Administration of the City of Troy's Worker's Compensation and Section 207A & 207C Programs

The City of Troy, New York is soliciting sealed proposals from qualified agencies to provide services for the administration of the City's Worker's Compensation and Section 207A & 207C Programs. The selected agency will be responsible for advising and assisting the City in the administration of Workers’ Compensation benefits and Section 207A and 207C Programs. Key responsibilities include: • Workers’ Compensation Claims Administration/Workers’ Compensation Case Management • Data Processing • Benefit Consulting • Benefit Management and Administration • Processing bi-weekly payments to employees on the Workers’ Compensation payroll • Reviewing medical and prescription bills and reducing according to the New York State Workers’ Compensation Medical Fee Schedule • Authorizing medical procedures and diagnostic tests, additional specialist treatment and rehabilitation services • Investigating fully any questionable claims • Responding directly to medical provider’s requests for payment status and other inquiries The contract term will be from January 1, 2026 through December 31, 2029 with an option for one additional two-year extension upon mutual agreement by both parties. Some of the key requirements for the proposal include: • A statement of qualifications, including a brief history and description of the agency, identification of the firm’s professional staff members who will be assigned to this engagement, and a summary of the firm’s general experience in providing employee health benefits consulting services • A description of the methods to be used to provide the services required, including data processing, benefit consulting, and benefit management and administration • A detailed breakdown of all fees for services rendered, including any additional expenses for which the agency expects to be reimbursed • A guarantee that no additional fees will be charged to the City without prior written consent by the City • Proof of insurance, including commercial general liability, professional liability, workers’ compensation, and comprehensive automobile liability coverage • A non-collusive certification, stating that the prices in the proposal have been arrived at independently without collusion, consultation, communication, or agreement with any other bidder or competitor. Some of the key evaluation criteria for the proposal include: • Proposed Plan for Administering the Program • Qualifications and Experience • Proposed Methods to Deliver the Services Required • Total Proposed Price/Fees The City reserves the right to reject any and all proposals, to waive any informalities and technical irregularities in the proposals received, or to accept any proposal deemed to be for the best interest of the City of Troy.