THE CITY OF MONTEREY REQUEST FOR PROPOSALS FOR WORKERS’ COMPENSATION THIRD-PARTY ADMINISTRATOR

The City of Monterey is seeking a qualified and licensed Third-Party Administrator (TPA) to provide Workers’ Compensation claims administration services for the City’s self-insured Workers’ Compensation Program. The selected TPA will be responsible for the administration of all existing Workers’ Compensation claims, as well as new claims filed on or after the program inception date of June 2, 2026. The TPA must demonstrate the ability to process claims in a timely and professional manner, actively pursue subrogation opportunities, assist in returning injured employees to work, and maintain strong communication with both the injured worker and City staff. The initial term of the contract is expected to be five years, with five optional one-year renewals, subject to mutual agreement and satisfactory performance. Key responsibilities of the TPA include: • Investigative services, including review of incident reports and conduct of thorough investigations • Claim handling, including determination of liability, evaluation of claims, and recommendation of reserves • Legal support services, including assistance in retaining outside counsel and representation of the City in small claims actions • Bill review, including review of bills for compliance with fee schedules and reduction of charges as appropriate • Medical management, including oversight of medical treatment and approval or denial of service requests • Information system, including provision of 24/7 internet-based access to claim data and reports • Insurance, including maintenance of professional liability and general liability coverage.