RFP 27-20-0610 Workers' Compensation Third Party Claims Administration Services

Forsyth County Procurement Department
2435 Freedom Parkway, Suite 3100
Cumming, GA 30041 | Phone 770.888.8872
REQUEST FOR PROPOSAL
RFP NO. 27-20-0610
Workers' Compensation Third Party Claims
Administration Services
Forsyth County Board of Commissioners
Cumming, GA
Closing Date and Time:
October 15, 2026 / 2:00 p.m.

FORSYTH COUNTY, GEORGIA
Request for Proposal No. 27-20-0610
Workers' Compensation Third Party Claims Administration Services
1. PURPOSE OF THE REQUEST FOR PROPOSAL
Forsyth County, a political subdivision of the State of Georgia ("County") is soliciting
Proposals from qualified firms to provide Workers' Compensation Third Party Claims
Administration Services for the Forsyth County Department of Risk Management.
All interested qualified firms are invited to submit a formal proposal with pricing
information to accomplish the Scope of Work described herein, in conformance with the
prescribed format. The proposal is to be signed by a principal in the firm.
It is the County's intent that this Request for Proposal ("RFP") permit competition. It shall
be the offeror's responsibility to advise the Procurement Agent in writing, if any language,
specification, etc., or any combination thereof, inadvertently restricts or limits the
requirements stated in this RFP to a single source. Such notification must be received by
the Procurement Agent not later than ten (10) days prior to the date set for acceptance of
the proposal.
While every effort has been made to ensure the accuracy and completeness of
information in the RFP, we recognize that the information may not be complete in every
detail and that all work may not be expressly mentioned in these specifications. It is the
responsibility of the proposing firm to include in their proposal all pertinent information
in accordance with the objectives of the County.
2. GENERAL INFORMATION
Proposals MUST be submitted in the format prescribed herein. Failure to comply with the
directions listed in this RFP, or omission of requested information could result in
disqualification of your firm's proposal.
Forsyth County uses a procurement portal powered by EUNA Procurement formerly
Bonfire Interactive ("Bonfire") for accepting and evaluating bids, statements of
qualification, and proposals digitally, found by using the link:
https://www.forsythco.com/Departments-Offices/Procurement/Bids-Results
Proposals shall only be accepted online through the EUNA Portal.
Proposals are due 2:00 p.m., (EST) Thursday, October 15, 2026. Names of submitting
firms will then be read aloud at 2:30 p.m. (EST), Thursday, October 15, 2026. All interested
parties and the general public are invited.
ALL QUESTIONS are to be asked via EUNA under Opportunity Q&A. Responses to
substantive questions will be provided as written Addenda and will be posted under
Public Files in EUNA. The deadline for questions is October 6, 2026, 12:00 p.m. (EST).
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Proposals and Pricing Information received will become the property of Forsyth County
and shall be used as the County sees fit. All information contained in the Proposals and
Pricing Information will remain confidential until after the awarding and signing of the
contract.
3. COST OF PROPOSAL
Forsyth County assumes no responsibility or liability for the costs incurred by the
submitting firm to prepare and/or submit a proposal. The entire cost of preparing and
submitting Proposals and Pricing Information, or any work in connection therewith will
be borne by the submitting firm or team of firms.
4. RESPONSIBILITY OF PROPOSER
Proposals must be signed by an authorized official to bind the offeror, and it shall contain
a statement to the effect that the Proposal is firm for a period of at least ninety (90) days
from the closing date for submission.
5. CONNECTIVITY
The County shall not be responsible for errors of any kind or nature occurring in the
transmission or downloading/uploading of any documents from the website. The County
does not guarantee continuous, uninterrupted, or secure access to this or other related
websites. Operation of this website may be affected from time to time by numerous factors
outside of our control. Site problems, user problems, internet problems, power outages, or
routine maintenance may interrupt or prevent access to information, documents, and/or
submission capabilities.
6. PROHIBITION OF GRATUITIES
Firms shall not offer any gratuities, favors, or anything of monetary value to any official,
employee, or agent of the Forsyth County Board of Commissioners for the purpose of
influencing consideration of this proposal.
7. CONTACT
To ensure all prospective respondents have the same level of knowledge relative to the
project, as well as ensuring any additional data is made available to all proposers, no
vendor shall contact or discuss any aspect of this RFP with any County employee, elected
official, evaluation/selection committee member, or project team member, during the
RFP process up until award has been made. If contact is made, that vendor may be
disqualified from the process. All questions in regard to this RFP are to be submitted via
EUNA under Opportunity Q&A as detailed in the General Information section of this
document. Any information obtained about this solicitation through any means other
than the solicitation itself or the addendums thereunto is not valid and should not be
considered in any response to this solicitation.
8. OWNERSHIP OF MATERIAL
Ownership of all data, material, and documentation originated and prepared for the
County pursuant to the Contract shall belong exclusively to the County.
9. TERM
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The Term of this Contract shall begin on January 1, 2027 and will end on December 31,
2031.
10. AGREEMENT
Attached to this RFP is a draft form of a General Services Agreement which contains
terms and conditions of the contractual arrangement for the services. Such form of
agreement will be modified as appropriate, in the County's discretion, to include any
additional specific terms related to the services being provided. Any questions regarding
the form of the General Services Agreement must be submitted in writing by the deadline
for questions specified in this RFP.
11. CHANGES
No change will be made to this RFP except by written modification by the County
Procurement Department. Requests for interpretation or changes must be in writing and
received at least seven (7) calendar days prior to the time set for opening of the proposals.
12. WITHDRAWAL OF PROPOSAL
Proposals may be withdrawn by written request only; if the request is received prior to
the time and date set for the opening of proposals. Negligence on the part of the Proposer
in preparing its proposal confers no right of withdrawal or modification of its proposal
after proposal has been opened. No proposal may be withdrawn for a period of sixty (60)
days after time has been called on the date of opening.
13. SUBSTITUTIONS
When references are made in these documents to trade names or to the brand names of
manufacturers, such references are made solely to designate and identify the quality of
materials or equipment to be furnished and are not intended to restrict proposals. If
comparable materials or equipment of trade names or of manufacturers' names which
are different from those mentioned in the RFP specifications are offered, the burden of
proving equality of a proposed substitution rest on the submitting firm and must be
provided with the proposal.
14. EXCEPTIONS TO SPECIFICATIONS
Any award resulting from this RFP shall bind the Proposer to all terms, conditions and
specifications set forth in this RFP. Proposers whose proposals do not conform should so
note on separate page if necessary. While the County reserves the right to make an award
to a nonconforming proposer when in the best interest of the County, such awards will
not be readily made, and proposers are urged to conform to the greatest extent possible.
No exceptions will be considered to have been taken by a Proposer unless it is properly
set out as provided above. No exception will be deemed to have been taken by the County
unless incorporated in an award resulting from this RFP and so stated.
15. RESERVATION OF REJECTION OR CANCELLATION
The County reserves the right to cancel the RFP or to reject any and all proposals
submitted in response to any solicitation, to reject any portion thereof, or to waive any
minor irregularity or administrative requirement, if it determines, in its sole discretion,
that such cancellation, rejection, or waiver is in the best interests of the County.
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16. AFFIDAVIT
The Proposer will be required to execute an Affidavit of Non-Collusion and submit it with
the RFP Documents.
17. INSPECTION OF RECORDS
The records of the Procurement Department are open and accessible to the public in
accordance with the provisions of the Georgia Open Records Act. Requests for inspection
of records must be in writing, must be reasonable, must contain sufficient information to
facilitate retrieval, and must not interfere with the orderly operation of the Procurement
Department.
Proposers are cautioned that any documentation submitted with or in support of a bid or
proposal will become subject to public inspection under the Georgia Open Records Act.
Labeling such information "Confidential," "Proprietary," or in any other manner will not
protect this material from public inspection upon request.
18. TRADE SECRETS
Careful consideration should be given before submitting confidential information to the
County. The County's disclosure of records and documentation is governed by the
Georgia's Open Records Act, which permits public scrutiny of most materials collected as
part of this process. If Proposer submits information that contains trade secret
information and if Proposer wishes to keep such information confidential, Proposer must
submit and attach to such information an affidavit affirmatively declaring that specific
information constitutes trade secrets pursuant to the Georgia Trade Secrets Act of 1990,
O.C.G.A. 10-1-760 et seq., and the Proposer and County will follow the requirements of
O.C.G.A. 50-18-72(a)(34) related thereto.
19. REGULATORY AGENCIES
Successful Proposer will be responsible for all required permits or license required by any
regulatory agency of the city, county, state or federal governments. Further, successful
proposer will be responsible for meeting all requirements of any regulation(s) or
guideline(s) of any of the said governments or any independent agency recognized by
said governments as publisher of any such regulation(s) or guideline(s).
20. INDEPENDENT CONTRACTORS
The Proposer represents to Forsyth County that it is fully experienced and properly
qualified to perform the functions provided for herein and that it is properly equipped,
organized and financed to perform such functions. The Proposer shall finance its own
operations hereunder, shall operate as an independent contractor and not as the agent
of Forsyth County and nothing contained in this RFP or a contract resulting from same
shall be construed to constitute the Proposer or any of its employees, servants, or agents
or subcontractors as a partner, employee, servant or agent of the County nor shall either
party have any authority to bind the other in any respect, it being intended that each shall
remain an independent contractor.
21. REQUIRED FORMS
All Proposing firms will be required to complete, execute, and submit with its proposal
the following:
* Affidavit of Non-Collusion
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* Contractor Affidavit and Agreement
* Subcontractor Affidavit (if applicable)
* Addendum Acknowledgement
22. EVALUATION METHOD AND CRITERIA
The County will evaluate all responsive proposals to determine which proposals best
meet the needs of the County based on the evaluation criteria. Proposals deemed
responsive advance; non-responsive proposal are disqualified. The County shall be the
sole judge of its own best interest, the proposals, and the resulting agreement. Evaluation
will be made by an evaluation committee established for this purpose. Award will be
based on a review of all information submitted. Proposing firms may be asked to appear
before the evaluation committee. Pricing information will be opened to all firms and the
general public after the RFP submission deadline has passed.
The proposal is limited to forty (40) pages, formatted on 8 12" x 11" paper, with a minimum
11 pt font size. The page count does not include mandatory required forms in paragraph
21 or Cost Proposal. Proposer must demonstrate their ability to satisfy all qualifications
and requirements to perform the services detailed in this RFP.
Proposals determined to be Responsive and Responsible will be evaluated on the
following criteria:
Cover/Transmittal Letter and Required Forms Pass/Fail
Capabilities 20 points
Experience and References 15 points
Questionnaire 30 points
Telephonic and Field Case Management 20 points
Risk Management Information System 15 points
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SCOPE OF SERVICES
Background
Forsyth County (County) is seeking Third Party Workers' Compensation Claims
Administration Services (TPA) committed to excellence in the oversight and management of
the County's workers' compensation claims through quality treatment of employees, timely
service of all claims, and use of professional affiliations to maximize cost savings.
Forsyth County's Risk Management Department is responsible for administering safety, loss
control, and insurance programs for Forsyth County Government. Currently the County
operates a self-insured workers' compensation program which insures approximately 2,681
employees including: Sheriff's Office, Firefighters (paid & volunteer), Water & Wastewater
Operations, Street & Road Construction, Parks, Senior Center, Automotive Mechanics, and
other general government services as well as the Forsyth County Public Library System. In
2025 the audited workers' compensation payroll was $133,352,047.
The Risk Management Department has four (4) full-time employees consisting of a Risk &
Safety Manager, a Risk Specialist, and two (2) Claims Administrators dedicated to the
oversight of workers' compensation claims and injury prevention. The County is dedicated to
the safety and well-being of its employees and has adopted and recognized a comprehensive
Loss Prevention Program with policies and oversight to continually monitor and improve
upon any areas of concern.
Forsyth County has an aggressive Return-to-Work Program and is committed to making
return-to work opportunities available as soon as medically reasonable through the use of
transitional employment for all employees who are temporarily disabled due to an on-the-
job injury.
Forsyth County Risk Management 5 Year WC Claims Summary
5 Year
2021 2022 2023 2024 2025
Summary
Lost Time 15 7 10 16 8 56
Medical Only 90 101 107 77 78 453
Record Only 0 0 0 0 1 1
Total Claims 105 108 117 93 87 510
Total Paid $1,144,694 $408,981 $600,001 $891,325 $501,112 $3,546,113
General Requirements
Forsyth County requires a team approach for quickly establishing and carrying through an
aggressive claims resolution and injury management strategy on each claim. Forsyth County
directors, managers, and supervisors have active roles in reporting and investigating injuries,
communicating with employees, claimants, and adjusters; and in returning employees to
work as soon as medically reasonable. Forsyth County expects the Contractor to facilitate a
relationship with these individuals, as well as other contacts and resources in the claims
management process. The Contractor should make every effort to understand and promote
Forsyth County's commitment to best practices and continuous improvement.
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The third party claims administrator Contractor must have a physical office located within the
state of Georgia and shall have a minimum of three currently active public entity (with fire or
police operations) clients.
Settlement requests must include the following:
* Nature and extent of injury
* Reasons for recommendations to settle
* Subrogation potential
* Structured settlement potential
* SITF/apportionment potential
* Current reserves and paid to date
* Resolution plan and budget outline
* Detailed settlement evaluation including summary of state and case law that could
impact the value and settlement
1. Reporting
The Contractor shall provide and maintain a secure, web based, browser agnostic Claims and
Risk Management Information System (RMIS) that complies with all current federal and
industry standards for data security, privacy, and interoperability. The system must not rely
on any specific operating system or browser environment and shall be fully accessible via
commonly supported browsers (e.g., Chrome, Edge, Safari, Firefox).
The platform must implement modern security controls, including but not limited to multi
factor authentication (MFA), role-based access management, encryption of data both in
transit and at rest, and full audit logging of all system activity. The Contractor shall ensure that
all system functions and data handling practices comply with applicable CMS Medicare
Secondary Payer (MSP) and MMSEA Section 111 reporting requirements and incorporate any
future updates issued by CMS during the term of the contract.
The RMIS must support secure integration with Forsyth County's existing systems, including
Origami Risk. This shall include automated data imports/exports, API based interoperability
where available, and error handling protocols that identify and communicate data transfer
failures in real time. The Contractor shall provide timely system updates, patches, and version
releases at no additional cost to Forsyth County and ensure continuity of operations during
such updates.
The Contractor shall ensure the RMIS has fully supported, automated data integration
capabilities, including:
* Automated Data Feeds: Scheduled imports and exports of claims data, financial
transactions, medical updates, and historical data using secure data formats (such
as API, SFTP, EDI, or encrypted file transfer).
* Origami Integration: Seamless interoperability with Forsyth County's current
RIMS platform (Origami) to support consolidated historical records, real time data
flow, and automated reconciliation of claims information.
* Error Reporting & Resolution: Built in mechanisms to identify, flag, and notify
Forsyth County of failed data transfers, data mismatches, or import/export
interruptions within one (1) business day. The Contractor shall document all errors,
corrective actions, and resolution timelines.
* Data Accuracy & Reconciliation: Ability to reconcile claim financials to the penny,
support banking system tie ins, and provide audit ready transaction histories.
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The RMIS must offer configurable reporting tools that allow Forsyth County and its broker to
create, customize, and export:
* Loss runs
* Transaction registers
* Allocation reports
* Ad hoc analyses
* Performance dashboards
* Historical loss summaries
All reports must be exportable in standard formats, including spreadsheet formats, and the
RMIS must allow customization of data fields such as department, location, shift, claim type,
and RTW status. The system must support tracking of lost workdays, transitional duty days,
medical only escalation triggers, and reserve changes with user defined fields.
The Contractor shall provide Forsyth County and its broker with secure, role based access to
all data, reporting tools, adjuster notes, and case management documentation. Access must
be available in real time, with all activity logged for audit purposes.
The Contractor shall ensure the RMIS produces monthly custom allocation reports and
integrates historical data on a monthly basis at no additional cost to Forsyth County. All
upgrades, patches, and version releases must also be provided at no additional cost and must
not disrupt system access or data continuity.
If Forsyth County elects not to renew the contract, the Contractor shall provide a complete,
usable data export of all claims, financials, notes, and historical records in a consistent,
industry standard format. The Contractor shall also provide an option for continued system
access for up to three designated County users for an indefinite period, with any associated
fees itemized in advance.
The Contractor shall maintain detailed documentation describing all data integration
processes, reporting capabilities, and system architecture. Forsyth County reserves the right
to request additional data specifications, conduct RMIS audits, or require enhanced reporting
elements as needed during the contract term.
The Contractor shall maintain communication standards that ensure timely, documented,
and auditable engagement on all workers' compensation claims. At a minimum, all telephone
calls, emails, and electronic inquiries must be returned within one (1) business day, and three
point contact with the injured employee, employer representative, and medical provider shall
be completed within twenty four (24) hours of claim receipt.
All attempted contacts must be documented in the claim file, including time, date, method of
contact, and outcome. The Contractor shall establish an internal escalation protocol for any
instance in which required timeliness benchmarks are not met. This protocol shall include
supervisory notification within twenty four (24) hours of the missed benchmark, corrective
actions taken, and documentation of compliance following resolution.
The Contractor shall provide Forsyth County with monthly or quarterly compliance reports
demonstrating performance against established communication standards. Such reports
must identify:
* Timeliness compliance rates for required contact points
* Instances of missed benchmarks
* Root cause explanations
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* Corrective actions implemented
* Any systemic issues affecting timeliness or communication
The Contractor shall ensure all communication, case notes, and contact documentation are
recorded in the RMIS in real time or within the same business day. Forsyth County reserves
the right to request additional documentation or review internal communication logs at any
time to verify adherence to required service standards.
Failure to meet these timeliness and communication requirements on a recurring basis may
trigger performance review, corrective action planning, and application of performance
guarantee provisions as outlined in this Scope of Work.
2. Workers' Compensation Telephonic and Field Case Management
Forsyth County believes management of the medical component is key to returning
employees back to work and facilitation of WC claim resolution. They have the following
expectations relating to medical:
a. A provider who actively and aggressively manages medical
b. A network of physicians specializing in Return to Work
c. A claims management team approach whereby the team understands and works as
partners in the RTW/Transitional-duty efforts.
We are very interested in the claims adjuster's philosophy on utilization of TCM & FCM within
their claims management model with the understanding that Forsyth County may elect to use
a separate managed care vendor.
3. Claim Escalation and Reserving Expectations
Forsyth County requires the Contractor to implement clear and timely claim escalation and
reserving practices to ensure accurate financial forecasting, statutory compliance, and
effective claim oversight. The Contractor shall adhere to the following minimum standards:
a. Initial Reserve Establishment
* Initial reserves shall be established within seven (7) calendar days of claim
assignment and must reflect a reasonable projection of expected medical and
indemnity exposure.
* Reserve levels must be documented with supporting rationale in the claim file,
including injury severity, anticipated treatment plan, lost time potential, and
known compensability issues.
* Reserves must comply with state workers' compensation reserving requirements
and accepted industry practices.
b. Reserve Reevaluation & Updating
* The Contractor shall reevaluate reserves at least every thirty (30) days for Lost
Time claims and every sixty (60) days for Medical Only claims unless conditions
require earlier revision.
* Reserves must be updated immediately upon significant medical developments,
changes in diagnosis, surgery recommendations, changes in modified duty status,
litigation involvement, or newly identified cost drivers.
* Each reserve change shall include documented justification, financial impact, and
a revised plan of action within the RMIS.
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