This Solicitation opportunity from Texas was posted on August 12, 2024. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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Outside Audit of Workers Comp TPA

Closed

141401State & Local

Submission Closed09/12/2024, 12:00:00 AM UTC

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

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NAICS: 524292

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DAS Medical Plan Third-Party Administrator

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The State of Ohio, through the Department of Administrative Services, is soliciting proposals for one or more Third-Party Administrators (TPA) to manage medical health benefits for approximately 103,000 covered lives. The selected contractor(s) will be evaluated by region and must administer the existing Ohio Med PPO, Ohio Med Select, and Ohio Med HDHP plan designs without exception. The contract term runs from the date of signature through June 30, 2030, with the contractor assuming responsibility for all claims incurred on or after July 1, 2027. Key responsibilities include seamless data integration with pharmacy, behavioral health, and population health management vendors, as well as daily reconciliation of plan accumulators. The procurement process requires a two-part electronic submission via OhioBuys, consisting of a technical proposal and a separate cost proposal. Mandatory requirements include agreement to existing plan designs and the execution of a nondisclosure agreement to access specific provider data. Pricing is structured around per employee per month (PEPM) administrative services only (ASO) fees, with additional costs for file feeds, communications, and disease management. Performance is monitored through strict Service Level Agreements (SLAs), including a requirement to mail ID cards within five days of enrollment. Contractors must also provide a Benefits Fund of $75,000 per awarded region for the initial three-year period and maintain compliance with State IT policies and HIPAA regulations via a Business Associate Agreement.

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Request for Proposal - Third Party Administrative and Actuarial Services

Solicitation # 2025-RFP-127

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Finance - Division of Risk Management

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TPA Workers' Compensation

Solicitation # 127-2026

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Vehicle Assistance and Claims AdministratorThe Vehicle Assistance and Claims Administrator subcontract, issued by the US Embassy Paris for the Department of State, involves providing roadside assistance and third-party insurance claims management for prime contractors in France. The selected provider will manage assistance for 112 vehicles, settle third-party claims, and recover expenses related to personnel and equipment. Key deliverables include the resolution of claims, the recovery of funds, and detailed documentation of all roadside assistance events. To be eligible, the contractor must possess a Kbis registration and appoint a Project Manager who is fluent in both English and French. The work will be performed in Paris, France, under NAICS code 524292. Responses for this opportunity are due by November 6, 2026.

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Announcement of RFP for Retirement Plan Administration and Record Keeping Services

Solicitation # LC26028

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Nevada State Pharmacy Benefit Manager

Solicitation # 41NHA-S3992

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410 - Nevada Health Authority Director's Office

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DEADLINE

Solicitation # 2611-KP

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Pharmacy Drug Benefits

Solicitation # HHS0017240

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Department of State Health Services

POSTED

DEADLINE

DAS Behavioral Health Third-Party Administrator RFP

Solicitation # SRC0000040548

The State of Ohio, through the Department of Administrative Services, is soliciting proposals for a Third-Party Administrator to manage its self-insured Behavioral Health Benefit Plan. Starting July 1, 2027, the selected contractor will provide administrative services for approximately 43,800 employees and 104,600 total lives. Key responsibilities include managing eligibility, claims history, prior authorizations, utilization management, and data integration with the State's data warehouse. The contract runs from the date of signature through June 30, 2030, with the possibility of a one-month discretionary renewal and further mutual renewals for up to four additional years. To be eligible, offerors must be NCQA accredited and comply with the Mental Health Parity and Addiction Equity Act. The evaluation process is based on a total score derived from technical requirements, cost, and presentations, with the highest-ranking responsible offeror recommended for award. Financial terms utilize a not-to-exceed unit cost fee structure, and the contractor must provide a Benefits Fund of at least 150,000 dollars. Strict compliance is required regarding HIPAA through a Business Associate Agreement, State IT policies, and secure data transfer protocols via SFTP. Proposals must be submitted electronically through the OhioBuys portal, consisting of separate technical and cost volumes.

Administrative Services

POSTED

DEADLINE

Employee Benefits- Life/STD/FSA/HSA/COBRA

Solicitation # 27-011CH-32RFP

The Tempe Union High School District is soliciting proposals under solicitation number 27-011CH-32RFP to secure a provider for the administration of employee benefits, including Basic and Voluntary Life and Accidental Death and Dismemberment, Short-Term Disability, Flexible Spending Account, Health Spending Account, and COBRA administration. The intended contract period runs from July 1, 2027, through June 30, 2032. Key requirements include the waiver of pre-existing condition limitations for initially enrolled employees and dependents, the elimination of active-at-work restrictions, and a guarantee that no employee suffers a loss of benefits during a carrier change. The selected vendor must provide a designated account management team, bilingual educational materials, and attendance at four days of annual open enrollment meetings in Tempe, Arizona. The award process utilizes a point formula system across three phases: initial evaluation, vendor interviews, and a best and final offer. Evaluation factors include responsiveness, cost, and past performance, with a minimum of 500 technical points required to proceed to price evaluation. The District intends to award the least number of vendors necessary, with contracts potentially awarded by individual product lines. Proposals must be submitted via the OpenGov portal by November 19, 2026. The contract is subject to Arizona Revised Statutes and School District Procurement Rules, featuring a zero-tolerance gift policy and net 30-day payment terms. Implementation must be completed 60 days prior to open enrollment, with a required 45-day support period following the July 1 effective date.

Business Services

POSTED

8 days ago

DEADLINE

in 22 days

AI Contract Overview

The City of Austin is seeking a qualified workers’ compensation claims auditing firm to conduct a comprehensive management audit of its Third-Party Administrator and Utilization Review Agent. The contract, identified under solicitation number 141401, is posted as a formal solicitation with a response deadline of September 12, 2024. The project falls within the NAICS code 524292, which pertains to claims processing and administration services, and is valued between $100,000 and $500,000. The audit aims to evaluate the effectiveness, compliance, and efficiency of the current claims management processes handled by the TPA and Utilization Review Agent, ensuring that the city’s workers’ compensation program operates optimally and adheres to relevant regulations. The contract will be managed by the City of Austin, Texas, with primary contact being Sandra Wirtanen, who can be reached via email at [email hidden] or by phone at [phone hidden]. The performance of the contract will take place within Texas, and interested firms are encouraged to review detailed solicitation information through the provided online link. This initiative underscores the city’s commitment to maintaining robust oversight of its workers’ compensation claims processes, seeking transparency, cost-effectiveness, and compliance through a thorough external audit.

General Info

Agency

Texas → City of Austin

NAICS

524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

Place of Performance

TX, USA

Set-Aside

NONE

Documents

RFP 5800 SLW3020 Attachment 2 - Workers Compensation Claims Data

specifications

High

RFP 5800 SLW3020 Attachment 2 - Workers Compensation Claims Data

specifications

High

RFP 5800 SLW3020 Attachment 3 - Claims Admin Program

specifications

High

RFP 5800 SLW3020 Attachment 3 - Claims Admin Program

specifications

High

RFP 5800 SLW3020 Attachment - Past Performance

past-performance

High

RFP 5800 SLW3020 Offer Sheet

rfp

High

RFP 5800 SLW3020 Offer Sheet

rfp

High

RFP 5800 SLW3020 - Outside Audit of Workers Comp TPA

rfp

High

RFP 5800 SLW3020 - Outside Audit of Workers Comp TPA

rfp

High

RFP 5800 SLW3020 Past Performance Attachment

past-performance

High

RFP 5800 SLW3020 Price Sheet

rfp

High

RFP 5800 SLW3020 Price Sheet

rfp

High

AI Contract Breakdown

Uniform Contract Format

Timeline

PhaseClosed

PostedAug 12

Solicitation

Response DeadlineSep 12

Deadline has passed

Submission Closed

09/12/2024, 12:00:00 AM UTC

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Organization & Contact Information

AgencyTexas → City of Austin

Contacts1 person available

OfficeN/A

Organization / AgencyTexas → City of Austin

Office AddressN/A

Contacts

Sandra Wirtanen

contact@example.gov

Full Description

The contractor shall be a qualified workers’ compensation claims auditing firm to provide a comprehensive workers’ compensation claims management audit of its Third-Party Administrator and Utilization Review Agent.