RFP Third Party Administrator Services

The City of O'Fallon, Missouri is seeking a Third-Party Administrator (TPA) to provide comprehensive services for its self-insured Workers' Compensation and Liability programs. The TPA will be responsible for claims intake and administration, medical bill review, network access, utilization review, subrogation, litigation support, Medicare compliance, data and reporting, and cost containment. The city has approximately 500 full-time and 325 part-time employees, and the TPA should have experience working with public entities of similar size and complexity. The TPA must be properly licensed, insured, and bonded, and must comply with all applicable laws and regulations. The scope of services includes: 1. Claims intake and administration 2. Medical bill review and PPO/network access 3. Utilization review and nurse case management 4. Pharmacy benefit coordination 5. Subrogation and recovery 6. Liability claims administration 7. Medicare compliance 8. Litigation management 9. Data, reporting, and analytics 10. Financial controls 11. Implementation and account management 12. Information systems and secure access 13. Customer service and accessibility 14. Compliance 15. Performance guarantees (fee-at-risk) 16. Cost containment programs The TPA will be required to provide quarterly claims review meetings, active claim management, and collaboration with the city on attorney selection and litigation management. The TPA must also demonstrate knowledge of municipal liability laws applicable to Missouri public entities. The proposal submission deadline is May 19, 2026, at 12:00 P.M. CDT. Proposals must be submitted in sealed envelopes with one original and two copies, along with an electronic copy on a flash drive. The city will evaluate proposals based on the respondent's experience, qualifications, and proposed services, and will award the contract to the most qualified respondent. Key dates: * Release and advertisement of RFP: April 24, 2026 * Deadline for submission of questions: May 1, 2026, at 12:00 P.M. CDT * Proposal submission deadline: May 19, 2026, at 12:00 P.M. CDT The city reserves the right to amend or cancel the RFP at any time, and proposers are responsible for checking the city's website for updates and addenda.