RFP 2025-P09 Workers Compensation Insurance & Administrative Services

Hays County, Texas is requesting proposals for workers' compensation insurance and administrative services under RFP 2025-P09, with proposals due November 7, 2025 at 10:00 AM. The county intends to award all service elements to a single vendor and is currently participating in a workers compensation pool, which it intends to continue.

Vendors must be licensed in Texas with at least five years of workers' compensation experience, hold an errors and omissions policy of at least $1,000,000, and demonstrate bilingual capability in English and Spanish for claims handling. The scope covers claims administration, medical managed care, loss prevention strategy, timely claims adjudication, quality medical care for injured workers, and return-to-work support. Vendors must provide detailed cost proposals covering claims administration fees for multiple claim types (workers compensation, incident, medical only, indemnity), field services, medical case management, utilization review, medical bill audits, healthcare networks, rehabilitation services, hearings attendance, and legal representation. The county requires monthly billing based on cost per claim and an annual safety rebate.

The contract term runs January 1, 2026 through December 31, 2028, with four optional two-year renewal periods. Hays County's total budgeted payroll for fiscal year 2025 is $79,044,595 across ten workers compensation class codes, projected to reach $88,547,037 for fiscal year 2026. The current annual workers compensation contribution is $340,000. Law enforcement represents the largest payroll class at over $35 million for FY2025, followed by clerical and administrative positions. The county processes approximately 1,900 medical bills annually (averaging 2022–2024 data), handles 26–44 preauthorization requests annually, and has minimal case management referrals. Evaluation criteria are proposed cost (35 points), claims processing and reporting capabilities (30 points), policy terms and conditions (20 points), and company experience (15 points), with a potential optional interview phase. Addendum #3, issued October 25, 2025, provided five-year loss history, budgeted positions documentation, and detailed claims volume data. Bidders must acknowledge receipt of all three addenda with their proposals.