MB-3488 - USA (Virginia) - Employee Health Insurance Services - Deadline November 26,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3488

Government Authority located in Virginia; USA based organization looking for expert vendor for employee health insurance services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide employee health insurance services consisting of a group self-funded medical and pharmacy with specific stop loss coverage, voluntary fully insured dental, vision, long term disability and administrative services for health savings account, COBRA, retiree billing and flexible spending account and pre-65 group retiree pharmacy coverage,
- Include, but not limited to:
- Maintain membership files for all covered individuals,
- Maintain central claims processing and customer service capabilities,
- Ability to accept claims from and pay reimbursements directly to providers of service,
- Provide explanations of benefits paid to insureds and accurately reporting current status of deductibles, co-payments, and out-of-pocket limits,
- Provide monthly or weekly accounting statements by benefit plan and subgroup showing funds received, enrolment, claims paid, administrative costs and claims exceeding the stop loss limit,
- Accurate data tracking and reporting including utilization reports, savings analysis and claims lag studies upon request or through an internet portal,
- Prepare plan summaries and communication materials to explain the plan to eligible covered individuals, communication materials will be reviewed and approved by the city prior to distribution,
- Provide each enrolee a summary plan description outlining and identifying covered services, exclusions, and claims filing procedures and continuation coverages,
- Provide all enrolled Covered Individuals with an identification card in a timely fashion as coordinated with the City,
- Provide local and toll- free customer service phone and email access for covered individuals,
- To provide employees with a quality, affordable health insurance program responsive to the diverse needs of employees,
- To ensure employees and their dependents are provided with the highest quality of care by providers and superior customer service,
- To ensure plans are managed effectively by taking advantage of cost and utilization management opportunities available in the marketplace while increasing quality,
- To provide employees access to consumer enhancing technology that assist in education and communication on provider choice, quality, transparency, personal health care, and cost.
(2) All the questions must be submitted no later than October 4, 2019.

[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 : Tuesday, 26 November, 2019

Question Answer Deadline : Friday, 4 October, 2019

Category : Medical Billing and Coding

Country : USA

State : Virginia

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