RFP - Assigned Claims Processing Agent Services

The State of Oregon Department of Consumer and Business Services, Workers' Compensation Division is requesting proposals for assigned claims and claims processing agent services under RFP S-44000-00017296, with proposals due July 30, 2026 at 2:00 PM Pacific Time.

The scope covers processing workers' compensation claims for noncomplying employers, defaulted and insolvent self-insured employers, and decertified self-insured employer groups under ORS Chapter 656 and Oregon Administrative Rules Chapter 436. The contractor must determine claim compensability, manage compensation payments, maintain claim files, pursue subrogation recoveries, and generate weekly invoices, detailed claims-paid reports, quarterly performance reports, and annual independent actuarial reports. Key personnel must hold valid Oregon workers' compensation certification with a minimum of five years' experience processing Oregon workers' compensation benefits within the last seven years. Claims examiners must meet Oregon certification with minimum three years' experience. The contractor must maintain an Oregon business location and satisfy a 92 percent performance standard in key claim processing activities. Adequate cash flow is required to cover weekly obligations averaging $110,000 before Agency reimbursement, with historical individual program amounts ranging from zero to over $500,000 weekly.

The estimated total contract value is $70 million for the cumulative contract term, with an initial five-year term and options to renew for a maximum of ten years total. The contract begins December 1, 2026. Contractor compensation comprises active claim fees and administrative fees for investigative, index, claim closure specialist, vocational rehabilitation, and attorney consultation services.

Proposers must demonstrate minimum qualifications including at least ten years of experience processing Oregon workers' compensation claims, authorization as an insurer, casualty adjuster, or third-party administrator, and immediate available funds. A Pay Equity Certificate from the Department of Administrative Services is required if the proposer employs 50 or more full-time workers and the prospective contract price exceeds $500,000. Proposers must document certification status under Oregon's Certification Office for Business Inclusion and Diversity (COBID) and identify anticipated subcontracting opportunities with certified disadvantaged businesses.

The evaluation totals 2,805 points, with scoring based on executive summary, administrative proposal, key persons, financial responsibility, technical proposal, assessment questions, proposed compensation plan, references, and price. Questions are due July 10, 2026 at 10:00 AM Pacific Time, with answers issued approximately July 15. Price proposals must remain firm for 180 days following bid opening. The Agency anticipates awarding one contract.