Third Party Administrative Services

Overview

Healthcare Services, Wellness & Biotech

Raleigh, North Carolina, United StatesPosted about 2 months agoDeadline: April 8th, 2026

Fit Score

Settle Intelligence

Settle helps teams find, evaluate, and respond to public RFPs. We continuously surface new opportunities, score them against your company strengths, and draft proposal responses so you can focus on the work that wins business.

SUMMARY

Seeking a provider for third party administrative services focused on claims adjudication, operations, and network development, in support of ongoing audit and performance standards.

KEY REQUIREMENTS

BUDGET

Estimate

$10,000,000 – $50,000,000

CONTRACT DURATION

53 months

TIMELINE

Issue RFP: March 20th, 2026

Deadline for Minimum Requirements Questions: March 27th, 2026

Proposal Opening Date: April 8th, 2026

Deadline for Remaining RFP Questions: April 21st, 2026

Deadline for Submission of Proposals: May 18th, 2026

Finalists Oral Presentations: June 2nd, 2026 – June 4th, 2026

Best and Final Offer: June 17th, 2026 – June 25th, 2026

Award of Contract: July 10th, 2026 – July 13th, 2026

Services Begin: January 1st, 2028

QUESTION DEADLINE

April 21st, 2026

Issuing Agency

State Of North Carolina, State Health Plan For Teachers And State Employees

Organization overview and procurement intelligence available on paid plans.

See Issuer Research

DESCRIPTION

The selected vendor will provide third party administrative (TPA) services, allowing the plan to delegate certain ancillary services, such as population health management, to other vendors. This structure enables the TPA partner to focus on core operational areas, claims adjudication, and network development, with an emphasis on optimizing the member experience and improving health outcomes.

The vendor will be required to support quarterly claims accuracy audits or standard audits using statistically valid random samples selected by the plan's audit vendor. These audits will assess claims accuracy to uphold performance guarantees and may identify overpayments owed to the plan. The winning vendor will be expected to share provider contracts and system pricing with plan auditors for comprehensive review. An audit plan outlining standard audit timelines will be established prior to the first quarterly audit. The contract is proposed for a one-year period.

Source attribution

This Settle analysis is based on the issuing organization’s public RFP listing.