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This Solicitation opportunity from Michigan was posted on August 8, 2025. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

Workers Compensation and Claims Administration and Excess Insurance Services

Closed
RFP-SH25-008State & Local

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

Active Opportunities Like This One

NAICS: 524292
New
SLED
712589: Third Party Liability Claims Administrator Services
Solicitation # 54879
Solicitation 54879 is a request for proposals from the City of Chicago Department of Law for Third Party Liability Claims Administrator Services. The selected contractor will provide general claims administration, inside claims specialist services, and outside claims adjuster services, with a focus on managing tort claims, conducting field investigations, and providing litigation support. The contract is structured as a Blanket Purchase Agreement with a base term of 60 months and an option for a single 24-month extension. Performance is measured by strict timelines, requiring routine claims to be processed within 70 days and complex claims within 182 days, with a required 80 percent adherence rate. On-site staffing is mandated from Monday through Friday, 8:00 am to 6:00 pm, and Saturdays from 8:00 am to 12:00 noon. The award process is weighted heavily toward professional and technical competence at 70 percent, followed by the implementation and management plan at 20 percent and the schedule of compensation at 10 percent. Several pass/fail requirements are in place, including financial stability, insurance compliance, and the submission of a sexual harassment policy affidavit. Contractors must adhere to strict data protection requirements for personally identifiable information and comply with MBE, WBE, and VBE participation goals. Payment is processed monthly with a 60-day term, and the City will provide a 100,000 dollar Claims Payment Fund to be maintained by the contractor. Proposals must be submitted electronically via the iSupplier portal by December 18, 2026.
Department of Law

POSTED

about 4 hours ago

DEADLINE

in about 2 months
NAICS: 524292
New
Federal
TRICARE Medicare Eligible Program Second Generation (TMEP2)
Solicitation # HT940226R0001
The TRICARE Medicare Eligible Program Second Generation (TMEP2) is a full and open competitive acquisition issued by the Defense Health Agency to provide health care claims processing, customer support, and administrative services for dual-eligible Medicare and TRICARE beneficiaries across the United States and its territories. This Firm Fixed-Price contract utilizes a best value trade-off source selection process, where technical approach and past performance are weighted as equal in importance and collectively significantly more important than price. The potential period of performance spans 8.5 years, consisting of a 12-month transition-in period, seven 1-year healthcare delivery periods, a 12-month transition-out period, and a possible 6-month extension of services. The scope of work includes the processing and payment of electronic and paper claims, management of beneficiary satisfaction through quarterly incentives, and adherence to strict quality standards outlined in a Quality Assurance Surveillance Plan. Key requirements include CMMC Level 2 certification as a condition of award and compliance with FedRAMP Moderate security standards for any cloud service providers used. Proposals must be submitted electronically via DoD SAFE in six separate volumes, with a specific focus on technical subfactors including claims processing, customer service, management functions, and transition management. Small business participation is evaluated on an acceptable or unacceptable basis and is required for award eligibility.
Defense Health Agency

POSTED

about 7 hours ago

DEADLINE

in about 1 month
NAICS: 524292
New
SLED
DAS Medical Plan Third-Party Administrator
Solicitation # SRC0000038100
The State of Ohio, through the Department of Administrative Services, is soliciting proposals for one or more contractors to serve as Third-Party Administrators for its self-insured medical plans, known as Ohio Med. The scope includes the administration of three plan options: the Ohio Med PPO, Ohio Med Select, and the Ohio Med HDHP, covering approximately 103,000 lives. The selected contractor will be responsible for administering all claims incurred on or after July 1, 2027, and must ensure a seamless transition of care and eligibility verification. Key requirements include providing case, care, disease, and utilization management, while behavioral health remains a carved-out service. The contractor must also integrate with the state's data warehouse vendor, Merative, and adhere to strict IT security standards, including HIPAA compliance via a Business Associate Agreement and various recognized security certifications such as SOC 2 Type 2 or HITRUST. The contract term runs from the date of signature through June 30, 2030, with options for short-term monthly renewals and potential mutual extensions for up to four additional years. Performance is measured by specific Service Level Agreements, such as mailing ID cards within five days of enrollment and maintaining zero errors in initial eligibility files. Financial terms involve weekly claims billing paid via ACH, with a cost proposal structure based on per employee per month fees for core and disease management services. Award selection is based on a total score combining technical, cost, and presentation evaluations. Proposals must be submitted electronically through the OhioBuys portal, with technical and cost components submitted as separate, non-password-protected electronic envelopes.
Administrative Services

POSTED

about 7 hours ago

DEADLINE

in 16 days
NAICS: 524292
New
SLED
Request for Proposal - Third Party Administrative and Actuarial Services
Solicitation # 2025-RFP-127
The City of Cleveland Department of Finance, Division of Risk Management, is soliciting competitive proposals under solicitation 2025-RFP-127 for a single qualified Third-Party Administrator (TPA) to provide comprehensive administrative and actuarial services. The primary objective is to manage Ohio Bureau of Workers' Compensation (BWC) claims and conduct detailed liability reviews to reduce premium costs and minimize organizational exposure. The scope of work includes full claims administration, subrogation identification and negotiation, and the establishment of claims reserves. The selected provider must integrate with the Ohio BWC TPA Portal, the Ohio Industrial Commission systems, and the City's Origami Risk Management Platform and Microsoft Teams, while adhering to strict AES-256 and TLS 1.3 encryption standards and providing annual SOC 1 and SOC 2 Type II reports. Proposals were due by October 29, 2026, for a contract start date of January 1, 2027. The City operates under an individual retro plan and evaluates bidders based on a two-phase process focusing on proposal quality, demonstrated ability, OEO compliance, key personnel credentials, and the proposed schedule, followed by potential interviews. Awardees must comply with the Cleveland Area Business Code and maintain specific insurance coverages, including $1,000,000 limits for Business Automobile Liability and Workers' Compensation employer's liability. The contract requires a 10 percent Cleveland Area Small Business participation goal and adherence to the City's Professional Services Contracts Reimbursables Policy for invoicing and billing.
Finance - Division of Risk Management

POSTED

about 23 hours ago

DEADLINE

in 1 day
NAICS: 524292
New
SLED
TPA Workers' Compensation
Solicitation # 127-2026
The Southwest Ohio Regional Transit Authority (SORTA), also known as Cincinnati Metro, is soliciting proposals for a Third-Party Administrator (TPA) to manage its self-insured Workers' Compensation program. The scope of work includes comprehensive claims administration, medical management, cost containment, legal support, and regulatory compliance in accordance with Ohio Bureau of Workers' Compensation and Ohio Industrial Commission requirements. Additionally, the selected vendor will provide safety consulting, OSHA/VSSR review services, and various reporting deliverables, including quarterly claims reports and bi-weekly payment forecasts. The contract is intended to begin in March 2027 and utilizes a firm-fixed price structure for a five-year term. Proposals must be submitted electronically via the OpenGov portal by November 4, 2026, and must be divided into two volumes to keep pricing separate from technical and business qualifications. Evaluation will be based on a points-based system focusing on price, project approach, and firm and staffing qualifications, specifically looking for public-sector or transit-related experience. Award decisions will be made based on the most advantageous proposal to SORTA. The successful contractor must adhere to NET 30 payment terms and comply with various federal and state non-discrimination and equal employment opportunity regulations.
Human Resources

POSTED

1 day ago

DEADLINE

in 7 days
NAICS: 524292
New
SLED
Actuarial Services
Solicitation # 2611-KP
The Sacramento Housing and Redevelopment Agency (SHRA) is soliciting proposals under RFP 2611-KP for a qualified actuarial services firm to manage its Other Post-Employment Benefits (OPEB) program. The selected contractor will be responsible for measuring liabilities, supporting funding decisions, and providing essential data for financial reporting and long-term planning. Key deliverables include GASB 75 reporting packages for fiscal year ends 2026 through 2030 and full actuarial valuations as of December 31 for 2026, 2027, and 2028. The scope also encompasses advisory services for prefunding strategies, scenario modeling, and the development of Actuarially Determined Contributions (ADCs) to ensure the fiscal sustainability of retiree medical and dental benefits. The contract is structured for an initial one-year term with options to extend for up to four additional periods, not to exceed five years in total. Proposals are due by October 29, 2026, via the OpenGov portal, with an anticipated start date of December 7, 2026. Evaluation follows a two-stage process where technical proposals must score at least 70% to be considered responsive before cost proposals are reviewed. Award criteria emphasize technical expertise in public-sector OPEB valuations, past performance with similar governmental agencies, and the qualifications of the project team. The agreement requires strict adherence to GASB 75 standards, the Federal Privacy Act of 1974, and applicable Actuarial Standards of Practice.
Finance

POSTED

6 days ago

DEADLINE

in 1 day
NAICS: 524292
SLED
Pharmacy Drug Benefits
Solicitation # HHS0017240
The Texas Department of State Health Services (DSHS) is soliciting proposals under solicitation number HHS0017240 for a Pharmacy Benefits Manager (PBM) to support the Texas HIV Medications Program (THMP). The selected PBM will act as a secondary payor to manage prescription drug benefits, premium payments, and copayments through three primary programs: the State Pharmacy Assistance Program (SPAP) for Medicare Part D costs, the Texas Insurance Assistance Program (TIAP) for medication copayments and COBRA premiums, and the Texas Insurance Assistance Program-PLUS (TIAP-PLUS) for private and federal marketplace plan assistance. The scope of work involves processing medication claims and monthly invoice premium payments, with historical data indicating the management of over 15,000 claims for approximately 2,764 participants. The contract features an initial one-year term with the possibility of four additional one-year extensions and one final option period at the discretion of DSHS. Award selection is based on best value, evaluated through a weighted scoring system consisting of the Project Workplan (45%), Cost Proposal (35%), and Qualifications and Experience (20%). Proposals must be submitted by November 19, 2026, via either USB drive or an online bid room. Requirements include a narrative proposal limited to 40 pages, a separate Excel-based cost proposal, and a VetHUB Subcontracting Plan. The contract is governed by Texas Government Code Section 2155.144 and incorporates various HHS uniform terms, additional provisions, and a Data Use Agreement.
Department of State Health Services

POSTED

7 days ago

DEADLINE

in 22 days
NAICS: 524292
SLED
DAS Behavioral Health Third-Party Administrator RFP
Solicitation # SRC0000040548
The State of Ohio, through the Department of Administrative Services, is soliciting proposals for a Third-Party Administrator to manage its self-insured Behavioral Health Benefit Plan. Starting July 1, 2027, the selected contractor will provide administrative services for approximately 43,800 employees and 104,600 total lives. Key responsibilities include managing eligibility, claims history, prior authorizations, utilization management, and data integration with the State's data warehouse. The contract runs from the date of signature through June 30, 2030, with the possibility of a one-month discretionary renewal and further mutual renewals for up to four additional years. To be eligible, offerors must be NCQA accredited and comply with the Mental Health Parity and Addiction Equity Act. The evaluation process is based on a total score derived from technical requirements, cost, and presentations, with the highest-ranking responsible offeror recommended for award. Financial terms utilize a not-to-exceed unit cost fee structure, and the contractor must provide a Benefits Fund of at least 150,000 dollars. Strict compliance is required regarding HIPAA through a Business Associate Agreement, State IT policies, and secure data transfer protocols via SFTP. Proposals must be submitted electronically through the OhioBuys portal, consisting of separate technical and cost volumes.
Administrative Services

POSTED

7 days ago

DEADLINE

in 16 days

AI Contract Overview

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The City of Sterling Heights in Michigan has issued a request for proposals (RFP-SH25-008) seeking qualified vendors to provide comprehensive services related to workers' compensation, claims administration, and excess insurance. The contract aims to secure a partner capable of managing workers' compensation claims, administering related processes efficiently, and providing excess insurance coverage to mitigate risk. The project is open to responses until September 2, 2025, with the contract value estimated between $500,000 and $2,000,000, reflecting its significant scope and importance for the city's risk management needs. Interested organizations can submit their proposals electronically and should direct any inquiries to Erik Skurda via email at [email hidden]. The solicitation is posted on BidNet Direct, providing detailed information and the opportunity for vendors to participate in this competitive procurement process.

General Info

Agency

Michigan → City of Sterling Heights

Place of Performance

MI, USA

Set-Aside

NONE

Documents

1

RFP-SH25-008 Workers Compensation and Claims Administration and Excess Insurance Services

PDF, High priority: read this firstrfp
High

AI Contract Breakdown

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Timeline

PhaseClosed
Posted

Solicitation

Response Deadline

Deadline has passed

Submission Closed

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Organization & Contact Information

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AgencyMichigan → City of Sterling Heights
Contacts1 person available
OfficeN/A
Organization / Agency
Michigan → City of Sterling Heights
Office AddressN/A
Contacts

Full Description

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RFP-SH25-008 - Services for Workers Compensation, Claims Administration, and Excess Insurance. Location: Macomb County, Michigan, United States, specifically the City of Sterling Heights. The City of Sterling Heights is inviting electronic submissions for proposals related to WORKERS COMPENSATION, CLAIMS ADMINISTRATION, and EXCESS INSURANCE SERVICES.

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