Orlando Opengov #RFP26-0265

This opportunity involves the City of Orlando seeking a qualified vendor to provide Third-Party Administration (TPA) services for workers’ compensation claims for its sworn firefighters: - Government Buyer: - City of Orlando, Procurement and Contracts Division - Oversight by the City’s Risk Management Division - OEMs and Vendors: - Current Pharmacy Benefit Manager (PBM): Mitchell Pharmacy Solutions - RFP is open to other qualified TPA and PBM vendors - Products/Services Requested: - Comprehensive TPA services for all prior and new workers’ compensation claims for approximately 584 sworn firefighters - Includes claims management, Pharmacy Benefit Management (PBM), Preferred Provider Organization (PPO) services - Utilization review, field case management, detailed reporting, and integration with City information systems - Support for light duty and loss prevention programs - Unique or Notable Requirements: - Must handle claims involving Florida-specific statutes (e.g., F.S. 112.18 Presumption, PTSD claims under F.S. 112.1815(5)) - Ability to provide detailed claims reporting and analytics - Experience with municipal firefighter claims and financial stability required - Flexible pricing models: per-claim or flat annual fee - Committee review for settlements above a specified threshold - Excludes TPA services for other City employees - Ten years of historical claims data provided for reference

The City of Orlando is soliciting proposals for third-party administration (TPA) services to manage workers' compensation claims specifically for sworn firefighters within the Fire Department. The scope includes handling both prior and new claims, incorporating pharmacy benefit management and preferred provider organization services. The program oversees approximately 584 sworn firefighters with historical claims data provided, and the City emphasizes claims management and loss prevention. Proposals are due by April 24, 2026, with questions accepted until April 10, 2026.