Description
The New Jersey Counties Excess Joint Insurance Fund seeks a qualified third‑party administrator to provide comprehensive claims administration services—including liability, workers’ compensation, and managed‑care functions—for its excess insurance program covering ten member counties. The contractor will manage excess‑layer claims, coordinate with member TPAs, handle payments and reserves, provide extensive reporting, and integrate claim data into the Fund’s Origami Risk RMIS. Additional responsibilities include maintaining a 24/7 medical network, bill repricing, early return‑to‑work coordination, and compliance with strict NJ state statutes.
• Core services: liability and workers‑comp claims administration, excess‑layer handling, reserve setting, payments, and audit support.
• Managed‑care: network maintenance, provider credentialing, medical bill repricing (≤ 5 business days), early‑return‑to‑work notifications, fraud reporting.
• Reporting: weekly updates, monthly loss summaries (within 10 days), quarterly loss runs (within 5 business days), and monthly data uploads to Origami Risk.
• Contract term: January 1 2027 – December 31 2029 (3 years) with a 30‑day termination clause and a minimum 60‑day proposal validity.