Riverside Transit Agency PlanetBids #RFP S26089

Riverside Transit Agency Solicits Third Party Administration for Workers’ Compensation and Managed Care Services

Riverside Transit Agency (RTA) is seeking a qualified contractor to provide third party administration (TPA) for its self-insured workers’ compensation program and managed care services. - Government Buyer: - Riverside Transit Agency (RTA), California - Contracts Manager: Lon-Det Givens - Services Requested: - Third party administration of workers’ compensation claims, including: - Claims investigation, adjustment, processing, and resolution - Medical bill auditing for accuracy, compliance, and cost containment - Utilization review of medical treatment requests (state-approved, URAC-compliant) - Medical case management, including nurse case management and coordination of care - Medicare reporting services (Section 111 compliance, conditional payment management) - Medical provider network management - Comprehensive reporting (monthly, quarterly, annual, and ad hoc) - Fraud prevention, cost containment, and data security - Online access to claims system and secure electronic dashboards - Transition support for open claims at contract start and end - Notable Requirements: - Contractor must be registered with the State of California and hold a valid Certificate to Administer from the Office of Self-Insurance Plans (OSIP) - Must be listed on California’s Roster of Third Party Administrators - Minimum five years of relevant experience - Ability to assume all open claims at contract start and process claims left open at contract end (hourly rates for transition) - Compliance with all state and federal regulations, including HIPAA and Medicare Secondary Payer rules - Detailed audit provisions and service delivery timelines - No specific OEMs or product part numbers are involved, as this is a service-based solicitation open to qualified TPA firms. - Contract Structure: - Firm-fixed price agreement - Three-year base term with two one-year option terms (up to five years total) - Services priced monthly; additional hourly rates for transition support

Description

Riverside Transit Agency (RTA) is soliciting proposals from experienced and qualified contractors to provide third party administration for workers’ compensation claims and managed care services. The scope of work is detailed in Exhibit A, and contractors must be registered with the State of California and hold a valid Certificate to Administer issued by the Office of Self-Insurance Plans (OSIP). The contract is anticipated to be a firm-fixed price agreement with a three-year base term and two one-year option terms. Proposals must be submitted electronically by August 14, 2026, and a pre-bid meeting is scheduled for July 20, 2026.

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