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MB-4618 - USA (Tennessee) - Administrative Services Only to Perform as Third-Party Administrator - Deadline December 3,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4618

Government Authority located in Tennessee; USA based organization looking for expert vendor for administrative services only to perform as third-party administrator.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide administrative services only to perform as third-party administrator for the State’s self-insured the plan supplemental medical insurance for retirees with Medicare.
- Provide an official document or letter from an accredited credit bureau, verified and dated within the last three (3) months and indicating a satisfactory credit rating for the Respondent,
- reflect an audit period for a fiscal year ended within the last 36 months,
- include the auditor’s opinion letter; financial statements; and the notes to the financial statements,
- Reviewed or Compiled Financial Statements will not be deemed responsive to this requirement and will not be accepted,
- The Respondent must hold a current Third-Party Administrator (TPA) license or other Certificate of Authority issued by the Department that will authorize the Respondent to perform the services required under this Contract,
- Coverage under the Plan will take effect for an eligible Retiree and designated dependents when the Retiree and such dependents satisfy all the eligibility requirements of the Plan. The Plan is only available to qualified Retirees, including their eligible dependents, whose initial employment with the state or other qualifying employer commenced prior to July 1, 2015,
- The Plan Administrator may make changes to the Plan, including benefit coverage, deductibles, maximums, co-payments, exclusions, limitations, definitions, eligibility or terminate the Plan at any time upon due authorization from the insurance committee. If the Plan is terminated, amended, or benefits are eliminated, the benefits available to Plan Participants are limited to Covered Charges incurred before termination, amendment or elimination,
- Failure to follow the eligibility or enrollment requirements of this Plan may result in delay of coverage or the inability to enroll in coverage. Reimbursement from the Plan can be reduced or denied because of certain provisions in the Plan, such as coordination of benefits, subrogation, exclusions, medical necessity, failure to timely file claims, or lack of coverage,
- The Plan will pay benefits only for the eligible expenses incurred while this coverage is in force. No benefits are payable for expenses incurred prior to the coverage effective date or after the coverage has terminated. An expense for an eligible service or supply is incurred on the date the service or supply is provided.
(2) A pre-proposal meeting will be held on October 21, 2020
(3) All the questions must be submitted no later than October 28, 2020
(4) Notice of intent must be submitted no later than October 22, 2020.

[C] Eligibility:

Onshore (USA organization Only)

[D] Work Performance:

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

[E] Proposal Submission:

Proposal can be submitted via E-mail.

Expiry Date : Thursday, 3 December, 2020

Pre-proposal Conference Date : Wednesday, 21 October, 2020

Question Answer Deadline : Wednesday, 28 October, 2020

Category : Medical Billing and Coding

Country : USA

State : Tennessee

Cost to Download This RFP Document : $ 5

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