Huntington Beach Planet bids #2026-0602

Huntington Beach Workers' Compensation TPA and Managed Care Program Services Solicitation

The City of Huntington Beach is seeking experienced vendors to provide Third-Party Administrator (TPA) and Managed Care Program (MCP) services for its workers' compensation claims administration. - Government Buyer: - City of Huntington Beach, Risk Management Department - Services Requested: - Third-Party Administrator (TPA) Services - Comprehensive administration of workers' compensation claims, including employee interface, claim file management, compensability determinations, medical treatment monitoring, fraud investigation, subrogation, and compliance with Alternative Dispute Resolution (ADR) programs - Administration of approximately 200 open indemnity claims, 425 future medical claims, and 46 medical-only claims - Access to claims management software and comprehensive reporting required - Managed Care Program (MCP) Services - Bill Review: Medical bill compliance review tailored to California workers' compensation statutes - Utilization Review: Review of medical treatment necessity and appropriateness, with California-based medical directors - Pharmacy Benefits Management: Pharmacy network management and reporting - Notable Requirements: - Vendors must have at least 10 years of experience providing similar services to California public agencies - Compliance with California workers' compensation laws and City-specific requirements - Insurance and indemnification requirements - The City may award TPA and MCP services bundled or separately, with TPA always awarded to one consultant - OEMs and Vendors Mentioned: - EK Health Services Inc - Gallagher Bassett Services, Inc. - Mitchell International - Pacific Secured Equities, Inc. - RehabWest, Inc. - Place of Performance: - City of Huntington Beach, 2000 Main Street, Huntington Beach, CA 92648

Description

The City of Huntington Beach is seeking proposals for Third-Party Administrator (TPA) services and Managed Care Program (MCP) services related to workers' compensation claims administration. The MCP services include three components: Bill Review, Utilization Review, and Pharmacy Benefits Management. Consultants may submit proposals for any combination of TPA and MCP services. The City reserves the right to award these services in any combination, either bundled or unbundled, and may award MCP components to one or more consultants, while TPA services will be awarded to one consultant.

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