State of South DakotaIssuing agency·South Dakota·via the State of South Dakota posting board (ESM Solutions)1.1.1 Background: The State of South Dakota, Bureau of Human Resources and Administration (“State”) is seeking a licensed and qualified business partner to provide Third Party Claims Administration for the State’s Workers’ Compensation Program. The selected vendor will be required to provide Medical Case Management, Medical Bill Review, and Medicare, Medicaid, and SCHIP Extension Act of 2007
(MMSEA) reporting
1.1.2 Goals and Objectives:
• Ensure timely, accurate, and consistent administration of workers’ compensation claims in accordance with applicable laws, regulations and State policies.
• Implement cost-containment strategies that reduce claim duration and overall program costs while ensuring injured employees receive appropriate medical care and benefits.
• Provide guidance and recommendations to assist the State in mitigating risk and improving workplace safety.
• Delivering meaningful reporting, analytics, and benchmarking that enables the State to monitor program performance in real time, identify trends, and make informed decisions.
• Serve as a strategic partner with the State to identify opportunities to improve claim outcomes, employee experience, return-to-work efforts, and overall program effectiveness.
• Provide specialized expertise and proactive management of complex workers’ compensation claims.
All written questions should be sent to: SD RFP Project Peggy.Canter@state.sd.us, only emailed questions will be accepted.
Each offeror may submit questions via email concerning this RFP to obtain clarification of requirements. No questions will be accepted after the date and time indicated in the above schedule of activities. Email questions to the email address listed above with the subject line “RFP#26RFP19880”. The questions and their answers will be sent to all offerors that submitted Letters of Intent, submitted questions, or requested the questions and answers via email before the proposal submittal date and will be sent by the date and time indicated in the above calendar of events. Offeror may not rely on any other statements, either of a written or oral nature, that alter any specification or other term or condition of this RFP that have not originated from the SD RFP Project Contact. Offerors will be notified in the same manner as indicated above regarding any modifications to this RFP. Offerors and their agents may not contact any state employee other than the Primary Contact regarding any of these matters during the solicitation and evaluation process. Inappropriate contacts are grounds for suspension and exclusion from specific procurements.
Invitation Only · Ready for Responses
Documents (8):
• BHRA Workers Comp TPA RFP 10.8.26.pdf (445 KB)
• BIT Attachment 1 ITSP v6.0.pdf (1149 KB)
• Exhibit D - FY27 Summary Plan Description.pdf (493 KB)
• Exhibit A - FY27BenefitsGuideFINAL.pdf (5326 KB)
• Exhibit C - BHRA Business Associates Agreement.docx (35 KB)
• Exhibit F - Security and Vendor Questions v3.3 Production.docx (84 KB)
• Exhibit G - BHRA RFP Workers Comp IT.docx (76 KB)
• Exhibit H - Contractor Security Acknowledgement Form 2026_.docx (77 KB)
View the full solicitation and download documents on South Dakota's posting board.
The Third-Party Administrator will evaluate and process payment of claims submitted pursuant to South Dakota Workers' Compensation statutes, and is responsible for investigating and/or defending workers' compensation claims. The TPA must provide injury reporting and response 24/7, be accessible to the State at 8 AM and 5 PM Central Time, and provide Medical Case Management, Bill Review, and MMSEA Reporting. The TPA is responsible for the intake and management of every State of South Dakota employee injury and illness or disease claim, including Electronic Payments, Monthly Payment Report (Report 107) to DOL, Reporting Form 101 (FROI) to DOLR, initial claimant letters, requesting medical information, and 1099 reporting. The TPA shall maintain complete electronic records of all reported claims and be responsible for payment of all appropriate medical bills. The TPA or their bill review company shall review, re-price the bills, and negotiate costs when necessary. The TPA is responsible for MMSEA reporting to the Centers for Medicare and Medicaid Services (CMS).
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Most South Dakota work asks for the two below, and the solicitation documents are where it’s stated. One prequalification covers both — on this bid and the next.
A surety’s written statement that it expects to bond you up to a stated amount, subject to final underwriting. It’s what a GC or agency asks to see before they take your bid seriously.
Source: South Dakota Procurement (event 19880), retrieved via the State of South Dakota posting board (ESM Solutions). View the official posting, and always confirm requirements and deadlines with the issuing agency.
