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Stop-Loss Claims Administration

Active
State & Local

Contract Overview

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

General Info

Agency

Illinois → InsuranceView Agency

NAICS

524291 - Claims AdjustingView NAICS

Place of Performance

Downers grove, IL, 60515, USA

Set-Aside

NONE

Documents

This scope was carved out of 26-557THA-FINAN-B-51084.

The full solicitation package (1 document), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

26-557THA-FINAN-B-51084 | GENERAL NOTICE: Employee Stop-Loss Insurance

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Timeline

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Organization & Contact Information

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AgencyIllinois → Insurance
ContactsNo contacts available
OfficeN/A
Organization / Agency
Illinois → Insurance
View Agency Profile
Office AddressN/A
ContactsNo contact information available

Full Description

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Performs administrative processing of stop-loss claims for prime insurance carriers on Illinois State Toll Highway Authority (ISTHA) employee benefits projects. Reviews medical claims against specified thresholds, validates eligibility, and calculates reimbursement amounts using HIPAA-compliant data handling systems and claims management software. Requires HIPAA Compliance certification and Professional Liability Insurance. Delivers processed claim reports and reimbursement disbursements.

Similar Contracts

Same NAICS industry code

NAICS: 524291
SLED
Liability Claims Adjusting Services RFP
Solicitation # 2026-RFP-0086
Sacramento County is seeking a qualified Third-Party Administrator (TPA) to provide professional liability claims adjusting services from July 1, 2027, through June 30, 2030, with a potential three-year extension. The TPA will manage the investigation, evaluation, processing, and settlement of bodily injury, personal injury, and property damage claims for the County's self-insured liability program, which averages 750 new claims and 100 litigated claims annually. Key responsibilities include litigation coordination, subrogation services, Medicare reporting, and trust checking account management, all while adhering to PRISM Liability Claims Administration and Defense Counsel Standards. The selected contractor must have at least 10 years of experience as a TPA for California public entities and must maintain an office within Sacramento County or within 35 miles of the County Administration building. Personnel requirements are stringent, requiring a principal adjuster with at least 10 years of experience in defending public entity claims and a deep understanding of the California Tort Claims Act. The contract emphasizes strict compliance with California law, including economic sanctions and PHI security safeguards. Award decisions will be based on a weighted evaluation of the bidder's approach and methodology, relative cost, technical capability, responsiveness, and conformance to the RFP and PRISM standards.
Personnel Services

POSTED

18 days ago

DEADLINE

in 29 days
View Details

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