74BAI-S2953 Q and A - 10.8.24.xls
XLS spreadsheet 35 KB Posted
- Solicitation number
- 74BAI-S2953
- Issued by
- Nevada
About this file
This document is a Q&A related to a Request for Proposal (RFP) issued by the State of Nevada, Department of Administration Purchasing Division, on behalf of the Department of Business and Industry Division of Industrial Relations (DIR), Workers' Compensation Section (WCS), to seek proposals from qualified third-party workers' compensation claim administrators (TPAs) to investigate, administer, and manage all claims for the Uninsured Employers' Claim Account (UECA). The initial contract term is four (4) years, anticipated to begin upon Board of Examiners approval and terminate on December 31, 2028. Proposals are due by October 17, 2024 at 2:00 pm Pacific Time, with a notice of award estimated on or about November 19, 2024.
The Q&A provides details on the current contract, including the incumbent vendor Sierra Nevada Administrators, Inc., the current contract amount of up to $500,660, and the current staffing which includes one dedicated claims adjuster. The RFP does not specify any set-aside designations or restrictions on the types of organizations that can respond, nor does it disclose the anticipated award value or budget range for this contract opportunity. The Q&A also includes information on the existing claims data, loss history, bill review, and RMIS system requirements.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachments for Signature~3.pdf | ||
| Proposed Staff Resume~2.docx | DOCX document | |
| Multiple Files to Reference Q and A.pdf | ||
| 74BAI-S2953 Scope of Work.docx | DOCX document | |
| Reference Questionnaire.docx | DOCX document | |
| Standard Form Contract~9.docx | DOCX document | |
| Terms and Conditions for Goods 2023-04-14.pdf | ||
| Quote Instructions.pdf | ||
| 74BAI-S2953 RFP - Revised Workers Compensation Uninsured Claims Administration.docx | DOCX document | |
| 74BAI-S2953 Cost Schedule.docx | DOCX document | |
| 74BAI-S2953 Insurance Schedule.docx | DOCX document | |
| 74BAI-S2953 RFP Workers Comp Uninsured Claims Administration.docx | DOCX document | |
| Terms and Conditions for Services~4.pdf | ||
| 74BAI-S2953 LOSS_RUN -redacted.xlsx | XLSX spreadsheet | |
| 74BAI-S2953 Letter of Intent.docx | DOCX document |
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Text version
Bid Q&A for Export Report
| Bid Q&A | ||||
| QUESTION_NBR | CREATED_BY | QUESTION_SUBJECT | QUESTION_TEXT | ANSWER_TEXT |
| 1 | BROADSPIRE | Breakdown of claim volume by type | Can you please provide the estimated number of New and open claims by Medical Only vs. Indemnity? | The RFP was revised on 9/17/2024 to include the Loss Run information located on the Bid Solicitation, under file attachments (74BAI-S2953 Loss Run-redacted.xlsx). As of 10/3/24, there are 47 open claims: 4 Medical Only and 43 Indemnity (including 13 PPD and 8 PTD/Survivors Claims). Each year, approximately 13 new claims are filed. |
| 2 | BROADSPIRE | Incumbent | Where will the data be consolidated from (which TPA) | Sierra Nevada Administrators, Inc. |
| 3 | BROADSPIRE | Link to Current contract and staffing model | Can the current contract, pricing and staff configuration be provided? | Yes. Current contract information as follows: |
Vendor: Sierra Nevada Administrators, Inc Initial Contract Term: 6/8/2021- 6/7/2023 Initial Contract Amount: Not to exceed $246,000 Contract Amendment #1: Extended contract to 6/30/2025 and increased total contract amount not to exceed $500,660.
Current vendor staffing includes one dedicated claims adjuster. Hearing Advocate is required at HO level but may not be dedicated. Other staff not dedicated include claims assistants, reporting staff, nurse case managers, claims manager and claims director. Current vendor has in-house bill review function but is not required in the Scope of Work.
| 4 | VALERIE_PYLANT@CORVEL.COM | Loss Run Information | Hello, are we able to obtain loss run information? | The RFP was revised on 9/17/2024 to include the Loss Run information located on the Bid Solicitation, under file attachment (74BAI-S2953 Loss Run-redacted.xlsx). Please also see the attached Loss Run Report (DIR_LOSS_RUN – redacted 10.3.24) | |
| 5 | PMA2024 | Claim Data | Please provide five (5) years of detailed Workers' Compensation claims data in MS Excel report format to provide accurate and competitive pricing. It should include but not be limited to: | ||
| a. | Dates: Loss Date, Report Date, Close Date, Coverage Year / Calendar Year | ||||
| b. | Claim Status: Open, Closed, Re-Opened | ||||
| c. | Claim Type: Lost Time (indemnity), Medical-Only, Incident/Report Only | ||||
| d. | Expenses to include: [1] Reserves, [2] Paid, [3] Total Incurred | The RFP was revised on 9/17/2024 to include the Loss Run information located on the Bid Solicitation, under file attachment (74BAI-S2953 Loss Run-redacted.xlsx). Please also see the attached Loss Run Report (DIR_LOSS_RUN – redacted 10.3.24) | |||
| 6 | PMA2024 | Current claim staff | Please outline the current claim staff structure. How many and what types of adjuster positions? Is the current team designated or dedicated? | Current vendor staffing includes one dedicated claims adjuster. Hearing Advocate is required at HO level but may not be dedicated. Other staff not dedicated include claims assistants, reporting staff, nurse case managers, claims manager and claims director. Current vendor has in-house bill review function but is not required in the Scope of Work. | |
| 7 | PMA2024 | BIll review | Please provide a bill review report of the past four years of bills reviewed. | See attached files outlining billing review information for 2021 – 2024: |
2021 DIR Bill Review Savings.pdf 2022 DIR Bill Review Savings.pdf 2023 DIR Bill Review Savings.pdf 2024 DIR Bill Review Savings.pdf
| 8 | PMA2024 | Program change | What is the reason for issuing the RFP/marketing your program? Are their issues your looking to improve? | Current vendor has notified DIR that they are ending operations as of 12/31/2024. |
| 9 | PMA2024 | TPA | Who is your current TPA partner? | Sierra Nevada Administrators, Inc. |
| 10 | PMA2024 | Excess carrier | Who is/are the insurance carrier(s) for the excess coverage? | Per Section 1.16.6 of Scope of the Work document, currently there is no excess insurance in place for uninsured claims. However, in the event the DIR purchases excess insurance coverage, the Awarded Vendor will comply with excess carrier requirements on behalf of the DIR. |
| 11 | ACONTRERAS@ATHENSADMIN.COM | Annual Claims Volume | Please provide a loss history to provide a breakdown of the types of claims files (medical only, PPD, etc). | The RFP was revised on 9/17/2024 to include the Loss Run information located on the Bid Solicitation, under file attachments (74BAI-S2953 Loss Run-redacted.xlsx). Please also see the attached Loss Run Report (DIR_LOSS_RUN – redacted 10.3.24) |
| 12 | ACONTRERAS@ATHENSADMIN.COM | Open Claims Inventory | Of the 48 open claims, please confirm the claim type for each (medical only, PPD, etc). | As of 10/3/24, there are 47 open claims: 4 Medical Only and 43 Indemnity (including 13 PPD and 8 PTD/Survivors Claims). Each year, the approximately 13 new claims are filed. |
| 13 | ACONTRERAS@ATHENSADMIN.COM | Program Staffing | Please provide the current staffing model provided with your current TPA. | Current vendor staffing includes one dedicated claims adjuster. A Hearing Advocate is required at Hearing Officer level but may not be dedicated. Other staff not dedicated include claims assistants, reporting staff, nurse case managers, claims manager and claims director. The current vendor has an in-house bill review function but this is not required in the Scope of Work. |
| 14 | ACONTRERAS@ATHENSADMIN.COM | Annual Administration Fee | What is your current annual administration fee? | Current year contract maximum is $127,330. |
| 15 | ACONTRERAS@ATHENSADMIN.COM | Current TPA | Please confirm your current TPA. | Sierra Nevada Administrators, Inc. |
| 16 | ACONTRERAS@ATHENSADMIN.COM | Managed Care | Please provide any bill review, UR, and/or managed care information (annual volume, savings, etc). | See attached files outlining billing review information for 2021 – 2024: |
2021 DIR Bill Review Savings.pdf 2022 DIR Bill Review Savings.pdf 2023 DIR Bill Review Savings.pdf 2024 DIR Bill Review Savings.pdf
| 17 | ACONTRERAS@ATHENSADMIN.COM | RMIS System | How many employees will need access to our RMIS system? | Per Section 1.14.5 of the Scope of Work document, the vendor will be required to provide six (6) designated DIR staff users remote access to the claim files in a manner that allows real-time access to data, documents, and information available to adjusters. |
| 18 | ACONTRERAS@ATHENSADMIN.COM | Paper Files | Are there any paper files that need to be converted electronically? If so, how many boxes? | There is a combination of paper and electronic files. Most current open claims are electronic. Some closed claims and some long-term claims are paper files and may require electronic conversion should they reopen. |
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