The government authority located in St. Louis, Missouri is seeking a vendor to provide self-funded Administrative Services Only (ASO) dental insurance administration services. The selected provider will be responsible for managing the entire enrollment process, addressing participant inquiries related to claims and coverage, and delivering ongoing support to the District.

Key requirements include the issuance of customizable Explanation of Benefits for each processed claim, prompt notification and written appeal handling for rejected claims, and assistance to participants in fulfilling claim submission requirements. The administrator must be prepared to liaise with healthcare providers on claims matters and conduct thorough investigations for coordination of benefits and subrogation.

Additional obligations comprise the establishment and maintenance of claim files as per plan provisions, the execution of internal audits on payments with periodic reporting to the District, and the submission of quarterly reports on plan claims performance and eligibility.