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The client is seeking a vendor to provide comprehensive third-party administration services for medical benefits. Responsibilities include administration of all medical benefit plans, processing claims, and handling provider billing. The selected administrator will manage investigation and settlement of claims, answer all related inquiries from claimants, and oversee all adjustment activities, thus relieving internal personnel of these duties.
The administrator will also handle COBRA administration for current and future employees, including those in fully insured plans, and will provide timely plan documents and summary descriptions as required. Additional duties involve giving ongoing advice on plan provisions, supply necessary retiree claim cost data to actuaries, and administer flexible spending account programs. The contract will have a five-year term, with vendors expected to provide at least the current level of benefit service.
Analysis generated by Settle AI from the source RFP.
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