General Requirements and Expectations. The TPA will perform all services required to supervise and administer a self-insured workers’ compensation program for the City, and to act as the City’s representative in matters relating to the City’s obligations under the workers’ compensation laws of the State of California. The TPA must be a recognized claims administrator of self-insured workers’ compensation programs licensed to do such business in California. The TPA must also have an office located in Northern California that will be the primary handling location for the City’s account. The City requires the ability to electronically view the progress of any of their claims. It is anticipated that the City will require access for 3 staff members. The City will have final approval for all claim services, case management services, and/or ancillary services utilized, including but not limited to defense attorneys, nurse case managers, vocational experts, utilization review, bill review, and investigative firms. It will be the TPA's responsibility to ensure that utilization review, bill review, and/or managed care services adhere to all of the requirements and deadlines as mandated by the State Labor Code, DWC, and all other applicable state and federal laws and regulations.
