16-05 - Third-Party Administrators Medical.pdf
PDF 95 KB Posted
- Solicitation number
- 26-71-P
- Issued by
- Denton County, Little Cypress CDP, Texas
About this file
This is an administrative proposal document for the City of Lewisville's competitive sealed bidding process for Employee Health and Welfare Benefits Third-Party Administrator services related to medical and dental coverage. The City of Lewisville is soliciting comprehensive proposals for multiple employee benefit components, including third-party administrators for medical and dental services, pharmacy third-party administrator services, medical and pharmacy stop loss coverage, ASO dental, fully insured vision, basic and voluntary life insurance with accidental death and dismemberment, long-term disability, employee assistance programs, health savings accounts, flexible spending accounts, and COBRA administration. All questions must be submitted through the Bonfire platform in the questions and answers section, and award determination will follow the requirements outlined in Texas Local Government Code Chapter 252. All services provided must comply with Americans with Disabilities Act standards and regulations, with successful bidders required to certify such compliance.
The proposal document outlines a detailed fee structure template requesting per-employee-per-month (PEPM) costs for various medical administration services, including medical network access fees, utilization review, large case management, disease management, behavioral health management, maternity management, nurse line services, wellness programs, telemedicine, stop loss reporting, external pharmacy benefit manager interfaces, plan documents, summaries of benefits and coverage, external vendor reporting, member advocacy services, and fiduciary responsibility. Bidders must provide specific PEPM rates, rate guarantees, performance guarantees, and information regarding carrier credits for implementation, communications, and wellness initiatives. A separate document titled "Carrier Allowances" is referenced for additional allowance information. Bidders are required to submit both the completed fee schedule and a separate detailed quote as part of their proposals.
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Text version
26-71-P Employee Health and Welfare Benefits CARRIER NAME Medical and Dental Administration Fees PROPOSED PEPM COST Medical Administration Medical Network Access Fee Utilization Review Large Case Management Disease Management Behavioral Health Management Maternity Management Nurseline Wellness Telemedicine Stop Loss Reporting / Interface Fee External PBM Carve-out / Interface Fee Plan Document Summary of Benefits and Coverage (SBC’s) External Vendor Reporting Included (Y/N) Expanded Reporting Included (Y/N) Booklets/SPDs ID Cards Eligibility Feeds Included (Y/N) If No, provide fee Shared Savings % of Savings Fee / Out of Network Negotiations Subrogation % of Savings Fee Member Advocacy Fiduciary Responsibility Other Fees (Outline) Total PEPM Admin. Fees Rate Guarantees Performance Guarantees Carrier Credits for Implementation, Communications & Wellness Please see separate document "Carrier Allowances."
CITY OF LEWISVILLE PURCHASING DIVISION – REQUIRED DOCUMENT
Please provide a quote in addition to providing pricing on this page.
Administration Fees
File details come from the government source that posted it. Updated .