Health Insurance Third Party Administration Services

RFP Issued: April 16th, 2026

Pre-Proposal Meeting: April 24th, 2026

Confidentiality Agreement Due: April 24th, 2026

Applicant Questions Due: April 29th, 2026

Answers Posted: May 4th, 2026

Proposals Due: May 18th, 2026

Applicant Interviews: July 9th, 2026

Applicant Selection: August 1st, 2026

Contract Execution: November 2026

Commencement of Work: January 1st, 2027

The City of Pennsylvania seeks a vendor to provide third party administration services for its health insurance program, covering active employees and eligible retirees. The medical insurance TPA will be responsible for administering the self-insured medical program, including claims processing, adjudication, and timely payment, with a focus on payment integrity and fraud prevention through pre- and post-pay edits.

The vendor should demonstrate established strategies to bridge healthcare inequities and address social determinants of health for plan members. Collaboration with other benefit providers is required to support the overall City benefit strategy. Additional responsibilities include developing and maintaining provider networks focused on social determinants, implementing care navigation and advocacy tools to guide members to high-quality, value-driven care, and delivering comprehensive program reporting—such as plan design recommendations, self-financing strategies, and customer service scores for physicians and office personnel.

The administrator must offer a robust member appeals process and provide multi-lingual support via customer service, communication materials, and website. The contract period is one year, and the program is self-insured for active employees and pre-65 city credit retirees.