The Vendor is required to provide for medical plan administrative services and stop loss insurance.
- Claims Administration – provide efficient operations to ensure claims are paid accurately and timely.
- Utilization Management – manage cases efficiently and effectively by evaluating and managing the appropriateness, need and efficiency of services, procedures and facility according to established guidelines.
- Disease Management – find and support members by developing relationships and guiding members to cost-effective treatment and/or self-management.
- Provider Network – offer well-established provider network whose providers adhere to quality and clinical standards and that provides competitive discounts.
- Employer and Employee Services – provide enhanced customer service through communication plans, a user-friendly website including provider quality and pricing information.
- Reporting – provide the on line access to aggregate reporting
- Online Enrollment Capabilities – provide a streamlined process for enrollment for members and for county administrators, etc.
- The County is self-insured for its health program and carries specific and aggregate stop loss coverage.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: April 30, 2025