MB-10530 - USA (New Jersey) - Third Party Administration Services - Deadline October 27,2026

(1) Vendor needs to provide third party administration services including workers compensation, auto general liability, and 1st party property claims administration and workers' compensation managed care services.A. Claims Management/Investigation– Provide complete handling of reported injury claims, including but not limited to all tasks associated from set up to closure. Set up for record only claim. The Risk Manager must advise whether a claim is reported only and not reportable.– If during an investigation the vendor determines the existence of a hazardous condition, the vendor shall immediately notify (telephonically) the Risk Manager.– Provide a reporting procedure for accidents occurring after normal business hours including weekends and holidays.– Determine compensability or coverage position for all reported claims. Determination shall be made within 72 hours of receipt of necessary facts.– The Risk Manager must be advised prior to issuing any denial of benefits/coverage– Index all claims for multiple claims and possible causation unrelated to work injury such as an auto accident.B. Managed Care Services– Telephonic case management and field case management.– All nurse case managers must be registered RNs.– Integrated electronic system between case managers and claim adjusters to assure file documentation is complete.– Provide Network Access.– Perform all repricing services pursuant to NetworkC. Legal Case Management– Assist Defense Counsel (internal/external) in evaluating, investigating, and determining the appropriate legal strategy.– Advise the Risk Manager if external Defense Counsel is not providing standardized status reports on assigned claims.(2) Contact period will be for one year.