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MB-3838 - USA (Ohio) - Health Care, Dependent Care, Limited Purpose Flexible Spending Accounts and Commuter Choice Program Administration Services - Deadline March 3,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3838

Government Authority located in Ohio; USA based organization looking for expert vendor for health care, dependent care, limited purpose flexible spending accounts and commuter choice program administration services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide health care, dependent care, limited purpose flexible spending accounts and commuter choice program administration services
- Administration of a fully automated pretax Commuter Choice benefit programs with knowledge of pretax transit regulations that must ensure compliance with current and future Internal Revenue Service regulations,
- The Contractor will be the main point of contact with Employees on all matters pertaining to the program, including any and all Employee complaints and disputes,
- Monitor and provide regular compliance communications to the State team regarding your organization, systems, and program legislative compliance,
- . Contractor shall manage participant accounts for those who are on a nonpaid leave of absence or have missed deductions,
- Contractor shall train all staff associated with the State account on the specifics of this account, Training must be completed for State specific plan administration at least two weeks prior to open enrolment,
- Accept claims submissions via US Mail, fax, e-mail, online and mobile app,
- Manage the mutually agreed upon turnaround time from the date a claim is received to the date a check or direct deposit is processed for HCSA, LPSA, DCSA and Commuter Choice claims,
- Manage the mutually agreed upon process for tracking receipts, status of claims and allocating claims,
- Facilitate direct deposit reimbursements to participants, if opted in,
- Auto-adjudicate known co-pays and work with the State’s medical, prescription, behavioural health, dental and vision, insurance providers, including those of the Union Benefits Trust to auto-adjudicate common insurance related claims,
- Provide account summaries online or via mail to the participant’s address,
- Manage the mutually agreed upon screening process for duplicate claims,
- Contractor shall manually substantiate claims that are unable to be auto-adjudicated.
- Process claims during the run-out period.
- Ensure all claims billed to client have cleared the Contractor’s bank account prior to invoicing.
- Communicate with participants regarding incomplete or denied claims.
- Reconcile incorrect payment of claims.
- Adhere to the mutually agreed upon appeals process.
- Issue reimbursement checks or a new direct deposit for deposits made into closed accounts,
- Initial communication to terminated employees that their HCSA, LPSA, and DCSA programs will continue to be administered for them by the Contractor until COBRA coverage ceases,
- Election form receipt and processing,
- Accept COBRA data in the form of paper and electronic regarding enrollment, account updates, and termination at no extra charge,
- Continue to administer HCSA and LPSA for any COBRA participants who have remained in the HCSA and LPSA programs,
- Statements and claim forms and
- Termination of COBRA rights and benefits,
- Access to participants’ real time balances and real time claims, payment, and reimbursement statuses,
- Eligibility guidelines and tools to help employees make enrolment and election decisions,
- Tax savings calculator and,
- View list of eligible expenses by program.
(2) All the questions must be submitted no later than February 25, 2020.

[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, 3 March, 2020

Question Answer Deadline : Tuesday, 25 February, 2020

Category : Medical Billing and Coding

Country : USA

State : Ohio

Cost to Download This RFP Document : $ 5

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