RFP Worker's Compensation Third Party Administrator

The State of Illinois, through the Chief Procurement Office for General Services and the Department of Central Management Services, is seeking proposals from Third Party Administrators (TPAs) to administer the State Employee Workers Compensation Program. The RFP requests comprehensive services to support the analysis, funding, and management of workers compensation claims, including claims processing, medical bill review, provider network management, and data reporting. The contract will have an initial term of five years, with the option to renew for up to five one-year terms or one five-year term, not to exceed a total of ten years. Proposals will be evaluated based on technical merits and pricing, which will be assessed independently. The RFP includes detailed requirements for the TPA services, such as toll-free customer service, dedicated account management, timely claims processing, and medical case management. The current provider of these services is TriStar, and the new contract is scheduled to begin on February 1, 2023.

The RFP includes a 20% Business Enterprise Program (BEP) goal for minority, women, and disabled-owned businesses, as well as a Veteran Small Business (VSB) participation goal. The State has issued an addendum inviting interested BEP and/or VSB firms to submit their contact information to be included in a listing of potential subcontracting opportunities. The total award amount for the contract, including renewals, is $84,421,189. Pricing will be structured on a per-claim basis, and the State will not consider splitting or unbundling the services.