Medical Plan Administration Services
Overview
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SUMMARY
DESCRIPTION
The agency seeks a vendor to administer its self-funded medical plan for active employees and pre-65 retirees. The requested services include medical administrative services only (ASO) with either integrated pharmacy services provided by the medical third-party administrator or pharmacy services carved out.
The administrator will provide full-service medical benefit administration in accordance with plan documents, summary plan descriptions, amendments, and applicable federal and state regulations. Responsibilities include compliance and regulatory support, eligibility and enrollment maintenance, electronic data exchange, online enrollment and verification, payroll reconciliation, accurate and timely claims adjudication, benefits coordination, recovery activities, appeals and grievance processing, and claim payment funding and disbursement options.
The vendor will also provide dedicated account management, regular account reviews and strategic planning meetings, monthly claims and utilization reporting, wellness and ancillary program communications, toll-free participant support, and secure online and mobile access. Questions must be submitted by September 11, 2026.
Similar RFPs
Frequently asked questions
- When is the submission deadline?
- Submissions are due September 16, 2026.
- Who is a good fit for this opportunity?
- Third-party administrators specializing in self-funded employer medical plans
- Demonstrated experience serving public-sector agencies and retiree populations
- Capability to provide integrated or carved-out pharmacy administration
- Strong claims adjudication, eligibility, compliance, and regulatory support systems
- Dedicated account management, reporting, participant support, and secure digital platforms
Analysis generated by Settle AI from the source RFP.
RFP Hunter shows what is open. Settle shows what is forming.
Settle pieces together buyer signals, budgets, contract activity, and the sources your team already monitors. See why an opportunity fits and what to do before the RFP posts.