Description
Luzerne County, PA is soliciting proposals from qualified Workers’ Compensation Administrators (TPAs) to provide comprehensive claim processing and medical‑management services for its self‑insured workers’ compensation program beginning January 1 2027. The selected TPA will act as the primary claims handler, performing eligibility determinations, reserve setting, payment processing, statutory filing, statistical reporting, and advisory functions while maintaining secure data handling and supporting the County’s compliance obligations. The contract is initially for one year with two optional one‑year extensions and may be terminated for cause or convenience. Proposals must be submitted electronically via PennBid (or by hard copy) by 4 PM EST on November 10 2026.
• Scope: full lifecycle workers’ comp claim administration, medical bill re‑pricing, reporting, and liaison with County risk‑management, HR, and legal teams.
• Required deliverables: monthly claim payment registers, loss runs, indemnity forecasts, bank reconciliations, and optional real‑time online access.
• Compensation: monthly fee plus annual CMS/Medicare administration fee; TPA retains 10 % of managed‑care medical‑expense savings.
• Mandatory certifications: professional liability insurance, workers’ comp coverage, and documented staff expertise.
• Evaluation criteria: price, reputation, quality, fit to County needs, and past performance.