Third Party Administrator Services for Self-Funded Medical Plan

RFP advertisement: March 27th, 2026

Last day to submit questions: April 20th, 2026

Proposal due date: April 27th, 2026

RFP review completed: May 15th, 2026

Interviews: June 8th-9th, 2026

Notice of Intent to Award: July 22nd, 2026

Notice to proceed: August 1st, 2026

Contract start: January 1st, 2027

This RFP seeks a vendor to provide comprehensive third party administrator (TPA) services for a self-funded medical plan, including fully administered vision benefits. The selected TPA will be responsible for administering the self-funded health plan, with duties such as accurate and timely claims processing, daily eligibility processing from the Tyler ERP system, coordination among multiple specialty vendors, and delivering consolidated reporting, analytics, and financial or claims accounting reconciliation. The scope includes compliant participant administration covering active employees, retirees, survivors, and continuation participants, including COBRA and continuation administration.

The TPA will manage eligibility administration, medical administrative services (including prescription drug and dental administration), benefits configuration and maintenance, claims adjudication and payment, appeals and grievance management, and centralized billing services. Additional responsibilities include operating a formal governance structure, providing implementation and transition support, coordinating stop-loss, managing mental health and chemical dependency services, network and access management, care and disease management, telephonic nurse support, wellness, consumerism, HR self-service, and advanced reporting, analytics, and predictive modeling.