Specifications include, but are not limited to: TPA will administer workers’ compensation claims of insolvent SIEs and SIAs, including but not limited to claim management, excess recovery, subrogation, payment, and settlement in consultation with Division staff and in accordance with Nevada laws. TPA will enhance or modify its claim handling software, as needed, to administer claims according to the Division’s requirements. TPA will receive electronic and hard copy versions, when available, of existing accepted claims and will integrate both versions of existing claim files into the TPAs claims administration system. Not later than 60 days of receipt of the claim files, the TPA will meet with Division staff to provide a review of each claim. Thereafter, the TPA will meet with the Division no less often than once each quarter to discuss activity on each file. TPA will administer existing known claims, unknown future claims, and reopened claims of insolvent SIEs or SIAs, whether currently insolvent or determined in the future to be insolvent, as those claims are accepted by the Division and assigned to the contracted TPA. TPA will submit a list of claims quarterly or when changes are made to the list.
