Workers’ Compensation Third-Party Administration (TPA) Services

The City of Chino is soliciting proposals from qualified firms to provide comprehensive Workers’ Compensation Third‑Party Administration (TPA) services for its self‑insured program. The selected vendor will administer claim intake, medical bill review, utilization review, pharmacy benefit management, litigation support, reporting, and all related financial and compliance functions in accordance with California workers’ compensation statutes and the PRISM standards. The contract is initially for two years with up to three one‑year renewal options at the City’s discretion. • Full claim lifecycle management (intake, adjudication, reserve posting, payments, and closure). • Required URAC certification by July 1 2027 and adherence to detailed PRISM performance timelines. • Reporting obligations include monthly administrative reports, custom data extracts, and statutory filings. • Must meet insurance coverage minimums (e.g., $1 M General Liability, $2 M aggregate) and comply with prevailing‑wage rules if classified as public work.