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MB-7176 - USA (Florida) - Medical Plan Service for Employees - Deadline March 16,2023

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-7176

Government Authority located in Florida; USA based organization looking for expert vendor for medical plan service for employees.

[*] Budget: Looking for Proposal

[*] Scope of Service:

Vendor needs to provide medical plan service for employees.
- Contractor will have accessible hours of customer service, a designated customer service team familiar with the county’s plan design and claims administration and demonstrated service results to administer the comprehensive health plan, including all medical and prescription drug benefits for active employees, COBRA participants, retirees and eligible dependents.
- Contractor will have an experienced, dedicated account management team assigned to the county to assist with claims, eligibility and day-to-day service issues.
- Web-based administrative tools will be made available to the county benefits department to view eligibility on an ongoing basis.
- Contractor will provide ADA compliant, web-based informational and educational tools, including online and via mobile app, to plan participants providing information on issues such as claims status, explanation of benefits (EOBs), network providers by specialty, health and wellness topics and provider or treatment cost calculators based on specific plan designs of the county.
- Contractor shall be the claims fiduciary and accept fiduciary responsibility for claims payment decisions and for defense of actions taken for claims adjudicated and related appeals, including the legal defense of claims determinations and medical and pharmacy clinical decisions. The county will be responsible for the legal defense of claims for which the county made the choice as to the determination of coverage.  
- Contractor will utilize a broad network of pharmacies for pricing guarantees that will include the major chain pharmacies as in network.

[*] Eligibility:

- Onshore (USA Organization Only);

[*] Work Performance:

Performance of the work will be Onsite and Offsite.

Expiry Date : Thursday, 16 March, 2023

Category : Medical Billing and Coding, Medical Services, Pharmaceutical, Pharmacy & Related Services

Country : USA

State : Florida

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