The vendor required to provide third-party administrator (TPA) to comprehensive, fully integrated benefits administration solution.
• A solution that is efficient, secure, compliant, and has user-friendly benefits ecosystem that supports the district’s employees, HR team, and strategic goals.
• An end-to-end technology and service delivery, including implementation, data integration, ongoing support, participant services, and regulatory compliance.
• A single-source platform is preferred, however at a minimum the solution shall streamline enrollment, provide eligibility management, account administration, and regulatory documentation while ensuring data security and accuracy.
• Contractor shall have capabilities to deliver all necessary software platforms, administrative services, and compliance support related to:
o Employee benefits administration
o Cobra continuation coverage administration
o Flexible spending account (FSA) administration
o Health savings account (HSA) administration, should it be required in the future.
- Benefits administration software platform
• Secure and fully hosted software platform for enrollment, eligibility, and ongoing benefits management.
• Employee self-service portal that is mobile-responsive for benefits enrollment, updates, document uploads, and regulatory notices.
• Configurable eligibility rules for all benefit group types.
• Configurable evidence of insurability (EOI) rules for all event types and applicable insurances.
• Automated custom or semi-custom and branded notices, including eligibility, enrollment window available, reminders, and confirmations.
• Participant customer service via phone, live chat, email, and secure message portal.
• Enrollment support
o Guided enrollment workflows with custom text options.
o Plan comparison tools.
o Data change triggered automation.
o Temporal change automation, such as an employee or dependent reaching a particular age.
o Pend coverage levels requiring evidence of insurability (EOI), and update guaranteed coverages.
o Annual enrollment period as specified by district.
o Qualified medical child support order (QMCSO)
• Store online beneficiary designations by employee.
• Store and send dependent data to carriers in weekly integrations.
• Receive, process, and store approved and denied EOI records.
• Calculate all benefit deductions and credits for employee and employer.
• Employer administrative portal with configurable real-time dashboards and reporting capabilities.
• Standard scheduled and on-demand reports for enrollment, utilization, compliance, and audits.
- Cobra administration
• Tracking of qualifying events in compliance with cobra regulations.
• Preparation and distribution of all cobra required notices, including initial, qualifying event, termination, and other notices within regulatory timelines.
• Collect premiums, track payments, send reminders, and process reinstatements.
• Premium remittance to district and carriers.
• Ongoing eligibility monitoring and termination of cobra coverage.
• Customer support for cobra participants.
• Maintenance of required cobra documentation and audit logs.
• Participant customer service via phone, email, and secure message portal.
• Cobra standard reporting for event logs, payment history, participant status, compliance timelines.
• Weekly eligibility and enrollment integrations with district insurance carriers.
• Ongoing software updates, maintenance, and security monitoring
o Provide notifications of system updates or outages.
o Maintain software functionality and compliance.
• Protect all confidential and personal data:
o Act-compliant data storage, transmission, and processing.
o Annual penetration testing and ongoing vulnerability monitoring
o Secure data encryption (in transit and at rest).
o Multi-factor authentication or single sign-on (SSO) required for both employees and administrators.
- Flexible spending account (FSA) account administration
• Automated creation and management of healthcare FSA and dependent care FSA accounts.
• Issuance and support of FSA debit cards with auto-substantiation features.
• Claims intake, adjudication, and reimbursement processing via mobile upload, web upload, mail, fax, or debit card processing.
• Substantiation processes and document storage for IRS compliance.
• Process auto-substantiation files from carriers.
• Participant contributions management, including payroll integration.
• Reporting for plan utilization, forfeitures, and year-end reconciliation.
• Participant customer service via phone, live chat, email, and secure message portal
o Ongoing software updates, maintenance, and security monitoring.
o Provide notifications of system updates or outages.
• Maintain software functionality and compliance.
• Protect all confidential and personal data
o Act-compliant data storage, transmission, and processing.
o Annual penetration testing and ongoing vulnerability monitoring.
o Secure data encryption (in transit and at rest).
o Multi-factor authentication or SSO required for both employees and administrators.
• Business continuity plan and disaster recovery processes.
- Contract Period/Term: 5 years
- Questions/Inquires Deadline: January 6, 2026
