Third-Party Administrator for Workers' Compensation Program

The City of Pasadena’s organizational structure for the Workers’ Compensation Section includes a Claims Supervisor, two Claims Examiners and one Senior Office Assistant. The Senior Office Assistant provides clerical support for the City’s claims department. The files are assigned based upon an alphabetical split, with one examiner assigned to last names beginning A-K, and the other assigned to L-Z. The Examiner’s caseloads include maintenance claims.

The City is requesting that the responders include in their proposal, system access for the City staff for the claims administered by the City of Pasadena. The City of Pasadena will be looking at the possibility of contracting for their own claims management system during this contract. Proposals should include pricing variability should the City procure a claims management system during this contract for both the City and the Third-Party Administered claims.

The City currently operates an approved Alternative Dispute Resolution (ADR) program for a portion of its California Workers’ Compensation claims. As part of its ongoing risk‑management strategy to reduce litigation exposure, streamline claim resolution, and improve outcomes for injured employees, the City intends to expand ADR coverage to all Workers’ Compensation claims. To support this initiative, the City is seeking a vendor with demonstrated expertise in California Workers’ Compensation ADR programs and a proven track record of collaborative, compliant, and solution‑oriented partnership.

The City uses Ventiv which is managed through the current TPA’s workers’ compensation system. The City also uses a third party for bill review, Utilization Review and Nurse Case Management.

The City requests that proposals p rovide Workers’ Compensation administration for all City departments with all dates of injury (approximately 601 claims).