MB-3072 - USA (New Mexico) - Third Party Administrator Services - Deadline May 13,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3072

Government Authority located in New Mexico; USA based organization looking for expert vendors for third party administrator services.

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide third party administrator services for IRS cafeteria plan and independent insurance carriers.
-  IRS Section 125 permits employers to structure a benefits program allowing employees to have the option of designating pre-tax dollars to pay for certain qualified benefits.
- This plan will be offered to full-time School District employees in all departments. Employees eligible for this plan are approximately 3,200.
- General Description of the Program:
- This program will be “premium only” to include those premiums which qualify for pre-tax treatment and which are paid for on a voluntary payroll deduction basis.
The successful vendor must provide to the Las Cruces Public Schools employees the option of the following core policies on a voluntary basis only Short-Term Disability, Cancer, Accidental Injury, Universal Life, Term Life, Critical Illness/Specified Diseases
Vision, Hospital Indemnity.
- Organizations will be considered on the basis of premium charges to employees, past experience relative to similar Section 125 Plans, overall record of service, ability to provide enrolment data and changes, and financial stability.
- IRS Section 125 Flexible Benefits Plan Administrative Services:
- Contractor shall conduct annual enrolment of all eligible employees.
1. Any payroll deductible products marketed by the Contractor during enrolment must be educationally oriented presentations only and without pressure. Products presented must have been approved in writing by authorized School District representatives.
a. Plan participants who have pre-existing conditions already covered by disability and/or medical insurance shall be guaranteed in writing by the Contractor that the conditions will, likewise, be covered by the Contractor's products prior to changing.
2. Contractor shall conduct enrolment that includes participant education of
plan benefits to meet the following participation percentages of all eligible
- Contractor shall update and electronically transfer file based upon employee deduction codes into the School District’s Financial Payroll System as required for official use and reporting to internal revenue services.
- Contractor shall obtain and process for the Employer vouchers, claim forms or other documentation necessary for the administration of the Plan.
- Contractor shall provide accounting services
- Maintain a list of participating employees, including but not limited to full names and social security numbers;
- Maintain records of contributions by, payments of benefits to, and resulting account balances of participating employees;
- Prepare and mail to participating employees quarterly and year-end reports of contributions made by and benefits paid to or on behalf of participating employees under the Plan
- Services relating to processing claims for reimbursing medical and child-care expenses include
- Communicating voucher procedures to each employee;
- Collecting vouchers from employees; certifying expenses as eligible and accurate; examining expense vouchers to assure participants are requesting funds from correct accounts, listing claims onto claims affidavit, obtaining approval from Employer:
- Maintaining copies of expense vouchers and claims affidavit lists along with documentation for expenses, all of which to be maintained on a plan-year basis;
- Maintaining copies of expense account reports;
- Verifying accuracy and then distributing reimbursement checks within days via mail directly to participants unless Contractor receives written request from individual participants to hold checks for pick up by that participant;
- Responding to all inquiries or resolving problems being experienced by participants;
- If Contractor determines that a given application for benefits is not eligible under the Plan, for whatever reason, Contractor shall promptly notify the participant with reason for denial and description of any additional information that might be necessary to perfect or complete the application.
(2) All question must be submitted no later than May 1, 2019.
(3) The contract term will be for three years.

[C] Eligibility:

Onshore (USA Only)

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Monday, 13 May, 2019

Question Answer Deadline : Wednesday, 1 May, 2019

Category : Medical Billing and Coding

Country : USA

State : New Mexico

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