WCB Third Party Administration Services

The New York State Workers’ Compensation Board (“WCB” or “Board”) is seeking proposals from experienced and qualified vendors, authorized to do business in New York State (NYS) to provide Third-Party Administration (TPA) and other claims-related services for the various types of claims that the Board is responsible for administering. The Board is seeking to contract with two (2) qualified vendors to provide the desired TPA services, and other claims-related services, in accordance with the specifications set forth in this RFP. One (1) qualified vendor will serve as the Primary Contractor (the highest Final Composite Score), and one qualified vendor will serve as the Secondary Contractor (the second highest Final Composite Score).

Contractor(s) will be responsible for fulfilling the claims administration responsibilities for:

• claims of the Special Fund for Reopened cases;
• claims of defaulted self-insured employers, group self-insured trusts and public self -insured groups;
• claims of the Uninsured Employers’ Fund;
• claims of the Special Fund for Disability Benefits; and/or
• claims under any other workers’ compensation or disability benefit the Board is responsible for administering.

Claims administration responsibilities shall include, but not be limited to:

• efficient and cost-effective case management using industry standard best practices;
• timely indemnity and medical payments; and
• monthly reporting to the Board.

This RFP, and the appendices and attachments referenced herein, provide specific service requirements, experience requirements, and other pertinent information. The specifications for the engagement and the terms and conditions set forth in this RFP will be incorporated into any resulting contract entered into between WCB and the selected bidder(s).