26-0137-RFP - Workers Compensation Third Party Administrator Services

The Pinellas County Board of County Commissioners (Board) desires to contract for the services of Workers Compensation (WC) Third-Party Administration (TPA) for the Pinellas County (County) Risk Management Worker's Compensation Program (WC Program), including tail claims. Should the governance of the Risk Management Program change during the duration of the contract, the Board will assign the Agreement to the body governing the WC Program. The successful proposer will provide all personnel, labor, materials, supervision, travel, facilities, software, and equipment to provide TPA services in compliance with the County's scope of work. Proposer will provide a toll-free or local area code (727) number for member services. Proposer will coordinate with the County's Risk Management Department, the State of Florida Department of Self-Insurance, the Florida Division of Workers' Compensation, the Agency for Health Care Administration (AHCA), and/or other regulatory departments to ensure proper handling of all filings, reports, and workers' compensation (WC) claims management. All Constitutional Officers of the County, and certain county-funded court employees are included in the WC Program, except as otherwise set-forth herein. With the exception of the Clerk of Court and Comptroller (Clerk), all Constitutional Officers of the County currently participate in the WC Program and make payments to the Risk Finance Program, established pursuant to Pinellas County Code Section 2-142, with regard to WC insurance premiums and claims. The Clerk previously participated, but since on or about July 1, 2011, maintains separate WC coverage. WC claims of Clerk employees that arose prior to July 1, 2011, remain within the WC Program. The WC Program carries a $2 million self-insured retention per occurrence and covers approximately 5,359 employees, of which 2,737 work for the Sheriff's Office. Pinellas County also provides coverage for its volunteers. Any claims that fall within the retention are paid from the County's Risk Finance Program during the year that indemnity payments, medical payments, or claims expense payments are made; regardless of when the claim occurred, until the claim is closed. Currently, claims are adjusted and managed internally with the assistance of the County Attorney's Office, and outside vendors are utilized for specific services. The policy coverage "limit" is "statutory" per Florida Statute 440. Risk maintains a Reserve Fund to cover outstanding liabilities for open WC claims. An actuary is engaged to advise on the current year operating fund for paying claims, as well as adequate amounts needed in the Reserve Fund for outstanding liabilities for open claims.