Administrative Services for Medical, Pharmacy, Stop Loss, Dental, and Vision Benefit Plans
Overview
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SUMMARY
KEY REQUIREMENTS
CONTRACT DURATION
TIMELINE
RFP Posted for Response: October 2nd, 2026 – November 17th, 2026
All Questions from Vendors due: November 10th, 2026
All Addenda posted: November 12th, 2026
Receive RFP Responses: November 17th, 2026
Tentative Vendor Presentations (in-person): Week of March 1st, 2027 and Week of March 8th, 2027
Tentative Negotiations: April 1st, 2027 – May 31st, 2027
Tentative Notice of Intent to Award: June 1st, 2027
QUESTION DEADLINE
CONTACTS
Primary procurement contact — name, title, email, and phone
Additional decision-makers and their departments
Issuing Agency
County of Albemarle
DESCRIPTION
The issuing county seeks a vendor to provide administrative services for its self-funded medical, pharmacy, stop loss, dental, and vision benefit plans. Medical plan responsibilities include claims adjudication and payment administration, claims appeals, coordination of benefits, prior authorization administration, and ACA-required external appeals.
The selected vendor must provide a dedicated toll-free member services number, escalation access for complex claims, eligibility and provider issues, call center operations, and issue resolution support. Customer service representatives must be based in the United States during standard business hours, with interactive voice response routing, average speed-to-answer standards, call abandonment reporting, and multilingual support.
The vendor will also support HIPAA, Transparency in Coverage, Mental Health Parity, the No Surprises Act, and other applicable compliance requirements. Additional responsibilities include implementation management and planning, coordination with county payroll, human resources, and benefits administration systems, utilization and case management, disease management, care coordination, population health programs, digital engagement tools, predictive analytics, care gap identification, and high-cost claimant intervention. Questions must be submitted by November 10, 2026.
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Frequently asked questions
- When is the submission deadline?
- Submissions are due November 17, 2026. Questions must be submitted by November 10, 2026.
- Who issued this RFP?
- It was issued by County of Albemarle. The work is located in Charlottesville, Virginia, United States.
- Who is a good fit for this opportunity?
- Established employee benefits administrator or third-party administrator
- Experience managing self-funded medical, pharmacy, dental, vision, and stop loss plans
- Strong claims processing, appeals, utilization management, and member services capabilities
- Demonstrated HIPAA, Transparency in Coverage, Mental Health Parity, and No Surprises Act compliance expertise
- Nationwide customer service operations with multilingual support
- Proven implementation experience integrating payroll, HR, and benefits administration systems
- Advanced population health, predictive analytics, and high-cost claimant management capabilities
Analysis generated by Settle AI from the source RFP.
RFP Hunter shows what is open. Settle shows what is forming.
Settle pieces together buyer signals, budgets, contract activity, and the sources your team already monitors. See why an opportunity fits and what to do before the RFP posts.