Third Party Administration of Workers' Compensation Benefits

The City of Hayward, California is soliciting sealed proposals under RFP 27-014 for third-party administration of workers' compensation benefits, with questions due November 19, 2026 and proposals due December 11, 2026 at 4:00 p.m. through the City's eProcurement Portal. Late proposals are deemed nonresponsive.

The scope covers the City's self-insured program for approximately 844 employees, including claims reporting, employee contact, lost-time salary information, manager and employee training, early return-to-work assistance, claimant service evaluation, and claims file maintenance in compliance with California law. Bidders must hold a California license, maintain a claims administration office in reasonable proximity to the San Francisco Bay Area, have at least five years administering claims for public entities, and demonstrate adequate resources for field investigations and specialized reporting. The awardee must comply with PRISM Standards for Workers' Claims Administration Services, which set claims examiner caseload targets of 150 with a maximum of 165 claims and require three-point contact with injured workers, employers, and treating physicians within 3 working days of claim receipt. The General Provisions require prevailing wage compliance under California Labor Code sections 1770-1780 with certified payroll available within ten days of request, and insurance with $1 million minimum single limits.

Pricing must be submitted on a not-to-exceed basis with itemized costs for labor, materials, bill review fees, utilization review fees, and Medical Provider Network fees, and no additional fees are permitted. The term is three years with two optional one-year renewals based on satisfactory performance, contingent on City Council approval of the negotiated contract, which is slated for February or March 2027.

Evaluation scores general qualifications and experience (30 points), responsiveness to RFP requirements (25 points), scope of work consistency (25 points), and proposed budget (20 points). Finalist interviews are scheduled for January 11, 2027, though the City may select based on written proposals alone without interviews.