Medical Administrative, Third Party Administration, and Pharmacy Benefit Manager Services

Issue Date: April 29th, 2026

Questions Deadline: May 12th, 2026

Response Deadline: May 20th, 2026

The City of Nebraska is seeking proposals from qualified vendors to deliver medical administrative services organization (ASO), third party administration (TPA), and pharmacy benefit manager (PBM) services for its self-funded medical and prescription drug plans. The successful contractor will be expected to provide competitive proposals that ensure excellent network access, favorable provider discounts, robust clinical and claims management programs, and superior customer service.

The scope of work includes establishing and maintaining adequate telephone lines and staffing a dedicated claims and customer service team responsible for efficiently responding to inquiries and resolving issues from plan participants, city staff, and providers. Vendors will be required to process claims in accordance with plan documents, collective bargaining agreements, and applicable administrative requirements. TPA and PBM solutions may include either integrated or carve-out prescription drug administration.

Contractors must design, implement, and maintain systems and procedures that adhere to industry standards, specifically leveraging software to correctly apply coding initiatives and claims editing for the accurate adjudication and payment of claims. The initial contract period will span three years.