Claims & Program Administration (TPA Services)

This subcontract for Claims and Program Administration TPA Services involves the administration of behavioral health benefits plans for prime contractors working on State Agency projects in Ohio. The selected provider will be responsible for processing and paying claims for covered services, issuing Explanations of Benefits, and managing co-pay and co-insurance levels. Additionally, the scope of work includes performing utilization management, step therapy, and prior authorizations, with a requirement to deliver regular utilization reports and processed claims data. To qualify, the provider must utilize a robust claims adjudication system and maintain strict HIPAA compliance, including the execution of a signed Business Associate Agreement. This opportunity is categorized under NAICS code 524292 and is managed by the Ohio Administrative Services agency. Interested parties must submit their responses by the deadline of November 13, 2026.