Third Party Administrative Services

Overview

Healthcare Services, Wellness & Biotech

Raleigh, North Carolina, United StatesPosted 16 days agoDeadline: May 4th, 2026

Fit Score

Settle Intelligence

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SUMMARY

Seeking a provider for third party administrative services, including claims processing, customized communications, and financial reporting for a health benefits plan in North Carolina.

KEY REQUIREMENTS

BUDGET

Estimate

$50,000,000 – $150,000,000

CONTRACT DURATION

53 months

TIMELINE

Issue RFP: April 21st, 2026

Deadline for Minimum Requirements Questions: April 24th, 2026

Deadline for Minimum Requirements Proposals: May 4th, 2026

Deadline for Remaining RFP Questions: May 12th, 2026

Deadline for Submission of Proposals: June 5th, 2026

Finalists Oral Presentations: June 22nd-24th, 2026

Best and Final Offer: June 26th-July 2nd, 2026

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

Implementation Period: July 13th, 2026-December 31st, 2027

Services Begin: January 1st, 2028

QUESTION DEADLINE

April 24th, 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

A vendor is sought to provide comprehensive third party administrative services for a health benefits plan. The selected provider will assist in executing the plan’s health benefit coverage strategy, leveraging technology and resources to align incentives among members, providers, and the plan itself.

Responsibilities include processing all claims (both Medicare primary and Medicare secondary) through a unified claims platform, managing gold carding for specified providers to bypass prior authorization and utilization management, and customizing appeals letters as requested by the plan. The vendor will also handle weekly reimbursement for any prompt pay penalties within claims disbursements, conduct complete bank reconciliations for all disbursing accounts, and track/report receivables and revenue (both earned and unearned) on behalf of the plan.

All questions regarding this opportunity must be submitted by April 24, 2026.

Source attribution

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