RFP PROPOSAL SUBMISSION DEADLINE EXTENDED TO 4/27/2023
Request for Proposal for WC TPA Services
Five Year Claim Loss Run
Current TPA Contract
QUESTIONS:
Claims Data
Bill Review, Managed Care, Loss Prevention – Risk Management Consultation
Incumbent
a. D’andre Law – Attorney: Mitchell Kim
b. Hermanson, Guzman, & Wang – Attorney: Iliana Guzman
c. Silberman & Van Ost – Attorney: Rachael Van Ost
d. Wall, McCormick, Baroldi & Dugan – Attorney: William McCormick
e. Karlin, Hiura & LaSota – Attorney: Julie Carbonara
Misc:
Request for Proposal for WC TPA Services
Five Year Claim Loss Run
Current TPA Contract
QUESTIONS:
Claims Data
- 5 years of Workers’ Comp claims data is provided in the Excel attachment
- Please provide the total number of open WC indemnity claims effective 04/01/2023.)
- Please provide the number of open WC indemnity claims w/ occurrence dates prior to 01/01/2017.
0 - Please provide the total number of open Future Medical claims effective 04/01/2023.
0 - Please provide the number of open Future Medical claims w/ occurrence dates prior to 01/01/2017.
0 - How many open WOCSFWCA litigated cases, effective April 1, 2023?
43 - How many WOCSFWCA subrogation claims <annually> for the past five years?
1 - In addition to regularly scheduled quarterly claims review meetings, how many additional administrative meetings does WOCSFWCA typically have?
10-11
- Does WOCSFWCA have a preferred open indemnity caseload for its dedicated examiner; 125, 150, or other?
Bill Review, Managed Care, Loss Prevention – Risk Management Consultation
- Does WOCSFWCA utilize the incumbent's Nurse Case Management services?
- The current nurse case management services are through Sedgwick
- Does WOCSFWCA utilize the incumbent's PBM services or a separate vendor.
Optum - Does WOCSFWCA utilize the incumbent's medical bill review or a different vendor?
The JPA currently uses Sedgwick’s Utilization Review - Does WOCSFWCA utilize 24-7 nurse triage?
- Does WOCSFWCA utilize the incumbent TPA's Loss Prevention?
We utilize the services from our TPA and also our broker, AJG. - Can WOCSFWCA provide detailed utilization review statistics, such as net-gross savings report, and utilization review volume for the past five years?
- Does WOCSFWCA utilize an MPN? If yes to the MPN, is yours proprietary?
We do not have a MPN
Incumbent
- Who is the incumbent TPA?
- May we have a copy of the current TPA – WOCSFWCA service agreement and/or current through 2022-2023 addendum?
- Does WOCSFWCA have preferred defense law firms?
a. D’andre Law – Attorney: Mitchell Kim
b. Hermanson, Guzman, & Wang – Attorney: Iliana Guzman
c. Silberman & Van Ost – Attorney: Rachael Van Ost
d. Wall, McCormick, Baroldi & Dugan – Attorney: William McCormick
e. Karlin, Hiura & LaSota – Attorney: Julie Carbonara
Misc:
- What workers' compensation program priority is most important for WOCSFWCA over the next three years?
The program priority is to reduce the claim count - Section A. Information to include in Written Proposal – Is it permissible to place Item 22 the Cover Letter at the beginning of the proposal?
Yes
- Should the bidder have any exceptions to the RFP and/or terms and conditions, where in the proposal should the bidder address these exceptions?
The bidder may include a separate Letter at the end of the bid to discuss the exceptions.
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