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

The City of Orlando's Procurement and Contracts Division issued Request for Proposal 26-0265 to procure Third-Party Administration (TPA) services for Firefighters' Worker Compensation Claims, a comprehensive administrative service covering all prior and new workers' compensation claims for the City's 584 sworn firefighters. The scope of services encompasses full claim administration including Pharmacy Benefit Management (PBM) and Preferred Provider Organization (PPO) medical services, with proposers required to demonstrate a minimum of five years of active TPA experience with governmental entities and at least three years of experience handling First Responder claims for a governmental entity, along with current Florida licensure for Third-Party Claim Administration. Deliverables include claims handling for approximately 87 currently open claims (roughly half of which are indemnity claims), with historical data showing an average of 113-173 total claims annually in recent years across four claim categories: First Aid, Indemnity, Medical Only, and total claims. Compensation shall be structured as a fixed-fee arrangement covering all service requirements, labor, and expenses including travel, lodging, meals, and communications, with allocated loss adjustment expenses such as provider bill review, nurse case management, outside attorney fees, and surveillance billed separately and subject to City pre-approval. The evaluation criteria allocate 28 points to Proposer's Experience, Staff Experience, and Financial Stability; 30 points to Claims Services and Information Services; 40 points to Price Proposal; and 2 points to Veteran Business Enterprise Participation, for a total of 100 points. The non-mandatory pre-proposal conference is scheduled for April 3, 2026, at 11:00 a.m. via Microsoft Teams, with written questions due by April 10, 2026, at 5:00 p.m., and proposals due electronically by April 24, 2026, at 2:00 p.m. Local Time. The City intends to award a three-year initial contract term with options to extend for seven additional twelve-month periods, providing a cumulative total of up to 120 months of service.

No set-aside designations for disadvantaged enterprises are mandated; however, Veteran Business Enterprise Participation is evaluated at 2 points within the total 100-point scoring structure. The current contractor, CorVel Corporation, holds the expiring contract and will be replaced through this procurement process. The successful proposer must execute the contract within 15 calendar days of the Notice of Award and provide required bonds and insurance certificates, including workers' compensation, commercial general liability with limits of $1,000,000 per occurrence, automobile liability, contractors pollution liability, and cyber liability insurance with limits of $10,000,000 per occurrence if applicable. While specific award values are not explicitly stated in the solicitation, the contract contemplates fixed-fee pricing as submitted by proposers, and awards exceeding $100,000 are subject to City Council approval. The ten-year historical claims data provided to proposers shows cumulative totals of 2,312 claims over the period from fiscal year 2015/16 through 2024/25, with less than 13.7% of claims resulting in litigation over the past five years and only three open claims involving Permanently Totally Disabled employees, establishing a relatively stable and manageable claims profile for cost estimation purposes. An Advisory Committee of at least five members will evaluate all responsive proposals, with the City reserving the right to conduct presentations and pre-award discussions with short-listed proposers prior to final selection.