The Vendor is required to provide third party administrators (“TPA”) for the administration of current and future assigned flexible spending accounts (“FSA”); management of county’s FSA medical and dependent care claims (collectively referred to as “claims”).
- Must be willing to accept current pending claims.
- The FSA plan year runs January 1 through December 31 and is offered to “benefits eligible” active employees only.
- Claim management and reporting are performed by the current TPA.
- Provide third party Claims administration services for all County FSA health and dependent care claims.
- Provide customer service to the plan participants, including but not limited to:
• Participant debit card access to FSA funds.
• Fund balance information for plan participants.
- Maintain files and records for all Claims according to applicable regulation.
- Ongoing monitoring of regulations and laws for legally compliant management of all types of FSA plans.
- Process FSA enrollments during the annual open enrollment periods and throughout the Plan year for eligible participants.
- Claims services.
• Examine and review all Claims that are submitted for accuracy, completeness and adherence to the terms of the FSA plans and regulations.
• Verify eligibility, account balances and compliance prior to reimbursement.
• Check for errors and reconcile discrepancies.
• Manage the distribution of Claim funds to the appropriate parties. Determine the quality of the Claim and the amount payable for the services.
- Claims Management System
• Permit secure online access to the Offeror’s Claim Management System by designated County representatives for Claim file review, claim research, claim financials, ad hoc reporting, and specified monthly reports.
• Provide various levels of authorized access.
• Meet all security requirements established by the department, office, and attorney’s office.
• Provide scheduled monthly export file or download of specified data elements of all files to the County’s Risk Management Information System.
• Accept online Claims.
• Provide standard FSA forms on the Offeror’s web page.
• Track and report FSA Medical and FSA Dependent Care expenses by Claim and aggregate totals.
- Reporting and Analysis Requirements
• Closed Claims
• Claims Pending
• New Claims Reported
• Claims by type
• Claims by Location
• Claims by Group
• Payment Reports
• FSA Medical and FSA Dependent Care Check Runs
• Claims by Employee/ County Department/Agency
• Bank Reconciliations
- Consultant shall be responsible for all costs associated with the transfer of all Claims information and documentation from the County’s current TPA’s system (File handler) to its own Claims system.
- Consultant must respond to County’s e-mails and voice mails within twenty-four (24) hours of receipt.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: October 20, 2025
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