AppendixB_RequiredForms.docx

This is an Appendix B Required Forms document for Los Angeles County's Workers' Compensation Claims Third-Party Administration (WCTPA) Services RFP. The document outlines mandatory submission requirements for bidders responding to the solicitation for comprehensive workers' compensation claims management services across designated County departments. Proposals are due October 7, 2026, with new contracts effective July 1, 2027. The scope encompasses all existing claims, reopened claims, and new claims reported during the contract period, operating under Los Angeles Code Section 5.31.050 as part of the Countywide self-insured workers' compensation system. The contract term will be indefinite with potential renewals as authorized by the County. Bidders are required to complete and submit a Certified Business Enterprise (CBE) form as a mandatory requirement for proposal consideration.

The Required Forms Appendix establishes the documentation and certifications that all bidders must include with their proposals to be responsive to the solicitation. Pricing and cost proposals constitute central evaluation criteria for award determination. Current contracts, approved by the Board in March 2019, expire June 30, 2027. Funding for the WCTPA services derives from the County's self-insured workers' compensation reserve fund. Selection will be based on demonstrated experience in workers' compensation claims management, technical qualifications, and proposed pricing structures. The Director of Personnel, delegated to the CEO, administers the program and will oversee contract implementation and performance.