Third Party Administrator Services for Self-Funded Medical Benefit Plans
Overview
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SUMMARY
DESCRIPTION
The issuing entity is seeking a vendor to provide third-party administrator (TPA) services for self-funded medical benefit plans. The scope includes administration of medical claims and coordination of benefits, network access and management, medical management services such as utilization management and case management, and member enrollment and eligibility maintenance.
Additional responsibilities include wellness program administration, health information and nurse line services, fraud deterrence and waste and abuse management, and administration of health reimbursement accounts or health savings accounts. The selected vendor will also be expected to provide website, web portal, and mobile application support, conduct focus groups, and deliver chronic disease management services.
A pre-bid conference is scheduled for July 29, 2026, and all questions must be submitted by August 10, 2026. The anticipated contract term is five years.
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Frequently asked questions
- When is the submission deadline?
- Submissions are due August 27, 2026.
- Who is a good fit for this opportunity?
- Established third-party administrator with self-funded medical plan expertise
- Experience serving municipal or public sector employee health plans
- Capabilities in claims processing, coordination of benefits, and eligibility administration
- Strong medical management services including utilization review and case management
- Proven chronic disease management and wellness program delivery
- HRA or HSA administration experience
- Integrated digital member tools including web portal and mobile applications
- Demonstrated fraud, waste, and abuse detection capabilities
- Capacity to support a five-year, large-scale benefits administration contract
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.