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This Solicitation opportunity from California was posted on June 1, 2026. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

WORKERS’ COMPENSATION THIRD PARTY ADMINISTRATION AND MANAGED CARE COST CONTAINMENT SERVICES RFP

Closed
2026-RFP-00430State & 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
Health, Pharmacy, Dental, Vision and Stop Loss Coverage Employee Benefits Plan
Solicitation # RFP 2428
The Township of Wayne, New Jersey, is soliciting proposals under RFP 2428 to establish a comprehensive employee benefits plan covering health, pharmacy, dental, vision, and stop loss coverage. The scope of work includes the appointment of a Medical Claims Third Party Administrator to manage claims adjudication, benefit administration, and member services. Key deliverables involve a detailed implementation and transition plan, the procurement of specific and aggregate stop loss insurance, and the provision of network disruption and geo-access analyses to ensure provider availability for employees. The contract is intended for a duration of up to three years, with a start date no later than 21 days following the award. Proposals are evaluated using a points-based system across five equally weighted categories: understanding of the work, technical competence, management and personnel qualifications, timeliness of completion, and cost. Bidders must provide detailed pricing exhibits, including per employee per month rates and stop loss options, while adhering to strict legal and regulatory requirements such as HIPAA compliance, EEO standards, and New Jersey state business registrations. Administrative requirements include monthly invoicing with detailed backup documentation, the submission of a performance bond within 14 days of the signed contract, and a waiver of subrogation in favor of the Township. The Township maintains the right to terminate the contract for convenience with 60 calendar days of advanced notice.
Purchasing Division

POSTED

4 days ago

DEADLINE

in 18 days
NAICS: 524292
SLED
Pharmacy Services – Specialty Medications QVL
Solicitation # STATE 0000000551SL
Solicitation STATE 0000000551SL is issued by the State of Missouri Office of Administration on behalf of the Missouri Veterans Commission to establish a Qualified Vendor List (QVL) for specialty pharmacy services. The scope of work includes the provision of pharmaceuticals, biologicals, IV therapy, and care coordination for veterans, with services required to be available 24 hours a day, 7 days a week. Awarded vendors must be responsive, responsible, and reliable, with the state intending to award contracts to all qualified vendors to ensure adequate coverage. Once the QVL is established, individual prescriptions will be awarded based on the lowest cost, with preference considerations given to Missouri-based firms, Service-Disabled Veteran Business Enterprises, and organizations for the blind or sheltered workshops. The contract mandates strict adherence to quality standards, including the United States Pharmacopeia and FDA Orange Book, and requires compliance with HIPAA and HITECH regulations through a Business Associate Agreement. Specific packaging and labeling requirements are detailed, including the use of bubble card systems for tablets and compliance with the Federal Food, Drug, and Cosmetic Act. Contractors must maintain veteran records for seven years and provide an updated product catalog annually. The agreement includes a base period with the option for four additional one-year renewals. Compliance certifications are required regarding the Anti-Discrimination Against Israel Act, E-Verify enrollment, and federal drug-free workplace standards. Payments are processed monthly via Electronic Funds Transfer within thirty calendar days of a valid invoice.
PROC OA DIVISION OF PURCHASING PROCUREMENTS

POSTED

17 days ago

DEADLINE

in 5 days
NAICS: 524292
SLED
Medical Claims Audit
Solicitation # RFP-12-2027
Multnomah County is seeking a qualified independent contractor to perform comprehensive medical, prescription, and dental claims audits and operational assessments for its self-funded health plans. The primary goals of this engagement are to ensure fiscal accountability, verify compliance with plan documents, and identify opportunities for cost recovery and process improvement. The selected vendor will be responsible for conducting audits at the County's discretion, implementing robust quality assurance and error-checking protocols, and providing a knowledge transfer plan, including training sessions for County staff. The contract may have a term of up to five years, with payment terms set at Net 30. Proposals are due by September 23, 2026, via the Multco Marketplace Supplier Portal. Evaluation is based on cost, expertise, methodology, innovation, and alignment with County needs, with a specific emphasis on responsible business practices, including energy conservation and living wage standards. High priority is placed on HIPAA compliance for data security and the integration of equity-focused principles to identify health plan disparities. The County strongly encourages participation from minority-owned, women-owned, and emerging small businesses. Award will be granted to the responsible proposer whose proposal is deemed most advantageous, with the highest-scoring responsive bidder entering negotiations for final contract terms.
Multnomah County

POSTED

22 days ago

DEADLINE

in 11 days

AI Contract Overview

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The County of San Mateo is seeking proposals from qualified Third-Party Administrators (TPAs) to manage its self-insured Workers' Compensation Program, including claims management and managed-care cost containment services for all new and existing claims. The County, which serves nearly 800,000 residents across 20 cities and 29 departments with approximately 7,250 employees, currently has about 694 open workers' compensation claims. The requested TPA staffing should ideally include a team with two Claims Supervisors, four Senior Claims Examiners, one Future Medical Claims Examiner, and two Assistant Claims Examiners, although some staffing flexibility is allowed with the possibility of adjustments after six months and annually thereafter. The County utilizes the Origami Risk Management Information System for claims data, which integrates with the TPA’s system to facilitate data exchange. Additionally, third-party vendors contracted through the selected TPA handle bill review, utilization review, nurse case management, and investigations, with the County retaining approval authority over these vendors. The solicitation, titled "Workers’ Compensation Third Party Administration and Managed Care Cost Containment Services RFP," is managed by the Human Resources Department in Redwood City, California, with proposals due by July 11, 2026. Key contacts for the solicitation include the Financial Management Analyst and Workers' Compensation Manager within the County.

General Info

San Mateo County seeks TPA for workers' compensation claims management, cost containment, staffing.

Agency

California → Human Resources DepartmentView Agency

NAICS

524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension FundsView NAICS

Place of Performance

CA, USA

Set-Aside

NONE

Documents

(4)

San Mateo County Special Claims Handling Instructions

PDFspecial-notice

San Mateo County RFP 2026-RFP-00430 Workers' Compensation TPA Services

PDFrfp

Standard Contract Template Over $200K Draft - San Mateo County

DOCX20 pagescontract-document

Standard Contract Template Under $200K Draft - San Mateo County

DOCX20 pagescontract-document

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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AgencyCalifornia → Human Resources Department
Contacts2 people available
OfficeRedwood City, CA, 94063, USA
Organization / Agency
California → Human Resources Department
View Agency Profile
Office AddressRedwood City, CA, 94063, USA
Contacts
Carling LukFinancial Management Analyst
Sarah PrinceWorkers' Compensation Manager

Full Description

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The County of San Mateo (the "County") covers most of the San Francisco Peninsula. The region covers 744 mi 2 and is home to nearly 800,000 residents and 20 incorporated cities. The County provides for the health and welfare of all people within its borders and serves as the local government for the unincorporated areas. Innovation thrives here in industries including bioscience, computer software, green technology, hospitality, financial management, healthcare, education and transportation. The County prides itself on how that prosperity fosters its commitment to protecting and enhancing the health, safety, welfare and natural resources of the community. The County is seeking proposals from qualified Third-Party Administrators (TPA) to provide Workers' Compensation Claims Management and Managed-Care Cost Containment Services for its self-insured Workers' Compensation Program. Services will be for all new and existing claims. There are approximately 694 total open claims comprised of 643 indemnity, 36 medical and 15 first aid/info only, with 249 open for Safety employees. The County's services and operations are supported by approximately 7,250 employees in 29 departments. We request that our future Third Party Administrator's staffing structure includes 2 fully dedicated Claims Supervisors, 4 fully dedicated Senior Claims Examiners, 1 fully dedicated Future Medical Claims Examiner, and 2 fully dedicated Assistant Claims Examiners, however the chosen TPA will have some flexibility to propose staffing. The County reserves the option to adjust staffing needs after the first 6 months, and then on an annual basis going forward. The County uses Origami Risk Management Information System, which is managed by a third-party vendor, and claims information is imported and exported through the current TPA's workers' compensation information system. The County also uses third-party vendors contracted through the current TPA for Bill Review, Utilization Review, Nurse Case Management and Investigation. The County reserves the right to approve all third-party vendors contracted through the chosen TPA.

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