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Third Party Administrator (TPA) / Claims Processor

Active
State & Local

Contract Overview

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

General Info

Agency

Texas → City Of El PasoView Agency

NAICS

524298 - All Other Insurance Related ActivitiesView NAICS

Place of Performance

TX, USA

Set-Aside

NONE

Documents

This scope was carved out of 2026-0495R.

The full solicitation package (15 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

Stop Loss

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Timeline

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Response Deadline

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Organization & Contact Information

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AgencyTexas → City Of El Paso
ContactsNo contacts available
OfficeN/A
Organization / Agency
Texas → City Of El Paso
View Agency Profile
Office AddressN/A
ContactsNo contact information available

Full Description

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Performs claims administration and financial reporting for prime contractors on Stop Loss Insurance projects. Manages the paid claims covered period, calculates claim accumulation on a per-member basis, and verifies 100% reimbursement percentages. Utilizes HIPAA-compliant data systems and claims management software. Requires documented experience with comparable contracts within the past five years. Delivers claims reports and reimbursement requests.

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Same NAICS industry code

NAICS: 524298
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The Department of Labor's Office of Workers' Compensation Programs is soliciting a firm-fixed-price contract under solicitation 1605C3-26-R-00011 to acquire benchmark-driven fee data for medical coding. The objective is to obtain statistically valid charge and allowed amounts for CPT, HCPCS, and CDT codes across all states and nationwide to ensure fair, market-based reimbursement and improve claimant access to care. The scope includes providing data by ZIP code and rural/non-rural classifications, performing updates at least twice yearly, and providing ongoing customer support for data interpretation and value calculations. The period of performance is scheduled from September 14, 2026, to September 13, 2027, with work performed at the contractor's facility. This is not a small business set-aside. Award decisions will be based on three weighted factors: Technical Capability, which is the most significant; Past Performance, requiring three relevant contracts from the last three years; and Price. To be considered, vendors must achieve at least an Acceptable rating for technical capability. Quotations must be submitted electronically in three separate volumes. Following Amendment 001, the response deadline has been extended to September 8, 2026, at 5:00 PM ET. The contract also includes specific requirements for Section 508 accessibility compliance and an organizational conflict of interest clause that may restrict the contractor from future agency awards.
DOL - Cas Division 3 Procurement

POSTED

5 days ago

DEADLINE

in 2 days
View Details

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