Third_Party_Administration_Firefighter's_Workman's_Compensation_Claims_Services_(Addendum_#1_Revision).pdf

Mayor Chief Procurement Officer Buddy Dyer David Billingsley, CPSM, C.P.M.

REQUEST FOR PROPOSAL (RFP)

RFP26-0265

THIRD PARTY ADMINISTRATION FIREFIGHTER'S WORKMAN'S

COMPENSATION CLAIMS SERVICES

The City of Orlando Procurement and Contracts Division has implemented an electronic bidding system to streamline solicitation responses.

CITY OF ORLANDO PROCUREMENT AND CONTRACTS SITE

https://www.orlando.gov/Our-Government/Departments-Offices/OBFS/Procurement

City of Orlando

REQUEST FOR PROPOSAL (RFP)

RFP26-0265

THIRD PARTY ADMINISTRATION FIREFIGHTER'S WORKMAN'S

COMPENSATION CLAIMS SERVICES

TABLE OF CONTENTS

1. INTRODUCTION

2. REQUEST FOR PROPOSALS INFORMATION

3. TERM OF CONTRACT

4. MANDATORY MINIMUM QUALIFICATIONS

5. SCOPE OF WORK AND TECHNICAL REQUIREMENTS

6. PRE-PROPOSAL CONFERENCE

7. PROPOSAL DUE DATE AND TIME

8. PROPOSAL PREPARATION AND FORMAT

9. REQUIRED PROPOSAL SUBMITTALS

10. DELIVERY OF PROPOSALS

11. CONFORMANCE TO SOLICITATION

12. EVALUATION CRITERIA

13. PROPOSAL ADVISORY COMMITTEE AND EVALUATION PROCESS

14. GENERAL TERMS AND CONDITIONS

15. ADDITIONAL INFORMATION

16. ADDENDUM TO REQUEST FOR PROPOSALS

17. APPLICABLE LAW AND APPEALS

18. CONTRACT

19. EXECUTION OF CONTRACT

20. AFFILIATED AGENCIES

21. EMPLOYMENT ELIGIBILITY; E-VERIFY SYSTEM

22. RIGHT TO AUDIT RECORDS

23. FISCAL YEAR FUNDING APPROPRIATION

24. PUBLIC ENTITY CRIMES

25. PROMPT PAYMENT ACT

26. INVOICES

27. DISPUTE RESOLUTION

28. PROPOSER'S GUARANTEE

29. INSURANCE / PERFORMANCE BONDS

30. FLORIDA SALES TAX

31. DRUG-FREE WORKPLACE CERTIFICATION

32. AMERICANS WITH DISABILITIES ACT

33. RECIPROCAL LOCAL PREFERENCE

34. PURCHASING CONTRACTS W/ OTHER GOVERNMENT AGENCIES

Third Party Administration Firefighter's Workman's Compensation Claims Services

35. FOREIGN CORPORATION

36. SUBCONTRACTORS

37. PURCHASING CARD PROGRAM

38. LIVING WAGE POLICY

39. PROHIBITION - CONTRACTING WITH SCRUTINIZED COMPANIES

40. SOFTWARE LICENSES

41. NON-DISCRIMINATION

42. GOVERNING LAW / VENUE

43. RECOVERED MATERIALS

44. PROHIBITION AGAINST CONSIDERING SOCIAL, POLITICAL, OR

IDELOGICAL INTEREST IN GOVERNMENT CONTRACTING

45. VENDOR QUESTIONNAIRE / ATTACHMENTS

Attachments:

A - RFP26-0265 Exhibit 1 - Contract

B - RFP26-0265 Exhibit 2 - 10 Years Historical Claims Data

C - RFP26-0265 Exhibit 3 - Claim Review Form

1. INTRODUCTION

1.1. Summary

The City of Orlando’s Procurement and Contracts Division, is soliciting proposals from interested and qualified Proposers to provide Third-Party Administration of Firefighters’

Worker Compensation Claims.

1.2. Background

A. This RFP is being issued by the City of Orlando (the “City”) whereas the City currently utilizes the services of a Third-Party Administrator (“TPA”) for the purposes of adjusting workers' compensation claims for the City’s self-insured sworn firefighters within the City’s Fire Department. The successful proposer will assume handling of all prior claims from the City’s Fire Department as well as new claims.

B. Pharmacy Benefit Management (PBM) shall be incorporated into the proposal's responsive documents. The current PBM is Mitchell Pharmacy Solutions, and the current PBM is self performed by the current TPA.

C. Preferred Provider Organization (PPO) is self performed by the current TPA.

D. TPA services for other City employees are not within the scope of this RFP.

E. The City currently utilizes the TPA services of CorVel Corporation for sworn firefighters within the City’s Fire Department. The City’s current Contract with

CorVel Corporation is expiring. Therefore, the City is seeking proposals from qualified and professional claim administration companies.

F. The City’s Fire Department currently has five hundred and eighty-four (584) sworn firefighters.

G. Ten Year Historical Claims Data: Ten (10) years of historical sworn firefighters’ workers compensation claims data is provided in Exhibit “Two” of this RFP.

H. There are 1 to 2 Utilization Review and 1 to 2 Field Case Management referrals per year.

I. The City’s Risk Management Division

1. The City’s Risk Management Division, under the Risk Management Division

Manager, oversees the activities of TPA.

2. A Risk Management Committee, comprised of five (5) senior City officials, meets monthly to review and approve all claim settlements of $25,000 or greater.

J. First Report of Injury (FROI) Dedicated Injury/Exposure Hotline: The City currently utilizes AdventHealth to accept 24 hours a day Workers Compensation

First Report of injury/illness via the City employee calling a dedicated injury/exposure hotline that takes the First Report of Injury (FROI) from either the employee or the supervisor. Risk Management and the Third-Party Administrator will then receive an email with the FROI and a likely referral to an Advent health facility for initial treatment. Currently, the City intents to continue to use

AdventHealth for claims reporting for completion of the FROI and triage/treatment.

K. Self-Insurance Program Background: The City has been self-insured since 1983 and has utilized TPA services for the City’s sworn firefighters since 2010. The

City’s formal risk management and self-insurance program is comprised of several important components, including:

1. Claims Management/Loss Control Emphasis:

a. The City’s elected officials and top management teams have a long-standing commitment to a sound risk management program with special emphasis on claims management and loss prevention/reduction. The Risk

Management Division provides administration and oversight of the claims adjusting function. Employees with the Risk Management Division perform safety audits and implement loss prevention programs, including loss prevention training for the City.

b. Through September 30, 2020, the City currently had excess carrier coverage that covered all City self-insured programs. As of October 1, 2020, the City no longer has excess carrier coverage over worker’s compensation claims.

c. There are currently eighty-seven (87) claims and approximately half of those are indemnity claims.

d. There are currently six (6) sworn firefighter claims that are piercing the excess carrier’s coverage.

2. Risk Management Committee: This Committee is charged with responsibility for, and guidance of, the self-insurance program. The Committee is comprised of high-level administrative executives who are uniquely familiar with, and committed to, the goals of the program. This Committee is also responsible for the review and approval of all settlements greater than

$25,000.

3. Light Duty Program: The City has an aggressive light duty program and most employees can be temporarily placed in sedentary positions.

1.3. Contact Information

Direct inquiries to the following:

Tara Urdininea

CPP, Purchasing Agent III

400 South Orange Avenue

Orlando, FL 32801

Email: tara.urdininea@orlando.gov

Phone: (407) 246-2368

Department:

Risk Management

1.4. Timeline

The following is the scheduled calendar of events with important dates and times. Dates are subject to change by the Chief Procurement Officer (“CPO”) of the Procurement and

Contracts Division or designee, at their sole discretion. If the Procurement and Contracts

Division determines that it is necessary to change these dates or times prior to the

Proposal due date, the change will be announced via an addendum.

Release Project Date March 24, 2026

Pre-Proposal Meeting (Non-

Mandatory)

April 3, 2026, 11:00am

JOIN THE VIRTUAL PRE-PROPOSAL

CONFERENCE.

Online:

https://teams.microsoft.com/meet/2311573

8960794?p=6X23LjrPCCkvgc8wRj

Or, call into the virtual meeting by dialing this phone number: +1 321-247-7568

Once dialed-in and prompted, enter the

Conference ID: 231 157 389 607 94

Passcode: Zu6Du7VH

Question Submission Deadline April 10, 2026, 5:00pm mailto:tara.urdininea@orlando.gov tel:(407)246-2368 https://teams.microsoft.com/meet/23115738960794?p=6X23LjrPCCkvgc8wRj https://teams.microsoft.com/meet/23115738960794?p=6X23LjrPCCkvgc8wRj

Proposal Submission Deadline April 24, 2026, 2:00pm

JOIN THE VIRTUAL PROPOSAL

OPENING.

Online:

https://teams.microsoft.com/meet/2493807

210065?p=NnoY5zSa4jY8APH9G1

Or, call into the virtual meeting by dialing this phone number: +1 321-247-7568

Once dialed-in and prompted, enter the

Conference ID: 249 380 721 006 5

Passcode: UY3L2Tf3

2. REQUEST FOR PROPOSALS INFORMATION

The Procurement and Contracts Division is the official source to obtain information relating to City of Orlando solicitations. It is incumbent on the Proposer to obtain solicitation and current award information prior to and after the scheduled opening date of a Request for Proposals. Information is updated daily as it becomes available. An award, or recommendation of award, may be made at any time after the scheduled opening date of a Request for Proposals. You may obtain award and other solicitation information in a variety of ways:

A. There are currently two Internet sites available to obtain RFP Selection

Committee rankings, Notice of Intended Action for award and other information:

1. The City of Orlando Procurement and Contracts Division’s Website:

http://www.orlando.gov/procurement/solicitations/ If you are interested in obtaining solicitation information, copy and paste the above link into your web browser and click on View Current Bids. Please remember that you must keep your registration information up to date in order to continue to receive notifications of bidding opportunities that meet your commodity code selections.

2. Direct link to the City's e-Procurement Portal:

https://procurement.opengov.com/portal/orlando.

B. You may visit the Procurement and Contracts Division, during normal business hours, to obtain award information, solicitation packages, addendums, and other documents. Our office is located at:

City of Orlando

Procurement and Contracts Division https://teams.microsoft.com/meet/2493807210065?p=NnoY5zSa4jY8APH9G1 https://teams.microsoft.com/meet/2493807210065?p=NnoY5zSa4jY8APH9G1 http://www.orlando.gov/procurement/solicitations/ https://procurement.opengov.com/portal/orlando

400 South Orange Avenue, Fourth Floor

Orlando, Florida 32801

You may also call the Procurement and Contracts Division at (407) 246-2291, during normal business hours, to request award and other solicitation related information.

We appreciate your interest in doing business with the City Beautiful and wish you much success with your business ventures.

3. TERM OF CONTRACT

It is the intent of the City is to award a Contract for a three (3) year term to begin upon approval and execution by the City. The Contract may, by mutual assent of the parties, be extended for seven (7) additional twelve (12) month periods or portions thereof, up to a cumulative total of one hundred twenty (120) months.

4. MANDATORY MINIMUM QUALIFICATIONS

The following mandatory minimum qualifications have been established. Subject to the

City’s right to waive minor irregularities, Proposers that do not meet the mandatory minimum qualifications will be deemed non-responsive and will not be considered for further evaluation.

A. The Proposer shall be actively in the business of performing similar TPA services for at least five (5) years with governmental entities and at least three (3) years’ experience handling First Responder claims for a governmental entity.

B. The Proposer shall be currently licensed and in good standing in the state of

Florida for Third-Party Claim Administration.

5. SCOPE OF WORK AND TECHNICAL REQUIREMENTS

As set forth in this RFP, Proposals shall conform to the scope of services and technical requirements as set forth herein.

5.1. Workers' Compensation Claim Service Standards

The Contractor shall be responsible for providing Pharmacy Benefit Management (PBM)

Services and Preferred Provider Organization (PPO) Medical Services for the City's sworn firefighters.

TPA services for other City employees are not within the scope of this RFP.

The Contractor shall assign the City an Account Manager with the following responsibilities:

A. Participate in claim reviews of selected files.

B. Act as service provider representative on any claim issues or problems.

C. Act as liaison between the insurer, adjusters, field staff, Medical Network, Claims

Information Systems department, and City of Orlando.

5.2. Status Reports

A. The Contractor shall provide the City quarterly claim reviews of selected files. A specimen of the Claim Review Form is included with this RFP as Exhibit “Three”.

B. The Contractor shall provide the City formal status reports on:

1. Files with total incurred reserves at $ 25,000 or more.

2. Reserve increases of $ 10,000 or more.

3. Files open over SIX (6) months.

4. The City, from time to time, may request the Contractor to provide interim reports or information on specific files.

5.3. Settlement Authority

The Contractor will have no settlement authority. The Contractor will provide all settlement evaluations to the City for review. The evaluation will include an outline of all exposures on the claim along with the proposed settlement value. The City will review and if accepted, determine the amount of settlement authority to extend to the Contractor. If the claim is litigated the City will require a settlement evaluation from the defense attorney as well.

If applicable, when settlement authority is to be requested from an Excess Insurance

Carrier, the Contractor will include the City on all communication with the Excess Carrier.

To coordinate authority requests the Contractor will contact the Risk Management

Division Manager, or designee.

5.4. Other General Information

The Contractor shall:

A. Provide, when requested, loss runs to City, within two business days of the request. The Risk Management Division Manager, upon request, can request a more comprehensive loss run.

B. Identify specific claim offices and/or resident adjuster locations that will service the City. The list should identify claim manager, supervisors, and adjusters at each location along with their fax, email and phone numbers. The City requires that the adjustor seeks approval for the case manager prior to assignment of the case. The nurse case manager must be located in Central Florida area and be readily available for local responses.

C. Provide designated claim personnel to be assigned and identified. In the event of a change in service personnel, the City requires advance notification and an introduction of new personnel within 30 days of such notification. The adjuster(s) must maintain appropriate licensure within the State of Florida.

D. Be available to meet with City personnel prior to program inception for introduction of designated claim representative(s), explanation of claim reporting instructions, and to establish communication and claim handling procedures.

E. Contact the City’s Risk Management Division Manager prior to issuing a Notice of Denial for entire claim controverts.

5.5. Worker's Compensation Claim Standards

The Contractor shall provide the following Worker’s Compensation Claims Processing

Standards:

A. The adjuster will make a determination of compensability and informational packets will be sent to the injured employee in accordance with statutory guidelines. If the claim is determined to be compensable the claims handling and provision of benefits will be consistent with Chapter 440, Florida Statutes, Florida

Administrative Code, and current case law. If the adjuster determines the claim is not compensable, a confirmation of this must be made by the adjuster’s supervisor with detailed notes in the file from the supervisor to support the denial of workers compensation benefits. The City’s Risk Management Division

Manager is to be notified of any potential denial of benefits before the claim is officially denied.

B. A realistic reserve will be established within five working days. Reserves will be reviewed at 30 days, 60 days, 90 days, and at least every six months thereafter. File notes must reflect reserves were reviewed. The City of Orlando does not allow stair-stepping of reserves. All claim reserves should be for the life of the claim as known at that time. Any reserve increase by an adjuster of

$10,000 or more must be reviewed and authorized by the adjuster’s supervisor with detailed notes of the approval in the file.

C. A diary system will be established so that each medical only case is reviewed by the adjuster at least every sixty (60) days, or more often as needed.

D. Every indemnity case will be reviewed by the adjuster every thirty (30) days or more often as needed. A supervisor review of indemnity and litigated claims will be performed every ninety (90) days or more often as needed. File notes by both the adjuster and supervisor must provide details of the review and direction of the claim handling.

E. All pre-approved payments, reserve revisions and file closings will be promptly entered into the computer system.

F. The claim reserve will take into consideration all potential payments including expenses. The reserving process must be documented in the file to support the reserve amount. All claims should be reserved based on the life of the claim.

5.6. File Documentation

The Contractor shall provide the following Worker’s Compensation Claims File

Documentation Standards:

A. The basis for initial reserves, reserve revisions and payments will be clearly explained in the file. Any reserve, reserve revision or payment of $10,000 or more by the adjuster must also contain authority from the adjuster’s supervisor with detail notes in the file from the supervisor. File notes will clearly indicate contact with the City’s Risk Management Division manager in accordance with the reserve change guidelines as outlined above.

B. Specific direction on the investigation and handling of all indemnity cases will be established within two (2) working days of receipt of the first report and clearly evidenced in the file. The extent of the direction will be based upon the seriousness or complexity of the case at hand.

C. An initial file summary by both the adjuster and supervisor will be completed on all indemnity cases.

D. Updated case analysis summaries will be completed and placed in all indemnity files at least every thirty (30) days after completion of the initial summary. The

Supervisor will complete a review of all open indemnity files every ninety (90) days. The summary will include any and all information that relates to the direction and value of the case, as well as further work to be done and a target day for returning the employee to full duty or light duty work.

E. All phone conversations, discussions, and meetings held on the case will be clearly documented in each file.

F. The diary schedule will be clearly evidenced in the file. There should be a diary schedule for all indemnity claims for both the adjuster and supervisor. Additional diary dates for the nurse case manager if applicable.

5.7. Investigation

The Contractor shall provide the following Worker’s Compensation Investigation

Standards:

A. Within 24 hours of receipt of the first report, contact will be made with the City on all questionable claims to discuss issues involving compensability.

B. The medical facility will be contacted by the adjuster prior to making the initial indemnity payment to establish the extent of injury, length of disability, and causal relationship of the injury to the job or work-related incident. The adjuster will also contact the City to determine if light-duty work is available within the injured employee’s restrictions.

C. A medical report will be obtained by the adjuster within twenty (20) working days of the first day of lost time and as often as needed thereafter to justify continuing indemnity payments. The medical facility will be contacted by the adjuster to verify all continuing indemnity payments.

D. Contact will be made with the injured employee and the City within 24 hours of receipt of the first report to establish the medical treatment plan and timely return to work. Contact with the treating medical provider must be made by the adjuster within 48 hours. Ongoing contact with the injured employee will continue through the life of the claim. If a Telephonic or Field Nurse case manager is authorized by the City to be assigned, all of the Nurse Case Manager notes will be a part of the adjuster’s file.

E. All medical and pharmacy bills will be reviewed for causal relationship to the accident/work-related injury prior to payment by the Contractor and reimbursement by the City. All medical and pharmacy bills will be reduced to the lowest applicable fee.

F. Specific direction on the investigation and handling of all indemnity cases will be established within two (2) working days of receipt of the first report and clearly evidenced in the file. The extent of the direction will be based upon the seriousness or complexity of the case at hand.

G. An initial file summary will be completed on all indemnity cases involving disability payments within fifteen (15) working days of receipt of the first report.

H. When the authorized treating physician is recommending rehabilitation or retraining, the Contractor will provide all documentation to the City for review.

I. Subrogation/contribution/coordination of benefits possibilities will be promptly recognized and investigated, including (where needed) preservation of needed evidence and the use of appropriate experts to provide a basis for recovery. When subrogation opportunity does exist, the adjuster will immediately file a notice of lien on behalf of the City and preserve the City’s right to reimbursement under F.S. 440.39.

J. Outside vendor services will be conducted using ordinary business standards.

Any vendor service utilized must be approved by the City.

K. All "medical only" cases will be reviewed for closing at least every 60 days.

L. When applicable, all claims meeting the reporting criteria of the excess workers’ compensation carrier will be reported by the adjuster. Excess reports will be provided to the carrier based on carrier requirement and copied to the City.

Excess reports will be performed at a minimum of every six months. Any monetary reimbursements due to the City from the excess carrier will be promptly requested and pursued by the adjuster.

5.8. Litigation Management

The Contractor shall provide the following Worker’s Compensation Litigation

Management Standards:

A. The Contractor will refer cases to an attorney only on those requiring legal intervention, i.e., need for deposition, appearance at legal proceedings, etc. Any and all attorney assignments must be authorized by the City prior to the assignment.

B. For attorney assignments the adjuster will prepare a summary of the claim to date and outline the need for an attorney assignment. The City retains all authority on both attorney assignment and the selection of the attorney to assign the file to.

C. Use of existing City of Orlando contracted legal counsel is preferred. However, legal counsel will be selected on the basis of expertise required for a particular matter. For expediency purposes the City maintains an approved panel list of counsel.

D. Defense counsel will not be authorized to perform or request anything that could be accomplished just as effectively, efficiently, and economically by the claim adjuster.

E. Within thirty (30) days after receipt of the case, defense counsel's written opinion as to value and settlement/defense strategy will be obtained. The City will be provided with a copy of defense counsel's report. See attached Litigation

Management Guidelines.

F. Itemized legal bills will be solicited and reviewed for payment at least quarterly.

The Contractor will review the bills for accuracy based on the assignment made.

The City may require employing the services of an outside vendor for legal bill review.

G. Settlement authority will be obtained in accordance with the City’s authority requirements as outlined earlier in this proposal.

H. The City currently has twenty-three (23) sworn firefighter workers compensation claims in litigation.

5.9. Communication

The Contractor shall provide the following Communication Standards:

A. The City will be notified at least ten business days prior to any mediation, pretrial or Judge of Compensation Claims (JCC) hearing and provide a copy of the legal pleadings or actual trial notice. The City will be provided with a claim summary by the adjuster and assigned legal counsel. This summary will outline the case to date as well as projected outcome and costs.

B. Reasonable requests made by the City will be responded to in a timely and cooperative manner.

C. Phone calls from the City or injured employee should be returned the same working day. Written requests from the City will be responded to in a timely manner, no later than three (3) days after receipt.

D. Changes involving the dedicated adjuster(s) will be communicated to Risk

Management at least thirty (30) days prior to the change being made, when possible.

5.10. Continuing Service

The City anticipates a long-term relationship with the successful service provider. However, in the event the relationship is terminated, please detail the services that will continue, and the costs associated with those services (see 6.10 through 6.15 inclusive).

5.11. Risk Management Information Systems

The Contractor shall provide the City Network Access to claim information.

5.12. Loss Information

The Contractor shall provide the City Hard Copy Loss Runs on a monthly basis.

5.13. Claims Files

A. The paper and electronic claim files are the property of the City of Orlando and will not be destroyed or transferred without written consent. Once a file is closed the Contractor is required to maintain a permanent electronic database as well as the paper file until such time the City request the return of said documents.

B. Assessments, fines, interest and penalties that result from late filing/payment of medical bills, reporting or Division audits will not be charged to the City of

Orlando. Audit compliance costs associated with third-party administration are solely the responsibility of the Contractor, unless the issue is directly attributed to the City’s negligence. Payments made to the Division or other agencies as a result of the Contractor’s error will be clearly identified in the claim payment ledger.

C. Medical records and reports associated or contained within a claim file are subject to the confidentiality requirements of the Health Insurance Portability and

Accountability Act (HIPAA). The Contractor shall be responsible for all litigation costs (including attorney's fees and attorney's fees on appeal), penalties (civil and criminal), and other fees arising from the Contractor's handling of medical records in its care, custody, or control.

6. PRE-PROPOSAL CONFERENCE

6.1. Date

A Non-Mandatory Pre-Proposal Conference will be held at:

JOIN THE VIRTUAL PRE-PROPOSAL CONFERENCE. Online:

https://teams.microsoft.com/meet/23115738960794?p=6X23LjrPCCkvgc8wRj Or, call into the virtual meeting by dialing this phone number: +1 321-247-7568 Once dialed-in and prompted, enter the Conference ID: 231 157 389 607 94 Passcode: Zu6Du7VH on

Friday, April 3, 2026 at 11:00 am.

6.2. Purpose

The Pre-Proposal conference is intended to provide prospective Proposer(s) the opportunity to ask questions or receive clarification from City representatives of any requirements of this Request for Proposals. Representatives from the Procurement and

Contracts Division and a technical representative from the using department will be present to discuss the project and answer questions.

6.3. Oral Interpretations and Addenda

All interpretations and clarifications related to the Request for Proposals, or supplemental instructions will be in the form of a written addendum from the Procurement and Contracts

Division. No oral interpretations or clarifications from City staff or by other means will be considered binding unless issued in writing.

6.4. Clarification of Requirements

To facilitate the clarification of requirements, it is strongly recommended that Proposer(s) submit all questions in writing, at least three (3) days prior to the pre-proposal conference along with attendance notification (first and last name of attendee, phone number and email address of all attendees of the firm) if applicable, and return via fax or email to:

Tara Urdininea, CPP, Purchasing Agent III

City of Orlando

Procurement and Contracts Division

400 South Orange Avenue, Fourth Floor

Orlando, Florida 32801

Telephone: (407) 246-2368

Fax: (407) 246-2869

Email: tara.urdininea@orlando.gov

Website: http://www.orlando.gov/procurement/

7. PROPOSAL DUE DATE AND TIME

7.1. Proposal Due Date

Sealed Proposals must be submitted electronically and received by Procurement and

Contracts Division, no later than 2:00 pm, Local Time, Orlando, FL, on Friday, April 24, 2026. Proposals received after this date and time, will not be considered.

7.2. Public Opening

Proposals will be publicly opened and announced by the Procurement and Contracts

Division on the due date and time as specified herein. The Proposer’s name and verification of bond submittal, if applicable, will be publicly announced aloud at the

Proposal opening.

Instructions to join the solicitation opening virtual meeting:

A. Select a method to join

1. Join a Microsoft Teams Meeting from your calendar, via dial-in number and conference ID, or sign in as a guest on the web. For information on joining a

Microsoft Teams Meeting from the app or on the web, visit:

https://support.office.com/en-us/article/join-a-teams-meeting-078e9868-f1aa-

4414-8bb9-ee88e9236ee4 http://www.orlando.gov/procurement/ https://support.office.com/en-us/article/join-a-teams-meeting-078e9868-f1aa-4414-8bb9-ee88e9236ee4 https://support.office.com/en-us/article/join-a-teams-meeting-078e9868-f1aa-4414-8bb9-ee88e9236ee4

B. Choose your device and download Teams

1. Go to https://www.microsoft.com/en-us/microsoft-365/microsoft-teams/download-app and download Microsoft Teams. You can use a smart phone, tablet, laptop, or desktop computer to download at no cost. Make sure to allow some extra time for the install before joining your first meeting. If you do not have one of the devices just mentioned, you can also call in to the meeting. If you cannot download the desktop or mobile application, follow the instructions to join a Microsoft Teams Meeting on the web.

C. Join the virtual meeting

1. See Introduction Section for the Location and/or link to the virtual Proposal

Opening.

a. Note: Sessions may be recorded. Please turn your camera off and mute your microphone before joining the meeting.

D. Provide live public comment

1. An opportunity to speak will be provided to all in attendance during the meeting. You will be called by the name, email or phone number listed. When called, unmute your device and state your name and address for the record.

7.3. Public Record

Proposals received in response to this Request for Proposals are exempt from disclosure under the provisions of the Public Records Law until such time as an award decision has been made known or until thirty (30) days after the Proposal opening, whichever is earlier.

8. PROPOSAL PREPARATION AND FORMAT

8.1. Preparation

Prepare your Proposal in a clear and concise manner. Ensure that the content of your

Proposal submittal is complete. Special attention should be given to the specific information, instructions and requirements of the Request for Proposals document to ensure responsiveness. Proposals that are incomplete or lack key information may be rejected. To help facilitate the review process, properly label each section or tab to correspond with your submittal information.

8.2. Incurred Expenses

The City is not responsible for any expenses which Proposers may incur in preparing and submitting Proposals including presentations and any other expenses called for in this

Request for Proposals.

https://www.microsoft.com/en-us/microsoft-365/microsoft-teams/download-app https://www.microsoft.com/en-us/microsoft-365/microsoft-teams/download-app

8.3. Proprietary Information

A. In accordance with Chapter 119 of the Florida Statutes (Public Records Law), and except as may be provided by other applicable State and Federal Law, all

Proposers should be aware the Request for Proposals and the responses thereto are in the public domain. Proposers are requested to identify specifically any information contained in their Proposals which they consider confidential and/or proprietary and which they believe to be exempt from disclosure to the public under applicable law, citing specifically the applicable exempting law; provided, however, that nothing herein shall be deemed to preclude the full disclosure without redaction of any and all information submitted by Proposers to

Committee members, advisors to the Committee, and City staff and officials administering this solicitation and evaluating the proposals. A generic notation that information is “confidential” is not sufficient. Failure to provide the

Procurement and Contracts Division Office with a detailed explanation and justification including statutory cites and specific reference to your Proposal detailing what provisions, if any, you believe are exempt from disclosure, may result in your entire Proposal being subject to disclosure in accordance with

Chapter 119 of the Florida Statutes.

B. Each Proposer shall complete the “Confidential and/or Proprietary Information

Exemption Form”, included with this Request for Proposals as Attachment “C”, and submit the form with their Proposal.

C. In addition to the Proposal submitted pursuant to Section 9.13, a Proposer asserting any exemptions from public disclosure regarding any portions of its

Proposal shall also provide a redacted copy of its Proposal in electronic format suitable for public disclosure, redacting only such portions of its proposal identified on Attachment “C” as exempt from disclosure under an applicable law.

D. By submitting a proposal, a Proposer acknowledges and agrees that should it designate any materials submitted to the City as confidential or exempt from public disclosure, the Proposer will upon the request of City (at the City’s discretion) defend the City (and its employees, Committee members and advisors, agents, and elected and appointed officials) against all claims and actions (whether or not a lawsuit is commenced) related to the Proposer's designation of material as confidential or exempt from public disclosure. A

Proposer shall indemnify and hold harmless the City (and its employees, Committee members and advisors, agents and elected and appointed officials) from any and all claims, actions, suits, judgements, fines, costs, fees (including attorneys' fees), related to the Proposer’s designation of material as confidential or exempt from public disclosure.

E. Nothing herein shall be deemed to preclude the City from exercising its own judgment regarding the disclosure of records and the City may take any action that the City in good faith believes is necessary for City to comply with federal and/or Florida public records laws, including but not limited to filing a declaratory action.

F. All Proposals received from Proposers in response to this Request for Proposals will become the property of the City of Orlando and will not be returned to the

Proposers.

9. REQUIRED PROPOSAL SUBMITTALS

Outline Format for Response

To ensure a uniform, comparable review process, please follow the specified proposal format. Responses must be entered directly into the designated worksheet fields. Do not use narrative text to refer reviewers to other parts of the proposal for information requested in the worksheets.

9.1. Title Page

Provide the name of Proposer's firm, address, e-mail address, telephone number, name of contact person, date, and the subject: RFP26-0265, Third Party Administration

Firefighter's Workman's Compensation Claims Services

9.2. Table of Contents

Include a clear identification of the material by section and by page number.

9.3. Letter of Transmittal

A. Limit to two (2) pages.

B. Briefly state the Proposer's understanding of the services to be provided and make a positive commitment to perform the work.

C. Give the names of the persons who will be authorized to make representations for the Proposer, their titles, addresses and telephone numbers.

9.4. Respondent's Certification

By submitting a Proposal, the Proposer certifies that the Proposer has fully read and understands the Proposal method and has full knowledge of the scope, nature, and quality of work to be performed.

Each Proposer shall complete the “Respondent's Certification Form,” included with this

Request for Proposals as Attachment “A,” and submit the form with their Proposal. The failure of a Proposer to submit this document will be cause for rejection of the Proposal.

9.5. Conflict of Interest Disclosure

Proposer shall provide the required “Conflict of Interest Disclosure Form” as attached to this RFP as Attachment “B.”

9.6. Confidential and/or Proprietary Information Exemption Form

Proposer shall provide the required Confidential and/or Proprietary Information

Exemption form as attached to this RFP as Attachment “C.” Attachment can be found in

Section 45 - Vendor Questionnaire/Attachments. If Proposer asserts confidentiality to any portion of its proposal, Proposer is reminded to submit a redacted copy of its proposal pursuit to section titled "Proposal Preparation and Format; Proprietary Information."

9.7. Proposer’s Experience, Staff Experience and Financial Stability

Proposers must provide the following information:

A. Proposers shall submit a verifiable statement of the Proposer's experience providing: The City of Orlando (City) requests Proposals from interested and qualified Proposers to provide Third-Party Administration of Firefighters’ Worker

Compensation Claims. Download, fill out and upload Attachment "D"- References and Attachment "G" - Firm's Experience, Size and Financial Stability. Both attachments are found in Section 45 - Vendor Questionnaire/Attachments.

B. The City reserves the right to request such additional financial information regarding Proposers as it deems necessary or appropriate from Proposers or from any other party having relevant information, including but not limited to utilizing Dun and Bradstreet or other financial reporting companies’ financial reports for evaluation purposes or to request credit references in its review process.

9.8. General Business Information

Proposals shall provide:

A. Legal Name of Proposer, the address of Proposer’s principal place of business, phone number, fax number, name of principal in charge and email address.

B. Name(s) of person(s) to be contacted for information or services if different from name of principal in charge.

C. Business Form - State if Proposer’s business is local, national, or international and indicate the business’s legal status (corporation, partnership, etc.) Provide the date the Proposer was organized or incorporated and state of incorporation.

If the Proposer is a joint venture, please list the partners and the date such joint venture was formed.

D. Indicate whether the Proposer’s business is a parent or subsidiary in a group of firms/agencies. If Proposer is a parent or subsidiary, identify: (1) any affiliated entities that substantially control or are substantially controlled by Proposer, describing their relationship to Proposer; (2) any affiliated entities that will be relied on or otherwise involved in providing services hereunder, including but not limited to any that will provide intellectual property, personnel or expertise, or financial guarantees to Proposer in connection with the project.

E. Provide the location of the office from which the work is to be performed and the number of professional staff employed at the office.

F. State if the Proposer’s business is licensed, permitted and/or certified to do business in the State of Florida and attach copies of all such licenses issued to the business entity.

9.9. Claims Services

Proposers shall complete and submit Attachment “H” - Claims Services. Attachment can be found in Section 45 - Vendor Questionnaire/Attachments.

9.10. Information Systems

Proposers shall complete and submit Attachment “I” - Information Systems. Attachment can be found in Section 45 - Vendor Questionnaire/Attachments.

9.11. Price Proposal Schedule

Complete and submit the following forms:

A. Schedule

1. Proposer’s price shall be submitted on the “Price Proposal Form” in the format provided. Complete, and return with the Proposal, the Price Proposal included as Attachment “J.” Attachment can be found in Section 45 - Vendor

Questionnaire/Attachments.

B. Proposed Total Price

1. Proposal should provide a fixed-fee price breakdown for meeting all service requirements and implementing each phase of the Scope of Services as outlined. Additionally, Proposal should provide hourly staff rates if additional work is required under the Contract.

2. The chargeable services shall be included in the proposed total price including all labor customarily associated with delivery of the services contemplated by this RFP. Similarly, all expenses such as but not be limited to travel, lodging, meals and telephone/faxes/copiers associated with delivery of the services contemplated by this RFP shall also be included in the total price.

3. There will be no separate reimbursement for such expenses under this total fee price arrangement.

C. Allocated Loss Adjustment Expenses Allocated loss adjustment expenses are those costs typically charged to the file under the expense column rather than under a medical or indemnity column. Routine examples of this type expense include provider bill review, nurse case management, outside attorney fees, surveillance/private investigators, private mediation fees, etc. Allocated loss adjustment expenses shall not be included in the total price and shall be billed separately to the claim file. All such expenses shall be pre-approved by the City prior to being incurred by the Proposer.

9.12. Human Trafficking Affidavit

The Vendor hereby represents, warrants, and certifies that Vendor does not use coercion for labor or services as defined in Section 787.06, Florida Statutes and that Vendor has provided the Human Trafficking Affidavit attached hereto as Attachment "E." Attachment can be found in Section 45 - Vendor Questionnaire/Attachments.

A completed Human Trafficking Affidavit should be included with your Submittal. A contract shall not be awarded to a Respondent who does not submit the form at the time of submittal or within seven (7) days of the date the City requests the form be submitted, if a Respondent fails to return the form with its response.

9.13. Veteran Business Enterprise Participation in Subcontracts

Proposer shall provide the required Veteran Business Enterprise Participation form as attached to this RFP as Attachment “F.” Attachment can be found in Section 45 - Vendor

Questionnaire/Attachments.

10. DELIVERY OF PROPOSALS

Except as provided in Section titled "Americans with Disabilities Act," for people needing special accommodations, to be responsive proposals for this solicitation must be submitted electronically. Paper responses will be deemed non-responsive.

10.1. Instructions for submitting a proposal

A. Once you have logged into your OpenGov account, go to the solicitation in which you want to bid/participate on. Then click on “Draft Response,” complete the information requested, upload your bid/quote/submittal, along with all required attachments, and submit.

Respondents are solely responsible for ensuring that their submittals are complete, uploaded and submitted in the e-Procurement Portal by the due date and time. The City shall not be responsible for any submission delays or failures caused by any occurrence.

10.2. Proposal Binding

All Proposals submitted shall be binding for one hundred eighty (180) calendar days following opening.

10.3. Late Proposals

Proposals received by the City after the time specified for receipt will not be considered.

Proposers shall assume full responsibility for timely delivery of the Proposals to the location designated for receipt of Proposals.

11. CONFORMANCE TO SOLICITATION

All Proposals submitted shall meet and conform to all material, mandatory requirements set forth in this RFP, provided that nothing herein shall be deemed to limit the City’s ability to waive minor irregularities without notice or the need to issue a written addendum.

If a Proposer desires to submit a Proposal which, if selected by the City, would require the City to waive, alter or omit a material, mandatory requirement set forth in this RFP, the Proposer must first submit a request to the City asking the City to amend the requirements of this RFP in the same manner provided for the submission of written questions by Proposers provided in the section of this RFP entitled “Questions Regarding

Solicitation or Proposal Process.” If the City, in its discretion, agrees to amend, alter, or waive the requirement, the City shall issue notice to all prospective Proposers of the change in the form of a written addendum.

Any request to waive, alter, or amend a mandatory requirement of the RFP should be in the form of a written question that can be answered in an Addendum issued to all prospective Proposers. Please note, the City is not asking the Proposer to send in their

Proposals prior to the submission date, but merely to request a waiver or amendment to a mandatory requirement necessary to allow submission of the intended Proposal.

12. EVALUATION CRITERIA

An Advisory Committee will be established to review all responsive Proposals. Proposals will be evaluated for short listing (if applicable) and final ranking using the evaluation criteria set forth herein. The information that will be considered for each criteria is as follows:

No. Evaluation Criteria Scoring Method Weight (Points)

1. Proposer’s Experience, Staff Experience and Financial Stability

The evaluation will include, but will not be limited to, responses provided in

Attachment “D” - References; and evaluation of the information submitted in response to Attachment "G" - Firm's

Experience, Size, and Financial Stability.

Points Based 28 (28% of Total)

2. Claims Services and Information

Services

The evaluation will include, but will not be limited to, evaluation of Proposer’s submittal; evaluation of the information submitted in response to Attachment “H” -

Claims Services; and Attachment “I” -

Information Services.

Points Based 30 (30% of Total)

3. Price Proposal

The evaluation will include, but will not be limited to, evaluation of the pricing information submitted in Attachment “J” -

Price Proposal.

Points Based 40 (40% of Total)

4. Veteran Business Enterprise participation in subcontracts

This criteria will include, but will not be limited to, evaluation of the information submitted in response to Attachment “F" -

Veteran Business Enterprise

Points Based 2 (2% of Total)

13. PROPOSAL ADVISORY COMMITTEE AND EVALUATION PROCESS

13.1. Initial Review of Responses

The Procurement and Contracts Division will perform an initial review of all Proposal submittals for preliminary qualification and documentation compliance. This review process may include, but is not limited to, forms verification, professional licensing, references, past performance, and other relevant criteria.

13.2. Advisory Committee

An Advisory Committee (hereinafter referred to as “the Committee”) consisting of at least five (5) members will be established to review, discuss, and evaluate all responsive

Proposals submitted in response to this Request for Proposals (RFP). The Committee may utilize City staff and/or consultants who are not members to advise and assist the

Committee in its review of the Proposals. The subsequent inability of one or more committee member to serve or complete service on a committee shall not require the appointment of a new committee or a replacement committee member even if the loss of such member(s) causes the number of remaining committee members to fall below five

(5).

13.3. Preliminary Evaluation; Short Listing

The Committee may conduct a preliminary evaluation of all Proposals on the basis of the information provided and, if the Committee deems desirable in its discretion, it may elect to short list two or more Proposers using the evaluation criteria set forth in this solicitation.

Upon short listing by the Committee, only those Proposers short listed shall remain eligible for further evaluation and consideration by the Committee.

13.4. Presentations

The Committee reserves the right to require oral presentations from and conduct pre-award discussion and/or pre-Contract negotiations with any or all responsive and responsible Proposers who submit Proposals determined to be reasonably acceptable of being selected for award. Presentations and pre-award discussions and negotiations may be limited at the discretion of the Committee to short listed Proposers. Discussions may be conducted for the purpose of clarification and to assure full understanding of, and responsiveness to, the solicitation requirements. The City will not be liable for any costs incurred by the Proposer in connection with such interviews, presentations, or negotiations (i.e., travel, accommodations, etc.).

13.5. Optional Discussion

At the discretion and in the best interest of the City, the City or Committee may conduct discussions with Proposers (or the short listed Proposers, as applicable) or seek revision of Proposals from Proposers (or the short listed Proposers, as applicable) deemed to be responsible and reasonably acceptable to be selected. Such Proposers (or short listed

Proposers) will be accorded fair and equal treatment with respect to discussion and revision of the Proposals. Revisions may be permitted after submission of Proposals and prior to award of a Contract for the purpose of obtaining best and final offers.

13.6. Award Without Presentations

The City may evaluate and award a Contract based on responses to this Request for

Proposals without discussions or oral presentations. Therefore, each response to this

RFP should contain the Proposer's best terms and conditions for consideration.

13.7. Scoring and Final Ranking

Each Advisory Committee member will evaluate the proposals based on the factors set forth in the…