client, the total maximum number and types of cases assigned for all clients must also be provided. In addition to claims adjusters, the Bidder must state the number of support staff proposed to assist the adjusters and their roles. Bidder should also identify the person(s) who will serve as the County’s liaison to provide customer service and ensure County’s needs are being met.
The Bidder shall designate a principal adjuster to be assigned to this account to act as the primary contact for the County. This individual shall be experienced and skilled in defending claims/lawsuits against public entities. The principal shall be well versed in the application of the California Tort Claims Act and shall have a minimum of 10 years of experience adjusting claims for a California public entity which includes experience with 1983 civil rights, law enforcement, Americans with Disabilities Act, and employment practices claims. Additional adjusters assigned to the County shall have a minimum of 5 years of experience adjusting claims. Adjusters or assistants with less than 5 years’ experience may be utilized for pothole claims or other non-complex claims, with agreement of the County.
The County must approve any personnel assigned to perform services for the County. If for any reason the County finds, in its sole discretion, that the service provided by any assigned personnel is unsatisfactory, the Bidder will agree to assign a replacement that must also be approved by the County. In the event of employee turnover, Bidder shall show a good faith effort to replace the adjuster with someone who meets the experience requirements.
1.3.2 Program Administration
Program administration shall, at a minimum, include the following:
1.3.2.1 Providing professional and technical staff to perform the services as outlined in this RFP.
1.3.2.2 Managing a successful transition from the current TPA (if applicable).
Non- incumbent Bidders should include in their response their plan for how to achieve a successful transition. Bidder shall include the cost of obtaining the claims files from the prior TPA (physical and/or electronic), if any, in their proposal. At the end of the contract term, Bidder agrees to assist with the orderly transition of claims files to the County or to any other party designated by the County without additional cost.
1.3.2.3 Maintaining a claims management information system with the capability to store and record file activity and generate reports. County users shall have access to view County claims data. Bidders should include any costs associated with providing County users with access to the claims management information system in their response.
1.3.2.4 Maintaining an effective claim electronic data security system which includes adequate access, integrity controls, financial controls and continuity for uninterrupted systems operations.
1.3.2.5 Attending meetings, conferences, court appearances, and on-scene investigations at the request of the County.
1.3.2.6 Assisting with loss prevention efforts by providing periodic claims reports and meeting with County departments upon request to review and identify trends and opportunities for improvement. Attend and participate in quarterly risk management meetings with County Executives.
1.3.2.7 Preparing, filing, and presenting annually, to the Board of Supervisors, under the direction and control of the County Counsel, a public written report summarizing the claims experience for the preceding calendar year.
1.3.2.8 Providing or arrange for translators to assist with non-English speaking claimants.
1.3.2.9 Informing the County of changes or proposed changes in statutes, rules and regulations and case law that may affect the County’s liability program.
1.3.3 Claims Administration
Claims administration services shall, at a minimum, include the following:
1.3.3.1 Conducting timely and complete investigations when the County becomes aware of an incident or condition that exposes the County to a claim for damages. The Bidder shall maintain 24-hour emergency contact capability and provide a rapid and effective local response to investigate, at the accident scene, serious incidents for which the County has potential liability. Bidders located outside of the County of Sacramento should describe their plan to provide this local response in their response.
1.3.3.2 Assuming the handling of existing open and new claims asserted against the County, its officers, agents, or employees for which County, its officers, departments, commissions, related agencies, or any of its employees are alleged to be legally responsible and bring them to resolution. Bidder shall coordinate, consult, and fully cooperate with County personnel in the administration of claims.
1.3.3.3 Beginning file review and initial investigation, within 48 hours of receipt of loss notice from the County.
1.3.3.4 Establishing and maintain a claim file for each new claim. Assemble relevant claims documentation, including loss scene photographs, police reports, statements, interviews, medical records, etc. and attach to the claim file.
1.3.3.5 As authorized by County, arranging for and contract with experts or other service providers, as may be necessary or appropriate for the defense or resolution of claims/lawsuits. This may include, but would not be limited to, investigators, professional photographers, independent medical examiners, professional engineers, and laboratories. The County reserves the right to approve or reject service provider that may be recommended by Bidder.
1.3.3.6 Initial assessment of liability shall be provided to the County no later than 5 working days from receipt of loss notice.
1.3.3.7 Resisting and defending claims that should be defended on grounds of liability, insufficient information on which to base County liability, or for which the value demanded exceeds the value the adjuster has placed on a given claim.
1.3.3.8 Conducting negotiations with claimants to reach a settlement within the authority provided and obtain releases and other necessary forms from all appropriate parties.
1.3.3.9 Issuing timely payments to claimants according to settlement agreements and outside attorneys, consultants, experts, and record providers conforming to negotiated billing rates.
1.3.3.10 Dairying all files at appropriate intervals to allow for timely completion of required activity.
1.3.3.11 Updating claim files within 48 hours of any claim activity or action taken on the claims. Claim files should be noted immediately after any contact with claimants.
1.3.3.12 Reviewing status of claims and adequacy of reserves on all active cases according to standard practices and PRISM Liability Claims Administration Standards. Significant increases in reserves, more than $50,000, should be reviewed with County prior to the change.
1.3.3.13 Reporting claims to insurance carriers per policy requirements and/or to
PRISM in accordance with their Liability Claims Administration Standards
1.3.3.14 Meeting with County each quarter to discuss the status of ongoing claims and litigation and make case strategy recommendations.
1.3.3.15 Monitoring litigation through closure and input information into the claims management system as it is made available from counsel or County staff.
1.3.3.16 Ensuring timely notice of claim/complaint is made to PRISM or other carriers and provide progress reports as requested.
1.3.3.17 Conducting Index Bureau searches.
1.3.3.18 At the request of County, pursuing subrogation on any applicable claims.
1.3.3.19 Assisting County with small claims court actions filed by and against the
County. This shall include obtaining witness information, gathering evidence, preparation for trial, and appearance at the trial if requested by the County.
1.3.4 Legal Administration
Legal administration services shall, at a minimum, include the following:
1.3.4.1 Selecting, retaining, prescribing the rate of compensation for, assigning files to, and supervising all law firms required to defend claims against the County. Bidder may be required to utilize the Request for Proposal (RFP) process, as prescribed by the County Counsel, for retaining legal defense attorney firms. Services of any retained law firm may be terminated by Bidder, County Counsel, or the Board of Supervisors.
1.3.4.2 Ensuring that law firms adhere to PRISM Defense Counsel Standards
(Attachment 2).
1.3.4.3 Reviewing attorney billing for appropriateness, accuracy, and adherence to standards and approving for payment.
1.3.4.2 Maintaining a master case calendar which includes dates of mediations, settlement conferences, and trials for tracking and County visibility of pertinent dates.
1.3.5 Subrogation Services
Bidder should include in their response their plan to provide this service and the cost. If the cost is an estimate, designate it as such. Subrogation services shall, at a minimum, include the following:
1.3.5.1 Initiating recovery/subrogation actions in the name and on behalf of the County and its related agencies and districts as referred by the Risk
Manager or designee. This includes pursuing the third parties responsible and/or their insurance carrier for recovery of damage sustained to County property as well as first party recoveries through the County’s applicable insurance policies.
1.3.5.2 With County approval, pursuing recovery through either small claims or by filing a civil complaint (limited or unlimited as appropriate) against the responsible party(ies). Bidder or any legal counsel retained by it shall not be authorized to commence on behalf of the County or on behalf of any officer or employee thereof a legal action, beyond the level of small claims court, for the recovery of damages, without advance approval by the Board of Supervisors. The same approval requirements shall apply, as necessary, to the Boards of the County’s related agencies and districts.
1.3.5.3 Retaining private independent counsel, experts, and investigative services, and shall be vested with discretion to determine and approve reasonable legal fees and other costs associated therewith. Prosecution of such subrogation actions rests with the retained legal counsel.
1.3.5.4 Maintaining accurate accounting of recoveries to submit to the County with proceeds.
1.3.5.5 Providing quarterly reports on recovery/subrogation files.
1.3.6 Reporting
Bidder shall, at a minimum, provide the following:
1.3.6.1 Responsibility for ongoing reporting and notification to PRISM (or other carriers as applicable) on behalf of the County in accordance with PRISM Liability Claims Administration Standards (Attachment 1). This includes notifying, on a timely basis, PRISM and the County of any claims that may exceed the County’s self-insured retention.
1.3.6.2 Recording all cases with potential recovery from the excess carrier and requesting reimbursement on behalf of the County within thirty (30) days of final County payment.
1.3.6.3 Providing statistical claims reports (i.e. loss runs, open/closed claims, financial reports) and costs paid on liability claims in a form and frequency acceptable to the County. Ad-hoc report capability for County users is highly desirable.
1.3.6.4 Reporting Medicare-eligible liability claims to Medicare (CMS) on behalf of the County, in accordance with Section 111 of the Mandatory Reporting Act. Any additional costs to provide this service should be included in the pricing proposal.
1.3.6.5 Reporting to the County any assigned claims determined to present a potential conflict of interest. Bidder will not represent the County where a conflict may exist without a written waiver from the County.
1.3.6.6 Reporting claims to the Index Bureau.
1.3.7 Records
Bidder shall, at a minimum:
1.3.7.1 Maintain an electronic or physical record of each actual claim reported and all associated documents.
1.3.7.2 Store all closed claim files according to the County retention policy.
Current retention of claims files is 10 years post closure. Physical records can be stored at a location agreed upon by the parties on the condition that the files can be retrieved within twenty-four (24) hours of Bidder receiving a request from the County.
1.3.7.3 Cooperate with the County and any auditors or actuaries reviewing the
County’s data and make claim files and records available upon request.
The County shall have access to the County’s records and files for audit purposes.
1.3.7.4 Research and provide relevant claims records in response to California
Public Record Act (PRA) requests received by the County.
1.3.7.5 Agree that the County’s claim files are the property of the County. All records, files, transcripts, reports, photos, tapes, media, information systems data, and any other materials regarding the administration of the County’s claims are the property of the County and must be relinquished in good order and condition upon termination of the contract without an additional cost.
1.3.7.6 Provide to the County, all historic claims/loss data at termination of agreement, at no cost to the County.
1.3.8 Financial/Accounting
The Bidder shall make timely payment of damages and claims expenses on behalf of the County. The County shall establish and maintain a checking account (imprest cash fund) for these expenses with Bidder as a signatory. The amount that will be maintained in the account shall be established by the County and confirmed in writing upon the opening of the account. Bidder should describe their procedures for financial management and how they ensure proper controls in their proposal. Bidder’s claims payment system, at minimum, shall be capable of identifying and preventing duplicate payments, flagging overlapping service date ranges and similar amounts paid for similar dates and provides vendor entry controls to eliminate duplicate vendors.
With regards to payments, the Bidder shall, at minimum:
1.3.8.1 Ensure generated checks are supported by documentation in the claims file.
1.3.8.2 Maintain a daily checking account balance of the imprest cash fund to ensure funding is available prior to issuing checks. If Bidder generates checks without sufficient funding, Bidder shall reimburse County any associated bank charges.
1.3.8.3 Request replenishment on at least a monthly basis which includes a cover letter stating the amount of the request, check/voucher register of all transactions made, and copies of checks issued for the period. The register shall list the checks/vouchers in numerical order, including the claim number, amount, payee, type of loss/payment, and provide any other information requested by the County.
1.3.8.4 Notify County, in writing and within one business day of knowledge of any overpayment or duplication of payment.
1.3.8.5 Resolve, or reimburse County for, any overpayments, duplicate payments, penalties, or fees that occur due to no fault of the County within thirty (30) days.
1.3.8.6 Maintain an effective IRS 1099 reporting and reconciliation system.
Bidder shall obtain required state and federal (W-9) forms from all payees.
The County maintains the right to audit the checking account and associated records at any time to ensure the integrity of the account. The account may also be subject to a Grand Jury audit at any time. Bidder shall cooperate with auditors or actuaries reviewing financial records.
1.3.9 Bidder Minimum Qualifications
Any firm submitting a proposal must meet the following minimum qualifications:
1.3.9.1 At least 10 years of experience administering claims as a TPA for California public entities, including claims/lawsuits stemming from law enforcement and employment activities. Experience shall be verified by at least 3 references.
1.3.9.2 Maintain an office within the Sacramento County boundaries, or an office within 35 miles, driving distance, of the County Administration building located at 700 H Street, Sacramento, or identify the Bidder’s plan to provide a local resource(s) for rapid response to incidents.
Bidder shall possess all permits, licenses and professional credentials necessary to perform services as specified. Bidder must demonstrate that all services will be performed in a manner commensurate with the highest standards of professionals in the industry.
1.3.10 Specific Compliance
Bidder shall be a licensed adjusting firm in the State of California. Bidder and any future subcontractors will be required to abide by all applicable local, Federal, and State laws and regulations and maintain the appropriate permits, licenses, certifications, and professional credentials needed to perform the services as specified in this RFP. This may include:
• California Public Insurance Adjuster License
• California Private Investigator License
SECTION 2 - RESPONSE FORMAT AND CONTENT
2.1 GENERAL INFORMATION
This section describes the required response format and content. The response should contain the requested information organized by the prescribed section and subsection numbers and titles. Any information provided beyond that of which is required in the response should be contained in a section sequentially numbered and entitled "Optional Exhibits and Attachments”.
Each Bidder shall submit a complete response, providing all information requested and a complete description of the functional operation of the proposed program/project. Failure to follow the prescribed format may result in the rejection of your response.
Responses must be complete in all aspects. A response may be rejected if it is conditional or incomplete, or if it contains any alteration of form or other irregularities of any kind. A response may be rejected if any such defect or irregularity constitutes a material deviation from the proposal requirements. The response must contain all costs required by the proposal.
2.2 RESPONSE FORMAT
The response must be developed on the forms provided in this package or must follow the proposal’s content requirements in the order in which they appear in the proposal.
Responses that do not conform to this format may not be considered for evaluation. All responses must be submitted in the name of the legal entity or authorized agency.
Responses must be signed in blue ink by the officer or officers legally authorized to bind the company, partnership or corporation.
The content and sequence of the response will be as follows:
2.2.1 Table Of Contents
The Table of Contents must be a comprehensive listing of the contents included in your response. This section must include a clear definition of the material, exhibits and supplemental information identified by sequential page numbers and by section reference numbers.
2.2.2 Executive Summary
The Executive Summary shall condense and highlight the contents of the Bidder’s response to provide the Evaluation Committee with a broad understanding of the Bidder’s approach, qualification(s), experience and staffing.
2.2.3 Bidder's Qualifications
Bidder shall provide a concise statement demonstrating that Bidder’s company has the qualifications, experience, and capability to fulfil the requirements of this RFP. The following sections must be included:
2.2.3.1 History
Provide a brief history of your company, including the number of years in business. State whether your organization is an individual proprietorship, partnership, corporation, or private nonprofit organization, and the date your company was formed or incorporated.
Provide a statement as to any judgment, litigations, licensing violations, or other violations, outstanding or resolved, against your company in the past five (5) years.
2.2.3.2 Background and Experience
A summary of relevant background information describing your company’s experience of major accomplishments and/or activities like the requirements set forth under this RFP, which demonstrates your company's ability to provide the service described in your response.
2.2.3.3 References
Provide a list of at least three (3) customer references. Include the agency/firm’s name; the name, title, and telephone number of a contact person; and the dates that these services were completed. Bidder may provide samples of its company's work to substantiate the previous experience.
2.2.3.4 Staff Assignment
A brief description of the experience and qualifications of the proposed key staff members assigned to the County and what percentage of their time will be devoted to the County. Show their function, level of education, degree and license, if appropriate, and a detailed resume for each person. Additionally, the Bidder must specify where the staff will be located.
2.2.4 Approach
The Bidder’s response shall clearly describe, in detail, how the Bidder will meet and perform the requirements outlined in section 1.3 of this RFP. Additionally, responses should provide any special or unique qualifications the Bidder has that will contribute to meeting the requirements of this RFP. Only those levels of performance the Bidder believes can be accomplished should be stated as measurable objectives. Each of the major tasks, or activities to be undertaken, as a means of reaching such objectives, must be specifically identified.
The merit of each response received in response to this RFP will be judged largely based on each Bidder’s narrative description as described in the approach of their response. It is important that your response contains all information required for an effective evaluation. The response should be written in such a manner that it provides sufficient detail for the Evaluation Committee members to know what is planned at every stage, and to make a judgment as to the probable success of the proposed effort.
2.2.5 Exceptions
This portion of the response will note any exceptions to the requirements and conditions taken by the Bidder. Exceptions should clearly explain why the Bidder is taking exception to the requirements. If exceptions are not noted, the County will assume that the Bidder's response meets those requirements as specified herein and that the Bidder accepts and intends to abide by all stated terms, conditions, and requirements. Exceptions will be considered by the County and may form a part of any resulting Agreement if the County explicitly so states in writing.
Exceptions shall be noted as follows:
• Exceptions to the Requirements (Section 1.3)
• Exceptions to any other part of this RFP
• Exceptions to terms in the Sample Agreement (Attachment 3)
2.2.6 Cost Proposal
Prepare two (2) cost proposals that provide pricing for at least the initial three (3) years of the contract. It is essential that all responding Bidders detail what is or isn’t included in fees and clearly detail all associated costs for claims adjusting and ancillary services outlined in the RFP in the response. All responses must have a narrative providing a thorough and clear explanation of your costs.
2.2.6.1 The first proposal should reflect claims adjusting services on a time and expense basis.
2.2.6.2 The second proposal should reflect claims adjusting services provided under this contract as a flat fee.
Attorneys’ fees and other allocated expenses will be the responsibility of the County.
These costs should not be included in your fees.
SECTION 3 - BASIS OF AWARD, SELECTION PROCESS, AND
EVALUATION CRITERIA
3.1 BASIS OF AWARD
Award will be given to the Bidder whose response demonstrates, at the discretion of the County, most adequately meets the needs of the County. The County shall not be obligated to accept the lowest cost response but will make an award in the best interests of the County after all factors have been evaluated.
The County reserves the right, at its sole discretion, to reject any or all responses or any part thereof, or to waive any informalities in the response and minor irregularities, technical defects, or clerical errors, to make an award based on suitability, quality of service(s) to be supplied, their conformity with the specifications and for the purposes for which they are required, and not confined to cost alone. The County shall not be liable for any costs incurred by the bidder in connection with the preparation and submission of this or any other response.
False, incomplete, or nonresponsive statements in connection with the response may be deemed sufficient cause for rejection. The County shall be the sole judge in making such determination. The County reserves the right to cancel or discontinue the response process and reject any or all responses in the event it determines that there is no longer a requirement for the furnishing of such items, materials, equipment, and/or services, funding is no longer available for this proposal, or it is otherwise in the County's best interest to cancel the RFP process.
3.2 EVALUATION PROCESS
The Evaluation Committee will consider only those responses which have been considered responsive to the proposal. Any response which fails to meet the requirements of the proposal will be considered non-responsive and may be rejected.
Responsiveness includes attention to detail in following the proposal format. The Evaluation Committee may also contact and evaluate Bidder’s references; contact any current users of Bidder’s services; solicit information from any available source concerning any aspect of a response and seek and review any other information deemed pertinent to the evaluation process. The Evaluation Committee shall not be obligated to accept the lowest priced response but shall recommend the proposal that is the most qualified, responsive, cost-effective and in the best interest of the County.
The RFP will be evaluated based on the following criteria:
CRITERIA WEIGHTED
SCORE
Overall responsiveness to the Request for Proposal and comprehensiveness of the Bidder’s response. Evaluates the clarity, completeness, and general quality of the proposal submitted. Also reflects the Bidder's understanding of the scope of work as evidenced by the response.
Qualifications, experience, and technical capability. Includes the expertise and experience of the Bidder and the proposed staff in providing similar services and professional certifications or licenses. Includes experience/familiarity with PRISM claims administration standards. Includes the effectiveness and efficiency of the claims management system(s), payment system(s), and reporting system(s) utilized to achieve the scope of work. Includes the expertise and experience of any proposed service providers and/or subcontractors.
Approach and methodology. Includes Bidder's capability to complete the requirements effectively and within time frames outlined. Includes full scope and detail of the processes to be used to sufficiently investigate, evaluate, process, manage, defend or settle, bodily injury, personal injury and property damage claims. Includes the recognition of County’s processes and requirements in the approach. Includes Bidder’s plan to provide subrogation services, a local investigative response, Medicare reporting, and other services as outlined in section 1.3 Requirements. Includes proposed procedures for management and control of the trust checking account.
Bidder’s conformance and acceptance of the expectations in the RFP, Liability Claims Administration Standards, and Sample Contract. Includes Bidder's commitment to cooperate with other providers, auditors, or actuaries, conformance to County insurance requirements, assumption of responsibility for TPA errors, and any exceptions to the RFP.
Relative cost of services proposed in relationship to the proposed scope of work.
Includes ancillary costs and pricing for proposed service providers and/or subcontractors.
| SECTION 1 - INTRODUCTION |
| 1.1 INTENT OF THE REQUEST FOR PROPOSAL |
| 1.2 BACKGROUND INFORMATION |
| 1.3 REQUIREMENTS |
| 1.3.1 Assigned Personnel |
| 1.3.2 Program Administration |
| 1.3.3 Claims Administration |
| 1.3.4 Legal Administration |
| 1.3.5 Subrogation Services |
| 1.3.6 Reporting |
| 1.3.7 Records |
| 1.3.8 Financial/Accounting |
| 1.3.9 Bidder Minimum Qualifications |
| 1.3.10 Specific Compliance |
| SECTION 2 - RESPONSE FORMAT AND CONTENT |
| 2.1 GENERAL INFORMATION |
| 2.2 RESPONSE FORMAT |
| 2.2.1 Table Of Contents |
| 2.2.2 Executive Summary |
| 2.2.3 Bidder's Qualifications |
| 2.2.4 Approach |
| 2.2.5 Exceptions |
| 2.2.6 Cost Proposal |
| SECTION 3 - BASIS OF AWARD, SELECTION PROCESS, AND EVALUATION CRITERIA |
| 3.1 BASIS OF AWARD |
| 3.2 EVALUATION PROCESS |
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