TPA Services for PPO

The State of Florida, Department of Management Services' Division of State Group Insurance is issuing an Invitation to Negotiate (ITN) to establish a contract for Third Party Administrative (TPA) Services for Preferred Provider Organization (PPO) health coverage. The Department is seeking Replies from interested Respondents to provide comprehensive PPO medical claims processing, customer service, network access, disease and clinical program management, and various reporting services effective January 1, 2024. The ITN outlines detailed administrative requirements, performance guarantees, and instructions for submitting Replies. Respondents must provide information on their national and regional networks, provider contracting and credentialing, fraud prevention, clinical programs, claims processing, customer service, and other administrative capabilities. The Department will evaluate technical proposals, network offerings, and cost proposals to determine the best value provider(s). Negotiations may be held with selected Respondents to achieve the best contract terms, and the Department reserves the right to award one or more contracts.

The ITN does not specify any set-aside designations or restrictions on the types of organizations that can respond. The incumbent TPA provider(s) are not identified in the provided information. The estimated contract amount for this procurement is $53,767,176, but specific pricing terms, budget ranges, and funding sources are not explicitly covered. The contract term is three years with up to three one-year renewal options, with an implementation date of January 1, 2024.