Third Party Administrator - Liability & Worker's Comp

Agency:	City of Orange Township
State:	New Jersey
Type of Government:	State & Local
NAICS Category:	524292 - Third Party Administration of Insurance and Pension Funds 541611 - Administrative Management and General Management Consulting Services
Posted Date:	Oct 24, 2025
Due Date:	Dec 4, 2025
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Department of Law

Gracia Robert Montilus, City Attorney

Municipal Building

29 North Day Street, Second Floor

Orange, New Jersey 07050

REQUEST FOR

QUALIFICATIONS

Third Party Administrator for General

Liability and Worker’s Compensation

January 1, 2026 - December 31, 2026

SUBMISSION DEADLINE

1:00 PM – December 4, 2025

RFQ: Third Party Administrator for General

Liability and Worker’s Compensation

January 1, 2026 - December 31, 2026

Page 1

PLEASE TAKE NOTICE, City of Orange Township (“The City”) requests qualifications for the

services set forth below in accordance to the “fair and open process” pursuant to N.J.S.A. 19:44A-20.5,

et seq.:

1. Financial Consulting/Auditing

2. Risk Management Consultants

3. Public Information and Community Relations Services

4. General Environmental Consulting Services

5. Third Party Claims Administrator & Managed Care Services

6. Investigative Services Regarding Sick/injury Leave

7. Financial Software Maintenance

Request for qualification (“RFQ”) responses shall be submitted to, and be received by the Office of

Procurement, via mail or hand delivery, by 1:00 p.m. on December 4, 2025. Qualification Statements

will not be accepted by facsimile or e-mail transmissions. Qualification Statement shall be opened in

the City Attorney’s Office, located on the 2nd floor of Orange City Hall, Orange, New Jersey.

Responses must be enclosed in a sealed envelope. The service provider must indicate the following on

the outside of the envelope: (1) the name and address of the service provider; (2) the service for which

the response is submitted; and (3) “Sealed RFQ Response”. Responses may be delivered by hand,

overnight courier or mail. The envelope containing the response must be received by the City by the

date and time set forth above. No later responses will be accepted.

If awarded a contract, the service provider shall be required to comply with the requirements of N.J.S.A.

10:5-31, et seq. (P.L. 1975, c. 127 as amended) and N.J.A.C. 17:27-1.1 et seq.

Contracts will be awarded based on the most advantageous responses as determined by the City. The

City reserves the right to reject any or all responses.

RFQ: Third Party Administrator for General

Liability and Worker’s Compensation

January 1, 2026 - December 31, 2026

Page 2

CITY OF ORANGE CRITERIA FOR SERVICES

THIRD PARTY CLAIMS ADMINISTRATION & MANAGED CARE

SERVICES

This Criteria for Services applies to the City of Orange Township (“the City”) Request for

Qualifications (“RFQ”) for third party claims administration & managed care services.

A. Evaluation Factors

Responses from potential vendors (hereinafter referred to as “TPA’s”) will be evaluated by

the City on the basis of the following factors:

1. Experience and reputation in the field;

2. Knowledge of the City of Orange Township, matters concerning the City of Orange

Township, and the subject matter to be addressed under the contract;

3. Availability to attend to the City of Orange meetings and other matters as required;

4. Availability of personnel, managed care providers, and other resources to provide such

services;

5. Ability to provide both third party administration and managed care services;

6. Other factors if demonstrated to be in the best interests of the City; and

7. Compensation proposal.

B. Contract Award

The contract will be awarded on the basis of which response is most advantageous to the

City, price and other factors considered.

C. Scope of Services

The third party administration and managed care services to be provided by the TPA shall

include the following:

1. Reviewing all the City’s claim forms submitted by the City of Orange and providing

complete handling of all loss adjustments, and medical case management in compliance

with industry standards;

2. Having the TPA’s key local personnel conduct service calls, as needed, to the City for the

purpose of establishing lines of communication and reporting procedures;

3. Establishing and maintaining estimated reserve figures for each claim file and

consulting with the City with respect to payment of any claim;

RFQ: Third Party Administrator for General

Liability and Worker’s Compensation

January 1, 2026 - December 31, 2026

Page 3

4. Furnishing claim forms necessary for proper claims administration, in

accordance with the Tort Claims Act, Title 59, of New Jersey Statutes;

5. Maintaining claim files for each reported claim throughout the life of the claim and to

retain all closed files for a period of three (3) years following closing of the file, or as

otherwise required by applicable law or regulation;

6. Transmitting to the City, on a weekly basis, a list of all medical/indemnify benefits and

allocated expenses and/or all claim expenses, awards, etc., to be paid;

7. Issuing checks in payment of benefits and allocated expenses. Said checks to be paid from

an account maintained by the City at a bank of its choice and any fee or charges in

connection with said account shall be the responsibility of the City.

8. Notifying the City and excess insurance carriers and reinsurers (specifically, but not

limited to, New Jersey Municipal Self-Insurers’ Joint Insurance Fund, Municipal Excess

Liability Fund and XL Insurance) of any specific claim that may involve the City’s excess

coverage, carriers or reinsurers. The TPA will comply with all reasonable claim reporting

requirements of the insurance funds excess carriers, reinsurers and the City;

9. Indemnifying, defending and holding the City harmless for the TPA’s acts or omissions;

10. Attending any regularly scheduled City claims meetings to review claims;

11. Aggressively pursuing subrogation claims on behalf of the City and providing any

necessary services related to subrogation claims, or the litigation of subrogation claims.

Said services shall not include litigation costs such as expert fees or attorneys fees, and the

City reserves the right to direct and control the assignment of counsel for subrogation

claims and litigation;

12. Being present at informal claims hearings, when necessary;

13. Obtaining the approval of the City before settling any claims;

14. Maintaining records of attorneys, making recommendations, and cooperating with the

City’s excess carriers and reinsurer’s defense counsel regarding lawsuits or hearings

involving the subject exposures. Monitoring all claims referred to defense counsel and

keeping the City advised on a continuing basis as to the status of the litigated cases, any

settlement proposals or recommendations, and the actual and anticipated cost relating

to said legal defense. The City reserves the right to direct and control the assignment of

counsel as to any subject exposure;

RFQ: Third Party Administrator for General

Liability and Worker’s Compensation

January 1, 2026 - December 31, 2026

Page 4

15. Subject at all times to the approval of the City, maintaining a roster of physicians and other

treatment facilities for treatment of industrial or casualty accidents on a first aid and

specialized basis, as well as maintaining or establishing a liaison with the treating

physicians. Also, at the direction of the City, the TPA will recruit specific

providers/facilities for participation in the TPA’s managed care organization. In addition,

the TPA will coordinate rehabilitation and medical treatment and will if appropriate, retain

rehabilitation coordinators on behalf of the City with express approval of the City.

16. Upon request by the City of Orange Township, making recommendations to the City

regarding risk management, reserves, and having a representative available to the City for

purposes of establishing, conducting and coordinating a risk management program;

17. Hiring appropriate assessors to evaluate property damage in all litigated and non-litigated

matters as directed by the City.

18. Providing to the City written claims reporting procedures, including occurrences occurring

after normal business hours, during holidays or on weekends;

19. Submitting monthly loss run reports by fund year and by line of coverage to the City and

the joint insurance fund administrator within ten (10) calendar days following the end of

each month. Copies shall further be submitted to the fund actuary, fund auditor and fund

attorney on a quarterly and annual basis;

20. At its own cost and expense, maintaining in full force and effect during the entire term of

the contract, the following insurance coverages, with the City being named as an additional

inured where applicable:

a) Workers’ Compensation: Statutory – in compliance with the Workers’ Compensation

Laws of the State of New Jersey;

b) General Liability: A minimum limit of liability of $1 million per occurrence for bodily

injury and a minimum of $250,000 per occurrence for property damage;

c) Automobile Liability: A minimum limit of liability of $1 million per occurrence for

bodily injury and a minimum of $250,000 per occurrence for property damage. This

insurance must include coverage for owned, hired and non-owned automobiles; and

d) Errors & Omissions: A minimum limit of liability of $1 million per occurrence.

21. Generating reports in any format reasonably requested by the City of Orange Township;

22. Preparing reports required pursuant to any New Jersey statutes and any regulations enacted

pursuant thereto;

This page summarizes the opportunity, including an overview and a preview of the attached documents.

Bid Title:	Third Party Administrator - Liability & Worker's Comp
Category:	Bids and Request for Qualification (RFQs)
Status:	Open

Third Party Administrator - Liability & Worker's Comp

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