MB-3090 - USA (Florida) - Employee Health Plans Administrative Services - Deadline June 17,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3090

Government Authority located in Florida; USA based organization looking for expert vendors for employee health plans administrative services.

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide employee group health plans administrative service for its full-time active employees and non-Medicare eligible retirees. The city will accept proposals from proposers that are to include medical plans, pharmacy services, and administrative services. The city will not contract with independent or national third parties acting as an agent, broker or consultant. Also, the city will not accept pharmacy only proposals from independent pharmacy benefit manager.
- Provide web portal access for members via PC or laptop, and via mobile device application to City
Plans coverage information, medical and pharmacy provider search and claims activity/status.
- The objective of the city is to obtain cost information for a self-funded ASO program that includes the present plan designs noted in the exhibits, so as to offer a medical plan with benefits and plan provisions most closely resembling the city’s current plan designs. the city may also be interested in alternative plan designs to be considered by the city. it is the goal of the city to obtain the appropriate plans, that provide competitive and affordable costs for claims and administrative fees, and plan designs that meet the needs of our plan participants.
- provide full administration services including claims processing, utilization review, medical management, predictive modelling and disease management, clinical programs, a 24/7 nurse call line, account management services, member services, and customer satisfaction surveys. in addition, the city is also interested in support for our wellness initiatives including educational materials to support health promotions, wellness appraisals, behaviour modification recommendations, customized
employee communications such as employee booklets that cover all employee benefits, newsletters, and any open enrolment related printed material. coordination with the city’s wellness specialist shall be designed to support the city’s wellness programs.
- Create awareness of the long-term benefits of a healthy lifestyle.
- Educate to improve health.
- Support behaviours change with coaching and other tools.
- Encourage and reward healthy behaviours
- Coordination with the City and financial responsibility for costs associated with a turnkey open enrolment process to ensure enrolment materials provided by ASO vendor are provided and enrolment meetings are conducted and made available to all city employees. assume 10 such 2-hour meetings during the open enrolment. two retiree meetings will be required each year for non-Medicare retiree’s open enrolment.
- The City’s self-billing statement utilizing a monthly deduction register for ASO fees and charges. the city will submit properly completed applications and other forms regarding enrolment changes in a timely manner for processing. the successful proposer shall accept some form of standard electronic payments (e.g. City P-Card, ACH, EDI, EFT), if the City chooses to make payments to the Successful Proposer electronically. Claims funding shall be via weekly draft to a City Impress account for the amount of claims paid in the prior week.
(2) A non-mandatory pre-proposal conference will be held on May 29, 2019.
(3) All question must be submitted no later than May 15, 2019.
(4) 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, 17 June, 2019

Pre-proposal Conference Date : Wednesday, 29 May, 2019

Question Answer Deadline : Wednesday, 15 May, 2019

Category : Medical Billing and Coding

Country : USA

State : Florida

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