Question_&_Answer.pdf
PDF 29 KB Posted
- Attached to
- Professional Automobile Liability, Medical-Malpractice and Property Claims Administration Services
- Solicitation number
- 2026-RFP-00548
- Issued by
- San Mateo County, California
About this file
This is a Question and Answer document pertaining to the County of San Mateo's Request for Proposals for Third-Party Administration (TPA) claims services covering automobile liability, medical malpractice, and property claims. The County anticipates transferring approximately 75 open claims to the selected vendor and requires the TPA to manage both open and closed claims, including new claims submissions. The TPA will be responsible for handling claims in litigation, managing insurance communications, participating in settlements and mediation where appropriate, and adjusting claims to total value rather than just the self-insured retention (SIR). The County indicated no preference regarding file review methodology (in-person or video conference) and confirmed it currently operates on a paperless system with no paper files requiring scanning or destruction.
Regarding pricing and operational terms, the County indicated openness to flexible billing arrangements beyond the current quarterly charge structure and is willing to consider proposals with alternative payment schedules such as hourly or monthly/annual rates. The County processes all TPA payments internally upon request and County approval rather than through a dedicated trust account. The incumbent vendor is Keith A. Hillegass Company, and the County's current agreement expires December 31, 2026. The County's insurance broker is James and Gable. Medical malpractice claims originate from both jail facility activities and the County hospital/medical facilities. The County does not track certain claims data including rejected claims pending statute of limitations expiration, subrogation claims, or small claims filings per year, and TPA attendance at small claims hearings is not typical unless specifically requested by the County.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Professional_Automobile_Liability,_Medical-Malpractice_and_Property_Claims_Administration_Services.pdf | ||
| Keith_A_Hillegass_Company_2025-2026_Contract_.pdf | ||
| LossRun5Yrs_6.1.2021_through_5.31.2026.xlsx | XLSX spreadsheet | |
| Standard_Contract_Template_-_Under_$200K_DRAFT.docx | DOCX document | |
| Standard_Contract_Template_-_Over_$200K_DRAFT.docx | DOCX document |
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Text version
Questions/Responses You detail total open claims to be transferred - does this RFP include the submittal of new claims as well? If yes, please provide historical claims data per line of business (med mal vs auto vs property) Yes, TPA will be responsible for new claims as well. See 5-year loss run in project attachments.
Will vendor handle claims that are in litigation? To what extent?
Yes, TPA would continue to handle all of the insurance communications and requested updates, and when appropriate, participate in settlements or mediation / where insurance is at issue.
How would the County like for us to submit pricing? Per hour? Per month/year?
Current contract charges quarterly but the County is open to applicant's proposal.
May we receive a 5-year loss run that includes all open and closed claims by type of claim and incidents?
See project attachments.
How many open claims have been rejected and are still pending the expiration of the 6-month statute of limitations?
This information is not tracked.
How many of your open claims rejected and awaiting the statue of limitations involved police claims?
This information is not tracked.
Please confirm if your claim counts are by occurrence vs. by individual claimant.
They are by individual claimant.
Please provide the total number of open claims to be transferred to the new TPA.
Estimated 75 open claims Please confirm the TPA will be processing all payments through a Trust Account.
Payments will be processed by the County upon request by TPA and approval by County.
How many 1st-party Subrogation claims were reported in the last fiscal year, and how many subrogation claims are currently open?
This information is not tracked.
In 2025, what was the frequency of Emergency Field investigation occurrences conducted by the County to date?
Unclear what Emergency Field investigation refers to.
Is it anticipated that file reviews will be in person or via video conference?
No preference.
Who is your insurance broker?
James and Gable Will the TPA adjust to just SIR or to total value?
The TPA would adjust to total value.
Does the County have paper files in need of scanning or destruction? Is your system currently "paperless"?
We are currently paperless.
Does the County currently contract with another provider for TPA services, or are they performed in-house? If contracted with another vendor, can the County please provide the vendor's name, current agreement, and/or fee structure?
We contract with Keith A. Hillegass Company. See project attachments.
Are your Medical Malpractice claims related to activity in jails, or does the County operate a hospital or other medical facilities?
Our Medical Malpractice claims are related to both jail activity and our County hospital/medical facilities.
How many small claims filings occur per year on average?
This information is not tracked.
Is the TPA expected to attend small claims hearings?
This is not typical as hearings are handled by County staff, but we may on occasion ask the TPA to attend on our behalf if deemed appropriate.
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