Medical Plan Administration Services

The vendor is required to provide medical plan administration this may include:
•    ASO self-funded medical plan administration
•    Flexible spending account (FSA) and health reimbursement account (HRA) administration
•    Cobra administration (optional)
•    Stop loss insurance (optional)
•    Wellbeing program administration (optional).
- Medical plan options to its active and retirees hired before 7/1/2012 population.
- This includes requirements for a health risk assessment and biometric health screening.
- Includes active employees only. 
- Counts may differ based on different timing of reporting.
- Third party vendor programs partnering with TPA
1. Diabetes prevention
•    The medical plan administration provides diabetes prevention through a digital health initiative designed to help individuals at risk of developing type 2 diabetes through personalized, science-backed support. 
•    This program is currently in partnership.
•    The program combines behavioral science with digital tools to help participants build sustainable habits that lower their risk of developing type 2 diabetes. 
•    Participants receive personalized support from health coaches, interactive lessons, and progress tracking to stay motivated and accountable throughout their journey.
2. The Asheville project™
•    The clinic health center oversees the Asheville project™ (TAP). 
•    The medical plan administration is expected to partner with the clinic where appropriate. 
•    Started in 1996 with a focus on diabetes, TAP has since evolved into a whole-person care program. 
•    It helps members manage their health by working directly with their healthcare providers, including their primary care physicians.
•    The program offers several key benefits:
o    Education on ongoing health conditions
o    Ongoing counseling with a TAP coach
o    Condition-specific lab tests
o    Condition-specific medications and supplies
- The medical plan administration and this include, but are not limited to:
•    Process claims accurately and timely 
•    Provide high level customer service to members 
•    Timely review and approval of appropriate procedures 
•    Manage and maintain a broad provider network that includes adequate access to all provider types and services 
•    Provide comprehensive tracking and reporting 
•    Support improved health outcomes, individually and in aggregate 
•    Promote wellness and the importance of screening and preventive services 
•    Save money: moderate trend and lower total health benefit spend 
•    Offer best in class resources, technology, services, member experience and pricing 
•    Collaborate with a proactive partner that provides strategic recommendations to continue to improve the medical plan.

- Contract Period/Term: 1 year
- Pre-Proposal Meeting Optional Date: October 20, 2025
- Questions/Inquires Deadline: October 24, 2025