Employee Healthcare Insurance and Administration Services

A government authority in San Antonio, Texas, is seeking a vendor to provide employee healthcare insurance and administration services. The selected provider will deliver third-party administration for self-funded preferred provider organization (PPO) plans that align with the current plan design and schedule of benefits.

The RFP encourages proposals that may also include alternative plan designs, such as accountable care organizations, value-based contracting, direct-to-provider contracting, medical home models, network tiered benefit plans, private exchanges, Medicare cost-plus programs, Medicare supplements, or other innovative strategies for cost and liability management. Administrative services are required for healthcare and dependent care flexible spending accounts.

Key objectives include reducing medical, pharmacy, dental, and vision costs; enhancing accountability of healthcare costs between employees and the employer through ongoing education and communication; and improving customer service for employees with features like a user-friendly website, a dedicated customer service unit, and the ability for benefits staff to access claims data to assist with claim issues. The goal is to improve the overall health risk of the employee population.