MB-10494 - USA (South Carolina) - Claims Administration and MMSEA Reporting Services - Deadline October 15,2026

(1) Vendor needs to provide claims administration and MMSEA reporting services. • Claims administration – Workers’ compensation:– Receive and record first reports of injury and investigations to determine the validity and compensability of any accidents or injuries claimed by agency employees to be a workers’ compensation claim and to accept or deny such claims.– Utilize external bill review services, if deemed prudent by the agency.– Provide managed care/case management for large/complex claims.• Claims administration – Liability:– Handle liability claims in accordance with agreed upon procedures.– Offer qualified adjusters and reliable communication options during agency office hours to address claims questions.– Provide access to agency for liability claims and related data.• Claims administration – Reporting and records reconciliation:– Set financial controls to meet guidelines and satisfy external auditors.– Submit monthly reports to the agency covering: Claims received, pending claims, payments made on behalf of the agency (lifetime and calendar year) and reserve estimates for actual, anticipated, or potential benefits and expenses.– Provide a set of monthly management reports as specified.– Handle and ensure conversion of the agency’s prior claims data.– Provide specific performance guarantees that include financial penalties for non–performance, an independent audit may be performed once every 3 years, audit by insurance carriers as required.– Provide cost control programs and practices to effectively control the cost of settlements, medical review, or other programs to control medical and pharmacy payments, litigation expenses and other such items payable through the claims system.(2) All the questions must be submitted no later than October 1, 2026. (3) The contract period will be for three years.