The Administration recommends that the Mayor and City Commission of the City of Miami Beach, Florida authorize the issuance of Request for Proposals (RFP) 2021-224-WG for claims administration services by a third-party administrator for workers’ compensation. The administrator will provide all specified adjusting services for all claims as well as all other required services, such as administrative, managed care/medical case management, computerized claims/loss statistical information and banking/loss fund reconciliation.

The City of Miami Beach (the “City”) is approved by the Florida Department of Labor and Employment Security/Division of Workers’ Compensation to self-insure for Workers’ Compensation.  The Division of Workers’ Compensation requires that the claims administration be provided by a State Certified Workers’ Compensation Claims Administrator. 

The City has approximately 2,184 employees, and averages 365 claims annually with approximately two-thirds of the claims being medical-only. 

On February 1, 2014, the City entered into an Agreement with CorVel Enterprise Comp, Inc. to provide third party claims administration services for its self-insurance worker’s compensation program pursuant to RFP 2014-302-SW. The Agreement had an initial term of two (2) years that commenced on February 1, 2014 and ended on January 31, 2016. Three (3) one-year renewals were exercised from February 1, 2017 through January 31, 2019.  On October 16, 2019, pursuant to Resolution No. 2019-31021, the Mayor and City Commission approved Amendment No.1 to the Agreement extending the term for two (2) additional years.  The Agreement is presently scheduled to expire January 31, 2022.

The City is seeking the professional services of an experienced and qualified firm to provide services as a third-party administrator for workers compensation claims.  The selected firm will provide all specified adjusting services for all claims as well as all other required services, such as administrative, managed care/medical case management, computerized claims/loss statistical information (RMIS) and banking/loss fund reconciliation.  The specific required services are outlined in greater detail within the RFP.

·         SCOPE OF WORK.  Please Reference, Appendix A, RFP 2021-224-WG Claims Administration Services by a Third-Party Administrator for Workers’ Compensation (attached).

·         SUBMITTAL REQUIREMENTS.  Please Reference Section 0300, RFP 2021-224-WG Claims Administration Services by a Third-Party Administrator for Workers’ Compensation (attached).

·         CRITERIA FOR EVALUATION.  Please Reference Section 0400, RFP 2021-224-WG Claims Administration Services by a Third-Party Administrator for Workers’ Compensation (attached).

Following the receipt of proposals an Evaluation Committee will review proposals in accordance with the criteria established in the RFP.

The City is self-insured for workers compensation and the selected third-party administrator pays all claims and allocated loss adjusting expenses from the Risk Management Claims account.  There is a separate account for legal fees incurred by our two outside Workers’ Compensation attorneys.  The budget for both accounts are set each year based on actuarial projections. 

I recommend that the Mayor and Commission authorize the issuance of the RFP 2021-224-WG for third-party claims administration services for workers’ compensation claims.