Third Party Administrator Services

The City of East Orange, New Jersey, is actively seeking proposals for comprehensive Third Party Administrator (TPA) Services. This Request for Proposal (RFP) is being issued due to the expiration of the current program and the municipality's periodic requirement for competitive bidding. The selected TPA will be responsible for administering a wide range of municipal insurance claims, including Workers’ Compensation (Lost Time/Indemnity, Medical Only, Record Only), Auto Liability (Bodily Injury, Property Damage, Physical Damage, Record Only), General Liability (Bodily Injury, Property Damage, Record Only), Employment Practice Liability, Police Professional Liability, Public Officials, and Property Damage claims. A critical component of the scope involves assuming the ongoing administration of all open claims from the incumbent TPA, Claims Resolution Corp., in addition to managing new claims, with email specified as the preferred method for initial loss reporting. Property claims will primarily be commercial in nature. While specific, detailed contractor qualifications are not explicitly outlined in this Q&A document, the breadth of claim types and the complexity of services indicate a requirement for highly experienced and capable third-party administrators. The document clarifies that a pre-proposal conference held on August 19 did not offer a teleconference option for remote participation. Medical Management services are expected to be fully integrated into the TPA's offering, without separate charges for medical bill review and utilizing a percentage of savings model for access to PPO networks. Furthermore, the TPA will need to support seven Risk Management Information System (RMIS) users who require access to detail claims, reports, and dashboards, and provide weekly/monthly claim output files (e.g., Claim Level Detail, Transactional Financials, Adjusters’ Notes) to an in-house or third-party RMIS system. The City is currently receiving services for Medical Appointment tracking, Work Status Tracking, Job Offer Tracking, and OSHA recordkeeping/DART support. Specific submission instructions, including the exact deadline, are not detailed within this Questions & Answers document. However, the anticipated effective date for the new TPA program is within 60 days of the RFP's acceptance. Bidders should be prepared for client references to be verified, potentially through questionnaires or phone interviews. Loss Control Services are currently provided by JIF, not the TPA, but the City is open to considering options for continuing with the existing firm or exploring alternative independent loss control firms. This Q&A document does not provide details regarding required bid security, performance bonds, or direct contact information for proposal submission inquiries, indicating such information would be in the primary RFP document.