Workers’ Compensation Third Party Claims Administration Services

Monroe County, Florida is conducting a competitive solicitation for Workers' Compensation Third Party Claims Administration Services through a Request for Proposals process. The procurement seeks qualified Third Party Administrators (TPAs) licensed in Florida to manage workers' compensation claims within the County's self-insured retention limit of $500,000 per claim, covering approximately 1,320 employees across multiple county agencies including the Board of County Commissioners, Sheriff's Office, and Constitutional Officers. Required services encompass initial claimant contact within 24 hours, recorded statements, physician contact, quarterly narrative summaries on major claims, medical bill reduction to State Fee Schedule, subrogation activities, state-mandated reporting, excess claim notification, quarterly meetings, monthly loss reports, support for the Monroe County Injury Helpline, PPO network maintenance, and direct system access. The contract term will be three years effective September 21, 2026 through September 20, 2029, with two optional one-year renewal periods at the County's discretion. Proposers must be currently licensed under Florida Statutes 626.88-626.8991 with individual adjusters meeting corresponding licensing requirements, provide resumes and supervisor information, and submit proposals electronically via the Bonfire platform no later than 3:00 PM on July 16, 2026, with virtual bid opening via Zoom at that same time. Evaluation criteria totaling 150 possible points include compliance with RFP specifications (5 points), ability to provide services (25 points), adjuster experience (20 points), length of time providing claims administration services (15 points), office proximity to Monroe County (15 points), quality of computer system and loss runs (15 points), adjuster caseload limits (20 points), pricing (25 points), and local business preference (up to 10 points).

The solicitation does not indicate specific set-aside designations for disadvantaged enterprises, though the evaluation criteria include a local business preference allowance of up to 10 points. The current incumbent contractor is Relation Insurance Services of Stuart, Florida. Proposers must assume responsibility for 82 currently open claims with $3,803,842 in outstanding reserves as of December 31, 2025, with separate pricing required for these "run-off claims." The County anticipates processing approximately 1,186 medical bills annually totaling approximately $2.1 million with expected bill reductions of approximately $1.09 million through State Fee Schedule and PPO network discounts. Proposers must maintain required insurance coverage throughout the contract term, including Workers' Compensation statutory coverage, Employers' Liability ($100,000/$500,000/$100,000), General Liability ($1 million), Vehicle Liability ($1 million), Professional Liability ($1 million), and Cyber Liability ($1 million). Pricing should be structured on a "Life of Contract" or "Cradle to Grave" annual flat fee basis paid in monthly installments, though alternative pricing structures will be considered; specific budget ranges or award values are not disclosed in the available documentation.