RFP PROPOSAL SUBMISSION DEADLINE EXTENDED TO 4/27/2023

Request for Proposal for WC TPA Services
Five Year Claim Loss Run
Current TPA Contract
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QUESTIONS:
Claims Data

1. 5 years of Workers’ Comp claims data is provided in the Excel attachment
2. Please provide the total number of open WC indemnity claims effective 04/01/2023.)
3. Please provide the number of open WC indemnity claims w/ occurrence dates prior to 01/01/2017.
   0
4. Please provide the total number of open Future Medical claims effective 04/01/2023.
   0
5. Please provide the number of open Future Medical claims w/ occurrence dates prior to 01/01/2017.
   0
6. How many open WOCSFWCA litigated cases, effective April 1, 2023?
   43
7. How many WOCSFWCA subrogation claims <annually> for the past five years?
   1
8. In addition to regularly scheduled quarterly claims review meetings, how many additional administrative meetings does WOCSFWCA typically have?
   10-11

Preferences

1. Does WOCSFWCA have a preferred open indemnity caseload for its dedicated examiner; 125, 150, or other?

Preferred case load of 125 claims total
 
Bill Review, Managed Care, Loss Prevention – Risk Management Consultation

1. Does WOCSFWCA utilize the incumbent's Nurse Case Management services?
2. The current nurse case management services are through Sedgwick
3. Does WOCSFWCA utilize the incumbent's PBM services or a separate vendor.
   Optum
4. Does WOCSFWCA utilize the incumbent's medical bill review or a different vendor?
   The JPA currently uses Sedgwick’s Utilization Review
5. Does WOCSFWCA utilize 24-7 nurse triage?


6. Does WOCSFWCA utilize the incumbent TPA's Loss Prevention?
   We utilize the services from our TPA and also our broker, AJG.
7. Can WOCSFWCA provide detailed utilization review statistics, such as net-gross savings report, and utilization review volume for the past five years?
8. Does WOCSFWCA utilize an MPN? If yes to the MPN, is yours proprietary?
   We do not have a MPN

 
Incumbent

1. Who is the incumbent TPA?


2. May we have a copy of the current TPA – WOCSFWCA service agreement and/or current through 2022-2023 addendum?

Included in attachment

1. Does WOCSFWCA have preferred defense law firms?

The Primary firms used
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:

1. What workers' compensation program priority is most important for WOCSFWCA over the next three years?
   The program priority is to reduce the claim count
2. 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

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1. 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.